Rethinking the foam cosmesis for people with lower limb absence.
Nicola Cairns, Jonathan Corney, Kevin Murray and 5 others
PMID 28521576WHAT IT FOUND
In testing, four prototype cosmeses failed after over 1 million knee flexion cycles on average, versus 352,666 cycles for standard cosmeses.
Six volunteers reported better shape match and knee movement, but small foam rips appeared where the zip joined the foam.
Key findings
01In mechanical testing, four prototype cosmeses had a mean failure rate of over 1 million knee flexion cycles, compared with a mean of 352,666 cycles for three standard control cosmeses.
02Six volunteers rated the new cosmesis positively for shape match to the sound limb and range of knee joint movement compared with a standard model, and reported that the artificial patella made kneeling more cushioned and comfortable.
03Three manufacturer clinical staff initially disliked the prototype because it did not reduce manufacturing time and they doubted the zip and aesthetics, but after a 10-week trial they reported no wear and tear and said the zip made it easier to put on and remove the cosmesis.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The durability comparison used four prototypes and three controls on a mechanical rig, not a randomised patient trial. The volunteer trial had six participants and no control group receiving the standard cosmesis as their only trial. Feedback was short term, with reviews at 4 and 10 weeks and 18 patient months in total. The paper does not describe the volunteers' amputation level, activity level or other characteristics. Clinical staff initially reported that the prototype did not reduce manufacturing time and doubted the zip and aesthetics. The zip produced small foam rips and could stick. Statements about reduced clinic visits, psychological rehabilitation, body image and costs are in the Discussion and were not tested in this paper.
Declared interests
The authors declared no potential conflicts of interest. They state that financial support was received. The volunteer trials took place at clinical sites of the project industrial partner, Chas A Blatchford Ltd.
The easy way to misread this
Do not read the new cosmesis as proven to improve walking, reduce clinic visits or lower costs. The durability result came from four prototypes and three controls on a rig, and the visit and cost claims are in the Discussion.