title: User experience of transtibial prosthetic liners: A systematic review.
abstract: BACKGROUND
  The liner is an integral part of a transtibial prosthesis designed to protect the residual limb, enhance comfort and provide suspension. Literature is difficult to interpret and use given the variety of interventions, outcome measures and method designs. Critical appraisal and synthesis of the evidence is needed to help inform decisions about liner prescription based on the user experience.
  
  
  OBJECTIVE
  To critically appraise and synthesise research describing the user experience of transtibial prosthetic liners.
  
  
  METHODS
  Systematic review.
  
  
  METHODS
  A comprehensive suite of databases were searched using terms related to amputation level, liner type and user experience. Included studies were in English and measured the first-person experience of using a transtibial liner. Studies were appraised using the McMaster University Critical Review Forms.
  
  
  RESULTS
  A total of 18 articles met the inclusion criteria. While the quality of the evidence has improved over time, a number of common issues (e.g. sampling bias, validity of outcome measures, incorrect inferential analysis) reduce our ability to differentiate between the user experience of different transtibial liners.
  
  
  CONCLUSIONS
  There is insufficient research to differentiate between the user experience of different transtibial liners. High-quality research is needed to inform decisions about liner prescription based on the user experience. Clinical relevance The available evidence suggests that the user experience of commonly reported problems (e.g. sweating) may be very similar between different liners. Aspects of the user experience that differ most between liners (e.g. unwanted noises, rotation within the socket) can help focus attention on what matters most when discussing prescription.
authors.affiliation: 1 George Brown College, Toronto, ON, Canada.
authors.forename: Amy
authors.initials: A
authors.lastname: Richardson
authors.affiliation: 2 La Trobe University, Melbourne, VIC, Australia.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Dillon
mesh_terms: D000672:Amputation Stumps; D001186:Artificial Limbs; D006801:Humans; D011474:Prosthesis Design; D013977:Tibia
keywords: Transtibial; experience; liner; satisfaction; suspension