Comparison of transhumeral socket designs utilizing patient assessment and <i>in vivo</i> skeletal and socket motion tracking: a case study

<i>Purpose</i>: This case study compares the impact of two prosthetic socket designs, a “traditional” transhumeral (TH) socket design and a Compression Released Stabilized (CRS) socket. <i>Methods</i>: A CRS socket was compared to the existing socket of two persons with transhumeral amputation. Comparisons included assessments of patient comfort and satisfaction with fit, as well as dynamic kinematic assessment using a novel high-speed, high-resolution, bi-plane video radiography system (XROMM, for X-ray Reconstruction of Moving Morphology). <i>Results</i>: Subjects were more satisfied with the comfort of the traditional sockets, although they had positive impressions about aspects of the fit and style of the CRS socket, and thought that it provided better control. Dynamic kinematic assessment revealed that the CRS socket provided better control of the residual limb within the socket, and had less slippage as compared to a traditional TH socket design. <i>Conclusions</i>: The TH CRS socket provided better control of the residual limb within the socket, and had less slippage. However, participants were less satisfied with the comfort and overall utility of the CRS socket, and stated that additional fitting visits/modifications to the CRS socket were needed. It is possible that satisfaction with the CRS socket may have improved with prosthetic adjustment and more acclimation time.Implications for RehabilitationA comfortable, good fitting prosthetic socket is the key factor in determining how long (or if) an upper limb amputee can tolerate wearing a prosthesis.This case series was a comparison of two socket designs, a 'traditional' socket design and a Compression Released Stabilized (CRS) socket design in persons with transhumeral amputation.The CRS socket provided better control of the residual limb within the socket, and had less slippage. However, its tightness made it more difficult to don.Both subjects were less satisfied with the comfort and overall utility of the CRS socket. However, satisfaction might have been improved with additional fitting visits and more acclimation time. A comfortable, good fitting prosthetic socket is the key factor in determining how long (or if) an upper limb amputee can tolerate wearing a prosthesis. This case series was a comparison of two socket designs, a 'traditional' socket design and a Compression Released Stabilized (CRS) socket design in persons with transhumeral amputation. The CRS socket provided better control of the residual limb within the socket, and had less slippage. However, its tightness made it more difficult to don. Both subjects were less satisfied with the comfort and overall utility of the CRS socket. However, satisfaction might have been improved with additional fitting visits and more acclimation time.### 案例研究目的 本案例研究旨在对比两种假肢接受腔设计的应用效果：其一为"传统"经肱骨（transhumeral amputation, TH）截肢适配接受腔，其二为减压稳定型（Compression Released Stabilized, CRS）接受腔。 ### 研究方法 将CRS接受腔与2名经肱骨截肢患者的现有适配接受腔进行对比。评估内容涵盖患者对接受腔适配的舒适度与满意度评价，以及采用新型高速高分辨率双平面视频放射成像系统——X射线运动形态重建系统（X-ray Reconstruction of Moving Morphology, XROMM）开展的动态运动学评估。 ### 研究结果 受试者对传统接受腔的舒适度满意度更高，尽管他们对CRS接受腔的适配性能与外观设计持有正面评价，并认为其操控表现更佳。动态运动学评估结果显示，CRS接受腔可实现残肢在腔内更佳的位置控制，且残肢滑移量较传统TH接受腔更小。 ### 研究结论 TH型CRS接受腔可实现残肢在腔内更佳的位置控制，且残肢滑移量更小；但受试者对CRS接受腔的舒适度与整体使用体验满意度更低，且表示需额外进行适配调整与多次适配回访。推测若经过更多的假肢适配调整与更长的适应周期，受试者对CRS接受腔的满意度或可得到提升。 ### 康复启示 适配舒适且贴合良好的假肢接受腔，是决定上肢截肢患者能否长期佩戴假肢（或是否愿意佩戴）的核心影响因素。本案例系列研究对比了两种假肢接受腔设计：传统经肱骨截肢适配接受腔与CRS接受腔在经肱骨截肢患者中的应用效果。CRS接受腔可实现残肢在腔内更佳的位置控制，且残肢滑移量更小；但其紧束特性导致穿戴难度更高。两名受试者均对CRS接受腔的舒适度与整体使用体验满意度较低，不过推测若经过额外的适配调整与更长的适应周期，受试者对CRS接受腔的满意度或可得到提升。