Gholizadeh H, Lemaire E.D, Nielen D, Lebel P. SATISFACTION AND EXPERIENCE WITH THE UNITY SUSPENSION SYSTEM. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. https://doi.org/10.33137/cpoj.v1i2.32030 1 OPEN ACCESS AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 ABSTRACT (ORAL PRESENTATION) SATISFACTION AND EXPERIENCE WITH THE UNITY SUSPENSION SYSTEM Hossein Gholizadeh *1,2, Edward D Lemaire1,3, David Nielen2, Patrick Lebel2 1Ottawa Hospital Research Institute, Centre for Rehabilitation Research and Development, Ottawa, Canada. 2Prosthetics & Orthotics, Ottawa Hospital Rehabilitation Centre, Ottawa, Canada. 3Faculty of Medicine, University of Ottawa, Canada. * Email: gholizadeh87@yahoo.com BACKGROUND While elevated vacuum suspension systems have some benefits over the other suspension approaches 1–5, elevated vacuum may not be appropriate for all amputees. The Unity sleeveless vacuum suspension system was developed to overcome issues related to knee range of motion and amputees comfort 6. This study compared the Unity suspension system with suction and pin/lock systems based on user satisfaction and experience with these systems. METHODS Twelve people with unilateral transtibial amputation were fitted with the Ossur Unity elevated vacuum suspension system, with 57.2 (SD=15.3) years mean age, 178.3 (SD=6.4) cm height, and 90.6 (SD=16.4) kg weight. Participants completed the Prosthesis Evaluation Questionnaire (PEQ) for their current prosthesis and again, following a minimum 4 week accommodation period, for the Unity suspension system. RESULTS On average, participants required seven sessions (SD=2) for casting, gait training, socket adjustment, and troubleshooting before successful fitting. All participants mentioned no movement inside the socket and improved proprioception (i.e., feel where the prosthetic leg is in space) compared to their previous suspension system. After completed the study protocol, 75% of participants (nine people) preferred to continue with the elevated vacuum suspension system since they felt more comfortable walking. Two people preferred their original pin/lock suspension system because they felt more freedom and comfort during kneeling and their job required kneeling most of the time. One participant preferred to continue with his original suction system (Seal-in X5 and one way valve) because he felt more pressure around the seal area with Seal-In V and elevated vacuum. All Prosthesis Evaluation Questionnaire scores improved with Unity suspension system (Table 1). CONCLUSION Amputee satisfaction can be improved with the Unity system compared to pin/lock and suction sockets. However, Unity may not be appropriate for some amputees since there is less freedom and comfort during kneeling compared to pin/lock systems. In this study, a high functioning group with transtibial amputation (K3, K4) was recruited. The Unity system’s effect on comfort for people with lower activity levels is still unclear. DISCLOSURE There is no conflict of interest in this study. ACKNOWLEDGMENT The authors would like to thank Knut Lechler, Nancy Dudek, Emily Sinitski and Kristleifur Kristjansson for providing clinical and technical advice and support. This study was financially supported by Mitacs and Ossur. All prosthetics components were provided by Ossur. REFERENCES 1. Board WJ, Street GM, Caspers C. A comparison of trans- tibial amputee suction and vacuum socket conditions. Prosthet Orthot Int. 2001;25(3):202–9. https://doi.org/10.1080/03093640108726603 Table 1: Prosthesis Evaluation Questionnaire scales Validated Scale Subjects (old prosthesis) Subject (UNITY) How many % improved Ambulation (AM) 64.9 81.2 25 Appearance (AP) 69.2 81.7 18 Frustration (FR) 57.2 75.0 31 Perceived Response (PR) 75.5 87.5 16 Residual Limb Health (RL) 54.9 75.6 38 Social Burden (SB) 72.5 81.9 13 Sounds (SO) 61.3 69.9 14 Utility (UT) 53.4 75.7 42 Well Being (WB) 60.0 77.8 30 DOI: https://doi.org/10.33137/cpoj.v1i2.32030 https://doi.org/10.33137/cpoj.v1i2.32030 mailto:gholizadeh87@yahoo.com https://doi.org/10.1080/03093640108726603 https://doi.org/10.33137/cpoj.v1i2.32030 Gholizadeh H, Lemaire E.D, Nielen D, Lebel P. SATISFACTION AND EXPERIENCE WITH THE UNITY SUSPENSION SYSTEM. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. https://doi.org/10.33137/cpoj.v1i2.32030 2 OPEN ACCESS AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 ABSTRACT (ORAL PRESENTATION) 2. Gholizadeh H, Lemaire ED, Eshraghi A. The evidence-base for elevated vacuum in lower limb prosthetics: Literature review and professional feedback. Clin Biomech. 2016;37:108–16. https://doi.org/10.1016/j.clinbiomech.2016.06.005 3. Arndt B, Caldwell R, Fatone S. Use of a partial foot prosthesis with vacuum-assisted suspension: A case study. JPO J Prosthet Orthot. 2011;23(2):82–8. doi: 10.1097/JPO.0b013e318217e5f7 4. Samitier et al. The benefits of using a vacuum-assisted socket system to improve balance and gait in elderly transtibial amputees. Prosthet Orthot Int. 2014;40(1):83–8. https://doi.org/10.1177/0309364614546927 5. Sanders et al. Effects of elevated vacuum on in-socket residual limb fluid volume: Case study results using bioimpedance analysis. J Rehabil Res Dev. 2011;48(10):1231. DOI:10.1682/JRRD.2010.11.0219 6. Seal-In V Catalog page [Internet]. Iceross seal-inV trans- tibial liner with wave. [online] Available at https://assets.ossur.com/library/31253/Iceross Seal-In V Catalog page.pdf. https://doi.org/10.33137/cpoj.v1i2.32030 https://doi.org/10.1016/j.clinbiomech.2016.06.005 doi:%2010.1097/JPO.0b013e318217e5f7 doi:%2010.1097/JPO.0b013e318217e5f7 https://doi.org/10.1177/0309364614546927 doi:10.1682/JRRD.2010.11.0219 https://assets.ossur.com/library/31253/Iceross%20Seal-In%20V%20Catalog%20page.pdf https://assets.ossur.com/library/31253/Iceross%20Seal-In%20V%20Catalog%20page.pdf