{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T01:51:29Z","timestamp":1779241889150,"version":"3.51.4"},"reference-count":29,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T00:00:00Z","timestamp":1622160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["825429"],"award-info":[{"award-number":["825429"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>A decision support system (DSS) was developed that outputs suggestions for socket-rectification actions to the prosthetist, aiming at improving the fitness of transfemoral prosthetic socket design and reducing the time needed for the final socket design. For this purpose, the DSS employs a fuzzy-logic inference engine (IE) which combines a set of rectification rules with pressure measurements generated by sensors embedded in the socket, for deciding the rectification actions. The latter is then processed by an algorithm that receives, manipulates and modifies a 3D digital socket model as a triangle mesh formatted inside an STL file. The DSS results were validated and tested in an FEA simulation environment, by simulating and comparing the donning process among a good-fitting socket, a loose socket (poor-fit) and several rectified sockets produced by the proposed DSS. The simulation results indicate that volume reduction improves the pressure distribution over the stump. However, as the intensity of socket rectification increases, i.e., as volume reduction increases, high pressures appear in other parts of the socket which generate discomfort. Therefore, a trade-off is required between the amount of rectification and the balance of the pressure distributions experienced at the stump.<\/jats:p>","DOI":"10.3390\/s21113743","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T03:45:29Z","timestamp":1622432729000},"page":"3743","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["A Sensor-Based Decision Support System for Transfemoral Socket Rectification"],"prefix":"10.3390","volume":"21","author":[{"given":"Michalis","family":"Karamousadakis","sequence":"first","affiliation":[{"name":"TWI-Hellas, 152 32 Halandri, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonis","family":"Porichis","sequence":"additional","affiliation":[{"name":"TWI-Hellas, 152 32 Halandri, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suranjan","family":"Ottikkutti","sequence":"additional","affiliation":[{"name":"KTH Royal Institute of Technology, 10044 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7048-0108","authenticated-orcid":false,"given":"DeJiu","family":"Chen","sequence":"additional","affiliation":[{"name":"KTH Royal Institute of Technology, 10044 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panagiotis","family":"Vartholomeos","sequence":"additional","affiliation":[{"name":"TWI-Hellas, 152 32 Halandri, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,28]]},"reference":[{"key":"ref_1","first-page":"35","article-title":"Functional Considerations in the Fitting of Above-knee Prostheses","volume":"2","author":"Radcliffe","year":"1955","journal-title":"Artif. Limbs"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"146","DOI":"10.3109\/03093647709164629","article-title":"Above-knee prosthetics","volume":"1","author":"Radcliffe","year":"1977","journal-title":"Prosthetics Orthot. Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1996","DOI":"10.1109\/TBME.2017.2775100","article-title":"Sockets for Limb Prostheses: A Review of Existing Technologies and Open Challenges","volume":"65","author":"Paterno","year":"2018","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_4","unstructured":"Muller, M.D. (2016). Transfemoral Amputation: Prosthetic Management. Atlas of Amputations and Limb Deficiencies, American Academy of Orthopaedic Surgeons. [4th ed.]. Chapter 46."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/00008526-200501000-00003","article-title":"Concepts of Pressure in an Ischial Containment Socket: Measurement","volume":"17","author":"Neumann","year":"2005","journal-title":"J. Prosthetics Orthot."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1080\/03093640008726523","article-title":"Scientific validation of two commercial pressure sensor systems for prosthetic socket fit","volume":"24","author":"Polliack","year":"2000","journal-title":"Prosthetics Orthot. Int."},{"key":"ref_7","first-page":"1","article-title":"A personalised prosthetic liner with embedded sensor technology: A case study","volume":"19","author":"Paterno","year":"2020","journal-title":"Biomed. Eng. Line"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2466","DOI":"10.1109\/TMECH.2016.2578679","article-title":"In-Socket Sensory System for Transfemoral Amputees Using Piezoelectric Sensors: An Efficacy Study","volume":"21","author":"Jasni","year":"2016","journal-title":"IEEE\/ASME Trans. Mechatron."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1038\/s41597-020-0494-7","article-title":"A kinematic and kinetic dataset of 18 above-knee amputees walking at various speeds","volume":"7","author":"Hood","year":"2020","journal-title":"Sci. Data"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/BF02522507","article-title":"Interface mechanics in external prosthetics: Review of interface stress measurement techniques","volume":"33","author":"Sanders","year":"1995","journal-title":"Med. Biol. Eng. Comput."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"172","DOI":"10.3109\/03093649309164378","article-title":"Computer-aided socket design for trans-femoral amputees","volume":"17","author":"Travis","year":"1993","journal-title":"Prosthetics Orthot. Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1098\/rsfs.2012.0082","article-title":"A digital patient for computer-aided prosthesis design","volume":"3","author":"Colombo","year":"2013","journal-title":"Interface Focus"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"863","DOI":"10.3722\/cadaps.2013.863-876","article-title":"Prosthesis Socket Design through Shape Optimization","volume":"10","author":"Frillici","year":"2013","journal-title":"Comput. Aided Des. Appl."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"126","DOI":"10.3389\/fbioe.2018.00126","article-title":"An Efficient Modelling-Simulation-Analysis Workflow to Investigate Stump-Socket Interaction Using Patient-Specific, Three-Dimensional, Continuum-Mechanical, Finite Element Residual Limb Models","volume":"6","author":"Ramasamy","year":"2018","journal-title":"Front. Bioeng. Biotechnol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Trillas, E., and Eciolaza, L. (2015). Fuzzy Logic: An Introductory Course for Engineering Students, Springer Publishing Company, Incorporated.","DOI":"10.1007\/978-3-319-14203-6"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/0020-0255(75)90017-1","article-title":"The concept of a linguistic variable and its application to approximate reasoning-III","volume":"9","author":"Zadeh","year":"1975","journal-title":"Inf. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1080\/03093640500468074","article-title":"Quantifying the regional load-bearing ability of trans-tibial stumps","volume":"30","author":"Zhang","year":"2006","journal-title":"Prosthetics Orthot. Int."},{"key":"ref_18","unstructured":"(2021, March 16). Lower Limb Prosthetic Sockets and Suspension Systems: Pressure Tolerant and Pressure-Sensitive Areas. Available online: https:\/\/www.physio-pedia.com\/Lower_Limb_Prosthetic_Sockets_and_Suspension_Systems."},{"key":"ref_19","unstructured":"(2021, March 16). JDWarner\/Scikit-Fuzzy: Scikit-Fuzzy Version 0.4.2. Available online: https:\/\/doi.org\/10.5281\/zenodo.3541386."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Botsch, M., Kobbelt, L., Pauly, M., Alliez, P., and L\u00e9vy, B. (2010). Polygon Mesh Processing, CRC Press.","DOI":"10.1201\/b10688"},{"key":"ref_21","unstructured":"(2021, May 16). Trimesh. Available online: https:\/\/trimsh.org\/."},{"key":"ref_22","unstructured":"Scarano, V., Chiara, R.D., and Erra, U. (2008). MeshLab: An Open-Source Mesh Processing Tool. Eurographics Italian Chapter Conference, The Eurographics Association."},{"key":"ref_23","unstructured":"(2021, April 16). Wikipedia Contributors. Logistic Function\u2014Wikipedia, The Free Encyclopedia. Available online: https:\/\/en.wikipedia.org\/wiki\/Logistic_function."},{"key":"ref_24","unstructured":"(2021, April 10). Quadrilateral Socket Model. Available online: https:\/\/www.thingiverse.com\/thing:3233555."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2972","DOI":"10.1007\/s10439-011-0389-z","article-title":"Finite element analysis of donning procedure of a prosthetic transfemoral socket","volume":"39","author":"Lacroix","year":"2011","journal-title":"Ann. Biomed. Eng."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.medengphy.2017.02.008","article-title":"Finite element analysis of the amputated lower limb: A systematic review and recommendations","volume":"43","author":"Dickinson","year":"2017","journal-title":"Med. Eng. Phys."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1007\/s00521-015-1923-y","article-title":"Monarch butterfly optimization","volume":"31","author":"Wang","year":"2019","journal-title":"Neural Comput. Appl."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Wang, G.G., Deb, S., and Coelho, L.d.S. (2015, January 7\u20139). Elephant herding optimization. Proceedings of the 2015 3rd International Symposium on Computational and Business Intelligence (ISCBI), Bali, Indonesia.","DOI":"10.1109\/ISCBI.2015.8"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/s12293-016-0212-3","article-title":"Moth search algorithm: A bio-inspired metaheuristic algorithm for global optimization problems","volume":"10","author":"Wang","year":"2018","journal-title":"Memetic Comput."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/11\/3743\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:09:34Z","timestamp":1760162974000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/11\/3743"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,28]]},"references-count":29,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["s21113743"],"URL":"https:\/\/doi.org\/10.3390\/s21113743","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,28]]}}}