The skin’s physiological response to repetitive stress is not well understood in prosthesis users. Improving this understanding could facilitate the design of a diagnostic tool to determine if the skin is adapting to tolerate stress from a prosthetic socket. The objective of this research was to develop a physical system that mechanically stresses the skin in a controlled manner and then implements the imaging modalities of infrared (IR) imaging and optical coherence tomography (OCT). IR imaging characterizes the skin’s temperature response, while OCT characterizes vessel diameter changes over time in the skin. The system was implemented in a single individual with a transtibial amputation. The system reliably maintained the force profile throughout testing. IR and OCT imaging were initiated after load application, and all curves demonstrated an initial rise in temperature immediately after load removal followed by a decrease towards baseline. The system was able to effectively detect a peak outcome (temperature and vessel area) with both imaging modalities. The system’s ability to maintain the loading throughout and begin imaging to capture the peak provides promise for expanded use to better understand the skin’s physiological response to loading in prosthesis users. This improved understanding may better inform treatment strategies to optimize patient outcomes.

Background/Objective: Changes in limb volume affect prosthetic socket fit and limb health, which in turn affects the comfort, stability, and usability of a prosthesis. The objective of this research was to identify and evaluate residual limb fluid volume metrics that could be used to identify the need for a prosthetic socket modification or replacement. Methods: A prospective observational study was conducted with transtibial prosthesis users undergoing socket modification or replacement. Participants performed a morning and afternoon 20 min structured activity protocol and self-reported their average socket comfort and other health outcomes before and after their socket was modified or replaced. Limb fluid volume changes across the protocol were recorded using bioimpedance analysis. Results: Anterior region residual limb fluid volume loss was low when the socket comfort score was high. Participants with ESCS_ave increases of ≥2 points pre- to post-modification experienced less limb fluid volume loss post-modification minus pre-modification (mean +0.6%) compared to participants with ESCS_ave increases of <2 points (mean −0.9%) (p = 0.0002). Conclusions: The percentage of fluid volume in the anterior limb may be a useful quantitative metric to explore for the application of bioimpedance monitoring in clinical care, helping to identify when sufficient change has occurred such that a new socket is warranted.