Article

Lower limb amputation leads to impaired balance, ambulation, and
transfers. Proper fit of the prosthesis is a determining factor for successful
ambulation. Vacuum-assisted socket systems extract air from the socket, which
decreases pistoning and probability of soft-tissue injuries and increases
proprioception and socket comfort. OBJECTIVES: To investigate the effect of
vacuum-assisted socket system on transtibial amputees' performance-based and
perceived balance, transfers, and gait. STUDY DESIGN: Quasi-experimental
before-and-after study. METHODS: Subjects were initially assessed using their
prosthesis with the regular socket and re-evaluated 4 weeks after fitting
including the vacuum-assisted socket system. We evaluated the mobility grade
using Medicare Functional Classification Level, Berg Balance Scale, Four Square
Step Test, Timed Up and Go Test, the 6-Min Walk Test, the Locomotor Capabilities
Index, Satisfaction with Prosthesis (SAT-PRO questionnaire), and Houghton Scale.
RESULTS: A total of 16 unilateral transtibial dysvascular amputees, mean age
65.12 (standard deviation = 10.15) years. Using the vacuum-assisted socket
system, the patients significantly improved in balance, gait, and transfers:
scores of the Berg Balance Scale increased from 45.75 (standard deviation = 6.91)
to 49.06 (standard deviation = 5.62) (p < 0.01), Four Square Step Test decreased
from 18.18 (standard deviation = 3.84) s to 14.97 (3.9) s (p < 0.01), Timed Up
and Go Test decreased from 14.3 (standard deviation = 3.29) s to 11.56 (2.46) s
(p < 0.01). The distance walked in the 6-Min Walk Test increased from 288.53
(standard deviation = 59.57) m to 321.38 (standard deviation = 72.81) m (p <
0.01). CONCLUSION: Vacuum-assisted socket systems are useful for improving
balance, gait, and transfers in over-50-year-old dysvascular transtibial
amputees. CLINICAL RELEVANCE: This study gives more insight into the use of
vacuum-assisted socket systems to improve elderly transtibial dysvascular
amputees' functionality and decrease their risk of falls. The use of an
additional distal valve in the socket should be considered in patients with a
lower activity level.
CI - (c) The International Society for Prosthetics and Orthotics 2014.

Langue : ANGLAIS