Moisture Permeability of the Total Surface Bearing Prosthetic Socket with a Silicone Liner: Is It Superior to the Patella-Tendon Bearing Prosthetic Socket?

Hachisuka, Kenji; Matsushima, Yasuyuki; Ohmine, Saburo; Shitama, Hideo; Shinkoda, Koichi

doi:10.7888/juoeh.23.225

Cited by 16 publications

(17 citation statements)

References 2 publications

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“…In the vast majority of people with amputation, all thermal transfer mechanisms, including convection, radiation, evaporation, and conduction, can be disturbed due to the socket barrier, decreased body surface area, and/or vascular disease [8][9]66]. This review identified that the unpleasant thermal environment inside the prosthetic socket is a long-lasting problem complained about by many people with amputation in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Despite this advantage, these liners prevent ventilation and air circulation at the prosthesis and residual-limb interface [68]. Moreover, low moisture permeability of the liner materials and direct contact of the skin with plastic, silicone, and other inorganic materials prevents sweat evaporation, which causes immersion of the residual limb in a salty liquid pool inside the prosthetic socket that consequently leads to skin irritations [7][8]15,69]. The thickness of materials applicable in the construction of prosthetic sockets and liners could influence their thermal conductivity.…”

Section: Discussionmentioning

confidence: 99%

“…These consequences could negatively affect quality of life, prosthesis suspension, prosthesis use, and activity level. Moreover, they cause discomfort, skin irritation, skin maceration, friction blisters, infection, unpleasant odor, and an environment for bacterial invasion to hair follicles of the residual limb [6][7][8][9][10][11][12][13][14][15][16][17]. Findings of a survey in 2001 revealed that thermal discomfort with the prosthetic socket could decrease quality of life in many people with amputation [12].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of heat and perspiration discomfort inside prostheses: Literature review

Ghoseiri¹,

Safari²

2014

J Rehabil Res Dev

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Abstract-People with limb amputation deal with thermal stresses in their daily activities. Unfortunately, in the majority of this population, all thermal transfer mechanisms, including convection, radiation, evaporation, and conduction, can be disturbed due to the prosthetic socket barrier, decreased body surface area, and/or vascular disease. The thermal environment inside prosthetic sockets, in addition to decreased quality of life and prosthesis use, comfort, and satisfaction, could put people with amputation at high risk for skin irritations. The current review explores the importance of thermal and perspiration discomfort inside prosthetic sockets by providing an insight into the prevalence of the problem. The literature search was performed in two databases, PubMed and Web of Knowledge, to find relevant articles. After considering the review criteria and hand-searching the reference sections of the selected studies, 38 studies were listed for review and data extraction. This review revealed that more than 53% of people with amputation in the selected studies experienced heat and/or perspiration discomfort inside their prostheses. In spite of great technological advances, current prostheses are unable to resolve this problem. Therefore, more attention must be paid by researchers, clinicians, and manufacturers of prosthetic components to thermal-related biomechanics of soft tissues, proper fabrication technique, material selection, and introduction of efficient thermoregulatory systems.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of heat and perspiration discomfort inside prostheses: Literature review

Ghoseiri¹,

Safari²

2014

J Rehabil Res Dev

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“…These elevated skin temperatures negatively affect quality of life for individuals with amputation, with more than 53 percent reporting discomfort from heat and/or perspiration inside their prosthetic socket in 38 reviewed studies [3]. The tight-fitting liner at the skinsocket interface required to maintain adherence and transfer forces to the residual limb lacks the ability to regulate temperature because of limited air convection, evaporative mechanisms [4], and thermal conductivity [5], trapping heat and contributing to thermal discomfort and skin breakdown. In a study of 90 subjects with transfemoral amputation, 72 percent reported that heat and sweat at least moderately affected their quality of life, with 62 percent reporting sores and skin irritation from their socket [6].…”

Section: Introductionmentioning

confidence: 99%

Residual limb skin temperature and thermal comfort in people with amputation during activity in a cold environment

Segal

Klute

2016

J Rehabil Res Dev

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Abstract-Thermal comfort remains a common problem for people with lower-limb amputation. Both donning a prosthesis and engaging in activity at room temperature can increase residual limb skin temperature; however, the effects of activity on skin temperature and comfort in more extreme environments remain unknown. We examined residual limb skin temperatures and perceived thermal comfort (PTC; 11-point Likert scale) of participants with unilateral transtibial amputation (n = 8) who were snowshoeing in a cold environment. Residual limb skin temperature increased by 3.9°C (3.0°C to 4.7°C) (mean difference [95% confidence interval], p < 0.001) after two 30 min exercise sessions separated by a 5 min rest session. Minimal cooling (0.2°C [-1.1°C to 0.6°C]) occurred during the rest period. Similar changes in PTC were found for the residual limb, intact limb, and whole body, with a mean scale increase of 1.6 (1.1 to 2.1) and 1.3 (0.8 to 1.8) for the first and second exercise sessions, respectively (p < 0.001). Activity in a cold environment caused similar increases in residual limb skin temperature as those found in studies conducted at room temperature. Participants with amputation perceived warming as their skin temperature increased during exercise followed by the perception of cooling during rest, despite minimal associated decreases in skin temperature.

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“…The material properties of prosthetic limbs certainly contribute to observed increases in residual limb skin temperatures. Although the elastomeric liners worn by amputees between their residual limb and prosthetic socket may help maintain secure adherence during ambulation, these materials are nearly impermeable to moisture [3] preventing thermal relief through evaporative cooling while their low thermal conductivity [7] prevents conductive heat transfer.…”

Section: Introductionmentioning

confidence: 99%

Does Activity Affect Residual Limb Skin Temperatures?

Klute

Huff

Ledoux

2014

Clinical Orthopaedics &Amp; Related Research

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Background Many lower limb amputees experience thermal discomfort as a result of wearing a prosthesis. The development of new prosthetic technology to address thermal discomfort requires an understanding of how activity (or inactivity) affects residual limb skin temperatures and how skin temperatures are mapped across the skin-prosthesis interface. Questions/purposes We studied skin temperatures inside the socket and suspension system of unilateral transtibial amputees to determine the following: (1) Does residual limb skin temperature change as a function of activity and its cessation? (2) If changes occur, are there regional differences (circumferential or proximal-distal) in temperature? Methods Nine unilateral transtibial amputees provided informed consent to participate in this institutional review board-approved study. Residual limb skin temperatures inside their prosthesis were measured at 16 distributed sites using thermistor sensors and a portable data acquisition system. The 150-minute protocol began with a 60-minute seated rest, continued with a 30-minute treadmill walk at a self-selected speed, and concluded after a second 60-minute seated rest. Data from the last minute of each of the three periods were used for analysis. Results The skin temperature was 31.0°± 1.5°C (mean ± SD) at the end of the initial rest period. After 30 minutes of treadmill walking, skin temperature increased to 34.1°± 1.3°C, an increase of 3.1°C (95% confidence interval [CI], 2.4-3.8; p \ 0.001). After the final 60 minutes of rest, the skin temperature was 33.2°± 1.2°C, 0.9°C lower (95% CI, 0.5-1.2; p \ 0.001) than at the end of treadmill walking but 2.2°C higher (95% CI, 1.4-2.9; p \ 0.001) than the temperature observed at the end of the initial rest period. Skin temperatures were warmest over the tibialis anterior region (p \ 0.006) and decreased from the most proximal to the most distal locations on the residual limb (p = 0.001). Conclusions Walking causes a dramatic increase in skin temperatures inside the prosthesis and subsequent rest of

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Moisture Permeability of the Total Surface Bearing Prosthetic Socket with a Silicone Liner: Is It Superior to the Patella-Tendon Bearing Prosthetic Socket?

Cited by 16 publications

References 2 publications

Prevalence of heat and perspiration discomfort inside prostheses: Literature review

Prevalence of heat and perspiration discomfort inside prostheses: Literature review

Residual limb skin temperature and thermal comfort in people with amputation during activity in a cold environment

Does Activity Affect Residual Limb Skin Temperatures?

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