# Evaluating Feasibility and Durability of the Aero Prosthetic Liner in Transtibial Prosthetic Users

## TL;DR

This study compares a new affordable prosthetic liner, AERO, to a common one, Pe-Lite, finding that AERO improves comfort and satisfaction but may wear out faster.

## Contribution

The study introduces and evaluates the AERO liner as a low-cost alternative for transtibial prosthetic users.

## Key findings

- AERO liner showed significant improvements in comfort and reduced user frustration compared to Pe-Lite.
- Liner thickness decreased over time in specific regions, raising concerns about long-term durability.
- AERO was rated higher in comfort scores both immediately and after three months of use.

## Abstract

The choice of prosthetic socket interface material significantly affects user comfort and satisfaction. The Affordable Ethylene-Vinyl Acetate Roll-On (AERO) liner was created with the aim of improving functionality and streamlining the wearing process for users.

The purpose of this study was to comprehensively assess user satisfaction, comfort, and durability of the AERO liner and compare it with the common soft Pe-Lite liner.

Fourteen individuals with transtibial amputation participated in this three-month randomized crossover trial study. The Prosthesis Evaluation Questionnaire (PEQ), Expanded Socket Comfort Score (ESCS), and liner thickness measurements were used to comprehensively compare the AERO and Pe-Lite liner.

The AERO liner demonstrated notable improvements in prosthetic comfort and functionality over Pe-Lite liner. After three months use, there was a significant reduction in reported frustration with the AERO liner (p=0.023, r=0.604) in the PEQ subscale. Specific aspects, such as walking with the prosthesis (p=0.030, r=0.601) and odor perception (p=0.024, d=0.579), favored the use of the AERO liner. The expanded socket comfort score (ESCS) revealed significant superiority for the AERO liner “at best” (p=0.04) and “on average” (p=0.02) after one and three months, respectively. Liner thickness analysis showed significant reductions at the mid-patellar tendon location for the AERO liner at one (0.57±0.48) and three months (0.90±0.69, p=0.01) and in the posterior region after three months (0.63±0.64, p=0.05).

Our study highlights the potential advantages of the AERO liner in enhancing comfort and satisfaction. Yet, durability and thinning of the liner when compared to Pe-Lite may be a concern which may eventually affect socket fit. These findings contribute to ongoing efforts to optimize prosthetic interventions and improve the quality of life of individuals with lower limb prosthesis in resource-limited environments.