Assessment of a pressure-cast socket for transtibial prostheses in under-resourced environments Toggle navigationUniversity Library Login Toggle navigation A gateway to Melbourne's research publications Minerva Access is the University's Institutional Repository. It aims to collect, preserve, and showcase the intellectual output of staff and students of the University of Melbourne for a global audience. View Item Minerva Access Engineering Biomedical Engineering Biomedical Engineering - Theses View Item Minerva Access Engineering Biomedical Engineering Biomedical Engineering - Theses View Item JavaScript is disabled for your browser. Some features of this site may not work without it. Assessment of a pressure-cast socket for transtibial prostheses in under-resourced environments Download Final thesis file (3.847Mb) Show Statistical Information Citations Altmetric Author Laing, Sheridan Nicole Date2019 Affiliation Biomedical Engineering Metadata Show full item record Document Type PhD thesis Access Status Open Access URI http://hdl.handle.net/11343/233931 Description © 2019 Sheridan Nicole Laing Abstract Current socket casting methods used in under-resourced environments are highly reliant on the skill and experience of the prosthetist. Pressure-casting methods have been advocated to reduce skill dependency in socket casting. To date, however, socket production studies have only been performed in resourced settings and involved qualified prosthetists. In this thesis, a pressure-casting method to reduce the skill dependency in socket casting has been described in detail. Appropriate and feasible measures to assess wearer outcomes comprised standard functional tests, spatio-temporal gait parameters, subjective measures of user satisfaction and quantification of the limb-socket interface pressures. The participants of all studies herein were adults with unilateral transtibial amputations. All studies were conducted in Vietnam and utilised pressure-cast (PCAST) sockets with low-cost polypropylene components. All sockets were cast by local orthopaedic technicians when appropriate. Wearer outcomes with the PCAST sockets were similar to the participants’ original prosthetic limbs and high levels of satisfaction were recorded following an extended usage period of five months. Temporal gait changes suggested greater willingness to load the prosthetic limb over the usage period. In contrast, satisfaction and comfort data suggested that feelings of comfort and stability decreased over the usage period. As a baseline, the participants’ original prostheses were not consistent due to varying age, quality and socket design. Thus, the outcomes of participants fit with both PCAST and PTB sockets were compared. The results showed no significant differences in the initial participant functionality, spatio-temporal gait characteristics, gait symmetry, or comfort between the skill-dependent PTB socket and the PCAST socket. PCAST socket fit was investigated by examining interface pressure distribution, magnitude and duration and exploring how these pressures vary with wearer comfort. The pressure distribution was non-uniform with high pressures identified at the bony prominences, especially the tibial crest. The duration, rather than magnitude, of these pressures, appeared to influence wearer comfort. High pressures in the anterior proximal region and longer loading durations at the lateral proximal and medial distal regions also potentially affected wearer comfort. These data may assist future researchers in analysing and interpreting socket interface pressures. The staged phasing of data collection periods permitted continual development of the PCAST technique. Wearing a thick sock during casting appeared to reduce tightness and pain around the tibial condyles. Thus, the use of a thick cotton sock during casting was deemed beneficial. Further research, including interface pressure analysis, is required to determine if using a Pelite liner with the PCAST socket improves wearer outcomes. This research has shown the PCAST technique is able to produce a functional, biomechanically sound and satisfactory socket for prosthetic users in under-resourced environments. Additional studies have been recommended based on the outcomes and limitations of the studies herein to further the understanding and potential for success for the PCAST socket in under-resourced environments. Keywords Transtibial; Below knee; Prosthetic; Socket; Rehabilitation; Biomechanics; Pressure; Functionality; Spatio-temporal; Satisfaction; Under-resourced environments; Developing country Export Reference in RIS Format Endnote Click on "Export Reference in RIS Format" and choose "open with... Endnote". Refworks Click on "Export Reference in RIS Format". Login to Refworks, go to References => Import References Collections Minerva Elements Records [45770] Biomedical Engineering - Theses [51] Search the Repository This Collection Minerva AccessDepositing Your Work (for University of Melbourne Staff and Students)NewsFAQs BrowseCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects My AccountLoginRegister StatisticsMost Popular ItemsStatistics by CountryMost Popular Authors
