Abstract
Sensor systems to measure pressure at the stump–socket interface of transfemoral amputees are receiving increasing attention as they allow monitoring to evaluate patient comfort and socket fit. However, transfemoral amputees have many unique characteristics, and it is unclear whether existing research on sensor systems take these sufficiently into account or if it is conducted in ways likely to lead to substantial breakthroughs. This investigation addresses these concerns through a scoping review to profile research regarding sensors in transfemoral sockets with the aim of advancing and improving prosthetic socket design, comfort and fit for transfemoral amputees. Publications found from searching four scientific databases were screened, and 17 papers were found relating to the aim of this review. After quality assessment, 12 articles were finally selected for analysis. Three main contributions are provided: a de facto methodology for experimental studies on the implications of intra-socket pressure sensor use for transfemoral amputees; the suggestion that associated sensor design breakthroughs would be more likely if pressure sensors were developed in close combination with other types of sensors and in closer cooperation with those in possession of an in-depth domain knowledge in prosthetics; and that this research would be facilitated by increased interdisciplinary cooperation and open research data generation.
Highlights
Even if emphasis is placed on preserving limb length [1], transfemoral amputations make up a substantial part of all amputations
Rehabilitation is especially difficult for transfemoral amputees, and research indicates that a high amputation level is associated with both prosthetic non-use and a decreased probability of remaining ambulatory [2,3]
The importance of a well-fitting socket is highlighted by the fact that several patient evaluation questionnaires, which aim to measure the success of prosthetic devices, refer to socket fit and comfort [12,13]
Summary
Even if emphasis is placed on preserving limb length [1], transfemoral amputations make up a substantial part of all amputations. The importance of a well-fitting socket is highlighted by the fact that several patient evaluation questionnaires, which aim to measure the success of prosthetic devices, refer to socket fit and comfort [12,13] To solve this problem, sockets—which couple the residual limb and prosthesis—must provide sufficient support and stability during activities of daily living. There are two main socket types: total surface bearing (TSB), which aims to distribute the load evenly across the residual limb; and specific surface bearing (SSB) regions, which attempt to apply load through tolerant areas and off-load more sensitive regions [16,17,18,19] For transfemoral amputees, these are most commonly ischial containment (IC) or sub-ischial–ramal containment sockets and quadrilateral (QUAD) sockets, respectively. This relies on the localized loading of the patellar ligament to off-load more sensitive regions, such as the fibula head and tibial crest [16,17,19,20]
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