University of Washington, Department of Bioengineering, Seattle, WA, USA.
University of Washington, Department of Rehabilitation Medicine, Seattle, WA, USA.
Clin Biomech (Bristol). 2023 Jun;106:105986. doi: 10.1016/j.clinbiomech.2023.105986. Epub 2023 May 13.
A challenge often faced by people with lower extremity amputation is management of prosthetic socket fit due to changes in fluid volume within their residual limb. Prior research suggests that intermittently doffing the prosthetic socket may help stabilize daily residual limb fluid volume.
To assess the effects of partial doff duration on residual limb fluid volume retention, participants with transtibial amputation were tested by walking on a treadmill in a controlled, laboratory setting under three conditions. An automated system to release the locking pin and enlarge the socket was used to produce the partial doffing. Percent limb fluid volume changes after partial doffing for 4 min (Short Rest) and for 10 min (Long Rest) were compared with no partial doffing (No Release). Limb fluid volume was monitored using bioimpedance analysis.
Mean percent fluid volume changes in the posterior region were -1.2% for No Release, 2.7% for Short Rest, and 1.0% for Long Rest. Short and Long Rests had larger increases than No Release (P = 0.005 and 0.03, respectively); Short and Long Rests were not statistically different (P = 0.10). Eight of the thirteen participants experienced a higher percent fluid volume gain for both release protocols while four experienced a higher percent fluid volume gain for only one release protocol.
A partial doff duration as short as 4 min may be an effective strategy to stabilize limb fluid volume in prosthesis users with transtibial amputation. Trials in at-home settings should be pursued.
下肢截肢者常面临因残肢内液体量变化而导致假肢接受腔适配不良的问题。先前的研究表明，间歇性脱下假肢接受腔可能有助于稳定日常残肢液体量。
为评估部分脱卸时长对残肢液体量保留的影响，研究人员在受控的实验室环境中让胫骨截肢者在跑步机上行走，在三种情况下进行测试。使用自动系统释放锁定销并扩大接受腔，以实现部分脱卸。与不进行部分脱卸（不释放）相比，比较部分脱卸 4 分钟（短休息）和 10 分钟（长休息）后的残肢液体量百分比变化。使用生物阻抗分析监测肢体液体量。
不释放、短休息和长休息时，后区平均液体量百分比变化分别为-1.2%、2.7%和 1.0%。短休息和长休息的增加幅度大于不释放（P=0.005 和 0.03）；短休息和长休息之间无统计学差异（P=0.10）。13 名参与者中有 8 名在两种释放方案下的液体量百分比增加均更高，而有 4 名参与者仅在一种释放方案下的液体量百分比增加更高。
短至 4 分钟的部分脱卸持续时间可能是稳定胫骨截肢者假肢使用者残肢液体量的有效策略。应在家庭环境中进行试验。
