Using Elevated Vacuum to Improve Functional Outcomes: A Case Report

Abstract

ABSTRACT Elevated vacuum (EV) is a promising technology in the field of prosthetics. It has been shown to improve the fit of the limb in the socket, resulting in many possible benefits to the function of a prosthesis. However, very little research has been done on its effect on patient function. This unique case report documents the effect on one patient's function of transitioning from a patella-tendon-bearing (PTB) socket with ischial weightbearing thigh cuff (IWBTC) to a prosthesis with an EV socket system. The patient underwent a transtibial amputation as a result of an avulsive trauma and used the PTB socket and thigh cuff for 16 years. In an effort to correct the patient's gait and improve his ability to perform the necessary tasks of his occupation, farming, the patient began using an EV prosthesis. He was interviewed and his functional status was evaluated 1 week, 1 month, and 1 year after receiving the prosthesis. After 1 week, the patient showed improvement in skin condition and expressed increased confidence in difficult locomotor tasks. At 1 month, he was no longer experiencing pain in his sound side knee and his gait symmetry had improved dramatically. After 1 year, the patient showed further improvement in gait and balance as well as the ability to wear the prosthesis comfortably for 24 hours at a time when necessary for his occupation. The transition from a PTB with IWBTC prosthesis to an EV system dramatically improved this patient's functional outcome and lessened the negative effects associated with wearing a prosthesis.