Enhancing prosthesis fitting: A protocol for acquiring thermal and biomechanical data from lower limb amputees

Abstract

Background:Despite advancements in prosthetic design, many lower limb amputees continue to experience discomfort and report abandonment rates between 25% and 57%. Issues at the residual limb-socket interface, such as pressure, friction, and poor fit, remain critical challenges affecting long-term prosthesis use. Objective: This study introduces a comprehensive protocol to collect and analyze quantitative data from transtibial amputees, incorporating thermal imaging and biomechanical measures to enhance prosthesis fitting in clinical settings. Study Design: Cross-sectional quantitative clinical study evaluating thermal and biomechanical parameters of prosthetic socket fitting in unilateral transtibial amputees. Methods: This is a cross-sectional study that employs quantitative analysis of thermal and biomechanical parameters in transtibial amputees. The study, conducted in a clinical setting, included independent unilateral transtibial amputees. Participants underwent a series of evaluations that included thermograms of the residual limb captured with a thermal camera, weight distribution using a plantar pressure platform, gait symmetry via an inertial sensor, and the 2-minute walk test (2MWT). The protocol aimed to compare the effectiveness of different suspension systems on prosthetic fit. Results: The analysis targets temperature variations at the stump-socket interface and between-system differences in thermal and biomechanical metrics. We hypothesize that suction-based systems demonstrate better thermal consistency and symmetry, pin-lock systems exhibit higher proximal temperature, and valve systems achieve the longest 2-minute walk test distances. Variability in weight distribution and symmetry will inform individualized socket adjustments. Conclusions: The integration of thermal imaging and biomechanical analysis provides a more comprehensive evaluation of prosthesis fitting. Infrared thermography (IRT), although underused, is a promising tool for identifying critical adjustments in prosthetic design. Further research and standardization of such protocols can enhance clinical outcomes and user satisfaction.