Sanders Joan E, Youngblood Robert T, Hafner Brian J, Ciol Marcia A, Allyn Katheryn J, Gardner David, Cagle John C, Redd Christian B, Dietrich Colin R
University of Washington, Seattle, WA, USA.
Prosthet Orthot Int. 2018 Aug;42(4):415-427. doi: 10.1177/0309364617752983. Epub 2018 Feb 5.
Fluctuations in limb volume degrade prosthesis fit and require users to accommodate changes using management strategies, such as donning and doffing prosthetic socks.
To examine how activities and self-report outcomes relate to daily changes in residual limb fluid volume and volume accommodation.
Standardized, two-part laboratory protocol with an interim observational period.
Participants were classified as "accommodators" or "non-accommodators," based on self-report prosthetic sock use. 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 the Socket Comfort Score and Prosthesis Evaluation Questionnaire. Activity was monitored while participants left the laboratory for at least 3 h. They then returned to repeat the bioimpedance test protocol.
Twenty-nine people were enrolled. Morning-to-afternoon percent limb fluid volume change per hour was not strongly correlated to percent time weight-bearing or to self-report outcomes. As a group, non-accommodators ( n = 15) spent more time with their prosthesis doffed and reported better outcomes than accommodators.
Factors other than time weight-bearing may contribute to morning-to-afternoon limb fluid volume changes and reported satisfaction with the prosthesis among trans-tibial prosthesis users. Temporary doffing may be a more effective and satisfying accommodation method than sock addition. Clinical relevance Practitioners should be mindful that daily limb fluid volume change and prosthesis satisfaction are not dictated exclusively by activity. Temporarily doffing the prosthesis may slow daily limb fluid volume loss and should be investigated as an alternative strategy to sock addition.
肢体体积的波动会降低假肢的适配性，要求使用者采用诸如穿脱假肢袜等管理策略来适应变化。
研究活动和自我报告结果如何与残肢液体体积的日常变化及体积适应情况相关。
采用标准化的两部分实验室方案及中间观察期。
根据自我报告的假肢袜使用情况，将参与者分为“适应者”或“非适应者”。使用定制的生物电阻抗分析仪和标准化的实验室活动方案测量参与者残肢液体体积的变化。用接受腔舒适度评分和假肢评估问卷评估自我报告的健康结果。在参与者离开实验室至少3小时期间监测其活动情况。然后他们返回实验室重复生物电阻抗测试方案。
共招募了29人。从上午到下午每小时肢体液体体积变化百分比与负重时间百分比或自我报告结果之间没有强烈的相关性。总体而言，非适应者（n = 15）脱下假肢的时间更多，且报告的结果比适应者更好。
除负重时间外的其他因素可能导致经胫骨假肢使用者从上午到下午的肢体液体体积变化以及对假肢的满意度报告。临时脱下假肢可能是比增加袜子更有效且更令人满意的适应方法。临床相关性：从业者应注意，日常肢体液体体积变化和假肢满意度并非完全由活动决定。临时脱下假肢可能会减缓日常肢体液体体积的流失，应作为增加袜子的替代策略进行研究。
