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An Investigation of Pressure Profiles and Wearer Comfort During Walking With a Transtibial Hydrocast Socket

Laing, Sheridan, BEng; Lythgo, Noel, PhD; Lavranos, Jim, BSc; Lee, Peter Vee Sin, PhD

American Journal of Physical Medicine & Rehabilitation: March 2019 - Volume 98 - Issue 3 - p 199–206
doi: 10.1097/PHM.0000000000001043
Original Research Articles

Objective The aims of the study were to conduct an investigation of the transtibial hydrocast socket interface pressures during walking and to explore potential relationships between pressures experienced and resultant wearer comfort.

Design In this cross-sectional study, pressure data at the limb and hydrocast socket interface during walking were collected from 16 users of hydrocast sockets. The pressures at this interface were described by location, magnitude, and duration for all participants and were compared between the most and least comfortable participants.

Results High pressures were found about the bony prominences of the residual limb, especially the tibial crest of the anterior distal region. Factors identified as potentially causing discomfort (P < 0.1, d > 0.80) were high peak pressures at the anterior proximal region and longer durations of submaximal loading at the lateral proximal region and the anterior and medial distal regions. High pressure variability at the anterior proximal region may also contribute to discomfort (P = 0.106, d = 0.88).

Conclusions The hydrocast socket interface pressures have been described for a cohort of users. A number of differences were found in the pressure profiles of the most and least comfortable participants. These differences suggest trends between the identified pressure parameters and resultant wearer comfort. Future studies should confirm these exploratory results.

From the Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia (SL, PVSL); School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia (NL); and Department of Prosthetics and Orthotics, Caulfield Hospital, Caulfield, Victoria, Australia (JL).

All correspondence should be addressed to: Peter Vee Sin Lee, PhD, Department of Biomedical Engineering, University of Melbourne, Grattan St, Parkville, VIC 3010, Australia.

This work was funded by the CASS Foundation (Australia), the Rotary Club of Richmond (Australia), the Promobilia Foundation (Sweden), and the Australian Government Research Training Program.

SL collected the pressure data, completed the data analysis, and drafted the article. PVSL and NL conceived of and secured funding for the study, designed the study, coordinated the study, and reviewed the article. JL contributed to the study design, assessed the participants’ limbs, supervised the production of the prostheses, and reviewed the article. All authors gave final approval for publication.

Sheridan Laing is in training.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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