{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:04:39Z","timestamp":1784264679444,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000090","name":"Congressionally Directed Medical Research Programs","doi-asserted-by":"publisher","award":["W81XWH\u201018\u20101\u20100656"],"award-info":[{"award-number":["W81XWH\u201018\u20101\u20100656"]}],"id":[{"id":"10.13039\/100000090","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Adjustable\u2010volume prosthetic sockets have been developed to allow users to accommodate volume fluctuations throughout the day. Improvement in socket fit is thought to enhance the connection between the user's residual limb and prosthesis and may therefore improve postural control and balance. However, no studies have assessed balance\u2010related outcomes or falls between different adjustable socket designs.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare balance\u2010related outcomes for people with transfemoral limb loss using three styles of adjustable\u2010volume sockets and a laminated socket.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Randomized clinical trial.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Prosthetics clinics and research laboratories.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n A convenience sample of 29 individuals with unilateral transfemoral amputation were recruited, of whom 23 completed testing in at least one adjustable\u2010volume socket and were included.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n Participants completed four 4\u2010week trials with each of three adjustable\u2010volume prosthetic sockets and a laminated socket, in random order. Adjustable\u2010volume sockets included Infinite (LIM Innovations, San Francisco, CA, USA), CJ (CJ Sockets Technologies, Beverly, MA, USA), and Quatro (Quorum, Windsor, CO, USA).<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n The primary outcomes were self\u2010reported balance, number of falls and stumbles, and balance confidence. Secondary outcomes included the Narrow Beam Walk Test (NBWT) and Timed Up and Go Test (TUG). Surveys were conducted after at least 3\u2009weeks of use of each socket, and functional measures were collected after 4\u2009weeks.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n There were no main effects of socket type on self\u2010reported balance (\n p<\/jats:italic>\n \u2009=\u2009.316), balance confidence (\n p<\/jats:italic>\n \u2009=\u2009.963), NBWT (\n p<\/jats:italic>\n \u2009=\u2009.159), or TUG (\n p<\/jats:italic>\n \u2009=\u2009.581). Eighteen participants (78%) reported falling or stumbling at least once in a 3\u2010week period in at least one socket condition. There were no differences in the proportion of fallers (1+ falls) or stumblers (1+ stumbles) between the laminated condition and any adjustable\u2010socket condition (\n p<\/jats:italic>\n \u2009>\u2009.210).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The adjustable\u2010volume prosthetic sockets tested demonstrated comparable performance to laminated sockets for balance and fall\u2010related outcomes. The high number of falls and stumbles reported suggests that future studies should focus on balance and falls training, acknowledging that changes to the socket may be insufficient to address this issue.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pmrj.70183","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:19:42Z","timestamp":1784261982000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of adjustable\u2010volume transfemoral prosthetic sockets on balance and falls: A randomized clinical trial"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6086-0913","authenticated-orcid":false,"given":"Deanna H.","family":"Gates","sequence":"first","affiliation":[{"name":"School of Kinesiology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9672-4518","authenticated-orcid":false,"given":"Jeffrey","family":"Wensman","sequence":"additional","affiliation":[{"name":"Orthotics and Prosthetics Center University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2215-1750","authenticated-orcid":false,"given":"Anthony R.","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Bionic Prosthetics and Orthotics Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Kartes","sequence":"additional","affiliation":[{"name":"School of Kinesiology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5724-0919","authenticated-orcid":false,"given":"Marco A.","family":"Avalos","sequence":"additional","affiliation":[{"name":"Center for Lower Extremity Ambulatory Research (CLEAR), Rosalind Franklin University of Medicine and Science North Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3971-6709","authenticated-orcid":false,"given":"Jenevieve A.W.","family":"Surkin","sequence":"additional","affiliation":[{"name":"School of Kinesiology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3901-7961","authenticated-orcid":false,"given":"Noah J.","family":"Rosenblatt","sequence":"additional","affiliation":[{"name":"Center for Lower Extremity Ambulatory Research (CLEAR), Rosalind Franklin University of Medicine and Science North Chicago Illinois 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