Prosthetic mechanobiology - how using a prosthesis can lead to deep tissue injuries
— University of Strathclyde Skip to main navigation Skip to search Skip to main content University of Strathclyde Home Help & FAQ Home Profiles Research Units Research output Projects Datasets Equipment Student theses Impacts Prizes Activities Search by expertise, name or affiliation Prosthetic mechanobiology - how using a prosthesis can lead to deep tissue injuries Marisa Graser, Sarah Day, Arjan Buis Biomedical Engineering Health and Wellbeing Research output: Contribution to conference › Abstract › peer-review 7 Downloads (Pure) Overview Fingerprint Abstract BACKGROUND Deep Tissue Injury (DTI) is a form of pressure ulcer that forms when soft tissues experience prolonged or high pressure and shear. Our understanding of this condition increased significantly over the last two decades, with major research on immobilised individuals. However, transtibial prosthetic users might also be at risk of developing DTI: Following amputation, the soft tissues of the residuum become part of the weight-bearing system, despite being inapt to withstand high loads. AIM To understand DTI development in prosthetic users and identify gaps in existing research, we carried out a scoping review with a focus on population-specific aetiology, risk factors and methodologies to investigate both. METHOD The scoping review followed a methodological framework by the Joanna Briggs Institiute [1], in compliance with the PRISMA-ScR checklist for scoping reviews [2]. Qualitative data was collected based on keywords related to transtibial prosthetic use in combination with DTI development. The database search in Pubmed, Ovid Excerpta Medica, and Scopus, together with reference lists and forward-citations returned 16 peer reviewed, English language studies. RESULTS We addressed three key areas: Firstly, the aetiology of DTI is a complex interplay between cellular deformation and the impairment of lymphatic and microvascular systems. However, the influence of prosthesis-specific aspects like dynamic loading and amputation-related alterations of the ancillary systems remain unclear. Secondly, we found several risk factors that make transtibial prosthetic users susceptible to DTI. Intrinsic determinants are amputation-related changes of the tissue morphology and its mechanical properties, and sensory impairment of the residuum. Extrinsic factors are the socket design and choice of prosthetic components. Finally, the methodology of most studies was based on biomechanics. They commonly combined different loading conditions with medical imaging and computational analysis. However, we found a great variety of input data, modelling assumptions, and outcome measures. Additionally, the variability in geometrical patient characteristics and prosthetic componentry was high. DISCUSSION AND CONCLUSION The results indicate that transtibial prosthetic users may be at risk of DTI, depending on a complex interplay of mechanical, anatomical, and physiological factors. However, fundamental research on the reaction of cells, tissues, and ancillary systems to mechanical loading is needed. Additionally, high inter-patient variability and methodological limitations complicate the interpretation of outcome measures. We therefore recommend interdisciplinary research to widen our understanding of DTI in transtibial prosthetic users, which has the potential to initiate advances in prosthetic practice. Original language English Number of pages 1 Publication status Published - 4 Nov 2021 Event International Society for Prosthetics and Orthotics 18th World Congress - Virtual Duration: 1 Nov 2021 → 4 Nov 2021 https://www.ispo-congress.com/ Conference Conference International Society for Prosthetics and Orthotics 18th World Congress Abbreviated title ISPO 2021 Period 1/11/21 → 4/11/21 Internet address https://www.ispo-congress.com/ Keywords prosthetics deep tissue injury mechanobiology Access to Document Graser-etal-IPSO-2021-Prosthetic-mechanobiology-how-using-a-prosthesis-can-lead-to-deep-tissue-injuriesAccepted author manuscript, 91.3 KB Other files and links https://www.ispo-congress.com/ Cite this APA Author BIBTEX Harvard Standard RIS Vancouver Graser, M., Day, S., & Buis, A. (2021). Prosthetic mechanobiology - how using a prosthesis can lead to deep tissue injuries. Abstract from International Society for Prosthetics and Orthotics 18th World Congress. Graser, Marisa ; Day, Sarah ; Buis, Arjan. / Prosthetic mechanobiology - how using a prosthesis can lead to deep tissue injuries. Abstract from International Society for Prosthetics and Orthotics 18th World Congress.1 p. @conference{8510d0b34b66414e9725676339ca0e88, title = "Prosthetic mechanobiology - how using a prosthesis can lead to deep tissue injuries", abstract = "BACKGROUND Deep Tissue Injury (DTI) is a form of pressure ulcer that forms when soft tissues experience prolonged or high pressure and shear. Our understanding of this condition increased significantly over the last two decades, with major research on immobilised individuals. However, transtibial prosthetic users might also be at risk of developing DTI: Following amputation, the soft tissues of the residuum become part of the weight-bearing system, despite being inapt to withstand high loads.AIM To understand DTI development in prosthetic users and identify gaps in existing research, we carried out a scoping review with a focus on population-specific aetiology, risk factors and methodologies to investigate both. METHOD The scoping review followed a methodological framework by the Joanna Briggs Institiute [1], in compliance with the PRISMA-ScR checklist for scoping reviews [2]. Qualitative data was collected based on keywords related to transtibial prosthetic use in combination with DTI development. The database search in Pubmed, Ovid Excerpta Medica, and Scopus, together with reference lists and forward-citations returned 16 peer reviewed, English language studies.RESULTS We addressed three key areas: Firstly, the aetiology of DTI is a complex interplay between cellular deformation and the impairment of lymphatic and microvascular systems. However, the influence of prosthesis-specific aspects like dynamic loading and amputation-related alterations of the ancillary systems remain unclear. Secondly, we found several risk factors that make transtibial prosthetic users susceptible to DTI. Intrinsic determinants are amputation-related changes of the tissue morphology and its mechanical properties, and sensory impairment of the residuum. Extrinsic factors are the socket design and choice of prosthetic components. Finally, the methodology of most studies was based on biomechanics. They commonly combined different loading conditions with medical imaging and computational analysis. However, we found a great variety of input data, modelling assumptions, and outcome measures. Additionally, the variability in geometrical patient characteristics and prosthetic componentry was high. DISCUSSION AND CONCLUSION The results indicate that transtibial prosthetic users may be at risk of DTI, depending on a complex interplay of mechanical, anatomical, and physiological factors. However, fundamental research on the reaction of cells, tissues, and ancillary systems to mechanical loading is needed. Additionally, high inter-patient variability and methodological limitations complicate the interpretation of outcome measures. We therefore recommend interdisciplinary research to widen our understanding of DTI in transtibial prosthetic users, which has the potential to initiate advances in prosthetic practice.", keywords = "prosthetics, deep tissue injury, mechanobiology", author = "Marisa Graser and Sarah Day and Arjan Buis", year = "2021", month = nov, day = "4", language = "English", note = "International Society for Prosthetics and Orthotics 18th World Congress, ISPO 2021 ; Conference date: 01-11-2021 Through 04-11-2021", url = "https://www.ispo-congress.com/", } Graser, M, Day, S & Buis, A 2021, 'Prosthetic mechanobiology - how using a prosthesis can lead to deep tissue injuries', International Society for Prosthetics and Orthotics 18th World Congress, 1/11/21 - 4/11/21. Prosthetic mechanobiology - how using a prosthesis can lead to deep tissue injuries. / Graser, Marisa; Day, Sarah; Buis, Arjan. 2021. Abstract from International Society for Prosthetics and Orthotics 18th World Congress. Research output: Contribution to conference › Abstract › peer-review TY - CONF T1 - Prosthetic mechanobiology - how using a prosthesis can lead to deep tissue injuries AU - Graser, Marisa AU - Day, Sarah AU - Buis, Arjan PY - 2021/11/4 Y1 - 2021/11/4 N2 - BACKGROUND Deep Tissue Injury (DTI) is a form of pressure ulcer that forms when soft tissues experience prolonged or high pressure and shear. Our understanding of this condition increased significantly over the last two decades, with major research on immobilised individuals. However, transtibial prosthetic users might also be at risk of developing DTI: Following amputation, the soft tissues of the residuum become part of the weight-bearing system, despite being inapt to withstand high loads.AIM To understand DTI development in prosthetic users and identify gaps in existing research, we carried out a scoping review with a focus on population-specific aetiology, risk factors and methodologies to investigate both. METHOD The scoping review followed a methodological framework by the Joanna Briggs Institiute [1], in compliance with the PRISMA-ScR checklist for scoping reviews [2]. Qualitative data was collected based on keywords related to transtibial prosthetic use in combination with DTI development. The database search in Pubmed, Ovid Excerpta Medica, and Scopus, together with reference lists and forward-citations returned 16 peer reviewed, English language studies.RESULTS We addressed three key areas: Firstly, the aetiology of DTI is a complex interplay between cellular deformation and the impairment of lymphatic and microvascular systems. However, the influence of prosthesis-specific aspects like dynamic loading and amputation-related alterations of the ancillary systems remain unclear. Secondly, we found several risk factors that make transtibial prosthetic users susceptible to DTI. Intrinsic determinants are amputation-related changes of the tissue morphology and its mechanical properties, and sensory impairment of the residuum. Extrinsic factors are the socket design and choice of prosthetic components. Finally, the methodology of most studies was based on biomechanics. They commonly combined different loading conditions with medical imaging and computational analysis. However, we found a great variety of input data, modelling assumptions, and outcome measures. Additionally, the variability in geometrical patient characteristics and prosthetic componentry was high. DISCUSSION AND CONCLUSION The results indicate that transtibial prosthetic users may be at risk of DTI, depending on a complex interplay of mechanical, anatomical, and physiological factors. However, fundamental research on the reaction of cells, tissues, and ancillary systems to mechanical loading is needed. Additionally, high inter-patient variability and methodological limitations complicate the interpretation of outcome measures. We therefore recommend interdisciplinary research to widen our understanding of DTI in transtibial prosthetic users, which has the potential to initiate advances in prosthetic practice. AB - BACKGROUND Deep Tissue Injury (DTI) is a form of pressure ulcer that forms when soft tissues experience prolonged or high pressure and shear. Our understanding of this condition increased significantly over the last two decades, with major research on immobilised individuals. However, transtibial prosthetic users might also be at risk of developing DTI: Following amputation, the soft tissues of the residuum become part of the weight-bearing system, despite being inapt to withstand high loads.AIM To understand DTI development in prosthetic users and identify gaps in existing research, we carried out a scoping review with a focus on population-specific aetiology, risk factors and methodologies to investigate both. METHOD The scoping review followed a methodological framework by the Joanna Briggs Institiute [1], in compliance with the PRISMA-ScR checklist for scoping reviews [2]. Qualitative data was collected based on keywords related to transtibial prosthetic use in combination with DTI development. The database search in Pubmed, Ovid Excerpta Medica, and Scopus, together with reference lists and forward-citations returned 16 peer reviewed, English language studies.RESULTS We addressed three key areas: Firstly, the aetiology of DTI is a complex interplay between cellular deformation and the impairment of lymphatic and microvascular systems. However, the influence of prosthesis-specific aspects like dynamic loading and amputation-related alterations of the ancillary systems remain unclear. Secondly, we found several risk factors that make transtibial prosthetic users susceptible to DTI. Intrinsic determinants are amputation-related changes of the tissue morphology and its mechanical properties, and sensory impairment of the residuum. Extrinsic factors are the socket design and choice of prosthetic components. Finally, the methodology of most studies was based on biomechanics. They commonly combined different loading conditions with medical imaging and computational analysis. However, we found a great variety of input data, modelling assumptions, and outcome measures. Additionally, the variability in geometrical patient characteristics and prosthetic componentry was high. DISCUSSION AND CONCLUSION The results indicate that transtibial prosthetic users may be at risk of DTI, depending on a complex interplay of mechanical, anatomical, and physiological factors. However, fundamental research on the reaction of cells, tissues, and ancillary systems to mechanical loading is needed. Additionally, high inter-patient variability and methodological limitations complicate the interpretation of outcome measures. We therefore recommend interdisciplinary research to widen our understanding of DTI in transtibial prosthetic users, which has the potential to initiate advances in prosthetic practice. KW - prosthetics KW - deep tissue injury KW - mechanobiology UR - https://www.ispo-congress.com/ M3 - Abstract T2 - International Society for Prosthetics and Orthotics 18th World Congress Y2 - 1 November 2021 through 4 November 2021 ER - Graser M, Day S, Buis A. Prosthetic mechanobiology - how using a prosthesis can lead to deep tissue injuries. 2021. Abstract from International Society for Prosthetics and Orthotics 18th World Congress. Powered by Pure, Scopus & Elsevier Fingerprint Engine™ © 2022 Elsevier B.V. We use cookies to help provide and enhance our service and tailor content. By continuing you agree to the use of cookies Log in to Pure About web accessibility Contact us
