Prevalence of heat and perspiration discomfort inside prostheses: Literature review

Ghoseiri, Kamiar; Safari, Reza

doi:10.1682/jrrd.2013.06.0133

Cited by 78 publications

(83 citation statements)

References 67 publications

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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.…”

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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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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“…Key factors in successful use of a prosthesis include skin integrity of the residual limb, its health and hygiene [1,2]. Skin irritation, ulceration, dermatitis, and excessive sweating are common complaints of amputees who use prostheses for their daily activities [3,4]. Heat and moisture that becomes trapped inside the socket leads to a jeopardizing, unpleasant, and infectious environment for amputees which greatly decreases the quality of life, satisfaction and use of the prosthesis, and social participation [3,5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Skin irritation, ulceration, dermatitis, and excessive sweating are common complaints of amputees who use prostheses for their daily activities [3,4]. Heat and moisture that becomes trapped inside the socket leads to a jeopardizing, unpleasant, and infectious environment for amputees which greatly decreases the quality of life, satisfaction and use of the prosthesis, and social participation [3,5,6]. In dysvascular and/or neuropathic patients, any area of the skin with 2ºC or more increased temperature compared to adjacent areas has increased risk of ulceration [7]; therefore, localized skin temperature is an indicator of a potential skin breakdown.…”

Section: Introductionmentioning

confidence: 99%

Determination of Localized Skin Temperature of the Transtibial Residual Limb

Ghoseiri

Allami

Murphy

et al. 2020

Preprint

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Background: Interventions to resolve thermal discomfort as a common complaint in amputees, are usually chosen based on the residual limb skin temperature while wearing prosthesis; whereas, less attention was paid to residual limb skin temperature while outside of the prosthesis. The objective of this study was to explore the localized and regional skin temperature over the transtibial residual limb (TRL) while outside of the prosthesis.Methods: Eight unilateral transtibial amputees were enrolled in this cross sectional study. Participants sat on a chair and rested for 30 minutes while their prosthesis was removed. Twelve sites were marked in four columns (anterolateral, anteromedial, posteromedial, and posterolateral) and three rows (proximal, middle, and distal) over the residual limb and used for attachment of analog thermistors. Skin temperature was recorded and compared during 11 minutes. Furthermore, the relationship of skin temperature with participants’ demographic and clinical characteristics were explored.Results: The middle and distal zones of the anteromedial column had the highest and lowest skin temperatures (29.8 and 26.3°C, p<0.05), respectively. The average temperature of the TRL was 27.73±0.83°C and had no significant relationships (p>0.05) with participants’ demographic and clinical characteristics.Conclusions: An unequal distribution of temperature over the TRL was found with significantly higher and lower temperatures at its anterior column and distal row, respectively. This temperature pattern should be considered for thermoregulation strategies. Further investigation of the residual limb temperature while considering muscles thickness and blood perfusion rate are warranted with and without prosthesis.

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“…People with lower-limb amputation often complain about uncomfortable residual-limb skin temperatures and the accumulation of perspiration within their prostheses [1][2][3][4][5][6]. Even short bouts of walking can cause substantial increases in residual-limb skin temperatures [7][8] and result in cumulative increases throughout the course of a typical day [9].…”

Section: Introductionmentioning

confidence: 99%

Prosthesis management of residual-limb perspiration with subatmospheric vacuum pressure

et al. 2016

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Abstract-For the ambulatory person with lower-limb amputation, insufficient management of perspiration can result in inadequate prosthesis adherence, reduced mobility, and discomfort. This study compared a dynamic air exchange (DAE) prosthesis designed to expel accumulated perspiration with a total surface bearing suction socket (Suction) that cannot. Five people with unilateral transtibial amputation participated in a randomized, crossover experiment. All subjects were given a 1 wk acclimation period to each study prosthesis while we measured their step activity levels. A rest-walk-rest protocol, including a 30 min treadmill walk at a self-selected speed while wearing thermally insulative garments, was then used to observe residual-limb skin temperatures and perspiration. Afterward, subject opinions about the prostheses were assessed with questionnaires. During the weeklong acclimation period, no statistical difference in step activity levels were detected between prostheses (p = 0.22), but this may have been due to self-reported behavioral modifications. During the rest-walkrest protocol, no differences in skin temperatures were observed (p = 0.37). The DAE prosthesis accumulated 1.09 +/-0.90 g and expelled 0.67 +/-0.38 g of perspiration, while the Suction prosthesis accumulated 0.97 +/-0.75 g. The questionnaire results suggest that participants were receptive to both prostheses. The DAE prosthesis was able to expel more than a third of the total perspiration, suggesting it may enable longer uninterrupted periods of perspiration-inducing activity.

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Prevalence of heat and perspiration discomfort inside prostheses: Literature review

Cited by 78 publications

References 67 publications

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

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

Determination of Localized Skin Temperature of the Transtibial Residual Limb

Prosthesis management of residual-limb perspiration with subatmospheric vacuum pressure

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