The modular socket system in a rural setting in Indonesia.

Background: Prosthetic services are inaccessible to people living in rural areas. Systems like the modular socket system have the potential to be fabricated outside of the prosthetic workshop. Objectives: This study aimed to evaluate the patient's performance and satisfaction with the use of the modular socket system, and the technical feasibility of its implementation in a rural setting. Study design: A quantitative longitudinal descriptive study design was followed. Methods: A total of 15 persons with a lower limb amputation were fitted with the modular socket system and followed over 4-6months. Performance was measured using a 2-min walk test, 10-m walk test and mobility and function questionnaire. Satisfaction was measured by the Socket Fit Comfort Score, Prosthesis Evaluation Questionnaire and EuroQoL 5 Dimensions 5 Levels. Notes on technical feasibility were taken at the moment of fitting (t(0)), at 1-3months post fitting (t(1)) and at the end evaluation at 4-6months post fitting (t(2)). Results: Performance did not change between t(0) and t(2). The comfort of the socket fit reduced between t(0) and t(2). Satisfaction with prosthesis and general health status stayed constant over time. The average fitting-time for the modular socket system was 6.4h. Conclusion: The modular socket system can be considered a useful alternative for use in rural settings. Clinical relevance The use of the modular socket system is feasible and can improve accessibility to prosthetic technology in rural areas. Experienced prosthetic users were satisfied with the performance and the device. The shorter manufacturing time and use of only hand-held tools makes it an ideal alternative for use in remote and rural settings.