A study published online May 22 in the journal Gait & Posture compared the gait and balance of individuals with transfemoral amputations when using either an ischial ramus containment (IRC) socket or brimless socket with vacuum-assisted suspension.
Ten individuals with unilateral transfemoral amputations were analyzed in a randomized experimental crossover study. The participants had a mean age of 42.9 years and a mean residual limb length of 60.3 percent of the sound-side femur length. Their mean time as an amputee was 8.3 years, and their median Amputee Mobility Predictor (AMP) score was 43. The average medial wall height for IRC interfaces was 0.7cm proximal to the distal-most aspect of the ischial tuberosity (IT), and the medial wall on the brimless design was an average of 3.3cm distal to the distal-most aspect of the IT. The main outcome measures used were spatiotemporal gait parameters, limits of stability, Four Square Step Test, and subjective perception using the Prosthetic Evaluation Questionnaire (PEQ).
The researchers concluded that the brimless design was equivalent to IRC in most gait and balance outcome measures. However, step length was more symmetrical with the IRC while base of support was narrowed with the brimless demonstrating mixed inconsistent performance changes. Further, the PEQ demonstrated significant subjective improvements in prosthetic related function and quality of life when participants used the brimless design. Given these results, the researchers wrote that the brimless interface design may be a clinically viable choice.
The researchers had a related study published in issue 50-9 of the Journal of Rehabilitation Research & Development. The purpose of that study was to determine whether a brimless socket would compromise coronal hip angle and socket movement, increase skin pressure, and be more preferable to patients than the standard of care IRC socket.
For more information, read “Study Compares IRC and Brimless Sockets.”