Walking in a vacuum-assisted socket shifts the stump fluid balance.
Gains in stump volume have been documented in trans-tibial amputees while walking in custom made under-sized, total surface-bearing, vacuum-assisted sockets (Board et al., 2001). These gains raised doubts as to whether the sockets were truly under-sized and concerns that using an over-sized socket with vacuum-assist could lead to swelling, resulting, in discomfort or pain. The purposes of the present study were to determine if: (a) walking in a vacuum-assisted socket causes the stump to retain or gain volume in excess of the available socket volume and (b) the resulting increase in stump volume with an over-sized socket causes discomfort, pain, and/or the skin to redden. The results of this study showed the stump retained or gained volume in excess of the available socket volume while walking in vacuum-assisted sockets of various sizes. The stump lost less volume than predicted, or gained volume, in under-sized sockets. It also gained more volume than predicted in over-sized sockets. No discomfort, pain, or skin reddening, resulting from the volume gain was reported by any of the subjects after walking in an over-sized socket. This change in fluid balance towards a net gain supports the findings by Board et al. (2001) that vacuum-assist ensures a good fit during the day in ambulatory trans-tibial traumatic amputees with mature stumps.
Health, Physical Education, Recreation and Sport Science, St. Cloud University, Minnesota 56301-4498, USA.
J
J
Goswami
R
R
Lynn
G
G
Street
M
M
Harlander
D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000379:methods; D000672:Amputation Stumps / Q000098:blood supply*; D000674:Amputees / Q000534:rehabilitation; D000704:Analysis of Variance; D001186:Artificial Limbs; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D012039:Regional Blood Flow; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013314:Stress, Mechanical; D013977:Tibia / Q000601:surgery*; D014618:Vacuum; D016474:Weight-Bearing