The functional, spatio-temporal and satisfaction outcomes of transtibial amputees with a hydrocast socket following an extended usage period in an under-resourced environment

Background Transtibial hydrocast sockets have been shown to be a potential alternative to hand-cast patella-tendon bearing sockets, the use of which would have particular benefits in under-resourced environments. However, data concerning wearer outcomes of hard hydrocast sockets (i.e. those without silicone liners), especially over long-term usage periods, is scarce in the literature. Research questions Are there any changes in wearer functional, spatio-temporal or satisfaction outcomes over a long usage period with a hydrocast socket? And how do the post-usage period outcomes compare with those from the wearers original prostheses? Methods In this pre-post interventional study, the clinical outcomes of twenty-one experienced transtibial prostheses users were evaluated using widely-accepted and employed methods to assess wearer functional capacity, mobility, gait and satisfaction. The participants were fit with a hard hydrocast socket and the outcomes after an extensive usage period of 5 months were compared to the pre-usage period data following initial fitting and the data collected from the participants' original prosthetic limb. Results Significant differences were found in the temporal parameters of gait, all indicating decreased reliance on the intact limb and an increased loading of the prosthetic limb with the post-usage period hydrocast socket compared to both the pre-usage period socket and the participants' original limbs. No differences in the functional capacity, mobility, spatial gait parameters or satisfaction were found between the socket conditions. Significance This is the largest study to date of functional, spatio-temporal and satisfaction outcomes of hydrocast sockets following an extended usage period in an under-resourced environment.