Leslie's story: an Adapttech case study

As you may know, if you are an attentive follower of our website and our social networks, INSIGHT® is an innovative system designed to improve the efficiency of the fitting process to rapidly deliver an ultra-comfortable, uniquely fitted lower-limb prosthesis for the patient.  

This blog post aims to show you, in a realistic way, how INSIGHT® works during appointments with patients. To achieve this goal, we present to you Leslie’s Case Study. 

LESLIE’S STORY 

Leslie is in the 50 to 64 age group, and he is employed in part-time. He has been a prosthetic user for over 20 years, but until he got to know our system, he wasn’t managing his sock ply correctly.  

Leslie's story is a very particular case because during his amputation, a peripheral artery bypass surgery was performed to restore blood flow via a plastic tube. Excessive pressure on the lateral aspect of his residual limb, where the plastic tube is located, was causing discomfort over time and was impacting the function of his plastic artery.  

His prosthetist has tried several different suspension styles over the years, such as anatomical suspension, suction and pin lock. Another solution involved making a channel in the socket to help relieve the plastic artery, however this would cause the socket to be looser due to the length of the plastic artery.  

Up to now, Leslie has been most comfortable using a 6-ply sock fit. When the prosthetist made a socket with a 0-3 ply fit, there was too much compression of the plastic artery throughout the day as his limb volume changed. If the offloaded channel was too big to account for this volume change, then the socket would significantly rotate. Leslie did not want to use suspension sleeves to help with this rotation, as the bunching behind the knee limited his range of motion. 

THE APPOINTMENT 

Due to all these issues that Leslie faced during the 20 years he was using his prosthesis, the day finally came when his prosthetist realized that INSIGHT® could be the solution to answer and solve all his problems.  

When Leslie removed his liner during his appointment, his limb was red and concerning, as you can see in the picture bellow. He was wearing a 3-ply sock fit and had only been wearing his prosthesis for 2 hours. His socket was scanned, and sensors placed onto areas of concern. 

INSIGHT® SOLUTION 

After the scanner had done its part of the job, by creating a 3D image of Leslie's socket and allowing the socket to be analysed through the INSIGHT App, Leslie and his prosthetist were able to see the pressure map of the socket during standing and walking exercises.

Through the analysis of the data provided by the App, his socket was noted to be loose fitting. After this finding, he went from a 3-ply sock fit to a 5-ply sock fit. Data was further collected, and Leslie was shown the pressure map of his socket with a snugger fit. 

He could clearly see pistoning within the socket when he did not have the proper socks on. He could see the lack of contact in the swing phase, and high-pressure results for the bottom of his socket and limb during the stationary phase. 

When Leslie had the appropriate sock ply on, the plastic artery was located in the proper position and no longer caused unusual swelling or discomfort. He felt that he could walk for much longer. 

MAIN FINDINGS 

With the analysis of all these data, the prosthetist was able to discover that the loose-fitting socket meant the plastic artery was receiving intermittent pressure, causing blood flow into the limb to be either completely free flowing, or if pressed upon blood flow stopped all together. This exchange from very high pressure on the artery to no pressure at all due to pistoning and movement within the socket meant Leslie had to take his socket off frequently throughout the day. 

INSIGHT® system was great in helping to determine whether his plastic artery was being over or under-compressed. Pressure mapping indicated that there was inconsistent pressure in this area, and it was under-compressed.  

“Wow. In all these years, I’ve never been able to see what’s going on with my leg. It’s great because you can see what I feel. I can actually see why my leg was turning red.”  

This experience is the kind result that Adapttech works hard to help achieve every day. Our purpose will always be to improve the quality of life for people with physical limitations, just like Leslie. 

What to know more about how INSIGHT® was designed by our team? Read our user experience blog post by clicking on the link.