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Iodine-starch test validity in amputee patients with hyperhidrosis.

Colby Hansen¹, Bradeigh Godfrey^1,2, Alfred Balch³

¹Department of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah, USA.

Disability and Rehabilitation

|March 30, 2026

Summary

The iodine-starch test shows a significant link to hyperhidrosis severity in amputees but lacks consistent reliability for repeated use. Further research is needed to improve its accuracy for clinical application.

Keywords:

Amputees amputation botulinum toxin hyperhidrosis starch test sweating validation

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Area of Science:

Dermatology
Medical Diagnostics
Prosthetics

Background:

Hyperhidrosis, a condition causing excessive sweating, impacts quality of life.
The iodine-starch test is a common diagnostic tool for hyperhidrosis.
Its utility and reliability in amputee populations require specific validation.

Purpose of the Study:

To validate the iodine-starch test in amputees by comparing the Amputee Iodine-Starch Result (AISR) with the Hyperhidrosis Disease Severity Scale (HDSS).
To assess the test-retest reliability of the AISR in patients experiencing hyperhidrosis.

Main Methods:

Amputee participants underwent iodine-starch testing on residual limbs and prosthetic sheaths.
The Amputee Iodine-Starch Result (AISR) was calculated based on sweat reaction intensity and area.
Ordinal logistic regression and intraclass correlation coefficients (ICC) were used for analysis.

Main Results:

The AISR demonstrated a significant association with the HDSS for both skin and sheath measurements.
Ordinal logistic regression revealed significant correlations (p<0.005) between AISR and HDSS.
However, ICC analysis indicated poor test-retest reliability for both skin and sheath measurements (ICC < 0.4).

Conclusions:

The iodine-starch test, when adapted for amputees (AISR), is significantly associated with hyperhidrosis severity.
The test exhibits poor test-retest reliability, limiting its use for consistent monitoring in this population.
Further refinement of the iodine-starch test is necessary for reliable application in amputee hyperhidrosis assessment.