Successful rehabilitation for people with lower-limb amputations requires that they accept and create a healthy and beneficial relationship with their prosthetic devices. Prosthesis acceptability depends on numerous factors including cosmesis, weight, comfort, and function. Comfort and function are directly dependent on the socket fit, on the suspension quality, and on components type and their relative position.1-3 The alignment of the prosthesis is defined by the position and orientation of the components, mainly the socket, joints, and terminal devices. This alignment impacts gait symmetry, comfort, stability, and pressure distribution inside the prosthetic socket.4
Individuals with lower-limb amputations are likely to develop a variety of comorbidities. Studies show that they have a higher incidence, compared to people without amputations, of knee pain; an increased risk of osteoarthritis in the contralateral limb; low back pain, possibly due to abnormal joint moments or gait patterns; and a higher risk of cardiovascular disease and diabetes, possibly due to decreased activity.5-8 Adjusting prosthetic alignment might help reduce these comorbidities by reducing abnormal limb loading, abnormal gait patterns, and promoting activity.