title: Effects of socket size on metrics of socket fit in trans-tibial prosthesis users.
abstract: The purpose of this research was to conduct a preliminary effort to identify quantitative metrics to distinguish a good socket from an oversized socket in people with trans-tibial amputation. Results could be used to inform clinical practices related to socket replacement. A cross-over study was conducted on community ambulators (K-level 3 or 4) with good residual limb sensation. Participants were each provided with two sockets, a duplicate of their as-prescribed socket and a modified socket that was enlarged or reduced by 1.8mm (∼6% of the socket volume) based on the fit quality of the as-prescribed socket. The two sockets were termed a larger socket and a smaller socket. Activity was monitored while participants wore each socket for 4 weeks. Participants' gait; self-reported satisfaction, quality of fit, and performance; socket comfort; and morning-to-afternoon limb fluid volume changes were assessed. Visual analysis of plots and estimated effect sizes (measured as mean difference divided by standard deviation) showed largest effects for step time asymmetry, step width asymmetry, anterior and anterior-distal morning-to-afternoon fluid volume change, socket comfort score, and self-reported utility. These variables may be viable metrics for early detection of deterioration in socket fit, and should be tested in a larger clinical study.
authors.affiliation: Department of Bioengineering, 3720 15th Ave NE, Box 355061, University of Washington, Seattle WA 98195-5061, United States. Electronic address: jsanders@uw.edu.
authors.forename: Joan E
authors.initials: JE
authors.lastname: Sanders
authors.affiliation: Department of Bioengineering, 3720 15th Ave NE, Box 355061, University of Washington, Seattle WA 98195-5061, United States.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Youngblood
authors.affiliation: Department of Rehabilitation Medicine, 1959 NE Pacific Street, Box 356490, University of Washington, Seattle, WA 98195-6490, United States.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Hafner
authors.affiliation: Department of Bioengineering, 3720 15th Ave NE, Box 355061, University of Washington, Seattle WA 98195-5061, United States.
authors.forename: John C
authors.initials: JC
authors.lastname: Cagle
authors.affiliation: Department of Bioengineering, 3720 15th Ave NE, Box 355061, University of Washington, Seattle WA 98195-5061, United States.
authors.forename: Jake B
authors.initials: JB
authors.lastname: McLean
authors.affiliation: Department of Bioengineering, 3720 15th Ave NE, Box 355061, University of Washington, Seattle WA 98195-5061, United States.
authors.forename: Christian B
authors.initials: CB
authors.lastname: Redd
authors.affiliation: Department of Bioengineering, 3720 15th Ave NE, Box 355061, University of Washington, Seattle WA 98195-5061, United States.
authors.forename: Colin R
authors.initials: CR
authors.lastname: Dietrich
authors.affiliation: Department of Rehabilitation Medicine, 1959 NE Pacific Street, Box 356490, University of Washington, Seattle, WA 98195-6490, United States.
authors.forename: Marcia A
authors.initials: MA
authors.lastname: Ciol
authors.affiliation: Department of Bioengineering, 3720 15th Ave NE, Box 355061, University of Washington, Seattle WA 98195-5061, United States.
authors.forename: Katheryn J
authors.initials: KJ
authors.lastname: Allyn
mesh_terms: D000672:Amputation Stumps; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011474:Prosthesis Design; D057566:Self Report; D013977:Tibia / Q000502:physiology
keywords: Accommodation; Amputee prosthetics; Limb volume; Outcome assessment; Socket fit