Outcome Measures Identify Appropriateness of Torsion Adapters

ORLANDO, Fla. — In a presentation, at the 2011 Annual Meeting and Scientific Symposium of the American
Academy of Orthotists and Prosthetists
, Maria J. Gerschutz, PhD, presented
her research regarding clinically feasible outcome measurements in the lower
limb amputee population. For her research, Gerschutz focused on torsion
adapters and found that these components appeared to improve ambulation,
decreased steps and increased the ability to perform certain tasks.

Gerschutz enrolled nine amputees in the study, which consisted of five
tasks: a figure-eight walking path; a physical movement task; a stair test; a
ramp test; and an uneven terrain test consisting of sand and gravel. She also
collected quantitative feedback from the patients prior to the study.
Participants were allotted a 30-minute acclimation period prior to the tasks,

Data was collected to measure participant performance for each of the
tasks. The use of a torsion adapter decreased the step count in five of the
nine participants, according to the study abstract, which resulted in 1.3 fewer
steps in the figure-eight test.

“For a ramp, we used a standard incline of 58·,”
Gershutz explained. “We saw similar effects as we did on the stairs. We
did not anticipate a big difference between the two treatment levels; however
we did notice a difference when they reached the platform to turn around. They
were able to pivot and turn with the prosthesis that incorporated the torsion

The last task was the uneven ground test.

“We had a pit that contained gravel and sand. [One patient]
commented that in the sand he felt a little more stable with the torsion
adapter. He also commented that it was a little easier to turn around to go
back with the torsion adapter than without. He didn’t feel much difference
in the gravel.”

Data revealed that use of the torsion adapter resulted in 1.8 fewer
steps for the gravel terrain and 2.3 fewer steps in the sand.

Patients were also asked about performance and their preference of each
prosthesis. Gerschutz explained that the participants reported improvement and
ease when using the torsion adapter regarding overall function, rotation,
pivoting and uneven ground walking. Additionally, they reported reduced joint
pain. Eight of the nine participants indicated that they would prefer to use
the prosthesis with the torsion adapter. One participant did not indicate a

“Even though a torsion adapter is not ideal for every patient, it
is also important for both the prosthetist and the amputee to assess if the
torsion adapter is appropriate for them,” Gerschutz explained. “A
patient with a considerable amount of twisting, turning and ambulation in their
daily life may benefit significantly from a torsion adapter.” — by
Jennifer Hoydicz

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