Sanders Joan E, Youngblood Robert T, Hafner Brian J, Cagle John C, McLean Jake B, Redd Christian B, Dietrich Colin R, Ciol Marcia A, Allyn Katheryn J
Department of Bioengineering, 3720 15th Ave NE, Box 355061, University of Washington, Seattle WA 98195-5061, United States.
Department of Bioengineering, 3720 15th Ave NE, Box 355061, University of Washington, Seattle WA 98195-5061, United States.
Med Eng Phys. 2017 Jun;44:32-43. doi: 10.1016/j.medengphy.2017.03.003. Epub 2017 Apr 1.
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.
本研究的目的是初步尝试确定定量指标，以区分经胫截肢患者中合适的接受腔与过大的接受腔。研究结果可用于指导与接受腔更换相关的临床实践。对具有良好残肢感觉的社区行走者（K级3或4）进行了一项交叉研究。为每位参与者提供了两个接受腔，一个是其按处方配置的接受腔的复制品，另一个是根据按处方配置的接受腔的适配质量扩大或缩小1.8毫米（约占接受腔体积的6%）的改良接受腔。这两个接受腔分别称为较大接受腔和较小接受腔。在参与者佩戴每个接受腔4周的过程中监测其活动情况。评估了参与者的步态、自我报告的满意度、适配质量和性能、接受腔舒适度以及上午至下午肢体液体量的变化。对图表的视觉分析和估计效应大小（以平均差异除以标准差衡量）显示，步时间不对称、步宽不对称、上午至下午前侧和前远端液体量变化、接受腔舒适度评分以及自我报告的效用方面的影响最大。这些变量可能是早期检测接受腔适配恶化的可行指标，应在更大规模的临床研究中进行测试。
