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Abstract
The distribution of interface stresses between the residual limb and prosthetic socket of a transtibial amputee has been considered as a direct indicator of the socket quality fit and comfort. Therefore, researchers have been very interested in quantifying these interface stresses in order to evaluate the extent of any potential damage caused by the socket to the residual limb tissues. During the past 50 years a variety of measurement techniques have been employed in an effort to identify sites of excessive stresses which may lead to skin breakdown, compare stress distributions in various socket designs, and evaluate interface cushioning and suspension systems, among others. The outcomes of such measurement techniques have contributed to improving the design and fitting of transtibial sockets. This article aims to review the operating principles, advantages, and disadvantages of conventional and emerging techniques used for interface stress measurements inside transtibial sockets. It also reviews and discusses the evolution of different socket concepts and interface stress investigations conducted in the past five decades, providing valuable insights into the latest trends in socket designs and the crucial considerations for effective stress measurement tools that lead to a functional prosthetic socket.
Highlights
The incidence of lower limb amputations is increasing worldwide due to the high rate of traffic accidents and vascular-related diseases [1,2]
The results revealed that altering the indentation depth at patellar tendon (PT) bar had no effect on the pressure distribution at all sites within the socket, and the subjects whowho participated in this study experienced no pain or discomfort from removing thethe and the subjects participated in this study experienced no pain or discomfort from removing bar, concluding that the bar could be eliminated during the socket fabrication
It is evident that interface normal and shear stresses in transtibial prosthetic sockets have been investigated using a variety of measurement systems developed during the past five decades
Summary
The incidence of lower limb amputations is increasing worldwide due to the high rate of traffic accidents and vascular-related diseases [1,2]. For further assessment, experienced prosthetists would insert stick corsets at the residual limb-socket interface to check the socket fit [7,8] This process requires highly skilled prosthetists/clinicians and does not even provide an overall picture of actual pressure distribution within prosthetic sockets. This article aims to provide a comprehensive overview of the evolution of various transtibial socket concepts as well as the operating principles, advantages, and disadvantages of conventional and emerging techniques used for measuring normal and shear stresses at the interface between the residual limb and prosthetic sockets. It summarized and discussed the interface stress investigations conducted during the past five decades using the aforementioned techniques. The authors believe that this work will help prosthetists/researchers select the appropriate sensing tool for their future applications
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