Thermal Symmetry Between Residual and Intact Limbs in Individuals with Lower Limb Amputation: Resting and Post-Activity Conditions

Background and Objectives: Individuals with lower limb amputation are at increased risk of developing post-amputation complications that may affect rehabilitation outcomes. Assessing thermal symmetry between the residual and intact limbs, as well as activity-related temperature changes, represents a non-invasive and cost-effective approach for preliminary clinical evaluation. This study aimed to investigate regional skin temperature symmetry between residual and intact limbs at rest and following activity, and to examine whether the presence of phantom limb sensation or pain influences thermal patterns. Methods: Twenty-three individuals with unilateral lower limb amputation (mean age: 42.2 ± 15.1 years) participated in this cross-sectional study. The presence of phantom limb sensation and pain was recorded. Skin temperature measurements were obtained using a non-contact infrared thermometer under two conditions: “resting” and “post-activity” following a 10 min self-selected walking task, conducted after prosthetic removal. Measurements were acquired from the patella, tibialis anterior, and distal points of both the residual and intact limbs in both conditions. Results: Significant inter-limb differences were observed in the patellar and tibialis anterior regions, with higher temperatures at the patella and lower temperatures at the tibialis anterior on the residual limb. No significant differences were detected at the distal regions under either condition. Post-activity temperature increases were observed in the tibialis anterior and distal regions of the intact limb, whereas no comparable adaptation was observed on the residual limb. Thermal profiles did not differ between participants with and without phantom limb pain or sensation. Conclusions: These findings demonstrate that skin temperature dynamics in individuals with amputation are region-specific and influenced by functional activity. The absence of post-activity thermal adaptation in the residual limb may have clinical implications for rehabilitation monitoring. Incorporating regional thermal assessment into routine evaluation may support individualized rehabilitation strategies following lower limb amputation.