title: THE EFFECT OF TRANSFEMORAL INTERFACE DESIGN ON GAIT SPEED AND RISK OF FALLS.
abstract: Falls and diminished walking capacity are impairments common in persons with transfemoral amputation (TFA). Reducing falls and optimizing walking capacity through such means as achieving a more normal gait speed and community ambulation should be considered when formulating the prosthetic prescription. Because walking capacity and balance confidence are compromised with TFA, these outcomes should be considered when evaluating interfaces for transfemoral prosthetic users. The purpose of this study was to compare the effect of TFA interface design on walking capacity and balance confidence A retrospective cohort design was utilized involving unilateral TFA patients who used ischial ramus containment (IRC) and High-Fidelity (HiFi) interfaces (independent variables). Dependent variables included the Activity-specific Balance Scale (ABC) and the two-minute walk test (2MWT). Complete records were available for 13 patients (n= 13). The age range was 26 to 58 years. Three patients functioned at the K4 activity level, whereas all others functioned at the K3 level. Mean ABC scores were significantly different (p≤ 0.05) at 77.2 (±16.8; 35.6 to 96.9) for IRC and 90.7 (±5.7; 77.5 to 98.7) for HiFi. The mean distance walked on the 2MWT was 91.8 m (±22.0, 58.3 to 124.7) for IRC compared to 110.4 m (±28.7; 64.7 to 171.1) for the HiFi socket (p≤ 0.05). Alternative transfemoral interface design, such as the HiFi socket, can improve walking capacity and balance confidence in higher-functioning TFA patients.
authors.affiliation: OP Solutions, Tampa, FL, USA; Prosthetic Design + Research, Tampa, FL, USA.
authors.forename: Jason T
authors.initials: JT
authors.lastname: Kahle
authors.affiliation: Prosthetics and Sensory Aids Service, James A. Haley Veterans' Hospital, Tampa, FL, USA.
authors.forename: Tyler D
authors.initials: TD
authors.lastname: Klenow
authors.affiliation: Sampson's Prosthetic & Orthotic Laboratories, Schenectady, NY, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Sampson
authors.affiliation: School of Physical Therapy & Rehabilitation Sciences, University of South Florida, Tampa, FL, USA; Extremity Trauma & Amputation Center of Excellence (EACE), U.S. Department of Veterans Affairs, Tampa, FL, USA; 319 Minimal Care Detachment, U.S. Army Reserves, Pinellas Park, FL, USA.
authors.forename: M Jason
authors.initials: MJ
authors.lastname: Highsmith
keywords: Above the knee amputee; Activity balance confidence; Compression release socket; High-fidelity interface; Ischial containment; Prosthetic socket; Walking tests