Article

OBJECTIVE: Investigate the effect of a brimless interface design compared with
ischial ramus containment (IRC) of interfaces when using vacuum-assisted
suspension (VAS) on transfemoral amputees (TFAs). DESIGN: Randomized experimental
crossover. SETTING: Household, community, and clinic. PARTICIPANTS: Unilateral
TFAs (N=12 enrolled, N=10 analyzed). Mean age: 42.9 years. Mean residual limb
length: 60.3% of the sound side femur length. Participants' mean time as an
amputee: 8.3 years and median AMP score: 43. INTERVENTIONS: (1) IRC VAS
interface, and (2) brimless VAS interface. Average medial wall height for IRC
interfaces was 0.7cm proximal to the distal-most aspect of the ischial tuberosity
(IT). The medial wall on the brimless design was an average of 3.3cm distal to
the distal-most aspect of the IT. MAIN OUTCOME MEASURES: Spatiotemporal gait
parameters, limits of stability, four square step test, and subjective perception
using the prosthetic evaluation questionnaire (PEQ). RESULTS: Step length was
significantly improved towards the IRC (p=0.04), when calculating degree of
asymmetry. Base of support was significantly narrowed toward the brimless
(p=0.03). All subjective measures reached statistical significance in favor of
improvement with the brimless design, compared to the IRC. CONCLUSIONS: The
brimless design was equivalent to IRC in most gait and balance outcome measures.
However, step length was more symmetrical toward the IRC while base of support
was narrowed toward the brimless demonstrating mixed inconsistent performance
changes. Further, the PEQ demonstrated significant subjective improvements in
prosthetic related function and quality of life when participants used the
brimless design. Brimless interface design may be a clinically viable choice.
CI - Copyright (c) 2014 Elsevier B.V. All rights reserved.

Langue : ANGLAIS