Frequent versus infrequent partial doffing in transtibial prosthesis users as a means to stabilize residual limb fluid volume.

Abstract

Daily residual limb fluid volume fluctuation is thought to be a driving factor behind prosthetic socket fit deterioration among people with lower limb amputation. Expanding the number and type of strategies available to manage daily residual limb fluid volume changes may improve socket fit. To investigate the effects of partial-doff frequency on residual limb fluid volume, participants completed two controlled laboratory sessions that differed in the number of times participants sat and partially doffed their prosthesis. Transtibial prosthesis users were recruited, fitted with a custom limb fluid volume monitoring device and a socket release-relock mechanism, and asked to complete a series of low- and high-activity ambulation bouts that mimicked daily prosthesis use. Mean limb fluid volume measures from the anterior compartment of the residual limb were significantly different between the one- and three-partial doff experimental protocols (-5.8 % and -2.1 % fluid volume, respectively, P < 0.01). The posterior compartment limb fluid volume, locking pin depth, locking pin magnitude of movement, anterior distal limb position depth, and anterior distal limb position total movement did not differ significantly between the two conditions. Partial doffing may offer prosthesis users an alternative means to accommodate limb fluid volume changes. More frequent partial doffing appears to better mitigate limb fluid volume loss when compared to less frequent partial doffing.