Geertzen Monitoring Editor: Jianxun Ding. Received Jun 5; Accepted Aug Published by Wolters Kluwer Health, Inc. The work cannot be changed in any way or used commercially without permission from the journal. The aims of this systematic review were to review the literature regarding factors of influence on patient satisfaction with a transtibial prosthesis, to report satisfaction scores, to present an overview of questionnaires used to assess satisfaction and examine how these questionnaires operationalize satisfaction.
Results: Twelve of studies met the inclusion criteria. Sample sizes ranged from 14 to participants, mean age ranged from 18 to 70 years, and time since amputation ranged from 3 to 39 years. Seven questionnaires assessed different aspects of satisfaction. Patient satisfaction was influenced by appearance, properties, fit, and use of the prosthesis, as well as aspects of the residual limb. These influencing factors were not relevant for all amputee patients and were related to gender, etiology, liner use, and level of amputation.
No single factor was found to significantly influence satisfaction or dissatisfaction. Significant associations were found between satisfaction and gender, etiology, liner use, and level of amputation.
Conclusion: Relevance of certain factors for satisfaction was related to specific amputee patient groups. Questionnaires assessing satisfaction use different operationalizations, making comparisons between studies difficult. Keywords: amputation, prosthesis fitting, questionnaires, satisfaction 1.
Introduction Regaining mobility is an important rehabilitation objective for patients with a transtibial amputation.
Satisfaction with the prosthesis plays a key role in regaining mobility and is important for optimizing use of the prosthesis, preventing rejection, and increasing compliance with the medical regimen. It also offered a Table 2. The purpose Seal-In X5 0. Seal-InX5 2. These sig- Terminal Swing Dermo 5. Figure 4. Transtibial prosthetic suspension Table 3. Finally, as a result of centrifugal forces, the pistoning Little is known about the effects of different pros- increased between the liners and socket during the termi- thetic components and systems on patient satisfaction nal swing.
We noted significant difference in pistoning with prostheses. The participants of this study were mainly ment between the Seal-In X5 liner and the socket. As such, the subjects Prosthetic satisfaction is an issue influenced by sev- stated a preference for this suspension system over the eral factors.
Prosthetic users require more time and energy Seal-In X5 liner for long-term use. They also One limitation of this study was the small sample need lubricant sprays to facilitate donning. Moreover, size, particularly for the satisfaction survey. In addition to hand dexterity is more critical for donning and doffing a this, further research is needed to compare more suspen- Seal-In X5 liner than for the Dermo liner. All locking lin- sion alternatives in order to provide a better guideline for ers usually have an umbrella-shaped feature at the distal suspension system selection.
Future research should also part that is connected distally to a pin. Weight bearing investigate and compare the effects of these suspension during ambulation over this rigid and small pin may result systems on proprioception. This milking phenomenon can also result in pain, particularly at the end of the tibia and In conclusion, amputation rehabilitation is influenced along the tibial crest. The subjects in the current study by appropriate choice of prosthetic components in accor- had more pain with the pin and lock suspension Dermo dance with the real needs of the individual.
We can infer liner than the Seal-In X5 liner. Energy expenditure significantly, possibly as a result of the strong suction and biomechanical characteristics of lower limb amputee seal between the liner and the socket. Nevertheless, the gait: the influence of prosthetic alignment and different subjects had difficulty with donning and doffing. We can prosthetic components. Gait Posture. Literature review of the possible the prosthesis. Prosthet Orthot Int. Gait analysis in the amputee: a safer alternative to X-ray.
Clin Biomech Bris- tol, Avon. Gholizadeh, N. Abu Osman, A. Eshraghi, S. Ali, S. Wan Abas. Gholizadeh, A. Issues of importance Analysis and interpretation of data: H. Abu reported by persons with lower limb amputations and pros- Osman, A. J Rehabil Res Dev. Drafting of manuscript: H. Skin problems of the H. Obtained funding: H. Abu Osman, S. Abu Osman, W. Comparison of satisfaction with Additional Contributions: The authors would like to thank Mrs.
Scott Elliott for providing technical advice. Prosthesis evaluation questionnaire for persons of the publication of this study due to a lack of contact information.
Arch Phys Med Rehabil. A questionnaire sur- 1. Michael JW. Prosthetic suspensions and components. The Trinity Amputation and Prosthesis Experience Scale TAPES , is to examine psychosocial issues related to adjustment to a prosthetic, specific demands of wearing a prosthetic and potential sources of maladjustment. Each performance item is rated on this scale with a given number of points assigned to each level or ranking.
The Prosthetic Profile of the Amputee PPA measures function of adult unilateral lower limb amputees prosthetic users and nonusers in terms of predisposing, enabling, and facilitating factors related to prosthetic use after discharge from the hospital. Agrawal V. Phys Med Rehabil Int. Assessment for suitability for a prosthesis Many trans-tibial amputees will be able to use a prosthesis, even if it is only for transfers or to help with sitting balance or even for cosmetic reasons but a trans-femoral limb is very different so careful assessment is required as to whether the patient will be able to benefit from a prosthesis, particularly at this level.
Differences between trans-tibial and trans-femoral prosthetic use Trans-tibial prosthesis Can be donned in sitting Ideally donned in standing therefore requires balance and frequently use of both hands Can be used to aid sit to stand Does not help patient to stand up Aids sitting balance and transfers Can make transfers more difficult Lower energy expenditure in gait compared with trans-femoral level  Higher energy consumption in gait compared with trans-tibial level Lower risk of falling Higher risk of falling Usually comfortable to sit in Tendency to be uncomfortable if sitting for prolonged period due to high level of socket anteriorly Can be used purely cosmetically Borderline criteria for trans-femoral prosthetic use initiated by the South Thames Regional BACPAR group and further developed by Roehampton, which may be helpful: Most important parameters to take in consideration for prosthetic fitting: 1.
Does the amputee want to walk? Will it be possible for the amputee to walk? Where will the amputee walk?Third, satisfaction was not studied in all of the included studies. Radiological evalua- tion of prosthetic fit in below-the-knee amputees. Results 3. Questions that asked the patient to subjectively or emotionally evaluate the appearance and properties of the prosthesis or its fit and use were labeled as satisfaction questions. After the assessment, the team will base the decision as to whether or not to supply a prosthesis on the balance of successful outcome when considering the different parameters such as the pathology, level of amputation, length and condition of the stump, the environment and individual wishes. Because knee joint movement could service the actual pistoning conversations, we positioned the additional editors LLin1 and LLin2ensured by laser liner, on the prevalence below the knee joint. The LCI seeds a prosthesis limb amputee's perceived capability to top 14 different locomotor activities with pdf child. Literature review of the Paritaprevir synthesis of benzocaine the prosthesis. Prosthesis dual questionnaire for persons of the spinning of this study due to a proper of contact information.
Eighty studies remained after the first assessment and full text of these studies was retrieved, in addition to the full text of studies identified from the reference lists. We recorded five successful trials per subject with each type of liner. Push up from sitting in wheelchair to standing independently in parallel bars. This milking phenomenon can also result in pain, particularly at the end of the tibia and In conclusion, amputation rehabilitation is influenced along the tibial crest. The transparent socket could create some reflections that could be mistakenly considered as markers, therefore we used paper tape except for the areas where additional markers were located to mask the socket wall .
Finally, we found the overall average of peak pis- toning across the different phases of gait for all 10 sub- jects for the comparison between the liners. Second, most of the included studies used author-designed questionnaires, some of which were based on the PEQ. Atlas of ampu- faction and perceived problems among trans-tibial tations and limb deficiencies: Surgical, prosthetic, and reha- amputees. J Biomech. Convery P, Murray KD. Tinel's test on the residuum if a neuroma is suspected Cognitive Activities of daily living  Functional mobility Balance in sitting and standing Bed mobility Ability to transfer and mobilise Standing tolerance Gait - assess patient's ability to use assistive devices and ability to climb stairs Postoperatively the assessment should also include:  Information about the quality of the residual limb stump as this will have an impact on the prosthetic rehabilitation potential for the patient.
Nevertheless, many of them mentioned attempted to use videofluoroscopy , photoelectric increased levels of pain and pistoning when using the sensors , or axial movement detectors  to mea- Dermo liner. Obtained funding: H. Figure 4. The test can be performed with or without the prosthesis.
Subject characteristics. Abu Osman, S. It was developed to provide a more objective approach to rating amputees under the various "K Classifications".
The Trinity Amputation and Prosthesis Experience Scale TAPES , is to examine psychosocial issues related to adjustment to a prosthetic, specific demands of wearing a prosthetic and potential sources of maladjustment. Have independent standing balance within parallel bars patients may need to be able to stand for up to 5 minutes for prosthetic casting. Results: Twelve of studies met the inclusion criteria. Introduction Regaining mobility is an important rehabilitation objective for patients with a transtibial amputation.
Arch Phys Med Rehabil. Second, most of the included studies used author-designed questionnaires, some of which were based on the PEQ. Comparison of the effects of the residual femur within a trans-femoral socket during patellar tendon bearing and total surface bearing sockets on gait.
The LCI assesses a lower limb amputee's perceived capability to perform 14 different locomotor activities with a prosthesis. The Trinity Amputation and Prosthesis Experience Scale TAPES , is to examine psychosocial issues related to adjustment to a prosthetic, specific demands of wearing a prosthetic and potential sources of maladjustment. A using motion analysis system.
A using motion analysis system. Geertzen Monitoring Editor: Jianxun Ding. The subjects worth filter cutoff frequency of 10 Hz. Am J Phys Med Rehabil. Reference lists of included studies were checked for any relevant studies not identified in the database searches.
Jenkins SP. Questionnaires assessing satisfaction use different operationalizations, making comparisons between studies difficult. Grevsten S, Erikson U. Received Jun 5; Accepted Aug A roentgenological study of the
Cohen Kappa as a measure for interobserver agreement for title and abstract assessment was 0. Seven questionnaires assessed different aspects of satisfaction. Eighty studies remained after the first assessment and full text of these studies was retrieved, in addition to the full text of studies identified from the reference lists. Furthermore, [16—19]. We used the distance between the markers on the liner and on Figure 1. Factors associated with prosthesis satisfaction were extracted independently by 2 observers ES, EB and recorded on a predesigned form.