Prosthetic Smart Socket Technology to Improve Patient Interaction, Usability, Comfort, Fit and Function
Abstract
Objectives/Specific Aims/Hypotheses: A below-knee prosthesis contains a prosthetic foot, pylon, and socket to interface the device to the residual limb. The interface between the body and the prosthetic socket is critical to comfort, function, and safety. When the socket is not fitting well, it is very likely that the user s residual limb volume has changed. When this happens, the weight-bearing forces are increased in pressure intolerant areas of the limb, which can cause skin breakdown, pain, and other problems. The typical feedback to prevent these problems is the patient s perception whereby discomfort hopefully triggers the patient to investigate the skin and fit. If a skin problem or compromised fit is noted, the user would likely add or remove socks to restore a proper fit and continue about their routine. This is a problematic methodology for many reasons. To begin with, a person with a newly acquired amputation lacks the historical experience to understand what they are feeling in terms of what is normal or abnormal specifically in a time when they are experiencing the most volume fluctuation and are most at risk of problems. The goal of this study is to determine if a prosthetic socket that notifies its user that the fit is compromised can actually train a user to adjust the sock ply of their prosthesis, thereby reducing skin problems and functional compromise more than persons reliant upon the usual feedback based solely upon their discomfort. Consider that many persons with amputation have compromised sensation due to nerve injury related to their traumatic amputation or a lack of sensation due to sequela from vascular disease. For these numerous reasons, the ability for many persons with lower limb amputation to "feel" and "perceive" a poor fitting socket is unreliable. This is a major problem as more than half of the nearly 2M persons with lower limb amputation experience skin problems related to ill-fitting prostheses. This is nearly five times the rate of skin complications in persons without amputations, which makes clear that socket fit is of vital importance to assure optimal comfort and utilization of the limb. If this smart-socket technology prompting methodology is successful, as evident by fewer skin problems and improved levels of function and activity, then it could be used as a standardized tool to help persons who lose their limb to transition more successfully into prosthetic use with fewer setbacks. This has fiscal impacts in terms of reducing healthcare utilization and increasing productivity of prosthetic users within society. For those persons with amputation who are employed, this could also result in fewer missed work days. Military Service members will certainly benefit with reduced prosthetic-related complications, reduced rehabilitation time, and return to duty sooner than traditional sensory feedback without smart socket prompting. Veterans with amputation will benefit in the same ways. All persons who use the technology are at no increased risk of complications as all aspects of the process are consistent with contemporary prosthetic fitting methodologies except that the socket prompts the user when fit is compromised. The study timeline is 3 years. Three years is needed to recruit an adequate number of prosthetic users to be able to determine, at a statistical level of significance, if use of the intervention actually enables attainment of these anticipated results. For the individual user, it is anticipated that the proposed results will be realized attained between 3 to 4 months following amputation; however, the benefits will follow the user for the rest of the portion of their life that they utilize a prosthesis for many reasons. For instance, starting as a prosthesis user with reinforced learning on how to manage and maintain a proper fit will solidify the importance and frequency of this critical behavior. Further, the smart socket will facilitate favorable,
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610785
Entities
People
- Jason Highsmith
Organizations
- United States Army
- University of South Florida