Walking, kayaking, swimming—if it’s happening outside, 39-year-old Cortney Small of Crimora, Virginia, is all in. It makes perfect sense, since she is something of a force of nature herself: After illness and infection threatened her life repeatedly, she’s fought her way back to live life to the full…and nothing’s going to hem her in.

“I was diagnosed with Stage 4 Hodgkin’s lymphoma when I was 16, and it was very serious,” Cortney recalls. “One thing they did in treating the cancer was
to remove my spleen, which impacted my immune system. So when I was diagnosed with diabetes at age 19, I had to be really careful because I knew
I wouldn’t heal from things as well as others.”

“I have back pain, and my old legs kind of forced me to walk hunched over, which didn’t help,” Cortney explains. “Now, with iFIT, I feel I stand taller and walk straighter—they just feel more sturdy. Plus, when my swelling increases or decreases, these prosthetics are very easy to adjust.”

Spend a few minutes talking to 41-year-old WT Fix, and you’ll know he’s a man on the move.  As a motorcycle enthusiast, firefighter with Churchville (Virginia) Volunteer Fire & Rescue, and manager of Fisher Auto, WT has no intention of watching life pass him by.  Even when an amputation threatened to sideline his activities, he simply made a decision to get back into action…and he’s been living life in the fast lane ever since.

In considering other prosthetic options for his volunteer firefighting, WT decided to try the highly accommodating, patented transtibial device from iFIT—Immediate Fit, Innovative Technology. As the only adjustable preparatory device on the market, iFIT offers one-session fittings for people with amputations to get them back on their feet quickly. Further, it handles fluctuating volume levels seamlessly—great for busy people with active lives.

“I love how it fits—iFIT is the only device that hasn’t caused a problem with my tibia. It took me a little over two hours to get fitted initially, and I walked out with a finished product and haven’t experienced any issues at all,” WT says. “With my old devices, I used to have to carry extra socks with me; with iFIT, I can adjust the fit quickly and easily as my limb volume changes,” WT says. Two more great perks for WT are iFIT’s easy-on design and safer release button. “I keep it right next to my bed: It’s so easy to put on, which is good for firefighting—when I get a call I’ve got to get there quickly. And with other systems, I learned the hard way that when a release button protrudes, you risk literally losing your leg at the wrong time. With iFIT, the release button is almost recessed, which virtually eliminates any accidents.”

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• Earlier receipt of a prosthesis is associated with reduced spending in the 12 months post-amputation of approximately $25,000 compared with not receiving a prosthesis.
• The results of this study suggest that not providing or delaying the provision of a prosthesis increases costs by about 25%.
• iFIT can help facilitate fitting patients soon after amputation with the ability to be fit anywhere — hospital, nursing home, patient homes, etc. in a single session.

Read full study

Miller, T.A., Paul, R., Forthofer, M. and Wurdeman, S.R., 2020. Impact of time to receipt of prosthesis on total healthcare costs 12 Months Postamputation. American journal of physical medicine & rehabilitation, 99(11), p.1026.

Your patients shouldn't have to wait for months to get the help they need. Amputees can suffer greatly with less movement, leading to more muscle atrophy, greater deconditioning, and reduced joint range of motion.  
iFIT can help with assessing your patients’ needs via Telehealth.
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• Trouble shoot the situation together  
• Simple solutions for modification
• Make cable adjustments easily 
  
• Help patients manage their volume

Method: Retrospective observational study on 4,578 Veterans hospitalized for LLA and discharged 2003- 2004, looking at time to all-cause mortality from the amputation surgical date up to the 3 yr anniversary.

Results: 1,300 (28.4%) persons received a prescription for a prosthetic limb within 1 yr after the surgical amputation. About 46% (n = 2,086) of all Veterans w LLA died within 3 yr of the surgical anniversary. Among those who received a prescription for a prosthetic limb, only 25.2% died within 3 yr of the surgical anniversary. 

Discussion: The time to receipt of the prescription for a prosthetic limb (prosthetic fitting) was associated with lower mortality.

Conclusions: 

• It is important that patients who would benefit from a lower limb prosthesis obtain one as soon as they are medically stable. 
• Early fitting may provide a psychological boost to patients’ motivation, further promoting their overall health.
• Patient-centered care and early prosthetic fitting, is associated
  with longer survival.

Reference:​ Kurichi JE, Kwong P, Vogel WB, Xie D, Cowper Ripley D, Bates BE. Effects of prosthetic limb prescription on 3-year mortality among Veterans with lower-limb amputation. J Rehabil Res Dev. 2015;52(4):385-96. doi: 10.1682/JRRD.2014.09.0209. PMID: 26348602; PMCID: PMC4563808

This summer, Dr. Timothy Dillingham and his son Rhys visited Botswana with a goal to help persons with limb loss obtain a comfortable, durable socket.  Through the UPenn-Botswana Partnership they visited several locations and fit 17 persons in a 7 day time period.  They had four hockey bags loaded with these modular devices and a backpack with hand tools.  

Many of these persons were not able to obtain a prosthetic, while others had devices that were old and uncomfortable.  The adjustable system was fit within 1-2 hours and allowed subjects to walk without issue.  See more about this trip in our tab "International Relief Efforts" under "Research".

Here is more on this article:  ​Two UB-UPENN Staff Members Provide 17 Batswana with Lower Limb Prostheses | University of Botswana

Adjustable prosthetics are the future direction for prosthetic technology.  Patients are seeking out ways to adjust their prosthetic when their limb changes and prosthetists are taking note of this demand.  Many patients report their limb goes through changes during the day and being unable to adjust can lead to skin irritation or even tripping and falling.  

Persons with recent amputation will experience drastic changes in their limb volume over the first year.  Using socks is one way to fill in the missing volume, however too many socks can reduce total contact and therefore a proper fit.  iFIT's patented buckle system allows the wearer to adjust their socket whenever and wherever they are.  All sockets are further modifiable by the prosthetist so they can accommodate even large changes in volume.

• An active 55-year-old male weighing 220 pounds desired an adjustable
  prosthetic socket.
• Patient experienced frequent blisters and rubbing with his suction socket. 
• He was fit with the iFIT Wide Transfemoral prosthesis with his micro-processor knee attached. The prosthesis was modified during a follow-up visit by trimming the socket brim and flaps to accommodate limb shrinkage.
• During a follow-up 4 months later, the patient reduced 5cm distally and 4cm proximally and was moved to a Standard size.

He reported improvement in socket fit and reduced skin irritation.

• A group of 22 volunteers with transtibial limb loss rated the iFIT socket as significantly better in terms of comfort, stability and fit versus their conventional prosthesis (iFIT average rating was 29.3±4.51 out of 35 possible points versus 25.2±6.8 for conventional socket).
• No falls or limb ischemia were reported or noted during follow up.
• Gait biomechanics revealed no differences across any temporal characteristics.
• Intrasocket peak pressures were significantly lower for the iFIT prostheses overall (P = .0014), at the anterior tibia (P = .0002), and the lateral side of the residual limb (P = .013).

This study provided preliminary evidence to support the feasibility of the iFIT system as it compared favorably to participants' conventional prostheses across all outcome measures. 
                                                                       Read full study

Dillingham, T., Kenia, J., Shofer, F. and Marschalek, J., 2019. A prospective assessment of an adjustable, immediate fit, transtibial prosthesis. PM&R, 11(11), pp.1210-1217.