Monofilament testing to identify insensate regions of the residual limb of individuals with transtibial amputation.

Abstract

Living with a lower limb amputation is a life-altering complication. This condition is often associated with a high prevalence of pressure ulcers and skin breakdown at the interface between the prosthetic socket and the residual limb. The purpose of this study was to describe a monofilament test method for identifying areas that lack protective sensation in individuals with transtibial amputation (TTA). Fifteen males and 5 females with TTA were evaluated using a standard 5.07/10 g monofilament test, which was adapted to test sensation at 10 locations on the residual limb. Thirty-five percent of the participants experienced loss of protective sensation on their distal anterior tibial crest, 50% of the participants had absent sensation along their incision line, and 20% of the participants experienced loss of sensation at the center of the distal end of the limb. The test method showed excellent intrarater reliability (Kappa = 1). Implementing a monofilament test is a reliable and practical option for practitioners to use in testing for loss of protective sensation in TTA because of the ease and speed of the test, as well as its low cost and potential for standardization.