Does temporary socket removal affect residual limb fluid volume of trans-tibial amputees?

Abstract

Background: Lower-limb prosthesis users typically experience residual limb volume losses over the course of the day that can detrimentally affect socket fit.

Objectives: To determine whether temporarily doffing the prosthesis encouraged residual limb fluid volume recovery and whether the recovered fluid was maintained.

Study design: Experimental design.

Methods: Residual limb fluid volume was monitored on 16 participants in three test sessions each. Participants conducted six cycles of resting/standing/walking. Between the third and fourth cycles, participants sat for 30 min with the prosthesis and liner: donned (ON), the prosthesis doffed but the liner donned (LINER), or the prosthesis and liner doffed (OFF).

Results: Percentage fluid volume gain and retention were greatest for the OFF condition followed by the LINER condition. Participants experienced fluid volume losses for the ON condition.

Conclusion: Doffing the prosthesis or both the prosthesis and liner during rest improved residual limb fluid volume retention compared with leaving the prosthesis and liner donned.

Clinical relevance: Practitioners should advise patients who undergo high daily limb volume losses to consider temporarily doffing their prosthesis. Fluid volume retention during subsequent activity will be highest if both the prosthesis and liner are doffed.

Keywords: Volume management; accommodation; bioimpedance analysis; residual limb shape.

© The International Society for Prosthetics and Orthotics 2015.

Figures

FIGURE 1. Electrode Layout

Current injecting electrodes were placed on the thigh (one anterior, one posterior) and on the distal inferior residual limb. Two voltage sensing electrodes were places on the anterior lateral side for the anterior channel (ant) and two on the posterior side for the posterior channel (post).

FIGURE 2. Data Points Used in Analysis

Labelled points correspond to variables in Equation 1.

FIGURE 3. A,B. Rest Period Percentage Fluid Volume Changes for All Subjects

Anterior (top panel) and posterior (bottom panel) changes are shown. Subjects ordered left to right from low to high anterior 30-minute rest fluid volume change for the OFF condition.

FIGURE 4. A,B. Short-Term Percentage Fluid Volume Changes for All Subjects

Anterior (top panel) and posterior (bottom panel) changes are shown. Subject ordering same as for Figure 3A,B.

FIGURE 5. A,B. Long-Term Percentage Fluid Volume Changes for All Subjects

Anterior (top panel) and posterior (bottom panel) changes are shown. Subject ordering same as for Figure 3A,B.