scholarly journals Residual limb volume changes in transfemoral amputees

Author(s):  
Linda Paternò ◽  
Michele Ibrahimi ◽  
Elisa Rosini ◽  
Giuseppe Menfi ◽  
Vito Monaco ◽  
...  

Abstract This study constitute the first attempt to systematically quantify residual limb volume changes in transfemoral amputees. The study was carried out on 24 amputees to investigate changes 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 minute 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 changes 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 changes overtime after prosthesis doffing showed a two-term decay exponential trend (R2 = 0.97), with the highest change in the initial 10 minutes and an average stabilization time of 30 minutes. A statistically significant increasing effect of both prosthesis removal and physical activity was verified. No differences were observed between measures collected in the morning and in the afternoon.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Linda Paternò ◽  
Michele Ibrahimi ◽  
Elisa Rosini ◽  
Giuseppe Menfi ◽  
Vito Monaco ◽  
...  

AbstractThis 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.


Author(s):  
Sara Salazar-Salgado ◽  
Fanny Valencia ◽  
Alejandro Uribe ◽  
Elizabeth Rendón-Vélez

Abstract There is a considerable amount of young adults who become amputees due to war and violence. For this population, a successful adaptation to their prosthesis depends on the socket fit, which in turn is caused by the volume change of the residual limb during the day. The literature reports several investigations on this topic, most of which use subjects walking on a treadmill to simulate their daily activity. However, this studies are focused on transtibial amputees and do not mention the relationship between this physical activity and other variables such as comfort, volume changes and gait. Therefore, the objective of this paper is to determine the effect of physical activity on the volume of the residual limb, the comfort and the symmetry of gait in traumatic transfemoral amputees. Plaster positive molds of the residual limb, the comfort perception and the gait data of five individuals were obtained at the first time of the day and after three sessions of treadmill walking of 15, 30 and 45 minutes. The positive molds of each individual were scanned and then, the volume was calculated. The gait data was acquired using a marker-based motion capture system and processed to obtain spatio-temporal, kinematic and kinetic parameters, including the Gait Deviation Index (GDI). Based on the literature, specific points of the gait data were selected and the symmetry index was obtain for each of them. A short comfort test was used after each session of treadmill walking. Data was analyzed throughout the tests within each subject. Statistical analysis was performed for the volume and the gait variables to check for statistical significance. After physical activity, a tendency towards residual limb volume decrease was found on almost all subjects, although it was not significant. The percentage of volume change obtained on almost all subjects are within the range considered “good socket fit” according to previous authors. Our results suggest that transfemoral amputees may have smaller volume changes than transtibial after treadmill walking. Significant difference was found on the symmetry index of “Swing phase” between the baseline and the 45-minute test. The values of gait symmetry on the gait parameters were consistent with previous findings regarding transfemoral amputees. The difference that arise may be due to the sample difference (cause of amputation, difference in prosthetic elements and use of walking aids). The lowest symmetry was noticed on the ankle kinematics. The comfort did not significantly change with the selected amount of physical activity. In subsequent research, it is recommended to increase the intensity or time of physical activity and/or increase the number of participants. This results can help the understanding of how the socket/residual limb interface behaves which can improve the design and prescription of prosthetic components.


Author(s):  
Linda Paternò ◽  
Michele Ibrahimi ◽  
Elisa Rosini ◽  
Arianna Menciassi ◽  
Leonardo Ricotti

Author(s):  
Sara Salazar-Salgado ◽  
Fanny Valencia ◽  
Alejandro Uribe ◽  
Elizabeth Rendón-Vélez

Abstract For lower limb amputees, the socket fit is affected by the physical activity performed during the day. The majority of the studies in this field include only transtibial amputees and do not examine the effects of this variable. This paper aims to determine the effect of physical activity on the volume of the residual limb (RL), the comfort, and the symmetry of gait in traumatic transfemoral amputees. RL volume and gait data of five individuals were obtained at the first time of the day and after three sessions of treadmill walking. The ratio symmetry index of selected points of gait parameters was calculated. A short comfort test was used after each session. Data were analyzed throughout the tests within each subject, and statistical analysis was performed. After the physical activity, a tendency toward volume decrease was found on almost all subjects, although it was not significant. Transfemoral amputees may have smaller volume variations than transtibial after treadmill walking tasks. Significant difference was found on the symmetry index of “swing phase (SWP).” The values of gait symmetry were consistent with previous findings regarding transfemoral amputees. The lowest symmetry was noticed on the ankle kinematics. The comfort did not significantly change with the selected amount of physical activity. In subsequent research, it is recommended to increase the intensity or time of physical activity and/or increase the number of participants. These results can help the understanding of how the socket/RL interface behaves, which can improve the design and prescription of prosthetic components.


2012 ◽  
Vol 36 (4) ◽  
pp. 443-449 ◽  
Author(s):  
Joan E Sanders ◽  
Daniel S Harrison ◽  
John C Cagle ◽  
Timothy R Myers ◽  
Marcia A Ciol ◽  
...  

Background: Residual limb volume may change after doffing, affecting the limb shape measured and used as a starting point for socket design. Objectives: The purpose of this study was to compare residual limb fluid volume changes after doffing for different test configurations. Study Design: The study was a repeated measures experimental design with three conditions ( Sit, Liner, and Walk). Methods: Residual limb fluid volume on 30 people with trans-tibial amputation was measured using bioimpedance analysis. Three tests were conducted – Sit: sit for 10 minutes, remove the prosthesis, socks and liner, sit for 10 minutes; Liner: sit for 10 minutes, remove the prosthesis and socks but not the liner, sit for 10 minutes; Walk: conduct sit, stand and walk activities for 30 minutes, remove the prosthesis, socks and liner, sit for 10 minutes. Results: The percentage fluid volume increase after doffing was significantly higher for Walk (2.8%) than for Sit (1.8%) ( p = 0.03). The time to achieve a maximum or stable fluid volume was shorter for Liner (4.3 min) than for Sit (6.6 min) ( p = 0.03). Conclusions: Activity before doffing intensified the post-doffing limb fluid volume increase. Maintaining a liner after doffing caused limb fluid volume to stabilize faster than removing the liner. Clinical relevance To minimize residual limb volume increase before casting or imaging, practitioners should have patients sit with their prosthesis donned for 10 minutes. Leaving a liner on the residuum will not reduce the post-doffing volume increase, but it will help to more quickly achieve a consistent limb fluid volume.


2019 ◽  
Vol 43 (5) ◽  
pp. 528-539 ◽  
Author(s):  
Brian G Larsen ◽  
Jake B McLean ◽  
Katheryn J Allyn ◽  
Jacob T Brzostowski ◽  
Joseph L Garbini ◽  
...  

Background: Strategies to maintain prosthesis users’ daily limb volume are needed. Objectives: Test how intermittent incremental socket volume adjustments affect limb fluid volume and limb-socket distance. Study design: Repeated measures. Methods: People with transtibial limb loss walked on an outdoor trail wearing a motor-driven adjustable socket that they adjusted a small amount, approximately 0.3% socket volume, every 2 min using a mobile phone app. Limb fluid volume and sensed distance between the socket and a target in their elastomeric liner were monitored. A gradual socket enlargement phase was followed by a gradual socket reduction phase. Results: An incremental socket enlargement significantly increased limb fluid volume ( p < 0.001) but not sensed distance ( p = 0.063). An incremental socket reduction significantly decreased both limb fluid volume ( p < 0.001) and sensed distance ( p < 0.001). Conclusion: Participants’ residual limb fluid volume increases during ambulation compensated for incremental socket volume increases. For incremental socket volume decreases, residual limb fluid volume decreases did not compensate and the socket fit became tighter. Clinical relevance Results support the hypothesis that for people without co-morbidities, intermittent incremental socket volume enlargements are an effective accommodation strategy to increase limb fluid volume while maintaining socket fit. Intermittent incremental socket volume reductions decreased limb fluid volume but also made the socket fit tighter.


1984 ◽  
Vol 106 (1) ◽  
pp. 29-35 ◽  
Author(s):  
P. Cawley

The susceptibility to bias error of two methods for computing transfer (frequency response) functions from spectra produced by FFT-based analyzers using random excitation has been investigated. Results from tests with an FFT analyzer on a single degree-of-freedom system set up on an analogue computer show good agreement with the theoretical predictions. It has been shown that, around resonance, the bias error in the transfer function estimate H2 (Syy/Sxy*) is considerably less than that in the more commonly used estimate, H1 (Sxy/Sxx). The record length, and hence the testing time, required for a given accuracy is reduced by over 50 percent if the H2 calculation procedure is used. The analysis has also shown that if shaker excitation is used on lightly damped structures with low modal mass, it is important to minimize the mass of the force gage and the moving element of the shaker.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Rianne Kofman ◽  
Raoul E Winter ◽  
Cornelis H Emmelot ◽  
Jan HB Geertzen ◽  
Pieter U Dijkstra

2019 ◽  
Vol 90 (12) ◽  
pp. 1000-1008
Author(s):  
Caleb D. Johnson ◽  
Alice D. LaGoy ◽  
Gert-Jan Pepping ◽  
Shawn R. Eagle ◽  
Anne Z. Beethe ◽  
...  

INTRODUCTION: Designed as a more ecological measure of reaction times, the Perception-Action Coupling Task (PACT) has shown good reliability and within-subject stability. However, a lengthy testing period was required. Perceptual-motor judgments are known to be affected by proximity of the stimulus to the action boundary. The current study sought to determine the effects of action boundary proximity on PACT performance, and whether redundant levels of stimuli, eliciting similar responses, can be eliminated to shorten the PACT.METHODS: There were 9 men and 7 women who completed 4 testing sessions, consisting of 3 familiarization cycles and 6 testing cycles of the PACT. For the PACT, subjects made judgments on whether a series of balls presented on a tablet afford “posting” (can fit) through a series of apertures. There were 8 ratios of ball to aperture size (B-AR) presented, ranging from 0.2 to 1.8, with each ratio appearing 12 times (12 trials) per cycle. Reaction times and judgment accuracy were calculated, and averaged across all B-ARs. Ratios and individual trials within each B-AR were systematically eliminated. Variables were re-averaged, and intraclass correlation coefficients (ICC) and coefficients of variation (CVTE) were calculated in an iterative manner.RESULTS: With elimination of the 0.2 and 1.8 B-ARs, the PACT showed good reliability (ICC = 0.81–0.99) and consistent within-subject stability (CVTE = 2.2–14.7%). Reliability (ICC = 0.81–0.97) and stability (CVTE = 2.6–15.6%) were unaffected with elimination of up to 8 trials from each B-AR.DISCUSSION: The shortened PACT resulted in an almost 50% reduction in total familiarization/testing time required, significantly increasing usability.Johnson CD, LaGoy AD, Pepping G-J, Eagle SR, Beethe AZ, Bower JL, Alfano CA, Simpson RJ, Connaboy C. Action boundary proximity effects on perceptual-motor judgments. Aerosp Med Hum Perform. 2019; 90(12):1000–1008.


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