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Transfemoral sockets with vacuum-assisted suspension comparison of hip kinematics, socket position, contact pressure, and preference: Ischial containment versus brimless. Jason T. Kahle, MSMS, CPO, FAAOP; M. Jason Highsmith, PT, DPT, PhD, CP, FAAOP. Aim
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Transfemoral sockets with vacuum-assisted suspension comparison of hip kinematics, socket position, contact pressure, and preference: Ischial containment versus brimless Jason T. Kahle, MSMS, CPO, FAAOP; M. Jason Highsmith, PT, DPT, PhD, CP, FAAOP
Aim • Investigate effect of brimless vs ischial ramus containment (IRC) prosthetic sockets when using vacuum-assisted suspension (VAS) on persons with unilateral transfemoral amputation (TFA). • Relevance • Prosthetic socket is most important aspect of prosthesis. • Connects person with amputation’s residual limb to components and ground during stance.
Method • Design: • Randomized crossover with 2 d accommodation. • Participants: • 9 people with unilateral TFA. • Interventions: • IRC VAS and brimless VAS sockets. • Main outcome measures: • Coronal hip angle and vertical and lateral socket movement as measured by X-ray. • Skin pressure measured by Tekscan. • Preference measured subjectively.
Results • Brimless design was statistically equivalent to IRC in all coronal hip angles and vertical and lateral socket displacement. • Peak/stance mean pressure in medial proximal aspect of socket: • 322 mmHG in IRC. • 190 mmHg in brimless condition. • Except for medial proximal pressure, no other measures reached statistical significance. • All subjects found brimless design more comfortable than IRC short-term.
Conclusion • Brimless VAS socket design may be clinically viable choice for people with TFA.