Title: Factors Associated with the Use of Endoskeletal and Exoskeletal Prosthesis Among Lower Extremity Amputees - A Tertiary Care Centre Experience
Authors: Chitra G, Unnikrishnan G, Meer Chisthi M
DOI: https://dx.doi.org/10.18535/jmscr/v4i11.57
Abstract
Background: Prostheses are used after amputation for better function, cosmetic appearance, and a psycho-spiritual sense of wellbeing. But they are mired by discomforts and disadvantages. Compared to the conventional exoskeletal prostheses, the modern endoskeletal ones claim to be functionally superior. The primary objective of the study was to compare the factors associated with the daily use of endoskeletal and exoskeletal prosthesis among lower extremity amputees who have used the prostheses for a minimum period of 3 months. Secondary objective was to compare the mobility status of persons using endoskeletal and exoskeletal prostheses and to find the difference in social and emotional aspects of persons using endoskeletal and exoskeletal prostheses.
Methods: This was a Cross sectional study, conducted from January 2014 to December 2014, at Government Medical College Hospital, Trivandrum. All the lower limb unilateral amputees who have used the prosthesis for a minimum period of 3 months who attended the Out Patient department of Physical Medicine and Rehabilitation Department were included in the study.
Results: The endoskeletal prostheses were more silent during ambulation, with a statistically significant difference. With regard to utility, it was found that exoskeletal prosthesis had better performance. Regarding ambulation, appearance, frustration, perceived response, residual limb health, social burden and well being no statistically significant difference was noted between the two types of prosthesis. Conclusions: Endoskeletal prosthesis and exoskeletal prosthesis both are having an almost equal acceptability among lower limb amputees. Exoskeletal prosthesis has better performance altogether while endoskeletal prosthesis is better in the silent ambulation aspect.
Keywords: functional outcome; lower extremity amputation; prostheses; quality of life.
1. Colwell MO, Spires MC, Wontorcik, Davis AJ, Cauley P. Lower-Extremity. Prosthetics and rehabilitation. In: Grabois M, Garrison SJ, Hart KA, Lehmkuhl LD, editors. Physical Medicine and rehabilitation. The complete approach. Massachusetts: Blackwell science, Inc.2000; 583-607
2. Hughes J, JS Taylor: Biomechanics and prosthetic practice. In: Murdoch G and Wilson AB Jr, Editors. Amputation surgical practice and patient. Management; 1st edition, Oxford, Butterworth-Heinemann. 1996,41-51
3. Leonard EI, McAnelly R Dm, Lomba M, Faulker VW, Lower Limb Prostheses. Editor Braddom RL, physical medicine and rehabilitation, 2nd ed. Philadelphia; B Saunder; 2000, 279-310
4. Govan NA. Biomechanics and prosthetic management, Editor. G Murdoch and A Bennet Wilson Jr, Amputation surgical practice and patient management; 1996, 59-62
5. Nader Max, Nader Hans George. Otto Bock Prosthetic Compendium- Lower Limb Prostheses, 3rd revised edition, Berlin; Schiele and Schon, 2002, 09-17
6. Zidarov D, Swaine B, Gauthier-Gagnon C. Life habits and prosthetic profile of persons with lower-limb amputation during rehabilitation and at 3-month follow-up. Arch Phys Med Rehabil. 2009 Nov;90 (11):1 953-9. doi: 10.1016/j.apmr. 2009.06.011
7. 7.Willingham, L. L., Buell, N. C., Allyn, K. J., Hafner, B. J., & Smith, D. G. (2004). Measurement of knee center alignment trends in a national sample of established users of the Otto Bock C-Leg microprocessor-controlled knee unit. Journal of Prosthetics and Orthotics, 16(3), 72-75. DOI: 10.1097/00008526-200407000-00002
8. Selles RW, Bussmann JBJ, Wagenaar RC, Stam HJ. Effects of prosthetic mass and mass distribution on kinematics and energetics of prosthetic gait: A systematic review. Arch Phys Med Rehabil. December 1999Volume 80, Issue 12, Pages 1593–1599
9. Gupta PK, Parmar VK, VrC, Mand GS. Patient satisfaction in prosthetic rehabilitation programme. Medical Journal Armed Forces India. April 2001volume 57, issue 2, pages 95–98. doi: http://dx.doi.-org/10.1016/s0377-1237(01)80122-2
10. Sahoo J, Mohanty RN, Das SK. Comparative Study of Laminated Exoskeletal versus Modular Endoskeletal Below Knee Prostheses. IJPMR 2010; 21 (1): 5-7