Sustainable, affordable and functional: reimagining prosthetic liners in resource limited environments.

Purpose: The purpose of this study was to evaluate function and performance of unilateral trans-tibial prosthesis users wearing an affordable liner in three types of socket designs.

Methods: Five unilateral trans-tibial amputees participated, were provided an Affordable Ethyl-Vinyl-Acetate Roll-On liner (AERO) roll-on liner with patella tendon bearing (PTB) prosthesis, PE-Lite liner with PTB prosthesis, and an (AERO) liner with total-surface bearing (TSB) prosthesis. A battery of outcome measures; step-counts, socket comfort score (SCS), orthotics prosthetics user survey (OPUS) and socket pressure measurement during walking were administered.

Results: Comparisons of step-counts indicated that PTB-AERO (3604 ± 815) was not significantly different than PTB-PE-Lite (3386 ± 942). Mean SCS was 9.2 ± .83 and 7.2 ± 2.1 for PTB-AERO and PTB-PE-Lite. A 6.6% decrease in mean peak pressure was observed between PTB-PE-Lite and TSB-AERO, and 3.2% difference between PTB-PE-Lite and PTB-AERO.

Conclusion: An affordable ($20 USD) and sustainably fabricated prosthesis liner was created and evaluated in trans-tibial prosthesis users. These initial results garner preliminary support for use of the AERO prosthetic liner and continued research.Implications for rehabilitationLower limb prosthetics in less-resourced settings can leverage locally sourced and affordable materials to fabricate roll-on liners for use in modern prosthetic sockets.The cost of the AERO liner is markedly lower than current standard of care gel liners, yet still facilitates use of current prosthetic sockets.