The influence of prosthetic suspension on gait and cortical modulations is persons with a transfemoral amputation: socket-suspended versus bone-anchored prosthesis.
Vera Kooiman, Joris van der Cruijsen, Ruud Leijendekkers and 3 others
PMID 38454427WHAT IT FOUND
Bone-anchored and socket-suspended prostheses produced identical gait patterns in highly active users.
However, EEG data suggest socket users rely more on intact-limb monitoring and control to maintain stability. This implies the fixed bone anchor may reduce cognitive load during walking, even if gait looks the same.
Key findings
01No significant differences were found in gait speed, step length, width, or stability measures between bone-anchored and socket-suspended prosthesis users.
02Socket users showed stronger decreases in alpha and beta brain power in frontal and parietal areas compared to bone-anchored users, particularly around heel strike.
03Socket users exhibited greater theta power increases in the central-lateral brain cluster corresponding to the intact limb during the prosthetic stance phase.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only highly active (K3-4) participants, so findings may not apply to less active patients who might struggle more with socket instability. Bone-anchored and socket-suspended groups had significantly different residual limb lengths and prosthesis weights, which could influence cortical activity even if gait parameters were unaffected. Cortical findings were exploratory and not statistically tested due to small sample sizes; they are descriptive observations of power changes exceeding a 1dB threshold. Level walking on a treadmill may not challenge gait stability enough to reveal differences in suspension performance that might appear during perturbations or uneven terrain.
Declared interests
Funded by Horizon 2020 and the Nederlandse Organisatie voor Wetenschappelijk Onderzoek. No commercial conflicts of interest reported.
The easy way to misread this
Do not conclude that bone-anchored suspension improves gait stability or mechanics based on this study. The gait parameters were identical between groups; the only differences were in brain activity, which was an exploratory finding without formal statistical testing.