Journal of Rehabilitation Research & Development (JRRD)

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Volume 51 Number 8, 2014
   Pages 1217 — 1228

Abstract — Coronal plane socket stability during gait in persons with transfemoral amputation: Pilot study

Stefania Fatone, PhD, BPO(Hons);1* Michael Dillon, PhD;2 Rebecca Stine, MS;1,3 Robert Tillges, CP4

1Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University Prosthetics-Orthotics Center, Chicago, IL; 2National Centre for Prosthetics and Orthotics, La Trobe University, Bundoora, Victoria, Australia; 3Jesse Brown Department of Veterans Affairs Medical Center, Chicago, IL; 4Tillges Certified Orthotic Prosthetic Inc, Maplewood, MN

Abstract — Little research describes which transfemoral socket design features are important for coronal plane stability, socket comfort, and gait. Our study objectives were to (1) relate socket comfort during gait to a rank order of changes in ischial containment (IC) and tissue loading and (2) compare socket comfort during gait when tissue loading and IC were systematically manipulated. Six randomly assigned socket conditions (IC and tissue compression) were assessed: (1) IC and high, (2) IC and medium, (3) IC and low, (4) no IC and high, (5) no IC and medium, and (6) no IC and low. For the six subjects in this study, there was a strong negative relationship between comfort and changes in IC and tissue loading (rho = −0.89). With the ischium contained, tissue loading did not influence socket comfort (p = 0.47). With no IC, the socket was equally comfortable with high tissue loading (p = 0.36) but the medium (p = 0.04) and low (p = 0.02) tissue loading conditions decreased comfort significantly. Coronal plane hip moments, lateral trunk lean, step width, and walking speed were invariant to changes in IC and/or tissue loading. Our results suggest that in an IC socket, medial tissue loading mattered little in terms of comfort. Sockets without IC required high tissue loading to be as comfortable as those with IC, while suboptimal tissue loading compromised comfort.

Key words: amputation, coronal plane stability, gait, ischial containment, Marlo Anatomical Socket, prosthesis, socket comfort, socket design, tissue loading, transfemoral prosthetic socket.

View HTML ¦ View PDF ¦ Contents Vol. 51, No.8

This article and any supplementary material should be cited as follows:
Fatone S, Dillon M, Stine R, Tillges R. Coronal plane socket stability during gait in persons with transfemoral amputation: Pilot study. J Rehabil Res Dev. 2014;51(8): 1217–28.
ResearcherID/ORCID: Stefania Fatone, PhD, BPO(Hons): E-8490-2011; Michael Dillon, PhD: M-6311-2014; Rebecca Stine, MS: M-7370-2014

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