This study examined the effects of socket flexion angle in trans-tibial prosthesis on stump/socket interface pressure. Ten trans-tibial amputees voluntarily participated in this study. F-socket system was used to measure static and dynamic pressure in stump/socket interface. The pressure was measured at anterior area (proximal, middle, and distal) and posterior area (proximal, middle, and distal) in different socket flexion angles (5°, 0°, and 10°). Paired t-test was used to compare pressure differences in conventional socket flexion angle of 5° with pressures in socket flexion angles of 0° and 10° (α=.05). Mean pressure during standing in socket flexion angle of 10° decreased significantly in anterior middle area (19.7%), posterior proximal area (10.4%), and posterior distal area (16.3%) compared with socket flexion angle of 5°. Mean pressure during stance phase in socket flexion angle of 0° increased significantly in anterior proximal area (19.3%) and decreased significantly in anterior distal area (19.7%) compared with socket flexion angle of 5°. Mean pressure during stance phase in socket flexion angle of 10° decreased significantly in anterior proximal area (19.6%) and increased significantly in anterior distal area (8.2%) compared with socket flexion angle of 5°. Peak pressure during gait in socket flexion angle of 0° increased significantly in anterior proximal area (23.0%) compared with socket flexion angle of 5° and peak pressure during gait in socket flexion angle of 10° decreased significantly in anterior proximal area (22.7%) compared with socket flexion angle of 5°. Mean pressure over 80% of peak pressure (MP80+) during gait in socket flexion angle of 0° increased significantly in anterior proximal area (23.9%) and decreased significantly in anterior distal area (22.5%) compared with socket flexion angle of 5°. MP80+ during gait in socket flexion angle of 10° decreased significantly in anterior distal area (34.1%) compared with socket flexion angle of 5°. Asymmetrical pressure change patterns in socket flexion angle of 0° and 10° were revealed in anterior proximal and distal region compared with socket flexion angle of 5°. To provide comfortable and safe socket for trans-tibial amputee, socket flexion angle must be considered.

Pressure ulcers are serious complications of tissue damage that can develop in patients with diminished pain sensation and diminished mobility. Pressure ulcers can result in irreversible tissue damage caused by ischemia resulting from external loading. There are many intrinsic and extrinsic contributors to the problem, including interface tissue pressure, shear, temperature, moisture, hygiene, nutrition, tissue tolerance, sensory and motor dysfunction, disease and infection, posture, and body support systems. The purposes of this study were to investigate the relationship between buttock interface pressure and seating position, wheelchair propulsion speed. Seated-interface pressure was measured using the Force Sensing Array pressure mapping system. Twenty subjects propelled wheelchair handrim on a motor-driven treadmill at different velocities (40, 60, 80 m/min) and seating position used recline (, , ) with a wheelchair simulator. Interface pressure consists of average (mean of the pressure sensor values) and maximum pressure (highest individual sensor value). The results of this study were as follows; No significant correlation in maximum/average pressure was found between a static position and a 40 m/min wheelchair propulsion (p>.05). However, a significant increase in maximum/average pressure were identified between conditions of a static position and 60 m/min, and 80 m/min wheelchair propulsion (p<.05). No significant correlation in maximum pressure were found between a recline (neutral position) and a , , or recline of the wheelchair back (p>.05). No significant difference in average pressure was found between conditions of a recline and both a and recline of wheelchair back. However, a significant reduction in average pressure was identified between conditions of a and recline of wheelchair back (p<.05). This study has shown some interesting results that reclining the seat by reduced average interface pressure, including the reduction or prevention in edema. And interface pressure was greater during dynamic wheelchair propulsion compared with static seating. Therefore, the optimal seating position and seating system ought to provide postural control and pressure relief. We need an education on optimal seating position and a suitable propulsion speeds for wheelchair users.