Residual limb volume fluctuations in transfemoral amputees

Linda Paternò, Michele Ibrahimi, Elisa Rosini, Giuseppe Menfi, Vito Monaco, Emanuele Gruppioni, Leonardo Ricotti, Arianna Menciassi, Linda Paternò, Michele Ibrahimi, Elisa Rosini, Giuseppe Menfi, Vito Monaco, Emanuele Gruppioni, Leonardo Ricotti, Arianna Menciassi

Abstract

This study constitutes the first attempt to systematically quantify residual limb volume fluctuations in transfemoral amputees. The study was carried out on 24 amputees to investigate variations due to prosthesis doffing, physical activity, and testing time. A proper experimental set-up was designed, including a 3D optical scanner to improve precision and acceptability by amputees. The first test session aimed at measuring residual limb volume at 7 time-points, with 10 min intervals, after prosthesis doffing. This allowed for evaluating the time required for volume stabilization after prosthesis removal, for each amputee. In subsequent sessions, 16 residual limb scans in a day for each amputee were captured to evaluate volume fluctuations due to prosthesis removal and physical activity, in two times per day (morning and afternoon). These measurements were repeated in three different days, a week apart from each other, for a total of 48 scans for each amputee. Volume fluctuations over time after prosthesis doffing showed a two-term decay exponential trend (R2 = 0.97), with the highest variation in the initial 10 min and an average stabilization time of 30 min. A statistically significant increase in residual limb volume following both prosthesis removal and physical activity was verified. No differences were observed between measures collected in the morning and in the afternoon.Clinical Trials.gov ID: NCT04709367.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
(a) Experimental set up for transfemoral residual limb 3D scanning; (b) residual limb 3D scan (in red a schematic representation of the two perpendicular lines projected by the laser level on the anterior part of the residual limb); (c) the pre-align option of the Surface Best-Fit alignment method: fixed model in blue and mobile model in green; (d) alignment result; (e) scan cutting plane in orange; (f) final mesh. These images were created using VXelements 6.0 (www.creaform3d.com) and SOLIDWORKS 2020 software (www.solidworld.com).
Figure 2
Figure 2
Experimental protocol for 1st test session (up) and for the other three ones (bottom). At the end of each scan, the subjects sat in a chair positioned behind them and remained sitting until the following scan. t*: stabilization time evaluated during 1st session for each amputee. This image was created using PowerPoint (www.microsoft.com).
Figure 3
Figure 3
Post-doffing volume fluctuations plotted against time: mean and standard deviation in black, two-term exponential decay fitting curve in red.
Figure 4
Figure 4
Mean and standard error of volume values at different times and significance of the three within-subject factors.

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