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Microcirculatory Assessment of Arterial Below-Knee Stumps: Near-Infrared Spectroscopy Versus Transcutaneous Oxygen Tension—A Preliminary Study in Prosthesis Users.

Authors :
Laroche, Davy
Barnay, José-Luis
Tourlonias, Bastien
Orta, Cyril
Obert, Christine
Casillas, Jean-Marie
Source :
Archives of Physical Medicine & Rehabilitation; Jun2017, Vol. 98 Issue 6, p1187-1194, 8p
Publication Year :
2017

Abstract

Objective To examine metrologic properties of near-infrared spectroscopy (NIRS) versus transcutaneous oxygen tension (TcPO 2 ) for microcirculatory assessment of vascular transtibial stumps at the stabilized period of prosthesis fitting, as a preliminary step before exploring its ability to predict stump healing, considering the previously identified limits of TcPO 2 (borderline area between 15 and 35mmHg). Design Prospective single-center observational study. Setting University-based rehabilitation center. Participants Individuals with unilateral transtibial amputation for peripheral artery disease, at the definitive stage of prosthesis fitting, able to perform a 2-minute walk test (N=30). Interventions Not applicable. Main Outcome Measures Test-retest, with the stump being evaluated in supine and inclined positions, first by NIRS (tissue saturation index [TSI], oxyhemoglobin, deoxyhemoglobin, and total hemoglobin) and second by TcPO 2 . Subjects carried out a 2-minute walk test and visual analog scales (wound healing and pain). Results Feasibility and tolerance of NIRS were satisfactory. The reliability of NIRS and TcPO 2 values was good (intraclass correlation coefficient >0.7; P <.05). No significant relation was found between NIRS and TcPO 2 . No responsiveness (inclined vs supine) was reported ( P >.05). A significant relation between TSI and the 2-minute walk test ( r >.49, P <.05) was found. Conclusions NIRS is painless, complication-free, and feasible, with good reliability. NIRS evaluates others domain than TcPO 2 that are more linked to metabolic adaptation. Its capacity to predict stump healing and tolerance to early prosthesis fitting is therefore interesting to estimate in future studies. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00039993
Volume :
98
Issue :
6
Database :
Supplemental Index
Journal :
Archives of Physical Medicine & Rehabilitation
Publication Type :
Academic Journal
Accession number :
123215553
Full Text :
https://doi.org/10.1016/j.apmr.2016.12.001