A new study published in PM&R aims to evaluate the impact of adjustable-volume sockets (AVS) on comfort, quality of life, and general satisfaction. The study, conducted by the Hanger Institute for Clinical Research and Education, also looked at satisfaction with walking ability and prosthetic mobility in a large clinical population.
The data, collected over a two-year period across multiple US prosthetic clinics, showed significant improvements across all outcomes measured.
The primary outcome was Socket Comfort Score (SCS). The SCS is an 11-point scale where individuals rate their socket comfort from 0-10 (0 being most uncomfortable and 10 being most comfortable). The sample included 444 patients who completed both pre- and post-assessments when trying out the AVS.
The positive impact of AVS use was significant and clinically meaningful across all measurements. These sockets are associated with improvements in socket comfort, quality of life, prosthetic mobility, and satisfaction with walking ability.
Ultimately, AVS are a viable alternative to fixed-geometry designs and “highlight the potential for enhanced user comfort and function through individualized fit adjustment.”
We spoke with Courtney Fields, an educator and amputee who’s been using the Ottobock Varos AVS for three years now, and her experience aligns with these findings as well.
“I got [Varos] due to the fact that at the time, with carbon fiber sockets, I was bottoming out, meaning the bone of my limb was hitting the bottom of my socket, and it was causing me a lot of pain,” she said. “So my prosthetist suggested that I try the Varos socket, which was the adjustable socket, which allowed me to suspend my limb, which I loved. And I also loved the fact that I was able to adjust the fit as I lost volume throughout the day.”
It was this adjustability that allowed Courtney to be comfortable in a variety of situations in her everyday life. “Your limb loses volume within minutes of just like outside in the heat versus being in the house,” she explained. “So if I say I’m at the in the car for 30 minutes, when I get out of the car, I would tighten my socket back up.”
The socket being the main point of contact between her residual limb and her prosthesis means the socket is perhaps the most integral part of the setup. When asked how important the socket is, Courtney explained:
“It’s very important because if you think about it, the socket is what is attached to your limb. If that is not comfortable, I won’t be able to walk no matter how fancy of a knee I have.”
Components are one thing, but when asked about what advice she has for someone who has just experienced limb loss or maybe they’ve been an amputee for a while and don’t have their setup locked in, she mentioned that the patient-prosthetist relationship and self-advocacy are the biggest pieces of the puzzle:
“My advice would be to advocate for yourself and don’t be afraid to start over and start over and start over to find a prosthetist that will truly listen to you. Because when you find somebody that is listening to your concerns is willing to figure out what it takes to make you comfortable, it’s a game changer.”
Sources
- Hanger Institute Research Shows Adjustable-Volume Prosthetic Sockets Significantly Improve Socket Comfort, Mobility, and Quality of Life
- Ottobock Varos web page
