Gait, cost and time implications for changing from PTB to ICEX® sockets
Gait, cost and time implications for changing from PTB to ICEX® sockets
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DOI：
10.1080/03093640408726696
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发表时间：
2004-08-01
影响因子：
1.5
通讯作者：
Martin, R
中科院分区：
文献类型：
--
作者：
Datta, D;Harris, I;Martin, R
ICEX（R）系统（Ossur，Iceland），允许直接在残肢上制造承窝，并且由于更好的压力分布而被认为提供了改善的舒适性，同时更容易装配和制造。该项目的目的是a）通过测量几种步态特征来比较步态性能，B）比较生产和装配时间，c）调查经济影响和d）尝试评估截肢者对接受窝舒适度的主观意见。对27名使用Endolite（TM）系统上现有髌腱支承（PTB）接受窝的经胫骨截肢者进行了一项随机对照试验（Chas A. Blatchford，UK）。21例受试者完成了研究。其中，对照组10例接受新的PTB插座，而实验组11例接受ICEX（R）。对佩戴现有插座的患者进行步态分析，并从测力板获得动力学数据。在6周的调整期后，用新的插座重复这一过程。在统计学评价中使用Mann-Whitney检验，显著性水平为5%。要求受试者使用插座舒适度评分（Hanspal等人，2003），并记录了接受腔分娩后3个月内接受腔调整的访视频率。虽然制造PTB假体所需的时间比ICEX（R）长得多，但生产ICEX（R）的总成本明显更高。受试者对ICEX（R）设计仅表现出轻微的舒适偏好，并且接受槽调整的平均就诊次数没有显着差异。鉴于提供ICEX（R）的相当大的额外成本以及缺乏任何测试参数改善的证据，不建议向未选择的经胫骨截肢者常规提供ICEX（R）假体。
The ICEX(R) system (Ossur, Iceland), allows a socket to be manufactured directly onto the stump and is thought to provide improved comfort due to better pressure distribution whilst being easier to fit and manufacture.The aims of this project were to a) compare gait performance by measuring several gait characteristics, b) compare production and fitting times, c) investigate financial implications and d) attempt to gauge the amputees' subjective opinions of socket comfort.A randomised, controlled trial was conducted on 27 trans-tibial amputees with an existing patellar tendon bearing (PTB) socket on the Endolite(TM) system (Chas A. Blatchford, UK). Twenty one (21) subjects completed the study. Of these, 10 in the control group received new PTB sockets while 11 in the experimental group received ICEX(R).Gait analysis wearing existing sockets was performed and kinetic data obtained from a force plate. This was repeated with the new sockets after a 6 week period of adjustment. Mann-Whitney tests were used in statistical evaluations with a significance level of 5%. Subjects were asked to score their prosthesis for comfort using the Socket Comfort Score (Hanspal et al., 2003) and the frequency of visits for socket adjustments over a three-month period post-delivery of the sockets was recorded.This study demonstrates no significant difference in any of the gait parameters measured. Though the time required to manufacture a PTB prosthesis was found to be considerably longer than the ICEX(R), the overall cost for producing the ICEX(R) was significantly greater. Subjects showed only minor comfort preference for the ICEX(R) design and there was no significant difference in the mean number of visits for socket adjustments.In view of the considerable additional cost of providing ICEX(R) and the lack of evidence of improvement in any parameter tested, the routine provision of ICEX(R) prostheses to unselected trans-tibial amputees cannot be recommended.