Researchers in Spain investigating the effects of a vacuum-assisted socket system found improvement in perceived balance, transfers, and gait among individuals with dysvascular-related transtibial amputations who were over 50 years old. The study was published online September 26 in the journal Prosthetics and Orthotics International.
Because lower-limb amputation can lead to impairments in balance, transfers, and ambulation, and prosthesis fit is a determining factor for successful ambulation, the researchers focused on the decreased pistoning of vacuum-assisted socket systems, which can reduce the probability of soft-tissue injuries, and increase proprioception and socket comfort.
Sixteen subjects with unilateral dysvascular-related amputations with a mean age of 65.12 years participated in the study. The participants were first assessed using their prosthesis with a regular socket, and were then re-evaluated four weeks after fitting of the vacuum-assisted socket system. The researchers evaluated each participant’s mobility grade using the Medicare Functional Classification Level (MFCL), the Berg Balance Scale, the Four Square Step Test (FSST), the Timed Up and Go (TUG) test, the six-minute walk test (6MWT), the Locomotor Capabilities Index (LCI), the Satisfaction with Prosthesis Questionnaire (SAT-PRO), and the Houghton Scale. According to the study’s authors, the participants demonstrated significant improvements in balance, gait, and transfers. Scores of the Berg Balance Scale increased from 45.75 to 49.06; FSST scores decreased from 18.18 to 14.97 seconds; TUG test scores decreased from 14.3 to 11.56 seconds; and the distance walked in the 6MWT increased from 288.53 to 321.38 meters.
Based on the results of this study, the researchers suggest vacuum-assisted socket systems improve functionality and decrease fall risk for elderly patients with transtibial dysvascular-related amputations, that the use of an additional distal valve in the socket should be considered in patients with a lower activity level.