Amputation is a complex problem for patients, the health care system, and the country. Dysvascular disease associated with diabetes accounts for about 82% of all limb losses. More than 180 million patients suffer from diabetes according to data from the WHO, of which Malaysia alone will face 2.48 million in 2030 that is 164% increase compared to year 2000.
Safe and effective use of prosthetic limbs requires that the prosthesis be suspended consistently and comfortably on the limb during patient activity. Selection of the optimal suspension is paramount to achieving efficient and safe prosthetic ambulation. An improperly fitting suspension may result in discomfort, pistoning of the device around the residual limb, skin breakdown, increased energy consumption, gait deviations, and falls. A good suspension reduces the risk of skin breakdown or irritation by minimizing the limb movement (pistoning) inside the prosthesis. The research should develop a new prosthetic suspension system to address some of the shortcomings of current designs.
Many choices in suspension system are available, and clinicians often rely on personal intuition and experience to choose which system is appropriate for which patient. Clinicians, administrators, medical researchers, and third-party payers are required to make decisions about the quality of care and the effectiveness of the prosthesis. The use of silicone liners in prosthetics is not new. It has two main functions, namely, protection of the amputation stump and suspension of the prosthesis. Suspension in silicone suction socket can be achieved in different ways, such as shuttle lock, sleeve, or a Hypobaric Sealing Membrane (HSM) around the liner (a new technology in silicone liners).
On the basis of the researcher’s experience, available suspension systems for lower limb amputations have not yet fully addressed the patients’ needs. A great number of amputees have some problems in their stump, like contracture, diabetic, or skin problem and they complain about the suspension system in terms of donning and doffing, gait and pain. It was the starting point to deal with this topic in general and invent a new suspension system which can cover some of the shortcomings of the existing suspension systems for lower limb amputees.
This study aims to:
To design and fabricate a new prosthetic suspension system.
To obtain kinematics and kinetics of trans-tibial and trans-femoral amputees gait using the new suspension system and compare that to the locking liner and Seal-in liner by using motion analysis approach.
To evaluate the biomechanical characteristics of each of the suspension systems (new system, locking or seal-in) in terms of comfort, function and satisfaction in amputees with normal stump, skin problems, flexion contracture, and diabetic or vascular diseases.