PTOtherProsthetics and orthotics international2019

Adjustable sockets may improve residual limb fluid volume retention in transtibial prosthesis users.

Jacob T Brzostowski, Brian G Larsen, Robert T Youngblood and 6 others

PMID 30628522

WHAT IT FOUND

Releasing the socket and pin lock for 10 minutes then returning to the same size helped short-term fluid retention but not long-term.

Returning to a slightly larger socket helped both short-term and long-term retention.

Key findings

01Releasing the socket and pin lock for 10 minutes, then returning to the same socket size, produced statistically significant short-term fluid volume retention but not statistically significant long-term fluid volume retention compared with projected no-intervention data.

02Releasing the socket and pin lock for 10 minutes, then re-donning with a socket about 2% larger, produced statistically significant short-term and long-term fluid volume retention compared with projected no-intervention data.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

Only 15 participants were studied, and 3 did not complete the No Intervention experiment while 1 did not complete the Full Return experiment. 13 of 15 participants had amputation due to trauma, so results may not generalize to other causes. 14 of 15 participants were male, so results may not generalize to females. The activity protocol was strict and lab-based, so benefits may not occur in free-living use. The studies were short, so later discomfort from the larger socket is unknown. The no-intervention comparison used projected data generated from a model. The study did not isolate whether the socket panel, pin release, or larger re-donning was the key component.

The easy way to misread this

Do not conclude that adjustable sockets fix long-term fit for all amputees. Returning the socket to the same size after release did not show long-term retention, and the larger-socket result was tested only in a short lab protocol.

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