Background: Lower limb amputees face many challenges, and most of them prefer to use prosthetics for daily tasks and activities. The prosthesis is usually a combination of connected prosthetic components, and their spatial orientation is called the prosthetic alignment. Proper alignment is essential, as it substantially affects the quality and comfort of a prosthesis.

Objective: The aim of this study was to create a method that could accurately and effectively quantify the alignment of a transtibial and transfemoral prostheses using Vicon optical motion capture system.

Methods: Two experimental series were conducted. The first one was to test the repeatability of the measurement. Three analysts placed retroreflective markers on the prostheses three times, and five measurements were recorded each time. Alignment parameters were calculated in Vicon ProCalc for each measurement, and a standard error of measurement was found for each alignment parameter. The standard error of measurement was calculated from three variance components, between-analyst, within-analyst, and between-trial variability. The second experimental series was conducted to understand the relationship between alignment adjustments and the outcome parameters. The socket height, internal rotation, flexion, adduction, and translation were modified and measured. The socket translation was calculated in three coordinate systems to study how they affect the outcome.

Results: For the first experimental series, the standard error of measurement for every alignment parameter was below 3° and 6 mm. The between-analyst variability was the most prominent, and the parameters calculated in the sagittal plane were more reliable than those calculated in the frontal and transverse plane. In the second experimental series, there was a linear relationship between the modifications and the measured outcome. When a connection between two prosthetic components was changed by turning the screws one round, the average change in angle between them was 2°, and the average translation change was 4.4 mm. Of the three coordinate systems, the translation calculated in ankle coordinates was more reliable than in global coordinates and describe the translation more effectively than in socket coordinates.

Conclusion: The reliability of the measurements was considered good. The standard error of measurement was low, and the main variability resulted from differences in marker placement between the analysts. The results from the measured alignment changes were as expected. All the parameters could be effectively interpreted, and the ankle coordinates were considered advantageous in describing the socket translation.