Kent Jenny A, Carnahan Kristin J, Major Matthew J
Department of Physical Therapy, University of Nevada Las Vegas, Las Vegas, NV, USA.
Michigan Medicine Orthotics and Prosthetics Center, University of Michigan Health, Ann Arbor, MI, USA.
Disabil Rehabil. 2025 May;47(9):2450-2458. doi: 10.1080/09638288.2024.2395454. Epub 2024 Aug 27.
The prosthetic socket provides the critical interface between prosthesis and residuum. The purpose of this pilot study was to explore the effect of altering socket-residuum coupling integrity on limb and body control, through the use of vacuum-assisted suspension. A secondary purpose was to explore the potential use of two measurement tools designed to assess mobility in a clinical context.
Individuals with unilateral transtibial amputation performed intentional sway ( = 7) and treadmill walking ( = 6) tasks at three vacuum levels. Sway deviation from a straight-line path to peripheral targets was measured using an instrumented balance platform. Step width variability and targeting accuracy were measured using an augmented reality treadmill.
There was a significant difference in intentional sway performance toward the target on the anterior diagonal toward the prosthetic side ( = 0.036); higher vacuum levels tended toward less deviation from a straight-line path. We found no group differences between total intentional sway deviation, step width variability or stepping accuracy across vacuum levels.
Improved socket-residuum coupling integrity vacuum may have measurable effects on functional control that warrant further investigation. We highlight limitations of the clinical testing paradigms to inform future work.Implications for rehabilitationThe fit of the socket is a critical factor in the success of lower limb prosthesis use.Vacuum-assisted suspension modifies the coupling between the residuum and socket.Changes in socket-residuum coupling may lead to measurable differences in control; however, these may be activity and person-specific.Clinically intended instrumented tests of movement function derived for an intact anatomy should be used with caution when assessing prosthesis users.
假肢接受腔提供了假肢与残肢之间的关键界面。本初步研究的目的是通过使用真空辅助悬吊来探索改变接受腔与残肢的耦合完整性对肢体和身体控制的影响。第二个目的是探索两种旨在评估临床环境中移动性的测量工具的潜在用途。
单侧胫骨截肢患者在三个真空水平下进行了有意摆动（n = 7）和跑步机行走（n = 6）任务。使用仪器化平衡平台测量从直线路径到周边目标的摆动偏差。使用增强现实跑步机测量步幅变异性和目标准确性。
朝向假肢侧前对角线方向的目标的有意摆动表现存在显著差异（P = 0.036）；较高的真空水平往往使偏离直线路径的偏差更小。我们发现不同真空水平下的总有意摆动偏差、步幅变异性或步幅准确性之间没有组间差异。
改善接受腔与残肢的耦合完整性（真空）可能对功能控制产生可测量的影响，值得进一步研究。我们强调了临床测试范式的局限性，以为未来的工作提供参考。康复意义接受腔的适配是下肢假肢使用成功的关键因素。真空辅助悬吊改变了残肢与接受腔之间的耦合。接受腔与残肢耦合的变化可能导致控制方面可测量的差异；然而，这些差异可能因活动和个体而异。在评估假肢使用者时，应谨慎使用针对完整解剖结构得出的临床预期的运动功能仪器测试。
