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Background: Transtibial hydrocast sockets have been shown to be a potential alternative to hand-cast patella-tendon bearing sockets, the use of which would have particular benefits in under-resourced environments. However, data concerning wearer outcomes of hard hydrocast sockets (i.e. those without silicone liners), especially over long-term usage periods, is scarce in the literature., Research Questions: Are there any changes in wearer functional, spatio-temporal or satisfaction outcomes over a long usage period with a hydrocast socket? And how do the post-usage period outcomes compare with those from the wearers original prostheses?, Methods: In this pre-post interventional study, the clinical outcomes of twenty-one experienced transtibial prostheses users were evaluated using widely-accepted and employed methods to assess wearer functional capacity, mobility, gait and satisfaction. The participants were fit with a hard hydrocast socket and the outcomes after an extensive usage period of 5 months were compared to the pre-usage period data following initial fitting and the data collected from the participants' original prosthetic limb., Results: Significant differences were found in the temporal parameters of gait, all indicating decreased reliance on the intact limb and an increased loading of the prosthetic limb with the post-usage period hydrocast socket compared to both the pre-usage period socket and the participants' original limbs. No differences in the functional capacity, mobility, spatial gait parameters or satisfaction were found between the socket conditions., Significance: This is the largest study to date of functional, spatio-temporal and satisfaction outcomes of hydrocast sockets following an extended usage period in an under-resourced environment., (Copyright © 2018 Elsevier B.V. All rights reserved.)

This study compared the physical function and comfort level of patients with unilateral transtibial amputation after being fitted with a hand-cast Patella Tendon Bearing (PTB) socket and a pressure-cast (PCAST) hydrocast socket. The latter technique aims to reduce the skill dependency currently required for socket manufacture and fit. The study was conducted at the Vietnamese Training Centre for Orthopaedic Technologies and involved seventeen Vietnamese participants with unilateral transtibial amputation, all of whom were long term users of prosthetics. All participants were fitted with two sockets manufactured using both hand-cast and PCAST techniques with International Committee of the Red Cross components. Walking tests (timed up and go test and six-minute-walk-test), spatio-temporal gait analyses and subjective comfort assessments were completed after a short acclimatisation period with each socket. The participant-preferred socket was also noted. No significant differences were found for the measures of mobility, functional capacity, spatio-temporal gait parameters, gait symmetry, perceived comfort or participant socket preference. The results show the initial patient outcomes are similar when participants are fitted with a hand-cast PTB socket and a PCAST hydrocast sockets. Future work should confirm these findings in a longer trial., (Copyright © 2017 Elsevier B.V. All rights reserved.)

This study investigated a low-cost and low-skill dependent pressure casting technique (PCAST) to fabricate and fit transtibial (TT) prosthetic sockets in a developing country. Thirteen adult volunteers (average age 47 yr) with unilateral TT amputation participated. After fitting, five participants were lost to follow-up (four rejected the prosthesis and one died). The eight remaining participants used the prosthesis for an average of 167 +/- 1 d and indicated regular use throughout this period. Success was evaluated by measures of satisfaction (Satisfaction with Prosthesis Questionnaire [SATPRO]), physical function, and gait recorded after fitting and following the usage period. SATPRO results showed high levels of satisfaction on both occasions. After the usage period, the timed up-and-go and six-minute walk performances increased by 1.7 +/- 2.0 s and 60 +/- 29 m (p = 0.001), respectively, whereas gait speed, cadence, step and stride length, support base, and percent gait cycle times remained unchanged. The results show that a TT PCAST socket (with some minor modifications) was successfully fitted to eight of the participants (success rate of 62%). It is reasonable to conclude that this technique may assist people with TT amputation in a developing country where there is a lack of trained personnel. Importantly, this technique may reduce TT prosthetic costs and increase fitting opportunity in a developing country.

This study investigated a low-cost and low-skill dependent pressure casting technique (PCAST) to fabricate and fit transtibial (TT) prosthetic sockets in a developing country. Thirteen adult volunteers (average age 47 yr) with unilateral TT amputation participated. After fitting, five participants were lost to follow-up (four rejected the prosthesis and one died). The eight remaining participants used the prosthesis for an average of 167 +/- 1 d and indicated regular use throughout this period. Success was evaluated by measures of satisfaction (Satisfaction with Prosthesis Questionnaire [SATPRO]), physical function, and gait recorded after fitting and following the usage period. SATPRO results showed high levels of satisfaction on both occasions. After the usage period, the timed up-and- go and six-minute walk performances increased by 1.7 +/- 2.0 s and 60 +/- 29 m (p = 0.001), respectively, whereas gait speed, cadence, step and stride length, support base, and percent gait cycle times remained unchanged. The results show that a TT PCAST socket (with some minor modifications) was successfully fitted to eight of the participants (success rate of 62%). It is reasonable to conclude that this technique may assist people with TT amputation in a developing country where there is a lack of trained personnel. Importantly, this technique may reduce TT prosthetic costs and increase fitting opportunity in a developing country. [ABSTRACT FROM AUTHOR]