Abstract
Walking on various surfaces encountered in everyday life requires lower limb prosthesis users to continually adapt their movement patterns. Elevated vacuum suspension systems could improve transtibial amputee gait on non-level surfaces; however, research is lacking to guide clinical practice. Twelve transtibial amputees were fitted with the Össur sleeveless vacuum suspension system (Unity). After a one month accommodation period, the CAREN-Extended system was used to evaluate gait on a self-paced treadmill when walking with continuous perturbations (medial-lateral translations, rolling hills, simulated uneven ground) with an active or inactive vacuum suspension system. Significant differences between active and inactive vacuum conditions (p<0.05) were found for some temporal-spatial and kinematic gait parameters, but the differences were small and not considered clinically significant. Our findings suggest that potential vacuum pump failures would not immediately affect gait performance in a moderately high functioning amputee population. However, residual limb volume changes over time due to the removal of elevated vacuum may adversely affect socket fit, leading to greater gait differences and reduced quality of life.
Highlights
A prosthetic socket is the critical component that connects the residual limb to the lower limb prosthesis
No significant differences were found between the vacuum suspension system (ON) and the suction suspension system (OFF) when walking with medial-lateral translations, for all temporal-spatial gait parameters evaluated
Significant differences were found between vacuum ON and OFF for few parameters, but the differences were very small and may not be clinically significant
Summary
A prosthetic socket is the critical component that connects the residual limb to the lower limb prosthesis. This interface is essential for comfort, gait symmetry, proprioception, and amputee satisfaction [1,2,3,4].selecting an appropriate suspension system is an important step in prosthetic rehabilitation to ensure the prosthesis is attached securely and efficiently to the residual limb. An external sleeve (i.e., suspension and vacuum seal layer) that covers the socket, knee, and lower thigh can limit knee range of motion [5]. The Unity elevated vacuum suspension system (Ossur) was developed to address these limitations
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