Establishing a measurement array to assess tissue tolerance during loading representative of prosthetic use

Area of Science:

• Biomedical Engineering
• Rehabilitation Science
• Tissue Mechanics

Background:

• Residual limb soft tissues lack mechanical conditioning in early amputation rehabilitation.
• Prosthetic use poses risks of damage to vulnerable residual limb tissues.
• Quantitative data on skin and soft tissue response to prosthetic loading is limited.

Purpose of the Study:

• To develop and validate an in-vivo protocol for assessing tissue tolerance to prosthetic loading.
• To establish quantitative measures for monitoring tissue status during early prosthesis use.
• To investigate the physiological responses of lower limb tissues to representative prosthetic loads.

Main Methods:

• An in-vivo protocol was designed to simulate early prosthesis use loading conditions.
• Ten non-amputee and one trans-tibial amputee participant were recruited.
• Measurements included interface pressures, transcutaneous oxygen (T_CPO₂) and carbon dioxide (T_CPCO₂) tensions, and inflammatory biomarkers.

Main Results:

• Maximum cuff pressure (60 mmHg) resulted in mean interface pressures of 66-74 mmHg.
• Decreased T_CPO₂ values were observed during loading, reversing upon pressure release.
• Significant upregulation of IL-1α and IL-1RA inflammatory biomarkers occurred immediately post-loading.

Conclusions:

• The developed protocol successfully applied representative prosthetic loads and monitored physiological responses.
• Measurement approaches demonstrated sensitivity to interface conditions, indicating tissue ischemia and inflammation.
• This offers a promising method for monitoring residual limb tissue status in individuals with amputation.