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

Publication date: Available online 31 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Davy Laroche, José-Luis Barnay, Bastien Tourlonias, Cyril Orta, Christine Obert, Jean-Marie Casillas
ObjectivesTo examine metrological properties of near-infrared spectroscopy (NIRS) vs. transcutaneous oxygen tension (TcPO2) 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 TcPO2 (borderline area between 15 and 35 mmHg).DesignProspective single-centre observational study.SettingUniversity-based rehabilitation center.ParticipantsIndividuals with unilateral transtibial amputation for peripheral artery disease, at the definitive stage of prosthesis fitting, able to perform a two-minute walk test (30).InterventionNot applicable.Main Outcome MeasuresTest-retest, the stump being evaluated in supine and inclined position, first by NIRS (Tissue Saturation Index (TSI), oxy-haemoglobin, deoxy-haemoglobin, total haemoglobin) and second by TcPO2. Subjects carried out a 2-minute walk test and visual analogue scales (wound healing, pain).ResultsFeasibility and tolerance of NIRS were satisfactory. The reliability of NIRS and TcPO2 values was good (ICC>0.7, p<0.05). No significant relationship was found between NIRS and TcPO2. No responsiveness (inclined vs. supine) was reported (p>0.05). Significant relationship between TSI and the 2-minute walk test (r>0.49, p<0.05) was found.ConclusionsNIRS is painless, complication-free and feasible, with good reliability. NIRS evaluate other domain than TcPO2, more linked to metabolic adaptation. Its capacity to predict the stump healing and tolerance to early prosthesis fitting is thus interesting to estimate in future studies.



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