Analytical review of modern alignment methods for adjustable and connecting devices and socket in lower limb prosthetics and orthotics

An analysis of modern methods for assessing the quality of prosthetic and orthotic alignment is presented. The most significant biomechanical parameters during prosthetic fitting and defines promising areas for automating the alignment process are identified. An analytical review of studies is conducted in accordance with PRISMA recommendations. Materials are selected from the PubMed, ScienceDirect, CyberLeninka, and Europe PMC databases for the period 2013–2025. An analysis of 15 studies using biomechanical analysis methods is conducted: measuring socket reaction moments, gait kinematics and kinetics, and stabilometric indicators. Particular attention is paid to studies using instrumental methods for recording alignment parameters. The results of a comparative analysis of key study parameters during fitting are presented. It is found that socket reaction moments demonstrate the greatest sensitivity to alignment changes, especially in the frontal plane, where displacements of 2–6 mm cause statistically significant changes in moments. Correlations are identified between angular changes in the prosthetic foot and the temporal characteristics of reaction moments. The data obtained substantiate the need to develop software packages for automated calculation of adjustment parameters for adjusting and connecting devices based on objective biomechanical parameters. A promising area is the implementation of such systems in clinical practice in the CIS countries, where the mass production of prosthetic and orthotic devices requires modern solutions for standardization and improved patient care. Further research is to be aimed at adapting automated adjustment algorithms to regional prosthetic specifics and state standard requirements.

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