I N TE RN ATI ON AL
I s0
S TAN D ARD
8548- 2
Fi rst
e d i ti o n
1 993-07-01
P ro sth eti cs
an d
d e fi ci e n ci e s
P art
orth oti cs
Li m b
-
-
2:
M e th o d
of
d e scr i bi n g
l o we r
l i rn b
am pu tati o n
stu m ps
P roth kses
P arti e
2:
m em bres
et
orth eses
M Bth o d e
de
-
M al form ati o n s
d escri pti o n
d es
d es
m em bres
m oi g n o n s
-
d ’ am pu tati o n
d es
i n fki eu rs
R e fe re n ce
I S0
n u m ber
85482: 1 993(E)
I S0
8548=2: 1 993(E)
Fo re wo rd
I S0
(th e
I n tern ati o n al
fed erati on
of
of
prepari n g
tech n i cal
wh i ch
stan d ard s
I n tern ati o n al
co m m i ttees.
a
tech n i cal
represen ted
an d
Org an i zati o n
n ati o n al
on
E ach
(I E C)
on
D raft
al l
m atters
of
to
Stan d ard
th e
n o rm al l y
bo d y
been
wi th
I S O,
Stan d ard s
by
at
for
ou t
i n terested
in
h as
take
wo rl d wi d e
part
Th e
work
th ro u g h
a
I S0
su bj ect
th e
o rg an i zati on s,
al so
a
ri g h t
for
to
be
g o vern m en tal
in
th e
E l ectrotech n i cal
wo rk.
I S0
Co m m i ssi on
stan d ard i zati o n .
ad opted
bo d i es
is
bo d i es) .
carri ed
establ i sh ed
I n tern ati on al
el ectrotech n i cal
approval
m em ber
I n tern ati on al
th e
m em ber
req u i res
is
h as
l i ai so n
wi th
I n tern ati on al
ci rcu l ated
in
cl o sel y
S tan d ard i zati on )
(I S 0
m em ber
com m i ttee.
n o n -g overn m en tal ,
col l abo rates
Stan d ard s
com m i ttee
th at
fo r
bod i es
by
th e
vo ti n g .
l east
75
%
tech n i cal
com m i ttees
P u bl i cati o n
of
th e
as
an
m em ber
are
I n tern ati o n al
bod i es
casti n g
a vote.
I n tern ati on al
Stan d ard
l SO/TC
P ro sth eti cs
I S0
1 68,
8548
th e ti cs
-
P art
-
P art
-
orth o
th e
-
was
prepared
by
Tech n i cal
C om m i ttee
orth oti cs.
fo l l owi n g
Li m b
parts,
u n d er
th e
g en eral
ti tl e
d escri bi n g
limb
2:
M eth o d
of
d escri bi n g
l o wer
limb
am pu tati on
stu m ps
P art
3:
M eth o d
of
d escri bi n g
u pper
limb
am pu tati on
stu m ps
-
P art
4:
Cau sal
-
P art
5:
P ati en t
I S0
th i s
ri g h ts
by
an y
re se rve d .
m e an s,
in
Case
in
No
l ead i n g
to
presen t
at
bi rth
am pu tati on
d escri ptors
of
part
e l e ctro n i c
wri ti n g
I n tern ati on al
P ri n ted
part
con d i ti o n s
d efi ci en ci es
I S0
8548
is
for
i n fo rm ati o n
o n l y.
1 993
Al l
m i s si o n
of
P ro s-
d efi ci en ci es:
of
A
1 :
of
ti cs
8548-2
an d
M eth o d
An n ex
0
con si sts
an d
I S0
P o stal e
fro m
or
th e
Org an i zati o n
56
S wi tze rl an d
l
of
th i s
pu bl i cati o n
m e ch an i cal ,
m ay
i n cl u d i n g
be
reprod u ced
ph otocopyi n g
pu bl i sh er,
for
C H - ‘ I 21 1
Stan d ard i zati on
G en eve
20
l
S wi tze rl an d
or
an d
u ti l i ze d
m i cro fi l m ,
in
an y
fo rm
wi th ou t
or
per-
I S0
8548=2: 1 993 (E)
I n tro d u cti o n
M an y
d i fferen t
stu m ps,
are
bu t
m an y.
Th e
wi th
d i fferen t
own
system s
i n tern ati on al
wi th
wi l l
system s
n on e
m eet
system
on e
of
wi th
h eal th
Th e
propo sed
cl i n i c
cord ed
I S0
in
8548
d escri bed .
d esi g n ed
pabl e
of
a
team
way
an d
th at
I t sh ou l d
th e
read y
cl i n i c
team s
ag ai n st
a
n eed s.
in
to
Th e
co m pare
d i fferen t
oth er
ph ysi cal
an d
al so
of
co u n tri es,
th ere
of
a
th i s
th ei r
n eed
on e
care
fo r
an
pu bl i cati on
g ro u ps
wh o
stu m ps
(especi al l y
o ccu pati on al
to
fo r
worki n g
d evel op
is
d escri bi n g
d octo rs
val u e
am pu tati o n
reason s
possi bi l i ti es,
H en ce
system
d i sci pl i n es,
is
cl assi fy
Th e
d i fferen t
o rd er
an o th er.
stan d ard i zed
system
in
tech n i cal
d evel oped
to
acceptan ce.
in-
th o se
th erapi sts,
an d
epi d em i o l o g i sts
an d
o ffi ci al s.
d el i beratel y
by
d evel o ped
d i fferen t
reh abi l i tati on ) ,
a
been
u n i versal
i n d i vi d u al
d i fferen t
g overn m en t
system
be
u se
Su ch
th e
an d
to
pro sth eti sts.
of
th e
th ei r
pati en t
an d
su rg eon s
con cern ed
of
pati en ts
to
an o th er,
h ave
ach i eved
m em bers
appreci ate
cl u d e
h as
be
h as
to
to
m eet
en abl e
can
be
ai m s
easi l y
at
feasi bl e
i n d i vi d u al
ad aptati o n
th e
th e
th e
d i fferen t
th e
i n corpo rated
in
reports.
th i s
i n sti tu ti o n ;
fo r
of
of
d efi n i n g
for
n eed s
d escri pti on
com pu ter
th e
minimum
i n form ati o n
th e
to
i n fo rm ati on
m em bers
stu m p
to
Th i s
i n form ati o n
be
i n cl u d ed
sh ou l d
in
al so
be
re-
part
of
to
be
fo rm s
be
ca-
an al ysi s.
.. .
III
This page intentionally left blank
I N TE RN ATI ON AL
P ro s th e ti cs
P art
part
scri bi n g
of
2
of
I S0
l o wer
cord i n g
th e
d e s cri bi n g
8548
limb
Th e
fo l l owi n g
th i s
part
Li m b
l o we r
limb
of
I S0
I S0
in
8548.
are
appl yi n g
stan d ard s
i n d i cated
m ai n tai n
reg i sters
of
an d
d e-
fo r
re-
At
th e
to
pro vi si o n s
con sti tu te
ti m e
Al l
of
ag reem en ts
m ost
bel o w.
of
to
M em bers
are
th e
su bj ect
based
on
th i s
i n vesti g ate
recen t
cu rren tl y
wh i ch ,
pu bl i cati on ,
stan d ard s
en co u rag ed
th e
am pu tati o n
3
D e fi n i ti o n s
Fo r
th e
ed i ti o n s
of
val i d
8548-l
: 1 989,
fi ci en ci es
-
P rosth eti cs
P art
presen t
at
1 :
an d
M eth o d
I EC
I S0
8549-2
4
M e as u re m e n t
4. 1
cabu l ary
-
pros th eses
: 1 989 ,
P art
an d
I d en ti fy
th e
I S0
G en eral
extern al
8549 -2 : 1 9 89 ,
prosth eses
-
an d
2:
I S0
8548,
I S0
th e
d efi -
8549- l
an d
of
l o we r
limb
l evel s
an d
re fe re n ce
pl an e s
th e
referen ce
an d
l evel
of
l evel s
an d
am pu tati on
pl an es
as
rel evan t
d escri bed
in
to
4. 1
.l
4. 1 . 2.
th e
of
an d
th e
I S0
d escri bi n g
-
Li m b
limb
4. 1 . 1
Referen ce
l evel s
Cro tch
wh i ch
a
to
cen trel i n e
th e
-
l evel
ci rcu m feren ti al
of
th e
m o st
proxi m al
m easu rem en t,
th e
th i g h ,
can
be
l evel
at
perpen d i cu l ar
o btai n ed .
d e-
an d
term s
orth o ti cs
fo r
-
extern al
Volimb
ti bi a1
M ed i al
pl ateau ,
kn ee,
a
o rth oses.
P rosth eti cs
P art
of
8548- 1 ,
s tu m ps
parti cu l ar
in
Term s
wearers
of
an d
rel ati n g
th ese
orth oti cs
to
-
extern al
pro sth eses.
j oi n t
u n l ess
wh i ch
case
ci rcu m feren ti al
cen trel i n e
cabu l ary
part
I S0
bi rth .
P rosth eti cs
7:
th i s
appl y.
R efe re n ce
4. 1 . 1 . 2
8549-l
of
in
g i ven
I n tern ati on al
o rth o ti cs
of
s tu m ps
pu rpo ses
n i ti o n s
4. 1 . 1 . 1
d efi ci en ci es
I S0
-
pro vi si o n s
Stan d ard s.
I S0
d e fi ci e n ci e s
am pu tati o n
text,
val i d .
parti es
8548
of
stu m ps
co n tai n
th i s
were
an d
possi bi l i ty
m eth od
i n form ati on .
stan d ard s
of
a
re fere n ces
i n d i cated
revi si o n ,
part
am pu tati on
referen ce
ed i ti o n s
establ i sh es
d escri pti ve
N o rm ati ve
th ro u g h
to
-
o rth o ti cs
S co pe
Th i s
of
an d
8548=2: 1 993(E)
2:
M e th o d
1
I S0
STAN D ARD
of
th e
line
th ere
th i s
-
th e
is
a
l evel
m easu rem en t
stu m p
can
be
l evel
fi xed
is
th e
of
th e
m ed i al
d efo rm i ty
of
h i g h est
wh i ch
at
perpen d i cu l ar
to
th e
th e
o btai n ed .
Volimb
4. 1 . 1 . 3
en d .
Stu m p
en d
l evel
-
th e
l evel
of
th e
stu m p
I S0
4. 1
8 5 48 = 2 : 1 9 9 3 ( E )
. ‘I . 4
ti en t
G rou n d
is
l evel
stan d i n g
-
th e
l evel
on
wh i ch
th e
pa-
4. 3
Assessm en t
4. 3 . 1
4. 1 . 1 . 5
“Fal l -away”
l evel
stu m ps
o n l y,
-
th e
in
l evel
tran s-fem oral
on
th e
th e
stu m p
aspects
as
at
it
wh i ch
cu rves
th e
in
sl ope
toward s
of
th e
th e
stu m p
4. 1 . 1 . 6
Minimum
an kl e
ci rcu m feren ti al
d i sarti cu l ati o n
minimum
stu m ps
ci rcu m feren ti al
Fem oral
l evel
o n l y,
ti cu l ati o n
stu m ps
l evel
si g n i fi can t
red u cti on
-
th e
in
l evel
of
j oi n t
th e
M axi m u m
M easu rem en t
4. 3 . 2
-
in
kn ee
d i sar-
m en t
an y
m axi m u m
d i stal
ci rcu m feren ti al
stu m ps
o n l y,
ci rcu m feren ti al
as
Referen ce
am pu tati on s
pl an es
l evel
th e
l evel
-
in
of
th e
th e
pect
of
th e
h eel
-
paral l el
fo r
pl an e
wi th
parti al
An teri or
ti bi a1
aspect
of
th e
at
th e
posteri o r
cen trel i n e
of
as-
th e
l eg .
pl an e
-
th e
pl an e
at
th e
1
th e
ti bi a
wi th
th e
cen trel i n e
of
S tu m p
4. 1 . 2. 3
paral l el
en d
wi th
at
th e
pl an e
th e
cabl e
4. 1 . 2. 4
of
Toe
of
th e
th e
red u cti o n
th e
an kl e
j oi n t
line
-
pl an e
-
th e
l eg
h e re .
Th e
th e
of
pl an e
as
at
th e
pl an e
at
paral l el
th e
wi th
ti ps
th e
of
th e
to
for
th e
1
to
7)
as
an d
record
th e
fo r
an d
th e
l en g th
appro pri ate
l evel
of
m easu rem en ts
tabl e
(see
tabl es
1
m o-
Acad em y
of
wh i ch
al l
d efi n ed
m oti o n s
zero
starti n g
power
power
l i kel y
to
affect
can
be
bu l ky
re l ati n g
are
or
to
e q u al l y
as
n ot
o bj e cti ve l y
wh i ch
is
m e as u re m e n ts
bu t
i n app l i -
of
p o we r
i n app ro pri ate .
to
h as
m easu red
ap p aratu s
wh e th e r
to
be
th e re
bas e d
is
on
s i g n i fi can t
an
th e
s tabi l i z e
s o cke t
in
p o we r
th e
th e
d e m o n s trated
ap pre ci -
pro xi m al
j oi n t
pro s th e ti c
wi th
s tan ce
wo u l d
th e
be
stu m p
in
a
ph as e .
Assessm en t
an
of
j oi n t
assessm en t
of
stabi l i ty
th e
j oi n t
stabi l i ty.
It
2
of
is
th e
8548,
bon y
re co g n i z e d
i n te g ri ty
th e
th e
e l e m e n ts .
In
re co rd i n g
an d /o r
th at
of
of
th e
th e
l i g am e n to u s
s tabi l i ty
of
osseou s,
co n te xt
j oi n t
a
j oi n t
is
a fu n c-
l i g am en to u s
of
i n stabi l i ty
i m pai rm e n ts
th i s
re fe rs
an d
th e i r
an d
p art
of
sol el y
co n s e -
as
to
7)
5
M eth o d
of
in
th e
th e
parti cu l ar
d e s cri bi n g
l o wer
limb
am pu tati o n .
5. 1
m easu rem en ts
reco rd
speci fi ed
th e
fro m
m ove-
j oi n t
m easu rem en ts
parti cu l ar
M easu re
in
j oi n t
of
q u e n ce s .
C i rcu m feren ti al
m en ts
1 9 64
m u scl e
j u d g em en t
am pu tati o n
4. 2. 2
of
s cal e s
wh e th e r
to
Record
to
M eas u rem e n ts
in
of
cen trel i n e
I S0
M easu re
ran g e
Am eri can
j oi n t
an d
po we r
n e u ro - m u s cu l ar
speci fi ed
j oi n t
stu m p
N OTE
Len g th
of
l eg .
l eg .
4. 2. 1
in
p o we r
cas e s
of
s u ffi ci e n t
th e
Th e
s u bj e cti ve
ti o n
4. 2
an y
par-
l eg .
cen trel i n e
co n tral ateral
an d
si g n i fi can tl y.
po l i o m ye l i ti s
4. 3 . 4
toes
th e
th e
of
e xpe n s i ve
we l l - fi tte d
en d
ran g e
m easu rem en t
m easu red
M u s cl e
re q u i re s
ati o n
al l el
are
an y
re d u cti o n
an teri o r
of
by
Assessm en t
Record
foo t
in
4. 1 . 2 . 2
power
m easu rem en t.
(u sed
th e
m u scl e
abn orm al
of
m eth od
Su rg eo n s
perform an ce
pl an e
re-
m ove-
th e
o n l y)
H eel
of
ad opted
j oi n t
N OTE
4. 1 . 2 . 1
be
posi ti on s.
4. 3 . 3
4. 1 . 2
of
abn orm al i ti es
u si n g
ti o n
d i stal
to
j oi n t
m ovem en t
o n l y.
d i sarti cu l ati on
of
kn ee
of
of
4. 1 . 1 . 8
n eed
ran g e
stabi l i ty.
Orth o paed i c
an kl e
wh i ch
of
sh ape
m easu rem en t.
con d yl ar
fu n cti on
abn o rm al i ti es
Record
4. 1 . 1 . 7
j oi n t
i n cl u d e
en d .
l o ss
an d
of
si d e
m en t,
ch an g es
fu n cti o n
an d
m ed i al
co rd ed
of
j oi n t
G en eral
Th e
tran s-ti bi a1
of
barefoo t.
ci rcu m feren ti al
appro pri ate
l evel
of
tabl e
am pu tati o n .
m easu re(see
tabl es
G e n e ral
D escri be
l i sted
by
s tu m p
th e
in
th e
th e
u se
stu m p
appro pri ate
of
th e
u si n g
th e
tabl es
g u i d an ce
rel evan t
(see
g i ven
in
tabl es
an n ex
d escri ptors
1
to
A.
7) ,
an d
I S0
5. 2
U se
Tran s- pel vi c
th e
5. 3
d escri pto rs
Hip
th e
am pu tati o n
sh own
in
tabl e
in
tabl e2.
u pp e r
at
ri g h t
an g l e s
th e
d escri ptors
” Hip
3
sh own
d i s arti cu l ati o n
ace tabu l o - fe m o ral
re fe re n ce
l e vel
j oi n t
as
or
re fe rs
”
an
to
am pu tati o n
d e s cri be d
fo r
am pu tati o n
abo ve
th e
u s u al
th e
at
th e
N OTE
6
m e n ts
tran s - fe m o ral
Th e
is
d escri pto rs
am pu tati o n
4
th e
Th e
is
th e
u pper
sh own
u pper
cro tch
in
at
ri g h t
an g l e s
wh i ch
re fe re n ce
bu t,
re fe re n ce
l e ve l
l e ve l
l eve l
in
fo r
cas e
th e
ce n tre l i n e
fo r
of
l e n g th
a ci rcu m fere n ti al
to
Kn e e
a
l e n g th
fl e xi o n
m e n ts
5
is
be
th e
th e
is
h i g h est
po s s i bl e
at
s tu m p.
wo u l d
be
m eas u rem e n t
of
in
tabl e
5.
re fe re n ce
u pper
at
ri g h t
j oi n t
line
l e vel
bu t,
re fe re n ce
wh i ch
a
an g l e s
to
l e ve l
in
fo r
th e
fo r
sh own
th e
in
Th e
u pp e r
cro tch
re fe re n ce
bu t,
in
th e
l e n g th
cas e
l e n g th
ci rcu m fe re n ti al
th e
m e as u re -
of
a
fl e xi o n
wo u l d
be
m e as u re m e n t
ce n tre l i n e
of
th e
is
(S ym e’ s )
th e
th e
is
stu m p.
d i sarti cu l ati o n
U se
th e
d escri pto rs
sh own
in
tabl e6.
h i g h est
po s s i bl e
at
N OTE
7
m e n ts
s tu m p.
is
Th e
th e
th e
l e ve l
at
u pper
m e d i al
u pper
at
ri g h t
re fe re n ce
j oi n t
line
re fe re n ce
wh i ch
a
an g l e s
to
l e ve l
bu t,
l e vel
in
fo r
th e
fo r
ci rcu m fe re n ti al
th e
ce n tre l i n e
tabl e4.
l e ve l
cas e
of
fo r
a
l e n g th
fl e xi o n
P arti al
fo o t
am pu tati o n
m e as u re d e fo rm i ty,
U se
th e
d escri ptors
l e n g th
cas e
l e n g th
d i sarti cu l ati o n
d escri ptors
th e
sh own
( be l o w- kn e e )
m e as u re d e fo rm i ty,
5. 8
N OTE
of
am pu tati o n
u pp e r
An kl e
po s s i bl e
th e
wo u l d
m e as u re m e n t
tabl e3 .
l e ve l
th e
at
h i g h est
U se
ce n tre l i n e
m ed i al
th e
d e fo rm i ty,
5. 5
l e n g th
( abo ve - kn e e )
5. 7
N OTE
th e
d e fo rm i ty,
Tran s - fe m o ral
m e n ts
th e
d escri ptors
po s s i bl e
th e
to
Tran s- ti bi a1
h i g h est
U se
fo r
th e
pro xi m al
am pu tati o n .
5. 4
l e vel
a ci rcu m fe re n ti al
d i sarti cu l ati o n
U se
N OTE
wh i ch
1 .
5. 6
U se
re fe re n ce
l e ve l
8548=2: 1 993 (E)
sh own
in
tabl e7.
of
m e as u re a
wo u l d
fl e xi o n
be
m e as u re m e n t
of
th e
s tu m p.
th e
is
I S0
8548-2:
1 993(E)
Tabl e
1
-
D escri ptors
for
tran s-pel vi c
D e s cri pto r
S tate m en ts
M e as u re m e n ts
N ot
S tu m p
th e
th e
co n tral ate ral
limb
is
th e
s i te
of
an
H e al e d /u n h e al e d
s car
S ki n
G e n e ral
b arri e r
S e n s ati o n
No
i n tact/s ki n
b arri e r
n o rm al /s e n s ati o n
ad d i ti o n al
not
i n tact
i m pai re d
s carri n g /ad d i ti o n al
s carri n g
C i rcu l ati o n
N o n e /pre s e n t/e xce s s i ve
Oe d e m a
ti s s u es
of
th e
s tu m p
Am o u n t
Ad e q u ate /i n ad e q u ate /e xce s s i ve
C o n s i s te n cy
N o rm al /fl abby/i n d u rate d
S i g n i fi can t
p ai n
S po n tan e o u s
p ai n
N o /ye s
Te n d e rn e s s
N o /ye s
P ai n fu l
N o /ye s
n e u ro m a
P h an to m
4
an n ex
A)
re l e van t
M o bi l e /ad h e re n t
P ai n
an d
re co rd e d
s tu m p
Am pu tati o n
S o ft
5. 2
Abs e n t/pre s e n t
re m n an t
If
of
be
(see
s h ape
P el vi c
S ki n
to
am pu tati o n s
afte r
p ai n
e xe rci s e
N o /ye s
N o /ye s
( g e n e ral i z e d ) /ye s
( l o cal i z e d )
am pu tati o n ,
s tate
th e
l eve l
I S0
Tabl e
2
-
D escri pto rs
fo r
D e s cri p to r
S tatem e n ts
M e as u re m e n ts
N ot
Stu m p
to
d i sarti cu l ati o n s
be
(see
5. 3
an d
an n ex
A)
re co rd e d
re l e van t
s h ap e
U pper
fe m o ral
re m n an t
Abs e n t/pre s e n t
If
S ki n
hip
8548=2: 1 993(E)
of
th e
th e
bu t
co n tral ate ral
not
limb
pro m i n e n t/pre s e n t
is
th e
si te
of
an
an d
pro m i n e n t
am pu tati o n ,
s tate
th e
l e ve l
s tu m p
Am pu tati o n
H e al e d /u n h e al e d
s car
M o bi l e /ad h e re n t
S ki n
G e n e ral
barri e r
S e n s ati o n
No
i n tact/s ki n
b arri e r
n o rm al /s e n s ati o n
ad d i ti o n al
n ot
i n tact
i m pai re d
s carri n g /ad d i ti o n al
s carri n g
C i rcu l ati o n
N o n e /pre s e n t/e xce s s i ve
Oed em a
S o ft
ti s s u e s
of
th e
s tu m p
Am o u n t
Ad e q u ate /i n ad e q u ate /e xce s s i ve
C o n s i s te n cy
N o rm al /fl abby/i n d u rate d
S i g n i fi can t
pai n
S p o n tan e o u s
pai n
N o /ye s
Te n d e rn e s s
N o /ye s
P ai n fu l
N o /ye s
n e u ro m a
P h an to m
P ai n
afte r
pai n
e xe rci s e
( g e n e ral i z e d ) /ye s
( l o cal i z e d )
N o /ye s
N o /ye s
5
I S0
8 5 48 - 2 : 1 9 9 3 ( E )
Tabl e
3
-
D escri ptors
fo r
tran s-fem o ral
tran sco n d yl ar
(above- kn ee)
am pu tati on s)
am pu tati on s
(see
be
fi g u re
1
(i n cl u d i n g
an d
an n ex
D e s cri pto r
S tatem en ts
M e as u re m e n ts
R e co rd
th e
-
th e
l e n g th
fro m
th e
cro tch
-
th e
l e n g th
fro m
th e
“fal l - away”
-
th e
l e n g th
of
th e
co n tral ate ral
limb
fro m
th e
th e
l e n g th
of
th e
co n tral ate ral
limb
fro m
th e
-
to
5. 4,
su pracon d yl ar
re co rd e d
fo l l o wi n g
m e as u re m e n ts ? )
to
th e
s tu m p
to
th e
en d ,
s tu m p
I,
en d,
cro tch
m ed i al
Z2
to
th e
j oi n t
g ro u n d ,
line
to
-
th e
ci rcu m fe re n ce
at
th e
cro tch ,
-
th e
ci rcu m fe re n ce
at
th e
“fal l - away”,
S tu m p
Ski n
co n tral ate ral
limb
is
th e
si te
C,
of
an
C2
am pu tati o n ,
s tate
th e
l e ve l
s h ap e
C yl i n d ri cal /co n i cal /bu l bo u s
G e n e ral
End
th e
of
of
N ot
fe m u r
th e
pro m i n e n t/pro m i n e n t
s tu m p
Am pu tati o n
H e al e d /u n h e al e d
s car
M o bi l e /ad h e re n t
S ki n
G e n e ral
barri e r
S e n s ati o n
No
i n tact/s ki n
b arri e r
n o rm al /s e n s ati o n
ad d i ti o n al
n ot
i n tact
i m pai re d
s carri n g /ad d i ti o n al
s carri n g
Ci rcu l ati o n
Col ou r
of
N o rm al /cyan o ti c/o th e r
ski n
Te m pe ratu re
( to
th e
e xam i n i n g
h an d )
So ft
d i s co l o rati o n
Warm /co l d
N o n e /pre s e n t/e xce s s i ve
Oed em a
ti s s u e s
of
th e
s tu m p
Am o u n t
Ad e q u ate /i n ad e q u ate /e xce s s i ve
C o n s i s te n cy
N o rm al /fl abby/i n d u rate d
Si g n i fi can t
pai n
S po n tan e o u s
N o /ye s
pai n
Te n d e rn e s s
N o /ye s
P ai n fu l
N o /ye s
n e u ro m a
P h an to m
P ai n
J oi n t
( l o cal i z e d )
N o /ye s
pai n
afte r
( g e n e ral i z e d ) /ye s
N o /ye s
e xe rci s e
fu n cti o n
Hip
R an g e
M u scl e
1 )
of
N o rm al /abn o rm al
m o vem e n ts
No
p o we r
s i g n i fi can t
S tabi l i ty
N o rm al /i m pai re d
P ai n
N o /ye s
If
th e
s tu m p
was
m e as u re d
wi th
th e
p ati e n t
in
an y
( S pe ci fy:
fl e xi o n /e xte n s i o n
re d u cti o n /s i g n i fi can t
po s i ti o n
o th e r
th an
or
ab d u cti o n /ad d u cti o n )
re d u cti o n
s tan d i n g ,
s tate
th e
p ati e n t’ s
Z3
th e
4
If
an d
A)
p o s tu re .
g ro u n d ,
I S0
Cro tch
Fal l - away
S tu m p
en d
l e ve l
8548=2: 1 993 (E)
-
LeveL
l e ve l
- M e d i al
j oi n t
line
,
-
Fi g u re
1
-
Referen ce
l evel s
an d
m easu rem en ts
fo r
tran s- fem o ral
G rou n d
Level
am pu tati o n s
l e ve l
I S0
8 5 48 - 2 :
Tabl e
1 993(E)
-
4
D escri pto rs
fo r
kn ee
d i sarti cu l ati on s
am pu tati o n s)
(see
(n o t
5. 5,
D e s cri pto r
S tate m e n ts
to
M eas u re m en ts
R e co rd
th e
-
th e
l e n g th
fro m
-
th e
l e n g th
of
-
th e
l e n g th
an d
su praco n d yl ar
A)
of
cro tch
to
th e
co n tral ate ral
th e
s tu m p
limb
co n tral ate ral
fro m
limb
en d ,
th e
I,
cro tch
fro m
th e
to
th e
m ed i al
g ro u n d ,
j oi n t
Zd
ci rcu m fe re n ce
-
th e
minimum
-
th e
ci rcu m fe re n ce
at
th e
cro tch ,
ci rcu m fe re n ce
co n tral ate ral
of
limb
th e
is
C,
of
th e
fe m o ral
th e
s i te
of
s tu m p,
co n d yl e s ,
an
C4
C T3
am pu tati o n ,
s tate
th e
l e vel
s h ape
C yl i n d ri cal /bu l bo u s /co n i cal
G e n e ral
Ski n
th e
th e
th e
tran sco n d yl ar
an n ex
m e as u re m e n ts : l )
th e
-
If
an d
re co rd e d
fo l l o wi n g
g ro u n d ,
Stu m p
be
i n cl u d i n g
fi g u re2
of
th e
stu m p
Am pu tati o n
H e al e d /u n h e al e d
s car
M o bi l e /ad h e re n t
S ki n
G e n e ral
b arri e r
S e n s ati o n
No
i n tact/s ki n
barri e r
n o rm al /s e n s ati o n
ad d i ti o n al
n ot
i n tact
i m pai re d
s carri n g /ad d i ti o n al
s carri n g
C i rcu l ati o n
Col ou r
of
N o rm al /cyan o ti c/o th e r
s ki n
Te m pe ratu re
( to
th e
e xam i n i n g
h an d )
N o n e /pre s e n t/e xce s s i ve
Oe d e m a
S o ft
d i s co l o rati o n
Warm /co l d
ti s s u es
of
th e
s tu m p
Am o u n t
Ad e q u ate /i n ad e q u ate /e xce s s i ve
C o n s i s te n cy
N o rm al /fl abby/i n d u rate d
S i g n i fi can t
p ai n
S po n tan e o u s
N o /ye s
pai n
Te n d e rn e s s
N o /ye s
P ai n fu l
N o /ye s
n e u ro m a
P h an to m
P ai n
J oi n t
( l o cal i z e d )
N o /ye s
pai n
afte r
( g e n e ral i z e d ) /ye s
N o /ye s
e xe rci s e
fu n cti o n
Hip
R an g e
M u s cl e
1 )
of
N o rm al /abn o rm al
m o ve m en ts
No
p o we r
s i g n i fi can t
S tabi l i ty
N o rm al /i m pai red
P ai n
N o /ye s
If
th e
stu m p
was
m e as u re d
wi th
th e
pati e n t
in
an y
( S peci fy:
fl e xi o n /e xte n s i o n
re d u cti o n /s i g n i fi can t
po s i ti o n
o th e r
th an
or
abd u cti o n /ad d u cti o n )
re d u cti o n
s tan d i n g ,
s tate
th e
pati e n t’ s
po s tu re .
5
line
to
th e
I S0
Crotch
M i n i m u m ci rcu m fe re n ce
Fe m o ral
co n d yl ar
Stu m p
en d
l e ve l
8548-2:
-
l e ve l
l e ve l
-
l e vel
M e d i al j o i n t
M
U
-
Fi g u re
1 993(E)
2
-
Referen ce
l evel s
an d
m easu rem en ts
for
kn ee
G rou n d
d i sarti cu l ati o n s
l e ve l
line
l e ve l
I S0
8548-2: 1 993(E )
Tabl e
-
5
D escri ptors
fo r
tran s-ti bi a1
(bel o w-kn ee)
to
D e s cri pto r
S tate m en ts
M e as u re m e n ts
R e co rd
th e
-
th e
l e n g th
fro m
th e
cro tch
-
th e
l e n g th
fro m
th e
m ed i al
-
th e
l e n g th
fro m
th e
“fal l - away”
-
th e
l e n g th
of
-
th e
l e n g th
th e
of
to
th e
j oi n t
to
po i n t
co n tral ate ral
th e
m e d i al
line
limb
co n tral ate ral
j oi n t
th e
to
fro m
limb
fi g u re3
an d
an n ex
l i n e,
stu m p
I,
th e
s tu m p
en d ,
th e
cro tch
to
fro m
th e
l2
th e
m e d i al
g ro u n d ,
j oi n t
th e
ci rcu m fe re n ce
at
th e
l e ve l
th e
ci rcu m fe re n ce
at
th e
“fal l - away”,
co n tral ate ral
limb
is
th e
of
s i te
of
th e
an
m ed i al
j oi n t
l i n e,
C,
C2
am pu tati o n ,
s tate
th e
l eve l
s h ap e
C yl i n d ri cal /co n i cal /bu l bo u s
G e n e ral
En d
of
ti bi a
N ot
pro m i n e n t/pro m i n e n t
En d
of
fi bu l a
N ot
pro m i n e n t/pro m i n e n t
of
th e
s tu m p
Am pu tati o n
H e al e d /u n h e al e d
s car
M o bi l e /ad h e re n t
S ki n
G e n e ral
barri e r
S e n s ati o n
No
i n tact/s ki n
b arri e r
n o rm al /s e n s ati o n
ad d i ti o n al
not
i n tact
i m pai re d
s carri n g /ad d i ti o n al
s carri n g
C i rcu l ati o n
Col ou r
of
N o rm al /cyan o ti c/o th e r
s ki n
Te m pe ratu re
( to
th e
e xam i n i n g
h an d )
S o ft
d i s co l o rati o n
Warm /co l d
N o n e /p re s e n t/e xce s s i ve
Oe d e m a
ti ss u e s
of
th e
s tu m p
Am o u n t
Ad e q u ate /i n ad e q u ate /e xce s s i ve
C o n s i s te n cy
N o rm al /fl abby/i n d u rate d
S i g n i fi can t
pai n
S po n tan e o u s
N o /ye s
pai n
Te n d e rn e s s
N o /ye s
P ai n fu l
N o /ye s
n e u ro m a
P h an to m
P ai n
J oi n t
( g e n e ral i z e d ) /ye s
( l o cal i z e d )
N o /ye s
pai n
afte r
N o /ye s
e xe rci s e
fu n cti o n
Hip
R an g e
M u scl e
of
N o rm al /abn o rm al
m o ve m en ts
No
po we r
s i g n i fi can t
( S pe ci fy:
fl e xi o n /e xte n s i o n
re d u cti o n /s i g n i fi can t
or
ab d u cti o n /ad d u cti o n )
re d u cti o n
N o rm al /i m pai re d
S tabi l i ty
Kn e e
R an g e
M u scl e
of
m o ve m en ts
N o rm al /abn o rm al
po we r
No
S tabi l i ty
P ai n
1 )
1 0
in
I f th e
s i g n i fi can t
( S pe ci fy:
fl e xi o n /e xte n s i o n )
re d u cti o n /s i g n i fi can t
re d u cti o n
N o rm al /i m pai re d
pro xi m al
stu m p
j o i n ts
was
m easu red
N o /ye s
wi th
th e
pati e n t
in
an y
A)
Z5
en d ,
Z4
-
th e
5. 6,
m e as u re m e n ts ? )
-
If
S ki n
(see
re co rd e d
fo l l o wi n g
g ro u n d ,
S tu m p
be
am pu tati o n s
po s i ti o n
o th e r
th an
s tan d i n g ,
s tate
th e
pati e n t’ s
p o s tu re .
Z3
line
to
th e
I S0
8 5 48 - 2 : 1 9 9 3 ( E )
C ro tch
- M e d i al j o i n t
line
l e ve l
Fal l - away
S tu m p e n d
- G ro u n d l e ve l
Fi g u re
3
-
Referen ce
l evel s
an d
m easu rem en ts
for
tran s- ti bi a1
am pu tati on s
1 1
I S0
8 5 48 = 2 : 1 9 9 3 ( E )
Tabl e
-
6
D escri ptors
for
an kl e
(Sym e’ s)
to
d i sarti cu l ati on s
I e s cri pto r
S tatem e n ts
Vl e as u re m e n ts
R e co rd
th e
-
th e
l e n g th
fro m
th e
cro tch
-
th e
l e n g th
fro m
th e
m ed i al
-
th e
l e n g th
of
-
th e
l e n g th
of
fi g u re4
an d
an n ex
A)
to
th e
j oi n t
co n tral ate ral
th e
m ed i al
line
limb
co n tral ate ral
to
j oi n t
th e
fro m
th e
limb
l i n e,
s tu m p
cro tch
fro m
Z5
en d ,
th e
to
Z6
th e
m e d i al
g ro u n d ,
j oi n t
Z4
th e
ci rcu m fe re n ce
th e
minimum
-
th e
m axi m u m
at
th e
m ed i al
ci rcu m fe re n ce
d i stal
co n tral ate ral
limb
of
j oi n t
th e
ci rcu m fe re n ce
is
th e
si te
of
l i n e,
of
an
C,
stu m p,
th e
C4
s tu m p,
am pu tati o n ,
Cs
s tate
th e
l e ve l
s h ap e
G e n e ral
C yl i n d ri cal /bu l bo u s
Bon e
N ot
Ski n
th e
-
th e
5. 7,
m e as u re m e n ts ? )
-
If
(see
re co rd e d
fo l l o wi n g
g ro u n d ,
Stu m p
be
of
th e
pro m i n e n t/pro m i n e n t
s tu m p
Am pu tati o n
H e al e d /u n h e al e d
s car
M o bi l e /ad h e re n t
S ki n
G e n e ral
barri e r
S e n s ati o n
No
i n tact/s ki n
b arri e r
n o rm al /s e n s ati o n
ad d i ti o n al
n ot
i n tact
i m pai re d
s carri n g /ad d i ti o n al
s carri n g
Ci rcu l ati o n
Col ou r
of
N o rm al /cyan o ti c/o th e r
s ki n
Te m pe ratu re
( to
th e
e xam i n i n g
h an d )
N o n e /pre s e n t/e xce s s i ve
Oed em a
So ft
d i s co l o rati o n
Warm /co l d
ti s s u e s
of
th e
s tu m p
Am o u n t
Ad e q u ate /i n ad e q u ate /e xce s s i ve
C o n s i s te n cy
N o rm al /fl abby/i n d u rate d
Si g n i fi can t
pai n
S po n tan e o u s
N o /ye s
pai n
Te n d e rn e s s
N o /ye s
P ai n fu l
N o /ye s
n e u ro m a
P h an to m
P ai n
J oi n t
( l o cal i z e d )
N o /ye s
pai n
afte r
( g e n e ral i z e d ) /ye s
N o /ye s
e xe rci s e
fu n cti o n
Hip
R an g e
M u scl e
of
N o rm al /abn o rm al
m o ve m e n ts
No
po we r
s i g n i fi can t
( S pe ci fy:
fl e xi o n /e xte n s i o n
re d u cti o n /s i g n i fi can t
or
ab d u cti o n /ad d u cti o n )
re d u cti o n
N o rm al /i m pai re d
S tabi l i ty
Kn e e
R an g e
M u scl e
of
N o rm al /abn o rm al
m o vem e n ts
No
p o we r
1 )
1 2
If
in
th e
( S pe ci fy:
fl e xi o n /e xte n s i o n )
re d u cti o n /s i g n i fi can t
re d u cti o n
N o rm al /i m pai re d
S tabi l i ty
P ai n
s i g n i fi can t
pro xi m al
stu m p
N o /ye s
j o i n ts
was
m e as u re d
wi th
th e
p ati e n t
in
an y
po s i ti o n
o th e r
th an
s tan d i n g ,
s tate
th e
pati e n t’ s
po s tu re .
Z3
line
to
th e
Cl
i
Cro tch
l e ve l
I /-- -- - -
-
- M e d i al
M n i m u m ci rcu m fe re n ce
M axi m u m d i s tal
l e vel
en d
-
l e vel
.
- G rou n d
Fi g u re
4
1 i n e l e ve l
l e ve l -
ci rcu m fe re n ce
Stu m p
j oi n t
-
Referen ce
l evel s
an d
m easu rem en ts
for
an kl e
l e ve l
d i sarti cu l ati o n s
1 3
I S0
8548-2:
1 993(E)
Tabl e
7
-
D escri pto rs
fo r
parti al
U l e as u re m e n ts
R e co rd
th e
-
th e
l e n g th
fro m
th e
h eel
-
th e
l e n g th
fro m
th e
an te ri o r
-
th e
l e n g th
of
S tu m p
fo l l o wi n g
an y
(see
fi g u re
5)
re co rd e d
m e as u re m e n ts:
th e
pl an e
co n tral ate ral
s i g n i fi can t
an d
co n tral ate ral
N ot
pro m i n e n t/pro m i n e n t
l e n g th
to
ti bi a1
th e
s tu m p
p l an e
fo o t
fro m
d i s cre p an cy
to
en d
th e
th e
h eel
b e twe e n
pl an e ,
stu m p
pl an e
th e
Z8
en d
to
pl an e ,
th e
s e g m e n ts
l i m bs
s h ap e
Bon es
S ki n
be
am pu tati on s
l e s cri pto r
R e co rd
to
fo ot
S tatem e n ts
of
th e
s tu m p
Am pu tati o n
H e al e d /u n h e al e d
s car
M o bi l e /ad h e re n t
S ki n
G e n e ral
barri e r
S e n s ati o n
No
i n tact/s ki n
b arri e r
n o rm al /s e n s ati o n
ad d i ti o n al
n ot
i n tact
i m pai re d
s carri n g /ad d i ti o n al
s carri n g
Zi rcu l ati o n
Col ou r
of
N o rm al /cyan o ti c/o th e r
s ki n
Te m pe ratu re
( to
th e
e xam i n i n g
d i s co l o rati o n
Warm /co l d
N o n e /p re s e n t/e xce s s i ve
Oed em a
S o ft
h an d )
ti s s u e s
of
th e
s tu m p
Am o u n t
Ad e q u ate /i n ad e q u ate /e xce s s i ve
C o n s i s te n cy
N o rm al /fl abby/i n d u rate d
S i g n i fi can t
pai n
S po n tan e o u s
pai n
N o /ye s
Te n d e rn e s s
N o /ye s
P ai n fu l
N o /ye s
n e u ro m a
P h an to m
P ai n
J oi n t
( l o cal i z e d )
N o /ye s
pai n
afte r
( g e n e ral i z e d ) /ye s
e xe rci s e
N o /ye s
fu n cti o n
Hip
R an g e
of
M u scl e
m o ve m en ts
N o rm al /abn o rm al
No
po we r
s i g n i fi can t
( S pe ci fy:
fl e xi o n /e xte n s i o n
re d u cti o n /s i g n i fi can t
re d u cti o n
N o rm al /i m pai re d
S tabi l i ty
Kn e e
R an g e
of
M u scl e
m o ve m en ts
N o rm al /abn o rm al
No
po we r
s i g n i fi can t
( S pe ci fy:
fl e xi o n /e xte n s i o n )
re d u cti o n /s i g n i fi can t
re d u cti o n
N o rm al /i m pai re d
S tabi l i ty
An kl e
R an g e
of
M u scl e
m o ve m en ts
S tabi l i ty
P ai n
Fo o t
1 4
in
N o rm al /abn o rm al
N o s i g n i fi can t
po we r
( S pe ci fy:
fl e xi o n /e xte n s i o n )
re d u cti o n /s i g n i fi can t
re d u cti o n
N o rm al /i m pai red
pro xi m al
j o i n ts
N o /ye s
re m n an t
G e n e ral
Oth e rwi s e
P l an ti g rad e
N o /ye s
O th e r
N ot
d e fo rm i ti e s
n o rm al /abn o rm al
s i g n i fi can t/s i g n i fi can t
( s pe ci fy)
( s pe ci fy)
or
ab d u cti o n /ad d u cti o n )
Z,
to e
of
pl an e ,
th e
Z9
affe cte d
I S0
-H eel
8 5 48 = 2 : 1 9 9 3 ( E )
p l an e
-
An ter
i or
ti bi a1
pl an e
-
Stu m p
en d
pl an e
-
-, - -
To e pl an e
/
I
I
I
‘ \A
/
-z - -c-
1 7
(N on - am pu tated
foot)
-
-
1 9
Fi g u re
5
-
Referen ce
pl an es
an d
m easu rem en ts
fo r
parti al
foo t
am pu tati o n s
1 5
I S0
8 5 48 = 2 : 1 9 9 3 ( E )
An n e x
A
(i n fo rm ati ve)
E xpl an ato ry
Am1
Th e
n o tes
for
d escri pto rs
A. 5
G en eral
m ai n
u se d
el em en ts
in
an y
d escri pti o n
sh ou l d
facto rs
reco rd ed
a)
stu m p
m easu rem en ts;
b)
stu m p
sh ape;
d
th e
a)
tabl e s
1
to
7
C i rcu l ati o n
M an y
i n cl u d e:
in
con cern i n g
bu t
wh eth er
it
is
th e
th e
en o u g h
ski n
is
ci rcu l ati on
to
might
wel l
be
state:
n o rm al ,
cyan o ti c
or
o th erwi se
d i scol ou red ;
co n d i ti o n
of
th e
ski n
of
th e
b)
stu m p;
wh eth er
it
is
warm
to
th e
exam i n i n g
h an d
or
n ot;
an d
d)
th e
co n d i ti o n
of
th e
ci rcu l ati on
e)
th e
co n d i ti o n
of
th e
soft
f1
.
pai n I
in
th e
stu m p;
c)
ti ssu es
of
th e
wh eth er
o ed em a
E xcessi ve
force
pro xi m al
9)
j oi n t
fu n cti o n ,
to
i n cl u d e
is
presen t.
stu m p;
ran g e
of
m o ve-
th e
d ay
or
wi th
a
oed em a
pati en t
su ch
th at
is
to
seen
take
on e
o ff
to
be
th e
wou l d
th at
wh i ch
pro sth esi s
h esi tate
to
wou l d
d u ri n g
fi t
th e
th e
pati en t
prosth esi s.
m en t;
rel evan t
h)
d i m en si o n s
of
th e
co n tral ateral
Am 6
l i m b.
Th e
A. 2
M e as u re m e n ts
Th e
no
m easu rem en ts
speci al
m em ber
m en ts
of
th e
u sed
ad eq u ate
ch osen
is
cl i n i c
no
are
an d
m ore
of
Th e
th an
th e
n o n -i n vasi ve,
can
team .
d escri pti o n
soft
term s
eq u i pm en t,
is
be
of
n ecessary
stu m p
an d
i ts
ti ssu es
of
th e
by
an y
to
g i ve
an
proporti on s.
Am 7
bu l bo u s
of
an d
provi d ed
th e
i n terpreted
In
ad d i ti o n
is
unduly
th e
cyl i n d ri cal .
word s
too
it
sh ape
is
are
restri cted
Bu l bo u s
is
“cyl i n d ri cal ”
l i teral l y,
th ey
i m po rtan t
to
or
are
to
record
con i cal ,
sel f- evi d en t
“con i cal ”
eq u al l y
P ai n
as
an
an d ,
are
en ti ty
of
ever
so u rce,
pai n
an d
fro m
th e
wi th
th e
req u i rem en t
d etai l
h eal ed
bu t
th e
it
ski n
of
th e
g en eral
th e
ski n
to
an d
ad d i ti o n al
1 6
th e
wh eth er
wh eth er
on l y
in
si g n i fi can t
to
after
pai n fu l
exerci se
is
ph an tom
d escri be
Th e
spo n tan eo u s
ten d ern ess,
pai n
d i ffi cu l t
m easu rem en t.
pai n
fro m
n eu rom a,
to
be
sen sati on s
an d
is
presen ce
or
wh at-
ph an to m
d i sti n g u i sh ed
an d
is
to
be
record ed .
n ot
wh eth er
an y
bon e
Am 8
J oi n t
fu n cti o n
prom i n en t.
d escri bi n g
n ote
d escri bed
d escri pti ve.
S ki n
si m pl y
are
co n si sten cy.
al ways
of
co m m on
j oi n t
m en t,
po wer
is
be
to
si tu ati o n .
ski n
h as
barri er
n o rm al
d escri be
sh o u l d
be
m obi l e,
scarri n g
stu m p,
th e
is
sh o u l d
is
sen sati on .
n o ted .
is
co n cern ed
su ffi ci en t
or
n o t,
Th ere
i n ci si o n
wh eth er
oth erwi se.
be
It
i n tact
operati on
reco rd ed
or
on e
Th e
th e
fu n cti o n
an d
or
in
term s
stabi l i ty,
n oted .
con tractu res)
In
is
i n capabl e
P ro xi m al
A. 4
stu m p
an d
P ai n
l arg el y
S h ape
D escri pti on s
th e
m easu re-
absen ce
A. 3
of
am ou n t
req u i re
m ad e
n u m ber
ti s s u e s
So ft
an d
Abn o rm al i ti es
excessi ve
of
ran g e
th e
of
m o ve-
presen ce
of
of
m ovem en t
m o vem en t
pai n
(e. g .
is
al so
stu m p
can
to
be
record ed .
to
an d
is
in
no
scar
presen ce
Am 9
C o n tral ate ral
limb
an y
is
of
In
o rd er
l ated
to
th at
th e
n eed s
som e
l en g th
from
th e
d escri pti on
pati en t
m i n i m al
th e
as
of
a wh ol e,
d i m en si o n al
cro tch
to
th e
th e
th e
d escri pti on ,
g rou n d .
be
co n tral ateral
e. g .
re-
limb
th e
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I S0
8548- 2:
U DC
61 6- 0 8 9 . 28 5 9 1 . 471 . 3 73
D escri ptors:
P ri ce
1 9 93 (E )
based
m e d i ci n e ,
on
1 6
pag es
pro sth eti c
d e vi ce s,
l o wer
l i m bs,
d efects,
d e scri pti on .