ISO 8548-3:2025
(Main)Prosthetics and orthotics — Limb deficiencies — Part 3: Method of describing the residual limb after upper limb amputation
Prosthetics and orthotics — Limb deficiencies — Part 3: Method of describing the residual limb after upper limb amputation
This document specifies a method of describing and measuring the residual limb after upper limb amputation. It also defines the measurements required for the provision of a prosthesis.
Prothèses et orthèses — Malformations des membres — Partie 3: Méthode de description du membre résiduel après amputation du membre supérieur
General Information
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Standards Content (Sample)
International
Standard
ISO 8548-3
Second edition
Prosthetics and orthotics — Limb
2025-01
deficiencies —
Part 3:
Method of describing the residual
limb after upper limb amputation
Prothèses et orthèses — Malformations des membres —
Partie 3: Méthode de description du membre résiduel après
amputation du membre supérieur
Reference number
© ISO 2025
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ii
Contents Page
Foreword .iv
Introduction .v
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
4 Description . . 1
4.1 General .1
4.2 Characteristics.1
4.3 Skin .2
4.4 Circulation .2
4.5 Pain .2
4.6 Phantom sensation and phantom pain .2
4.7 Joint and muscle function.2
4.7.1 Measurement of the range of joint movement .2
4.7.2 Assessment of the residual limb muscle strength .3
4.7.3 Assessment of residual limb muscle activity .3
4.7.4 Assessment of joint stability .3
4.7.5 Assessment of joint pain .3
4.7.6 Assessment of hand function .3
5 Measurements of the residual limb . 3
5.1 Reference levels and reference planes.3
5.2 Measurements . .4
iii
Foreword
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This document was prepared by Technical Committee ISO/TC 168, Prosthetics and orthotics.
This second edition cancels and replaces the first edition (ISO 8548-3:1993), which has been technically
revised.
The main changes are as follows:
— in line with changes in ISO 8549-4, the remaining part of the limb is referred to using the preferred term
“residual limb”, or residuum, as opposed to “stump”;
— the residual limb descriptors have been revised;
— the lists of measurements to be taken by all members of the interprofessional team (doctors, prosthetist,
physical, and occupational therapists, nurses) and the additional measurements to be taken only by the
prosthetist have been revised;
— the use of hyphens in anatomical terms, such as transradial, has been removed in line with other parts
of the ISO 8549 series.
A list of all parts in the ISO 8548 series can be found on the ISO website.
Any feedback or questions on this document should be directed to the user’s national standards body. A
complete listing of these bodies can be found at www.iso.org/members.html.
iv
Introduction
This document provides all members of the interprofessional team (doctors, prosthetists, physical and
occupational therapists, nurses) treating the person with a method for describing and measuring the
residual limb after upper limb amputation.
A standardized method allows comparisons of the outcomes of amputation surgery and rehabilitation.
Such a method is also of value to epidemiologists, government health officials, and for those researching and
reporting on prosthetic use.
v
International Standard ISO 8548-3:2025(en)
Prosthetics and orthotics — Limb deficiencies —
Part 3:
Method of describing the residual limb after upper limb
amputation
1 Scope
This document specifies a method of describing and measuring the residual limb after upper limb
amputation. It also defines the measurements required for the provision of a prosthesis.
2 Normative references
The following documents are referred to in the text in such a way that some or all of their content constitutes
requirements of this document. For dated references, only the edition cited applies. For undated references,
the latest edition of the referenced document (including any amendments) applies.
ISO 8549-1, Prosthetics and orthotics — Vocabulary — Part 1: General terms for external limb prostheses and
external orthoses
ISO 8549-2, Prosthetics and orthotics — Vocabulary — Part 2: Terms relating to external limb prostheses
ISO 8549-4, Prosthetics and orthotics — Vocabulary — Part 4: Terms relating to limb amputation
3 Terms and definitions
For the purposes of this document, the terms and definitions given in ISO 8549-1, ISO 8549-2 and
ISO 8549-4 apply.
ISO and IEC maintain terminology databases for use in standardization at the following addresses:
— ISO Online browsing platform: available at https:// www .iso .org/ obp
— IEC Electropedia: available at https:// www .electropedia .org/
4 Description
4.1 General
Specify the amputation side and describe the residual limb using the relevant descriptors listed in Tables 1
to 7 and in 4.2 to 4.6.
4.2 Characteristics
The shape of the residual limb shall be described as either conical, bulbous or cylindrical.
The soft tissues of the residual limb shall be described by reference to their amount and consistency.
The amount shall be described as sufficient, insufficient or excessive and the consistency described as
normal, firm or flaccid.
It should be recorded whether the residual limb musculature is attached, detached or displaced.
Relevant bony features such as prominences, remnants, length or position shall be described.
The presence of any prominent foreign bodies, e.g. implants, shrapnel, shall be noted. The ability of the
residual limb-end to tolerate contact shall be recorded.
For partial hand amputations, record the level of amputation as specified in ISO 8549-4. The complete
description shall include the identification of the amputated bones and their level of amputation.
4.3 Skin
It should be noted whether the skin barrier is intact or not and whether the skin has normal sensation.
The position/orientation of the incisional scar and whether it is healed or not and mobile or adherent shall
be recorded. Additionally, the presence and condition of other scarring or skin grafting shall be noted.
Any history of skin pathology e.g. dermatitis, skin allergy and/or hyperhidrosis that can affect the residual
limb and prosthetic fitting shall be noted.
4.4 Circulation
The factors concerning the circulation which shall be described are colour, temperature and oedema.
The skin shall be described as either normal in colour, cyanotic or otherwise discoloured.
The skin shall be described as either normal in temperature or hot or cold to examination.
The presence of excessive oedema shall be noted. Excessive oedema is considered as that which would
adversely affect healing of the residual limb or prosthetic fitting and use.
4.5 Pain
Significant pain is regarded as that which is greater than expected at the stage of treatment.
The presence of significant pain or tenderness from whatever source, (e.g. painful neuroma, pain after
exercise or from prosthetic use) shall be recorded using an appropriate pain scale.
The location of pain and what modulates and elicits the pain shall be recorded.
4.6 Phantom sensation and phantom pain
Phantom sensation and phantom pain are felt as if in the amputated part of the limb. Phantom sensation is
common after amputation.
The capacity to perceive movement of the phantom limb shall be noted as well as the perceived resting
position of the phantom limb.
Phantom pain varies in intensity and shall be recorded using an appropriate pain scale.
The location of pain and what modulates and elicits the pain shall be recorded.
4.7 Joint and muscle function
4.7.1 Measurement of the range of joint movement
Abnormalities of the range of joint movement in the proximal joint(s) of the residual limb shall be recorded
using the neutral zero method in which zero is the anatomical position.
4.7.2 Assessment of the residual limb muscle strength
Reduced strength of the muscle groups responsible for producing movements at the proximal joint(s) of the
residual limb shall be recorded using the manual muscle testing 0 to 5 scale.
Surface electromyography (EMG) testing of the muscles may be conducted.
4.7.3 Assessment of residual limb muscle activity
The ability to selectively activate the muscles of the residual limb
...
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