QUT ePrints

Regional differences in pain threshold and tolerance of the transtibial residual limb: Including the effects of age and interface material

Lee, Winson C.C., Zhang, Ming, & Mak, Arthur F. (2005) Regional differences in pain threshold and tolerance of the transtibial residual limb: Including the effects of age and interface material. Archives of Physical Medicine and Rehabilitation, 86(4), pp. 641-649.

View at publisher

Abstract

Objectives To compare the pain threshold (the minimum pressure inducing pain) and pain tolerance (the maximum tolerable pressure) of different regions of the residual limbs of amputees by the indentation method and to evaluate the interface pressure distribution and distortion of the skin surface on indentation by finite element (FE) analysis.

Design Crossover trial.

Setting Rehabilitation engineering center.

Participants Eight transtibial amputees for indentation test and 1 for FE analysis.

Interventions The load applied to the residual limbs using a Pelite or polypropylene indenter attached to a force transducer was increased until subjects could no longer tolerate the load. An FE model was built to simulate the indentation process with the experimentally recorded pain threshold used to load the indenters against the soft tissues.

Main outcome measures Pain threshold and tolerance and interface pressure and distortion of soft tissues.

Results The patellar tendon and distal end of the fibula were the best and the worst load-tolerant regions, respectively. Some regions with a thicker layer of soft tissue had lower pain thresholds and tolerance than those with a thinner tissue layer. There was a trend for pain threshold and tolerance to decrease with age. The FE model showed that the peak pressure at the skin surface was very close when both indenters were loaded against the soft tissue at pain threshold limit.

Conclusions Contrary to common beliefs, regions with a thicker layer of soft tissue did not have a higher load-tolerant ability than thin-skinned regions. Pain threshold and tolerance could be age dependent. The FE model suggests that pain is triggered when peak pressure is applied to the residual limb exceeding a certain limit.

Impact and interest:

19 citations in Scopus
Search Google Scholar™
12 citations in Web of Science®

Citation countsare sourced monthly from Scopus and Web of Science® citation databases.

These databases contain citations from different subsets of available publications and different time periods and thus the citation count from each is usually different. Some works are not in either database and no count is displayed. Scopus includes citations from articles published in 1996 onwards, and Web of Science® generally from 1980 onwards.

Citations counts from the Google Scholar™ indexing service can be viewed at the linked Google Scholar™ search.

Full-text downloads:

519 since deposited on 19 Dec 2005
75 in the past twelve months

Full-text downloadsdisplays the total number of times this work’s files (e.g., a PDF) have been downloaded from QUT ePrints as well as the number of downloads in the previous 365 days. The count includes downloads for all files if a work has more than one.

ID Code: 2929
Item Type: Journal Article
Keywords: pain threshold, pain tolerance, prosthetics, prosthesis, prosthetic design, indentation, finite element analysis
DOI: 10.1016/j.apmr.2004.08.005
ISSN: 0003-9993
Subjects: Australian and New Zealand Standard Research Classification > ENGINEERING (090000) > BIOMEDICAL ENGINEERING (090300) > Rehabilitation Engineering (090305)
Divisions: Past > QUT Faculties & Divisions > Faculty of Built Environment and Engineering
Copyright Owner: Copyright 2005 Elsevier
Copyright Statement: Reproduced in accordance with the copyright policy of the publisher.
Deposited On: 19 Dec 2005
Last Modified: 11 Aug 2011 04:37

Export: EndNote | Dublin Core | BibTeX

Repository Staff Only: item control page