The Relationship between Socket Comfort, Pain, and Mobility Over Treatment Milestones for Individuals with Lower-Limb Loss

Abstract

Introduction This study investigates the relationships among mobility, pain, and socket comfort for people with lower-limb amputations who use prostheses over specific treatment milestones. Methods This is a retrospective chart analysis from January 1, 2015, to July 15, 2021. Outcome measures included are the Socket Comfort Score, Pain Scale, 2-Minute Walk Test, and PLUS-M (Prosthetic Limb Users Survey of Mobility). Data were collected at 4 milestones: Baseline and Discharge from Rehabilitation for those receiving their first prosthesis in rehabilitation and Initial Evaluation and Definitive Fitting for experienced prosthesis users receiving a replacement socket. Demographic data were analyzed using descriptive statistics, and the strength of the correlations was determined using Pearson’s correlations. Results Measures were included from 59 individuals in rehabilitation and 165 individuals receiving a replacement socket. The sample was in general older males with transtibial amputations due to a variety of etiologies. The Pain Scale was negatively correlated with the Socket Comfort Score (−0.49 < r < −0.60), and the PLUS-M was correlated with the 2-minute walk test (0.41 < r < 0.61) at all milestones. Additionally, there were positive correlations between the PLUS-M and Socket Comfort Score (0.30 < r < 0.32), and negative correlations between the PLUS-M and Pain Scale (−0.46 < r < −0.32) for those receiving a replacement socket. Conclusions The relationship among comfort, pain, and mobility changes over the treatment timeline. There is evidence that, by addressing comfort and pain for those with experience using a prosthesis, clinicians can support the goal of increasing self-reported functional mobility. Clinical Relevance This study provides novel information about the relationships among pain, comfort, and mobility and the importance of considering the impact of treatment milestones when taking outcome measures and providing interpretative values as scores and relationships differ over the course of treatment.