Activity Not a True Measure of Residual Limb Volume Fluctuations

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Twenty-nine people with transtibial amputations participated in a test to determine whether daily activity effected measurable changes in residual limb fluid volume and volume accommodation.

In an article published online February 5 in the Prosthetics and Orthotics International, participants' residual limb fluid volume change was measured using a custom bioimpedance analyzer and a standardized in-laboratory activity protocol. Self-report health outcomes were assessed with a socket comfort score and prosthesis evaluation questionnaire.

Results showed that factors other than time spent weight bearing may contribute to morning-to-afternoon limb fluid volume changes and reported satisfaction with the prosthesis among transtibial prosthesis users.

Participants were classified as "accommodators" or "non-accommodators," based on self-reported prosthetic sock use. Activity was monitored while participants left the laboratory for at least three hours before returning to repeat the bioimpedance test protocol. Morning-to-afternoon percentage of limb fluid volume change per hour was not strongly correlated to the percentage of weight bearing time or to self-report outcomes, the researchers reported.

As a group, the 15 non-accommodators reported spending more time with their prosthesis doffed and better outcomes than the accommodators. Temporary doffing may also be a more effective and satisfying accommodation method than sock addition and should be investigated as an alternative strategy, according to the study.