Evaluating the use of a thermoplastic socket in Kenya: A pilot study.
Giulia Barbareschi, Wesley Teerlink, Josepg Gakunga Njuguna and 3 others
PMID 35333813WHAT IT FOUND
Walking test times improved in the 10 of 26 Kenyan adults who returned for follow-up, but socket satisfaction and comfort decreased, and the ambulation scale did not show a clear change.
Key findings
01Only 10 of the 26 participants fitted with the Confidence Socket returned for follow-up within 6 months.
02Among participants who completed follow-up, L test time was 30.51 ± 14.73 seconds at visit 1 and 24.59 ± 9.1 seconds at follow-up.
03Among participants who completed follow-up, satisfaction with the socket was 6.44 ± 0.53 at visit 1 and 5.4 ± 1.17 at follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was a pilot with 26 fitted participants, and only 10 returned for follow-up, so the before-after analysis was small and may not represent all fitted users. The paper reports changes in the same participants from fitting to follow-up, not a comparison with another treatment described in the methods. Follow-up was difficult and varied from 1 to 6 months, partly due to travel, cost, awareness, time, opportunity cost, and COVID-19 restrictions. The fitted sample included 20 male and 6 female participants, and 14 had trauma-related amputation, which may limit generalisation to other groups. The TAPES were translated from English to Kiswahili, which could change interpretation. The low number of participants prevented further subgroup analysis. The project deadline prevented follow-up beyond 6 months.
Declared interests
Funding came from the UK Foreign, Commonwealth & Development Office through the AT2030 Programme, which is led by the Global Disability Innovation Hub. The authors disclosed receipt of financial support. The socket is an Amparo product, and an instructor from Amparo provided the 1-week training.
The easy way to misread this
Do not conclude that the thermoplastic socket alone improves mobility. Participants received a socket plus silicone liner, pylon, foot, knee sleeve, and spacer pads, and only 10 of 26 returned for follow-up. The study cannot separate the socket's effect from the rest of the prosthesis or from the small follow-up group.