According to authors of a recent systematic review, prosthetic alignment is seemingly a subjective concept that lacks reliability. Outcome responsiveness to prosthetic alignment quality could improve subjective and instrument assisted prosthetic alignment. To that end, the researchers conducted a review of studies evaluating the variables used to assess clinically acceptable alignment to determine the outcome responsiveness to prosthetic alignment quality to improve subjective and instrument-assisted prosthetic alignment.
Of the 25 studies that were included, 24 assessed standing position or walking to establish clinically acceptable alignment. Only one study measured outcomes in both situations. A total of 253 adults with transtibial amputations and mean age of 48.71 years participated in the included studies. The authors’ confidence level of the studies was low to moderate, and before–and-after trial was the most common study design (n = 19).
The joint angle, load line location with respect to joints, and center of pressure-related parameters were reported as sensitive outcomes to prosthetic alignment quality in standing posture. The amount of force at various parts of the gait cycle and time of events were sensitive to prosthetic alignment quality during walking, the studies found. Standing balance and posture and temporal parameters of walking could help to locate clinically acceptable alignment.
The search was done in Google Scholar, PubMed, EBSCO, EMBASE, ISI Web of Knowledge, and Scopus. The first selection criterion was based on abstracts and titles. The American Academy of Orthotics and Prosthetics checklists were also used for paper risk of bias assessment.
