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How does adding and removing liquid from socket bladders affect residual-limb fluid volume?

Joan E Sanders1, John C Cagle, Daniel S Harrison

  • 1University of Washington, 3720 15th Ave NE, Seattle, WA 98195. jsanders@u.washington.edu.

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Summary
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Adjustable prosthetic sockets with fluid bladders may cause residual limb fluid loss in amputees. This study found that fluid removal, not just addition, can lead to gradual volume reduction over time.

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Area of Science:

  • Biomedical Engineering
  • Prosthetics and Orthotics
  • Rehabilitation Science

Background:

  • Prosthetic socket volume adjustment is crucial for amputee comfort and function.
  • Fluid bladders offer a method to dynamically adjust socket volume.
  • Understanding the physiological effects of fluid bladder use is essential.

Purpose of the Study:

  • To investigate the impact of adding and removing liquid from adjustable prosthetic socket bladders on residual limb fluid volume.
  • To determine the preferred fluid volume for socket comfort and fit.
  • To assess the long-term effects of fluid bladder use on residual limb fluid dynamics.

Main Methods:

  • 19 individuals with transtibial amputation participated in the study.
  • Fluid bladders were integrated into regular prosthetic sockets.
  • Subjects underwent cycles of fluid addition and removal while sitting, standing, and walking.
  • Bioimpedance analysis was used to measure residual limb fluid volume.

Main Results:

  • The preferred bladder liquid volume was determined to be 16.8 ± 8.4 mL.
  • Residual limb fluid volume reduction occurred upon fluid addition and was not fully recovered upon removal.
  • 15 out of 19 subjects experienced gradual residual limb fluid volume loss during the session.

Conclusions:

  • Adjustable socket technologies using fluid bladders require careful implementation.
  • Reducing socket volume through fluid bladders may exacerbate residual limb fluid volume loss.
  • Further research is needed to optimize fluid bladder use in prosthetic sockets.