Novel Lower-Limb Prostheses: Comparing Adherence, Perspiration, and Residual Limb Skin Health in a Hot, Humid Environment and During Activities of Daily Living
Abstract
Individuals with lower-limb amputation often complain about uncomfortable residual limb skin temperatures and the accumulation of sweat inside their prostheses that occurs when they participate in vigorous activities. It doesn’t take long before the presence of sweat on the residual limb leads to a lack of confidence in the security of their prosthetic suspension. Many circumstances allow the civilian lower-limb amputee to doff their prosthesis before it falls off, wipe it and the residual limb dry, and then don it again. Another option for these individuals is to simply reduce the intensity of activities before sweat becomes a problem. However, the Warfighter amputee may not be afforded such accommodations. For these Service personnel, inadequate moisture management is more than bothersome; it can significantly limit or inhibit their mobility. The objective of the proposed research is to provide lower-limb amputees who work in demanding environments with a prosthesis that remains secure despite profuse residual limb sweating without compromising residual limb health and comfort. The aim of this research is to compare three different, lower-limb prosthetic suspension systems and identify which is most effective at maintaining a secure adherence when worn in conditions that result in profuse sweating. We also aim to compare how the three study prostheses affect residual limb skin health and comfort when participants pursue their usual activities in the home, work, and community environments. To achieve these aims, we propose to recruit 20 Veteran below-knee amputees who are active community ambulators to participate in a human subject experiment. These individuals are able to traverse most environmental barriers and navigate with few restrictions in and about the community. Each subject will be asked to be asked to wear three different prostheses: (1) their as-prescribed prosthesis, (2) a new-to-market prosthesis with a unique liner with holes in it that allow sweat to flow away from the skin, and (3) an innovative prosthesis that has a body weight-activated pump to flow air between the prosthesis and the residual limb skin, allowing expulsion of any accumulated sweat. Subjects will wear each of these prostheses in the home, work, and community environments for 2 weeks, after which we will measure their residual limb health and comfort. Subjects will then walk at their self-selected speed on a treadmill in a room whose climate will be set to Middle East-like conditions: 35 °C (95 °F) and 50% relative humidity. After 30 minutes, we will measure any slippage of their prosthesis relative to their limb and how much sweat is expelled. The study will be complete when each subject has worn all three prostheses. The risks of this experiment are related to walking in a hot environment and wearing a new prosthesis; we will monitor participants for the onset of heat-related illnesses and provide protections for trip and fall hazards. The results from this 2-year experiment will reveal the readiness and capacity of individuals with lower-limb amputation who work or want to work in demanding environments. It will set a benchmark for the current standard of care and may show the benefit of new devices. While we are proposing to conduct this experiment with the help of below-knee amputees of traumatic etiology, we anticipate the results will benefit all individuals with lower-limb amputation independent of amputation level (below-, through-, or above-knee) or the cause of amputation (trauma, diabetes, tumor, congenital). It is our ambition that the work proposed herein in this 2-year project will result in widespread adoption of the prosthesis that maximizes adherence to the residual limb in demanding environments while maintaining a healthy and comfortable residual limb. Expanding the conditions under which individuals with lower-limb amputation can confidently work, despite profuse sweating, is where the Dep
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1810559
Entities
People
- Glenn Klute
Organizations
- United States Army
- VA Puget Sound Health Care System