Adjustable-Volume Prosthetic Sockets: Enhancing Comfort and Mobility

To determine if adjustable-volume sockets affect patient comfort and quality of life, researchers fitted participants with commercially available adjustable-volume prosthetic sockets for testing. They found that while participants abandoned a number of sockets due to discomfort or instability, there were also improvements in some outcome measures.

The randomized clinical trial was completed at two prosthetics clinics and two research laboratories with 29 people who had unilateral transfemoral amputations and were prescribed conventional laminated sockets or adjustable volume sockets. Each participant was fitted with three sockets that were each used at home for separate four-week trials (Infinite Socket, LIM Innovations; CJ Sail, CJ Sockets Technologies; and Quatro, Quorum).

The primary outcome measures were socket comfort scores, prosthetic evaluation questionnaire (PEQ) subscales, socket-specific individual questions from the PEQ, and health-related quality of life (SF-36). Assessments were conducted after at least three weeks of socket use.

The participants abandoned a large number of sockets during the acclimation due to discomfort or instability, according to the study: CJ (41 percent), Infinite (25 percent), and Quatro (24 percent). When successful, the CJ and Quatro sockets improved the participants’ utility, ambulation, and social burden PEQ subscales, as well as fit, feel and sitting comfort compared to the laminated socket.

There were few differences for the Infinite socket, though it was perceived as having poorer appearance. Participants who selected adjustable designs at the conclusion of the study reported measurable improvements in socket comfort.

The researchers concluded that adjustable-volume sockets offer an alternative to conventional laminated sockets that can positively affect comfort, perceived mobility, and prosthetic utility, and future work should identify the characteristics of individuals that predict success with different socket designs.

The study, “The impact of transfemoral adjustable-volume sockets on socket comfort and quality of life: A randomized clinical trial,” was published in the Archives of Physical Medicine and Rehabilitation.