Nonetheless there was considerable variation within the heterogeneous cohort of participants with amputation. In most cases, reduced ischaemia and inflammatory biomarker upregulation was observed in residual limbs compared to intact limbs, suggesting enhanced tolerance to loading. Cuff loading was observed to produce a transient compromise to tissue viability, reflected in a reduction in transcutaneous oxygen tension and an upregulation of inflammatory biomarkers, suggesting a degree of local ischaemia and inflammation, respectively. In the majority of cases, residual limbs displayed less compressive strain when loaded compared to intact limbs, the differences being statistically significant at a number of tested sites (median strains -6 to 2 % vs. During prescribed loading, cuff pressure at the highest inflation of 60 mmHg resulted in mean interface pressures ranging from 66.2 - 83.6 mmHg. This effect was reduced significantly in the contralateral limbs of those individuals with greater socket use (r = -0.88, p <0.01), indicative of adaptation post-activity. MRI revealed increased adipose infiltrating muscle tissue in residual limbs (median 2.5 %, range 0.2 - 8.9 %) compared to intact limbs (median ≤ 1.7 %, range 0.1 - 5.1 %), indicating muscle atrophy post-amputation. Transcutaneous oxygen and carbon dioxide tensions were measured, and inflammatory biomarkers were collected at sites relevant to prosthetic load transfer, each of which reflected compromise to the skin tissues. In order to evaluate intrinsic factors (soft tissue composition), Magnetic Resonance Imaging was used to visualise tissue composition and gross soft tissue deformation and a MyotonPROTM device was used to estimate tissue stiffness. The protocol was then applied to a cohort of participants with unilateral transtibial amputation. This involved incremental pressure application through a pneumatic cuff and an array of measurements before, during and after this loaded period to characterise the response of the underlying skin and soft tissues. A protocol for applying representative mechanical loading on lower limb tissues was developed with a cohort of volunteers without amputation. However, to date, there is a scarcity of literature utilising these techniques to evaluate the residual limb-socket interface, resulting in a lack of evidence-based practice to prevent socket sores. Bioengineers have established an array of measurements to understand the pathogenesis of soft tissue damage and assess multiple aspects of tissue tolerance during loading. This impacts upon quality of life and can lead to rejection of the prosthesis. In the early stages of rehabilitation, residual limb tissues have not been conditioned to support loading and are vulnerable to damage. ![]() The residual limb tissues of an individual with below knee amputation form a critical loaded interface with the prosthetic limb.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |