Beyond step counts: Including wear time in prosthesis use assessment for lower-limb amputation

Abstract

Introduction The purpose of this study was to test a novel activity monitor that tracks the time a prosthesis is worn, and the nature of the ambulatory activity conducted with the prosthesis. These capabilities allow prosthesis users’ wear and accommodation practices (e.g., temporary doffing) to be monitored, and the intensity of their activities to be assessed. Methods A portable limb-socket motion sensing system was used to monitor doffs, walk bouts (≥5 steps), low locomotion (2–4 steps), stationary positions, and weight shifts in a group of transtibial prosthesis users. The relationship between doff time and active motion time was investigated, and durations of low and high intensity active motions were compared. Results For the 14 participants tested, the median prosthesis day duration ranged from 12.8–18.8 h. Eleven participants typically doffed five or fewer times per day, and three participants typically doffed 10 or more times per day. Nine participants demonstrated a positive correlation between daily doff duration and active motion duration. Six participants spent more time in weight shifts than walk bouts, while eight participants spent more time in walk bouts than weight shifts. Conclusion Capturing don time and temporary doffs and distinguishing weight shifts from walks may provide insight relevant to patient care. Longer-term monitoring studies should be conducted, and the clinical utility of the data evaluated.

Testing the Reliability of Optical Coherence Tomography to Measure Epidermal Thickness and Distinguish Volar and Nonvolar Skin

“…Even for higher-activity prosthesis users, skin irritation and breakdown throughout the rehabilitation process can impede their return to activity by limiting time in their prosthetic socket. Prior work has shown that lower-extremity prosthesis users doffed their sockets several times over the course of the day likely owing to pain or discomfort or change their liners to limit unfavorable conditions within the socket, even when wearing their prosthesis from 12.8 to 18.8 hours a day ( DeGrasse et al, 2023 ). Finding a solution to prevent skin irritation and breakdown is paramount to continued success of all prosthesis users.…”