Post-doffing residual limb fluid volume change in people with trans-tibial amputation

Residual limb volume may change after doffing, affecting the limb shape measured and used as a starting point for socket design.

The purpose of this study was to compare residual limb fluid volume changes after doffing for different test configurations.

The study was a repeated measures experimental design with three conditions (Sit, Liner, and Walk).

Residual limb fluid volume on 30 people with trans-tibial amputation was measured using bioimpedance analysis. Three tests were conducted--Sit: sit for 10 minutes, remove the prosthesis, socks and liner, sit for 10 minutes; Liner: sit for 10 minutes, remove the prosthesis and socks but not the liner, sit for 10 minutes; Walk: conduct sit, stand and walk activities for 30 minutes, remove the prosthesis, socks and liner, sit for 10 minutes.

The percentage fluid volume increase after doffing was significantly higher for Walk (2.8%) than for Sit (1.8%) (p = 0.03). The time to achieve a maximum or stable fluid volume was shorter for Liner (4.3 min) than for Sit (6.6 min) (p = 0.03).

Activity before doffing intensified the post-doffing limb fluid volume increase. Maintaining a liner after doffing caused limb fluid volume to stabilize faster than removing the liner. Clinical relevance To minimize residual limb volume increase before casting or imaging, practitioners should have patients sit with their prosthesis donned for 10 minutes. Leaving a liner on the residuum will not reduce the post-doffing volume increase, but it will help to more quickly achieve a consistent limb fluid volume.