One of the challenges amputees face when obtaining a prosthetic is finding a socket that fits just right. Residual limbs may swell or shrink throughout the day and based on health conditions, requiring the need for adjustments in socket “fit.” This may involve a suction device, called vacuum-suspension technology, in the socket. These can be adjustable, to help better allow for fluctuation in limb volume.
One such device is the SmartPuck, an “intelligent” socket vacuum option for lower limb sockets. As yet another example of mobile health, the SmartPuck syncs up with the user’s iOS, and allows for adjustments to be made to the socket’s pressure on the fly, through the SmartPuck app. There are three pressure settings: Sit, Walk, and Spot, as well as a customizable socket pressure option. Additionally, the app can alert the user if a leak in the socket pressure is detected. Such pressure not only helps the amputee ambulate in a variety of situations, but also can potentially improve circulation to a limb.
Is there any evidence that such an approach with a “smart socket” actually works? A 2012 study in the European Journal of Physical and Rehabilitative Medicine investigated this question. They compared traditional suction socket to a vacuum-assisted socket system in a group of amputees with wounds and/or ulcers on their residual limb. While this wasn’t the SmartPuck (they utilized the vacuum-assisted socket system from OttoBoch), the study did show that more patients in the vacuum-assisted group could walk indeptendly at the end of 12 weeks and utilized their prosthesis’ to a greater extent. At the study completion, both groups had similar pain and wound healing scores, without inhibiting wound healing despite the heavier initial usage demonstrated in the intervention group. There doesn’t appear to be any current evidence available on the specific Smartpuck device at this time.
Devices like the SmartPuck demonstrate yet another example of the gradual trend towards linking smartphones to advanced healthcare devices. Continuous glucose monitors, pacemakers, and more are starting to offer such mobile connectivity, as healthcare joins the world of smart technology.