EFFECT OF SOCKET FIT ADJUSTMENT ON PROSTHESIS SATISFACTION IN LOWER LIMB AMPUTEES
Keywords:
Prosthetic Socket Fit, Lower Limb Amputation, Prosthesis Satisfaction, Socket Comfort, Rehabilitation, Pakistan.Abstract
Background: The best fitting socket determines how satisfied lower limb amputees are with their prosthesis. Most research on this topic is done in high income countries, and there is little to no evidence regarding lower limb amputees in Pakistan, where the vast majority of amputations are from trauma.
Objective: The objective of this study is to assess adjustments in socket fit and review the subsequent changes in prosthesis satisfaction.
Methodology: This was a pre-post test quasi-experimental study done at the Chal Foundation, Swabi, Khyber Pakhtunkhwa, Pakistan. The study included 40 adult patients (mean age 30.3 ± 6.9, 80% male) with a unilateral amputation and a prosthesis. Patients completed a socket fit adjustment performed by a prosthetist. Socket fit adjustments were performed by a qualified prosthetist.
Post adjustment satisfaction, and other clinical outcomes were evaluated. These outcomes included the OPUS Client Satisfaction with Devices (CSD) module, Socket Comfort Score (SCS), VAS Pain (rest, activity), OPUS Locomotor Capability and Psychosocial modules, a Residual Limb Health Checklist, Prosthesis Fit, and the Patient Global Impression of Change (PGIC).
Appropriate to the sample distribution, paired t-tests or Wilcoxon signed-rank tests were performed. Effect size was calculated using Cohen’s dz.
Results: Large, significant improvements were shown for all outcomes (p<.001; dz = 1.81 to 2.58). These included improvements in prosthesis satisfaction and socket comfort, as well as pain and all domains of well-being and health. Residual limb condition improved from the impact of adjustment. Seventy percent of the participants reported a clinically significant change on the PGIC. Moreover, the proportion of participants achieving the high satisfaction threshold of the OPUS-CSD increased to 30%.
Conclusion: The adjustment of prosthetic sockets to improve fit resulted in large, clinically significant improvements in numerous prosthesis-related outcomes. Therefore, routine adjustment of prosthetic sockets should be part of the standard care for all patients undergoing prosthetic rehabilitation.
