Hossein Gholizadeh (حسین قلی زاده ) is a PhD candidate and Prosthetics & Orthotics lab instructor in the Department of Biomedical Engineering,University of Malaya, Kuala Lumpur, Malaysia.
He holds a Master of Engineering Science in Biomedical Engineering from University of Malaya (2009-2011), and a BSc degree in Prosthetics & Orthotics from the Tehran University of Medical Sciences, School of Rehabilitation Science (1996-2001).
Abstract: Abstract
Background: Good suspension lessens the pistoning (vertical displacement) of the residual limb inside the prosthetic socket. Several methods are used for measuring the pistoning.
Study Design: Clinical trial.
Objectives: To introduce and evaluate a new simple method for measuring the pistoning between the soft liner and socket in transtibial prostheses.
Methods: Five transtibial prostheses with Iceross silicone liner and shuttle lock were made for the subjects. The pistoning was measured between the liner and socket by a photographic method in single limb support on the prosthetic limb (full weight bearing), non-weight bearing and under three static axial loading conditions (30, 60 and 90 N).
Results: This new method enabled us to measure the pistoning between the liner and prosthetic socket. The reproducibility of measurements in different trials of one session and between two sessions by two observers was shown to be high. The average of displacement between the liner and socket was about 9 mm in non-weight bearing compared with full weight bearing. Furthermore, as we expected, the average of pistoning increased consistently by adding the loads.
Conclusions: This new method provides for easy and inexpensive determination of pistoning between the liner and socket by every prosthetist in clinical settings.
Clinical relevance
A new method is demonstrated for evaluating the pistoning between the liner and socket in transtibial prosthesis. This provides a faster and easier way of clinical pistoning measurement. It can be implemented in any prosthetic centre by every prosthetist.
Abstract: Background: The method of attachment of prosthesis to the residual limb (suspension) and socket fitting is a
critical issue in the process of providing an amputee with prosthesis. Different suspension methods try to
minimize the pistoning movement inside the socket. The Seal-In® X5 and Dermo® Liner by Ossur are new
suspension liners that intend to reduce pistoning between the socket and liner. Since the effects of these new
liners on suspension are unclear, the objective of this study was to compare the pistoning effect of Seal-In® X5
and Dermo® Liner by using Vicon Motion System.
Methods: Six transtibial amputees, using both the Iceross Seal-In® X5 and the Iceross Dermo® Liner,
participated in the study. The vertical displacement (pistoning) was measured between the liner and socket in
single limb support on the prosthetic limb (full-weight bearing), double limb support (semi-weight bearing),
and non-weight bearing on the prosthetic limb, and also under three static vertical loading conditions (30 N,
60 N, and 90 N).
Findings: The results demonstrated that the pistoning within the socket when Seal-In® X5 was used,
decreased by 71% in comparison to the Iceross Dermo® Liner. In addition, a significant difference between the
two liners under different static conditions was found (pb0.05).
Interpretation: Participants needed to put in extra effort for donning and doffing the prosthesis with Seal-In®
X5; however, this type of liner provided less pistoning. The new approach that uses the motion analysis
system in this study might be an alternative for measuring the pistoning effect in the prosthetic socket.
Abstract: ABSTRACT
Gholizadeh H, Abu Osman NA, Kamyab M, Eshraghi A, Lu´ ðvı´ksdo´ ttir A´ G,
Wan Abas WAB: Clinical evaluation of two prosthetic suspension systems in a
bilateral transtibial amputee. Am J Phys Med Rehabil 2012;91:00Y00.
The effects of Seal-In X5 and Dermo liner (O¨ ssur) on suspension and patientâs
comfort in lower limb amputees are unclear. In this report, we consider the case
of a 51-yr-old woman with bilateral transtibial amputation whose lower limbs were
amputated because of peripheral vascular disease. The subject had bony and painful
residual limbs, especially at the distal ends. Two prostheses that used Seal-In
X5 liners and a pair of prostheses with Dermo liners were fabricated, and the subject
wore each for a period of 2 wks. Once the 2 wks had passed, the pistoning
within the socket was assessed and the patient was questioned as to her satisfaction
with both liners. This study revealed that Seal-In X5 liner decreased the residual
limb pain experienced by the patient and that 1Y2 mm less pistoning occurred
within the socket compared with the Dermo liner. However, the patient needed to
put in extra effort for donning and doffing the prosthesis. Despite this, it is clear that
the Seal-In X5 liner offers a viable alternative for individuals with transtibial amputations
who do not have enough soft tissue around the bone, especially at the end of
the residual limb.
Key Words: Rehabilitation, Amputation, Pain, Prostheses
