Digital Weight-Bearing Shape Capture Socket Technology to Preserve Limb Health and Improve Rehabilitation Outcomes
Abstract
The field of lower-extremity prostheses has advanced greatly in recent years. Pioneering investments made by government agencies and others over the past decades has led to the development of advanced mechatronic systems. Such systems intend to restore the function of the missing anatomical parts with novel techniques to provide efferent and afferent control methodologies. While these new prosthetics knees, ankles, and control/feedback strategies have the capability to do more, their true functionality is effectively restricted to the form and fit of the prosthetic socket, which is tailored by prosthetists. Presently, the techniques used for socket design/fit by prosthetists is non-weight-bearing and lack quantitative metrics of success. Under the current paradigm of prosthetic socket fitting, inadequate and/or misinformation communicated to the prosthetist can lead to suboptimal fit and comfort of the prosthetic system. This contributes to repeated clinical visits to rectify areas of discomfort, or in more extreme cases rejection of the prosthesis and preference toward other assistive devices such as wheelchairs. The socket is responsible for many aspects of proper prosthesis function, including allowing the amputee to bear weight on their prosthesis. Thus, to ensure optimal comfort and safety, there is nothing more important than prosthetic socket design. The Symphonie Aqua Digital System (SADS), a hydrostatic weight-bearing socket computer-aided design (CAD) in a compression environment that achieve uniform pressure distribution across residual limb tissues. This system has the ability to quantify the quality of prosthetic socket form and fit as well as prosthesis function. Preliminary data have shown SADS to be effective helping prosthetists to determine the best shape of the socket. Additionally, it also measures the fit over time for more informed clinical decisions. A pilot clinical study to investigate the impact of SADS on socket fitting and amputee residual limb health as compared to sockets fabricated using non-weight-bearing CAD/computer-aided manufacturing techniques that more commonly used is warranted. The overall objective of this study is to test whether providing quantitative patient-centric objective limb health data to users and providers enables customized care that improves limb health, function and patient-reported outcomes from their prosthesis platform. The ultimate applicability of the research will benefit the growing number of Service men and women with lower limb amputation, as well as the one million plus Americans (military, Veteran, and civilian) living with limb loss and the prosthetists that treat them. Socket fit is reported to be the primary concern among prosthesis users. Amputee feedback is a major contributor in deciding the success of the socket. High levels of dissatisfaction with prosthesis comfort continues to be reported. The current fitting process is pain-staking and time-consuming. This novel technique is particularly useful for amputees with limited or no sensation in lower limb. This technology is also helpful for debut prosthetist who has limited experience in fitting a prosthetic socket. One major advantage of such automated digital technology is that one could robustly fabricate multiple sockets very efficiently over the early rehabilitation time, and thus keep up with the changing shape and volume of the residual limb during the first 12 to 18 months following amputation. The SADS socket fit data can be tracked with each socket iteration. This will enable the clinician to quantify the impact of altering socket volume on the fit and subsequent residual limb health. New strategies can be developed to reduce the time burden for patients to receive a comfortable socket, which will maximize the health of the residual limb and functional performance allowing for better overall health, which is ultimately expected to reduce healthcare costs. Through this research, prosthetists
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2210274
Entities
People
- Sashwati Roy
Organizations
- Indiana University
- United States Army