Management of residual limb volume affects decisions regarding timing of fit of the first prosthesis, when a new prosthetic socket is needed, design of a prosthetic socket, and prescription of accommodation strategies for daily volume fluctuations. This systematic review assesses what is known about measurement and management of residual limb volume change in persons with lower-limb amputation. Publications that met inclusion criteria were grouped into three categories: group I: descriptions of residual limb volume measurement techniques; group II: studies investigating the effect of residual limb volume change on clinical care in people with lower-limb amputation; and group III: studies of residual limb volume management techniques or descriptions of techniques for accommodating or controlling residual limb volume. We found that many techniques for the measurement of residual limb volume have been described but clinical use is limited largely because current techniques lack adequate resolution and in-socket measurement capability. Overall, limited evidence exists regarding the management of residual limb volume, and the evidence available focuses primarily on adults with transtibial amputation in the early postoperative phase. While we can draw some insights from the available research about residual limb volume measurement and management, further research is required.

Sensing and monitoring technologies offer enormous potential to enhance the quality of healthcare provided to persons with lower-limb loss. Incorporation of these technologies into the rehabilitation process creates opportunities for a multidimensional exchange of timely, relevant, and meaningful health information between patients, their prostheses, and healthcare providers. Here, the authors envision a conceptual model for enhancing prosthetic rehabilitation through use of integrated physical and/or biological sensors and remote monitoring methods. Several specific applications that target treatment, diagnosis, and prognosis of health issues faced by persons with limb loss are proposed in an effort to demonstrate how collecting and using objective data can facilitate clinical decision making. Contemporary integrated sensors that may be used in these applications are reviewed and their limitations discussed. It is hoped that the considerations proposed here may serve to stimulate development of clinically useful monitoring and sensing technologies and promote their integration into routine amputation rehabilitation.

A preliminary investigation was conducted to characterize the magnitude and distribution of volume change in transtibial residua at two time intervals: upon prosthesis removal and at 2 week intervals.