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Pediatric Rehabilitation

Session: An adjustable prosthetic socket for children and adolescents with lower limb loss to accommodate growth

An Adjustable Prosthetic Socket for Children and Adolescents with Lower Limb Loss to Accommodate Growth

Friday, October 24, 2025
8:00 AM - 9:15 AM MT
Location: Original Research Theater

    Poster Presenter(s)

  • Timothy Dillingham, MD, MS

    Professor and Chair
    University of Pennsylvania Health System PM&R Program
    Philadelphia, Pennsylvania

    • Co-Author(s)

  • JK

    Jessica Kenia, MS

    Research Project Manager
    University of Pennsylvania
    Philadelphia, Pennsylvania

  • LP

    Laura A. Prosser, PhD, PT

    Associate Professor of Pediatrics
    The Children's Hospital of Philadelphia
    Philadelphia, Pennsylvania

  • JM

    James S. Marschalek, Other

    VP Engineering
    Advanced Design Concepts
    HARTLAND, Wisconsin

  • FS

    Frances S. Shofer, PhD

    Director, Epidemiology & Biostatistics, Adjunct Professor of Emergency Medicine
    University of Pennsylvania Perelman School of Medicine
    Philadelphia, Pennsylvania

Disclosure(s):
Jessica Kenia, MS: No relevant disclosure to display
Background and/or Objectives: Children with limb loss constitute a unique group of prosthetic users who quickly grow out of their conventionally made hard sockets. Skin breakdown and discomfort are recurring issues, and for their families, the financial and scheduling demands of acquiring a new prosthesis can be overwhelming. A prosthesis with adjustable features was developed to address these issues. This research aims to assess an adjustable, immediate-fit prosthesis, focusing on its comfort, user satisfaction, and overall functionality.

Design: This is a prospective trial where adolescents age 3 to 18 years with transtibial, transfemoral or symes limb loss were fit in one session with an adjustable transtibial prosthesis and instructed to wear it for a two-month trial period.

Setting : Physical Medicine & Rehabilitation Department of a University Health System

Participants : 26 children (13 male, 13 female) participated (average age 11.4 ± 4 years)

Interventions: An immediate fit, adjustable prosthesis

Main Outcome Measures: Participants completed a Prosthetic Evaluation Questionnaire (PEQ) based survey (60 points total) on their conventional prosthesis at the initial visit and on the adjustable prosthesis at follow-up. A temporal analysis of walking gait was completed for both devices. Falls, skin abrasions, or device mechanical failures were recorded.

Results: Fifteen participants returned for follow up. PEQ scores for the adjustable devices versus the subjects’ conventional prostheses were higher, however, the difference was not significant (45.8 vs 42.5, p=.29). Ability to adjust achieved statistical significance with the adjustable prosthesis rated better (mean difference=1.53, p=. 0.0019), as was the temperature of the residual limb (mean difference=1.07, p=0.0007). Walking speed was nearly identical between devices (mean difference=.065, p=0.24) There were no cases of skin irritation or breakdown reported or seen at follow-up

Conclusions: In this trial, the adjustable pediatric prosthetic system was a feasible option for children. This suggests that the adjustable prosthesis may be an affordable option for children and families desiring an adjustable device.