A study published in Volume 52, Number 2, 2015, of the Journal of Rehabilitation Research & Development (JRRD), examines the incidence, severity, and impact of hyperhidrosis, excessive sweating, in people with lower-limb amputations. This study utilized the Hyperhidrosis Disease Severity Scale (HDSS), a qualitative scale that allows tailoring of treatment based on patient-identified severity and effect on daily activities, as a subjective measure of hyperhidrosis severity and impact. The researchers said their study lends support to the fact that sweating is a common problem in people with amputations: Among the 121 study subjects, 66 percent reported it to be at least a mild problem that interferes with optimal prosthetic fit and function, and 13 percent reported it to be a severe problem, for which more aggressive management may be appropriate.
According to the study, sweating was more severe in cases of transtibial amputations, patients under the age of 60 years, warm weather, and vigorous activity. There was no relationship between sweating severity and functional mobility, time since amputation, etiology of amputation, or duration of daily prosthetic use. Subjects reported trying multiple interventions, but the self-reported effectiveness of these treatments was low. Among the interventions tried were the use of prescription and over-the-counter antiperspirants, an extra sock or a sheath, and talcum powder. Thirty-eight percent of the subjects had not tried any intervention. A relatively small minority reported significant relief with the interventions tried, yet no interventions were superior to others.
The authors stated that these results should inform clinicians of the substantial burden that hyperhidrosis plays in the lives of their patients with amputations. Further, although generalizations to the entire amputee population cannot positively be made from these results, these findings confirm and augment current research and indicate the usefulness of the HDSS as a viable tool for measuring patients’ hyperhidrosis and assessing treatment needs. Further research is required to provide evidence-based guidelines for the management of this condition.
