TY - JOUR
T1 - Socket-residuum coupling integrity affects perception of external stimuli
T2 - Effects of altering the transtibial interface using vacuum-assisted suspension
AU - Kent, Jenny A.
AU - Carnahan, Kristin J.
AU - Major, Matthew J.
N1 - Publisher Copyright:
© 2023 International Society for Prosthetics and Orthotics.
PY - 2024/4/1
Y1 - 2024/4/1
N2 - Background: Relative movement between the socket and residual limb can impair function in prosthesis users. It is plausible that, in addition to its mechanical effect, the integrity of the socket-residuum interface influences the ability of an individual to sense tactile cues through the prosthesis. Vacuum-assisted suspension (VAS) has been shown to reduce relative movement at this interface, providing a means to test this premise. The purpose of this pilot study was to assess the effects of altering socket-residuum interface integrity through the VAS pressure level on the thresholds of perception of an externally applied vibration stimulus. Methods: Seven unilateral transtibial prosthesis users participated. Socket-residual limb integrity was altered using the VAS subatmospheric (vacuum) pressure level. Vibration perception tests were conducted at low, mid, and high vacuum levels, targeting 0, 8, and 19 in Hg respectively, and performed in partially loaded and fully loaded conditions. Vibration intensity was increased using a dial until participants delivered a verbal signal indicating it was perceptible, and the nominal intensity was recorded. Results: Intensity thresholds decreased (ie, sensitivity increased) from low to high vacuum settings when fully loaded (P 5 0.008). Differences when partially loaded were nonsignificant and variable across participants. Conclusion: This study provides preliminary evidence that altering the integrity between the socket and residual limb by modifying the vacuum level affects sensation related to the external environment experienced through the prosthesis, although translation of these findings to real-world stimuli remains to be tested.
AB - Background: Relative movement between the socket and residual limb can impair function in prosthesis users. It is plausible that, in addition to its mechanical effect, the integrity of the socket-residuum interface influences the ability of an individual to sense tactile cues through the prosthesis. Vacuum-assisted suspension (VAS) has been shown to reduce relative movement at this interface, providing a means to test this premise. The purpose of this pilot study was to assess the effects of altering socket-residuum interface integrity through the VAS pressure level on the thresholds of perception of an externally applied vibration stimulus. Methods: Seven unilateral transtibial prosthesis users participated. Socket-residual limb integrity was altered using the VAS subatmospheric (vacuum) pressure level. Vibration perception tests were conducted at low, mid, and high vacuum levels, targeting 0, 8, and 19 in Hg respectively, and performed in partially loaded and fully loaded conditions. Vibration intensity was increased using a dial until participants delivered a verbal signal indicating it was perceptible, and the nominal intensity was recorded. Results: Intensity thresholds decreased (ie, sensitivity increased) from low to high vacuum settings when fully loaded (P 5 0.008). Differences when partially loaded were nonsignificant and variable across participants. Conclusion: This study provides preliminary evidence that altering the integrity between the socket and residual limb by modifying the vacuum level affects sensation related to the external environment experienced through the prosthesis, although translation of these findings to real-world stimuli remains to be tested.
KW - amputation
KW - perception
KW - prosthesis
KW - prosthetic socket
KW - sensation
KW - transtibial
KW - vacuum-assisted suspension
UR - http://www.scopus.com/inward/record.url?scp=85190359517&partnerID=8YFLogxK
U2 - 10.1097/PXR.0000000000000257
DO - 10.1097/PXR.0000000000000257
M3 - Article
C2 - 37498767
AN - SCOPUS:85190359517
SN - 0309-3646
VL - 48
SP - 184
EP - 189
JO - Prosthetics and Orthotics International
JF - Prosthetics and Orthotics International
IS - 2
ER -