{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T23:17:48Z","timestamp":1771024668548,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2014,9,9]],"date-time":"2014-09-09T00:00:00Z","timestamp":1410220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>The suspension system and socket fitting of artificial limbs have major roles and vital effects on the comfort, mobility, and satisfaction of amputees. This paper introduces a new pneumatic suspension system that overcomes the drawbacks of current suspension systems in donning and doffing, change in volume during daily activities, and pressure distribution in the socket-stump interface. An air pneumatic suspension system (APSS) for total-contact sockets was designed and developed. Pistoning and pressure distribution in the socket-stump interface were tested for the new APSS. More than 95% of the area between each prosthetic socket and liner was measured using a Tekscan F-Scan pressure measurement which has developed matrix-based pressure sensing systems. The variance in pressure around the stump was 8.76 kPa. APSS exhibits less pressure concentration around the stump, improved pressure distribution, easy donning and doffing, adjustability to remain fitted to the socket during daily activities, and more adaptability to the changes in stump volume. The volume changes were adjusted by utility of air pressure sensor. The vertical displacement point and reliability of suspension were assessed using a photographic method. The optimum pressure in every level of loading weight was 55 kPa, and the maximum displacement was 6 mm when 90 N of weight was loaded.<\/jats:p>","DOI":"10.3390\/s140916754","type":"journal-article","created":{"date-parts":[[2014,9,9]],"date-time":"2014-09-09T09:51:28Z","timestamp":1410256288000},"page":"16754-16765","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Development of an Air Pneumatic Suspension System for Transtibial Prostheses"],"prefix":"10.3390","volume":"14","author":[{"given":"Gholamhossein","family":"Pirouzi","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noor Azuan","family":"Abu Osman","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azim","family":"Oshkour","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sadeeq","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hossein","family":"Gholizadeh","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wan","family":"Wan Abas","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2014,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.3109\/03093649309164354","article-title":"The iceross concept: A discussion of a philosophy","volume":"17","author":"Kristinsson","year":"1993","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"146","DOI":"10.3109\/03093641003645528","article-title":"Prosthetic liners for lower limb amputees: A review of the literature","volume":"34","author":"Klute","year":"2010","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1080\/17461550500069612","article-title":"Literature review of the possible advantages of silicon liner socket use in trans-tibial prostheses","volume":"29","author":"Baars","year":"2005","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_4","first-page":"51","article-title":"Cad\/cam evaluation of the fit of trans-tibial sockets for trans-tibial amputation stumps","volume":"53","author":"Isozaki","year":"2006","journal-title":"J. Med. Dent. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/00008526-200103000-00012","article-title":"Radiographic comparison of vertical tibial translation using two types of suspensions on a trans-tibial prosthesis: A case study","volume":"13","author":"Tanner","year":"2001","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_6","unstructured":"Radcliff, C., Foort, J., and Inman, V. (1961). The Patella-Tendon Bearing Below-Knee Prosthesis, University of California."},{"key":"ref_7","first-page":"21","article-title":"Artificial-limb fabrication without the use of commercially available components","volume":"4","author":"Girling","year":"1972","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_8","first-page":"22","article-title":"Negative pressures during swing phase in below-knee prostheses with rubber sleeve suspension","volume":"56","author":"Chino","year":"1975","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_9","first-page":"14","article-title":"Criteria for use of supracondylar and supracondylar suprapatellar suspension for below-knee prostheses","volume":"27","author":"Breakey","year":"1973","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_10","first-page":"1","article-title":"Suspension of the below-knee prosthesis: An overview","volume":"33","author":"Charlesh","year":"1979","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1682\/JRRD.2004.04.0591","article-title":"Quantification of prosthetic outcomes: Elastomeric gel liner with locking pin suspension versus polyethylene foam liner with neoprene sleeve suspension","volume":"41","author":"Coleman","year":"2004","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.artmed.2011.09.005","article-title":"Static and dynamic pressure prediction for prosthetic socket fitting assessment utilising an inverse problem approach","volume":"54","author":"Sewell","year":"2012","journal-title":"Artif. Intell. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/S1350-4533(00)00079-5","article-title":"Comparison of computational analysis with clinical measurement of stresses on below-knee residual limb in a prosthetic socket","volume":"22","author":"Zhang","year":"2000","journal-title":"Med. Eng. Phys."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1682\/JRRD.1992.10.0001","article-title":"Interface shear stresses during arnbulation with a below-knee prosthetic limb","volume":"29","author":"Sanders","year":"1992","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1109\/TNSRE.2007.906967","article-title":"Finite element analysis for evaluation of pressure ulcer on the buttock: Development and validation","volume":"15","author":"Makhsous","year":"2007","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.1016\/j.clinbiomech.2007.09.005","article-title":"Development of a finite element model of female foot for high-heeled shoe design","volume":"23","author":"Yu","year":"2008","journal-title":"Clin. Biomech."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1016\/j.clinbiomech.2012.08.006","article-title":"New brace design combining cad\/cam and biomechanical simulation for the treatment of adolescent idiopathic scoliosis","volume":"27","author":"Clin","year":"2012","journal-title":"Clin. Biomech."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.clinbiomech.2011.07.004","article-title":"Transtibial prosthetic socket pistoning: Static evaluation of Seal-In\u00ae X5 and Dermo\u00ae liner using motion analysis system","volume":"27","author":"Gholizadeh","year":"2012","journal-title":"Clin. Biomech."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1177\/0309364611431625","article-title":"Pistoning assessment in lower limb prosthetic sockets","volume":"36","author":"Eshraghi","year":"2012","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1080\/03093640008726519","article-title":"A study of technical changes to lower limb prostheses after initial fitting","volume":"24","author":"Rommers","year":"2000","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1080\/03093640308726666","article-title":"Walking in a vacuum-assisted socket shifts the stump fluid balance","volume":"27","author":"Goswami","year":"2003","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1682\/JRRD.2006.11.0147","article-title":"Review of secondary physical conditions associated with lower-limb amputation and long-term prosthesis use","volume":"45","author":"Gailey","year":"2008","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1682\/JRRD.2010.09.0189","article-title":"Residual limb volume change: Systematic review of measurement and management","volume":"48","author":"Sanders","year":"2011","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1682\/JRRD.2003.09.0146","article-title":"Comparison of interface pressures with pin and suction suspension systems","volume":"41","author":"Beil","year":"2004","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1016\/j.apmr.2011.05.019","article-title":"Vacuum-assisted socket suspension compared with pin suspension for lower extremity amputees: Effect on fit, activity, and limb volume","volume":"92","author":"Klute","year":"2011","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1682\/JRRD.2008.01.0007","article-title":"Differences in function and safety between medicare functional classification","volume":"46","author":"Hafner","year":"2009","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/S0003-9993(97)90160-X","article-title":"Lower extremity residual limb slippage within the prosthesis","volume":"78","author":"Commean","year":"1997","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3109\/03093649709164551","article-title":"Suspension effect and dynamic evaluation of the total surface bearing (tsb) trans-tibial prosthesis: A comparison with the patellar tendon bearing (ptb) trans-tibial prosthesis","volume":"21","author":"Narita","year":"1997","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1177\/0309364611423130","article-title":"A new approach for the pistoning measurement in transtibial prosthesis","volume":"35","author":"Gholizadeh","year":"2011","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_30","unstructured":"(2010). Tekscan, Inc. F-Socket\u2122 System."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"179","DOI":"10.3109\/03093649709164552","article-title":"Calibration problems encountered while monitoring stump\/socket interface pressures with force sensing resistors: Techniques adopted to minimise inaccuracies","volume":"21","author":"Buis","year":"1997","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/0966-6362(96)01073-9","article-title":"Gait analysis in the amputee: Has it helped the amputee or contributed to the development of improved prosthetic components?","volume":"4","author":"Czerniecki","year":"1996","journal-title":"Gait Posture"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1007\/BF00401811","article-title":"Radiological evaluation of prosthetic fit in below-the-knee amputees","volume":"17","author":"Newton","year":"1988","journal-title":"Skeletal Radiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/j.clinbiomech.2012.06.004","article-title":"Clinical investigation of the interface pressure in the trans-tibial socket with dermo and Seal-In X5 liner during walking and their effect on patient satisfaction","volume":"27","author":"Ali","year":"2012","journal-title":"Clin. Biomech."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.clinbiomech.2005.02.005","article-title":"Development of an integrated cad-fea process for below-knee prosthetic sockets","volume":"20","author":"Goh","year":"2005","journal-title":"Clin. Biomech."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1016\/j.jbiomech.2003.12.024","article-title":"Load transfer mechanics between trans-tibial prosthetic socket and residual limb\u2014Dynamic effects","volume":"37","author":"Jia","year":"2004","journal-title":"J. Biomech."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.clinbiomech.2005.03.001","article-title":"A quasi-dynamic nonlinear finite element model to investigate prosthetic interface stresses during walking for trans-tibial amputees","volume":"20","author":"Jia","year":"2005","journal-title":"Clin. Biomech."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2686","DOI":"10.1016\/j.jbiomech.2009.08.019","article-title":"Patient-specific analyses of deep tissue loads post transtibial amputation in residual limbs of multiple prosthetic users","volume":"42","author":"Portnoy","year":"2009","journal-title":"J. Biomech."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1016\/j.jbiomech.2008.03.035","article-title":"Internal mechanical conditions in the soft tissues of a residual limb of a trans-tibial amputee","volume":"41","author":"Portnoy","year":"2008","journal-title":"J. Biomech."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1080\/03093640008726532","article-title":"Developments in the trans-tibial prosthetic socket fitting process: A review of past and present research","volume":"24","author":"Sewell","year":"2000","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/1350-4533(95)00038-0","article-title":"Frictional action at lower limb prosthetic socket interface","volume":"18","author":"Zhang","year":"1996","journal-title":"Med. Eng. Phys."},{"key":"ref_42","unstructured":"Center, A.T. Pump It Up. Available online: http:\/\/www.amputee-center.com\/pump.htm."},{"key":"ref_43","first-page":"325","article-title":"Biomechanical basis of choosing the rational mass and its distribution throughout the lower limb prosthesis segments","volume":"32","author":"Farber","year":"1995","journal-title":"J. Rehabil. Res. Dev."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/14\/9\/16754\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T21:15:43Z","timestamp":1760217343000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/14\/9\/16754"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9,9]]},"references-count":43,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2014,9]]}},"alternative-id":["s140916754"],"URL":"https:\/\/doi.org\/10.3390\/s140916754","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9,9]]}}}