Investigating transtibial prosthetic alignment practices: A cross-sectional study in Malaysia, Jordan, and Saudi Arabia

Background: Prosthetic alignment is a critical factor in the functionality and comfort of transtibial prostheses, which are still based on amputee's feedback prosthetist experience and clinical judgment. Proper alignment involves a series of procedures, including bench, static, and dynamic alignment, each contributing to the overall success of the prosthesis. Objective: This cross-sectional study aims to explore transtibial prosthetic alignment practices among prosthetists in Malaysia, Jordan, and Saudi Arabia, focusing on the associations of demographic data, occupational status, and knowledge on common prosthetic alignment guidelines. Study Design: A cross-sectional study. Methods: A survey-based approach among experienced prosthetists was conducted via Google Forms and distributed online through email and professional networks that had prosthetists' demographics, 3 main sections relevant to common guidelines regarding transtibial prosthetic alignment, and an open feedback question allowed respondents to give feedback on their current prosthetic alignment practices. Quantitative data analysis involved duplicate removal, categorizing responses into themes, and calculation of alignment scores, whereas associations of demographic data with engagement in prosthetic alignment were tested using χ 2 tests. Results: The findings revealed significant associations between higher education levels ( P < 0.01) and monthly income ( P < 0.01) in relation to average score of dynamic alignment practices. Despite the availability of advanced technology, 86.79% of prosthetists rely on traditional tools and qualitative methods. Conclusions: The study highlights the need for standardized guidelines that incorporate personalized considerations to improve the quality and consistency of prosthetic alignment. These guidelines should address the diverse practices and preferences of prosthetists to enhance patient outcomes.