Marable W R, Smith C, Sigurjónsson B Þ, Atlason I F, Johannesson G A
Össur Americas, Foothill Ranch, California, USA.
Össur HF, Reykjavik, Iceland.
Can Prosthet Orthot J. 2020 Nov 23;3(2):34672. doi: 10.33137/cpoj.v3i2.34672. eCollection 2020.
Direct Socket for transfemoral (DS-TF) prosthetic user is a novel method of fabricating a laminated interface on to the residual limb but requires different training, production method and service model than what most prosthetists are familiar with. This method and model may improve patient satisfaction by enabling interface fabrication and delivery in one visit.
Document patient satisfaction regarding DS-TF interface versus the prosthetic users' previous socket in terms of interface function and the clinic service model.
In this longitudinal study (from July 2018 to April 2020), the DS-TF was implemented in six prosthetic clinics across the United States. Certified prosthetists (CP) and assistants were trained using a standard protocol. 47 prosthetic users participated, both those in need of a new socket and those without need. Two modules from the Orthotics and Prosthetics Users' Survey (OPUS), involving questions related to satisfaction with the Device and Services, was used to evaluate each DS-TF user outcome vs. baseline. The only part of the prosthesis that was replaced was the interface, except in 2 cases.
Each DS-TF interface was fabricated, fit and delivered in a single clinic visit. At 6-months follow-up, 38 users reported an average of 29.8% increase in satisfaction with their new interface compared with original, and a 14.8% increase in satisfaction with the services they received from the clinic in providing of the new prosthesis vs. their original prosthesis. The main outcome increases were between baseline (initial fitting) and 6-week follow-up and remained consistent after 6 months. This improvement was consistent irrespective if the user needed a new socket for clinical reasons or not.
This study shows that after a standardized training and implementation, the DS-TF fabrication process including a new interface, improves the user's satisfaction with their prosthetic device and services.
经股直接套接式（DS-TF）假肢使用者是一种在残肢上制作分层界面的新方法，但与大多数假肢师熟悉的方法相比，需要不同的训练、制作方法和服务模式。这种方法和模式可以通过一次就诊完成界面制作和交付，从而提高患者满意度。
记录患者对DS-TF界面与假肢使用者之前的接受腔在界面功能和临床服务模式方面的满意度。
在这项纵向研究（2018年7月至2020年4月）中，美国六个假肢诊所实施了DS-TF。认证假肢师（CP）和助手接受了标准方案的培训。47名假肢使用者参与，包括需要新接受腔的使用者和不需要的使用者。使用矫形与假肢使用者调查（OPUS）中的两个模块，涉及与对设备和服务满意度相关的问题，来评估每个DS-TF使用者的结果与基线相比的情况。除2例情况外，假肢中唯一被更换的部分是界面。
每个DS-TF界面在一次诊所就诊中制作、适配并交付。在6个月随访时，38名使用者报告称，与原来相比，对新界面的满意度平均提高了29.8%，对诊所提供新假肢服务的满意度比原来提高了14.8%。主要结果的提高发生在基线（初次适配）和6周随访之间，6个月后保持一致。无论使用者是否因临床原因需要新接受腔，这种改善都是一致的。
本研究表明，经过标准化培训和实施后，包括新界面的DS-TF制作过程提高了使用者对其假肢设备和服务的满意度。
