Diment Laura E, Thompson Mark S, Bergmann Jeroen H M
Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK.
Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK.
Clin Biomech (Bristol). 2019 Oct;69:148-155. doi: 10.1016/j.clinbiomech.2019.07.020. Epub 2019 Jul 19.
Thermal discomfort is prevalent among prosthesis users. This observational study of thirty unilateral lower-limb prosthesis users compared their skin temperatures and the thermal discomfort experienced during exercise between their residual and contralateral limbs.
Participants performed a 2-minute interval cycling exercise test. Skin temperature was measured at matched locations on each leg during the 1-minute rest intervals. Average rate-of-change in skin temperature was compared between legs using a repeated measures analysis of variance. Participants rated thermal discomfort on each leg before and after exercise, and a Wilcoxon signed-rank test was used to compare legs. Ordinal regression evaluated the relationship between the rate-of-change in temperature on the residual limb and the perceived thermal discomfort.
After exercise, thermal discomfort ranked higher on the amputated side (P = 0.007). On average, both legs cooled during exercise (P = 0.002), but the difference between legs was not significant. The rate-of change in skin temperature on the residual limb during exercise did not relate to the thermal discomfort experienced (odds ratio of 0.357).
These findings indicate that in this patient population, skin temperature does not explain the thermal discomfort experienced, and subjective thermal discomfort is inadequate for detecting thermoregulatory issues, with potential implications for long-term tissue health.
假体使用者普遍存在热不适。这项针对30名单侧下肢假体使用者的观察性研究比较了他们残肢和对侧肢体在运动过程中的皮肤温度以及热不适情况。
参与者进行了2分钟的间歇骑行运动测试。在1分钟的休息间隔期间，测量每条腿上匹配位置的皮肤温度。使用重复测量方差分析比较双腿之间皮肤温度的平均变化率。参与者在运动前后对每条腿的热不适进行评分，并使用Wilcoxon符号秩检验比较双腿。有序回归评估残肢温度变化率与感知热不适之间的关系。
运动后，截肢侧的热不适评分更高（P = 0.007）。平均而言，两条腿在运动过程中均降温（P = 0.002），但双腿之间的差异不显著。运动过程中残肢皮肤温度的变化率与所经历的热不适无关（优势比为0.357）。
这些发现表明，在该患者群体中，皮肤温度并不能解释所经历的热不适，主观热不适不足以检测体温调节问题，这可能对长期组织健康产生影响。
