Dataset Information

Effects of activity intensity, time, and intermittent doffing on daily limb fluid volume change in people with transtibial amputation.

ABSTRACT: BACKGROUND::The volume of a prosthesis user's residual limb changes during the day and may affect the fit of the prosthesis. These changes must be managed by the user to prevent discomfort, skin breakdown, and falls. OBJECTIVES::The objectives were to test how activity, time of day, and intermittent doffing affected residual limb fluid volume in people with transtibial amputation. STUDY DESIGN::Standardized, repeated measure (A-B-A) out-of-laboratory protocol. METHODS::Participants with transtibial amputation completed three 6-h test sessions. Two sessions served as controls (A protocol) during which participants left their prosthesis donned, and one session was an intervention (B protocol) where participants doffed their prosthesis twice for 20?min during the 6?h of testing. Within-socket fluid volume was measured using a custom portable bioimpedance analysis system. RESULTS::A total of 13 participants completed the study. The rate of limb fluid volume loss was higher early in the session compared with late in the session. Participants experienced less fluid volume loss during high activity than low activity. Socket users with pin suspension experienced less posterior fluid volume loss when they intermittently doffed their prosthesis. Intermittent doffing did not benefit limb fluid volume of mechanical vacuum and suction suspension users. CONCLUSION::High activity may reduce fluid volume loss compared with low activity. Intermittent doffing may provide volume accommodation for transtibial prosthesis users with pin suspension. CLINICAL RELEVANCE:Prosthetists should query their patients about the intensity of activity they conduct when advising them on limb volume management. Patients using sockets with pin suspension may be able to offset limb fluid volume loss by periodically doffing the prosthesis.

SUBMITTER: Youngblood RT

PROVIDER: S-EPMC7447527 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Effects of activity intensity, time, and intermittent doffing on daily limb fluid volume change in people with transtibial amputation.

Youngblood Robert Tyler RT Hafner Brian J BJ Allyn Katheryn J KJ Cagle John C JC Hinrichs Paul P Redd Christian C Vamos Andrew C AC Ciol Marcia A MA Bean Nate N Sanders Joan E JE

Prosthetics and orthotics international 20180716 1

<h4>Background:</h4>The volume of a prosthesis user's residual limb changes during the day and may affect the fit of the prosthesis. These changes must be managed by the user to prevent discomfort, skin breakdown, and falls.<h4>Objectives:</h4>The objectives were to test how activity, time of day, and intermittent doffing affected residual limb fluid volume in people with transtibial amputation.<h4>Study design:</h4>Standardized, repeated measure (A-B-A) out-of-laboratory protocol.<h4>Methods:</ ...[more]

PMID: 30010494

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Project description:PurposeThis study sought to measure and identify factors associated with satisfaction with care among veterans. The metrics were colelcted for those receiving prosthetic limb care at the US Department of Veterans Affairs (VA) and US Department of Defense (DoD) care settings and at community-based care providers.MethodsA longitudinal cohort of veterans with major upper limb amputation receiving any VA care from 2010 to 2015 were interviewed by phone twice, 1 year apart. Care satisfaction was measured by the Orthotics and Prosthetics User's Survey (OPUS) client satisfaction survey (CSS), and prosthesis satisfaction was measured by the OPUS client satisfaction with device (CSD), and the Trinity Amputation and Prosthetic Experience Scale satisfaction scales. The Quality of Care index, developed for this study, assessed care quality. Bivariate analyses and multivariable linear regressions identified factors associated with CSS. Wilcoxon Mann-Whitney rank tests and Fisher exact tests compared CSS and Quality of Care items at follow-up for those with care within and outside of the VA and DoD.ResultsThe study included 808 baseline participants and 585 follow-up participants. Device satisfaction and receipt of amputation care in the prior year were associated with greater satisfaction with care quality. Persons with bilateral amputation were significantly less satisfied with wait times. Veterans who received amputation care in the VA or DoD had better, but not statistically different, mean (SD) CSS scores: 31.6 (22.6) vs 39.4 (16.9), when compared with those who received care outside the VA or DoD. Those with care inside the VA or DoD were also more likely to have a functional assessment in the prior year (33.7% vs 7.1%, P = .06), be contacted by providers (42.7% vs 18.8%, P = .07), and receive amputation care information (41.6% vs 0%, P =.002). No statistically significant differences in CSS, Quality of Care scores, or pain measures were observed between baseline and follow-up. In regression models, those with higher CSD scores and with prior year amputation care had higher satisfaction when compared to those who had not received care.ConclusionsSatisfaction with prosthetic limb care is associated with device satisfaction and receipt of care within the prior year. Veterans receiving amputation care within the VA or DoD received better care quality scores than those receiving prosthetic care outside of the VA or DoD. Satisfaction with care and quality of care were stable over the 12 months of this study. Findings from this study can serve as benchmarks for future work on care satisfaction and quality of amputation rehabilitative care.

Dataset Information

Effects of activity intensity, time, and intermittent doffing on daily limb fluid volume change in people with transtibial amputation.

Publications

Effects of activity intensity, time, and intermittent doffing on daily limb fluid volume change in people with transtibial amputation.

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