A Device for Characterizing Skin Physiological Response to Mechanical Loading in Transtibial Prosthesis Users

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.