RASTAF-ARI

This provisional prosthesis enables the fitting to be adapted to variations in stump volume, and also to determine the adjustments required for its use. Among these adjustments, the orthoprosthetist and/or rehabilitator estimate the anteroposterior and mediolateral inclination of the socket in relation to the body of the prosthesis, as well as its anteroposterior translation. A second level of adjustment concerns the inclination of the prosthesis stem, in order to determine its support on the ground. The final level concerns the orientation of the prosthetic foot. Despité the complexitý of these adjustments, it appears that there are no quantitative data to help practitioners with their clinical needs. Thus, diagnosis and assessment of prosthetic needs depend mainly on the experience of the physiotherapist and orthoprosthetist, as well as on patient feedback.

The main clinical lock-in relates to clinicians' difficulty in accessing measurement systems that enable them to make objective decisions. As a result, provisional prosthesis adjustments are essentially based on subjective clinical assessment and, above all, on the feelings expressed by the patient, who is not necessarily aware of the long-term negative impact of the compensations that are put in place at the time of fitting.

The main clinical lock is linked to the difficulty for clinicians to access measurement systems that enable them to make objective decisions.

From a scientific point of view, although each prosthesis is delivered with a basic parameterization enabling it to function properly mechanically, there is currently no data enabling these settings to be customized to the patient's morphological and functional characteristics. At present, research and development efforts are focused more on the prosthesis's own technology than on the functional aspects linked to its use.

Biomechanical measurements in the orthostatic position and when walking are being carried out in the rehabilitation department at Valenciennes Hospital. At the end of these experiments, biomechanical parameters are proposed to the clinical teams in order to objectify and personalize the settings of the provisional prosthesis, its alignment, as well as its functional use by the patient.

This research project therefore offers strong clinical added value, and is also in line with the main themes of LAMIH and UPHF: mobility and disability. It also brings significant societal benefits.