Our Clinical Specialist, Anthony Ung, has been overseas in Europe supporting our newest International Certified Provider, Pace Rehabilitation. Pace is a reputable and well known prosthetic clinic in England and we are happy to have them on our team. After three successful and time saving fittings, the patients were walking, riding bikes, and all smiles after the process.
If you were to ask an established above the knee amputee what they would ideally like from their prosthetic socket, it would be expected that they would reply with comments relating to the ability to adjust the fit in response to daily and short term changes to volume.
We typically hear descriptions of a well rehearsed and sometimes lengthy morning routines to apply the prosthesis, a period of good fit during the day and then a little more movement experienced later as the limb reduces in size.
For some, prosthetic socks are applied as the day goes on. Others are less keen and continue regardless. Then there’s other challenges such as changes to shape and size according to weather and seasons. Summer months and hot weather often cause some increase in volume, colder months some reduction. Christmas and holiday periods also tend to lead to tight fitting sockets soon after. For many it’s a continual challenge to maintain the good fit of the socket.
Over the years, attempts have been made with varying success to provide a prosthetic socket with a degree of adjustability. We’ve seen air inflated bladders used, assisted vacuum units attempting to minimize volume fluctuation and BOA type systems to wind in further tension to the socket.
Recently at Pace Rehabilitation, we have been working closely with the team at LIM, a company based in San Francisco to evaluate their Infinite socket design. Commercially available since September 2014 and with almost 300 fittings carried out, this unique design of self adjustable socket has recently become available within the UK.
Following live on line training sessions with the US team, video conferences, casting and data capture sessions, three existing above the knee amputees who receive support from Pace Rehabilitation have been fitted under the guidance of one of the LIM prosthetists within our clinics.
We are in the process of fitting those using locking liner and Seal-In type designs of interface system. Early initial response is very positive and encouraging with improvements being offered to the levels of comfort during standing, walking and sitting from this softer and more forgiving design. Of course the ability for the user to adjust the fit of the socket during the day by the use of a ratchet strap or Velcro strapping is especially welcomed.
Self adjustments to the to the socket, temporarily removing support under the ischium within the backside along with a softer brim at the top seems to allow for comfortable use on a bike where full support can be returned after the fitness session or ride. The control of the prosthesis from the socket appears as good if not better in some cases during walking when compared to a more rigid and conventional design.
During this period of evaluation we will continue to learn the capabilities of LIM Infinite socket. We can certainly see the potential from this design and expect that this will become a serious offering to those who we support in clinic.
Further designs are in development, including an option for below the knee amputations. We will continue to provide information when it becomes available.