Colby Hansen1, Ben Wayment1, Stephanie Klein2, Bradeigh Godfrey1,3. 1. a Division of Physical Medicine and Rehabilitation , University of Utah School of Medicine , Salt Lake City , UT , USA. 2. b Department of Dermatology , University of Utah School of Medicine , Salt Lake City , UT , USA. 3. c George E. Wahlen Department of Veteran Affairs Medical Center , Salt Lake City , UT , USA.
Abstract
PURPOSE: Hyperhidrosis is a common problem for amputees. The iodine-starch test is frequently used to assess hyperhidrosis, but a method for its application has not been described for amputees. METHODS: We performed an unblinded comparison of the iodine-starch test using various methods to protect the prosthesis in 10 prosthetic limb users with hyperhidrosis. RESULTS: Plastic wrap produced a diffuse pattern of sweating in 70% of subjects. Forty percent had complaints about this method, and 50% experienced leakage of iodine stain onto prosthetic liners. The prosthetic sheath produced a focal or multifocal reaction in 100% of subjects after 10 min of ambulation. Eighty percent had minor leakage onto the liner, and complaints were noted in 10%. The proportion that experienced diffuse sweating was significantly higher in the plastic wrap condition (p = 0.016; difference in proportions = 70%; 95% confidence interval = 32-100%). The prosthetic sock was tested in four subjects and all had at least mild complaints; three had minor leakage onto the liner. Repeated complaints and lack of stain prevention led to discontinuation with this method. CONCLUSIONS: Of the three methods, the sheath produces a focal or multifocal reaction after 10 min of ambulation and tends to cause less subject complaints. It should be the preferred method to apply the iodine-starch test to amputees. Implications for rehabilitation Hyperhidrosis is a common problem in amputees which negatively affects quality of life. The iodine-starch test is commonly used to guide treatment decisions for hyperhidrosis, but a preferred method for applying it in amputees has not been described. This study describes different methods for applying the iodine-starch test. A prosthetic sheath covering should be the preferred method for the iodine-starch test in amputees.
PURPOSE:Hyperhidrosis is a common problem for amputees. The iodine-starch test is frequently used to assess hyperhidrosis, but a method for its application has not been described for amputees. METHODS: We performed an unblinded comparison of the iodine-starch test using various methods to protect the prosthesis in 10 prosthetic limb users with hyperhidrosis. RESULTS: Plastic wrap produced a diffuse pattern of sweating in 70% of subjects. Forty percent had complaints about this method, and 50% experienced leakage of iodine stain onto prosthetic liners. The prosthetic sheath produced a focal or multifocal reaction in 100% of subjects after 10 min of ambulation. Eighty percent had minor leakage onto the liner, and complaints were noted in 10%. The proportion that experienced diffuse sweating was significantly higher in the plastic wrap condition (p = 0.016; difference in proportions = 70%; 95% confidence interval = 32-100%). The prosthetic sock was tested in four subjects and all had at least mild complaints; three had minor leakage onto the liner. Repeated complaints and lack of stain prevention led to discontinuation with this method. CONCLUSIONS: Of the three methods, the sheath produces a focal or multifocal reaction after 10 min of ambulation and tends to cause less subject complaints. It should be the preferred method to apply the iodine-starch test to amputees. Implications for rehabilitation Hyperhidrosis is a common problem in amputees which negatively affects quality of life. The iodine-starch test is commonly used to guide treatment decisions for hyperhidrosis, but a preferred method for applying it in amputees has not been described. This study describes different methods for applying the iodine-starch test. A prosthetic sheath covering should be the preferred method for the iodine-starch test in amputees.