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Prosthetics and Orthotics International

Saffran Möller, David Rusaw, Kerstin Hagberg, Nerrolyn Ramstrand
BACKGROUND: Individuals using a lower-limb prosthesis indicate that they need to concentrate on every step they take. Despite self-reports of increased cognitive demand, there is limited understanding of the link between cognitive processes and walking when using a lower-limb prosthesis. OBJECTIVE: The objective was to assess cortical brain activity during level walking in individuals using different prosthetic knee components and compare them to healthy controls...
October 30, 2018: Prosthetics and Orthotics International
Kate Sherman, Andrew Roberts, Kevin Murray, Sarah Deans, Hannah Jarvis
BACKGROUND: Reduced function and health in individuals with lower limb amputation is well documented. Step count measurement could facilitate rehabilitation and help monitor functional health outcomes. OBJECTIVES: To determine whether mean daily step count changed between in-patient rehabilitation and consecutive leave periods. STUDY DESIGN: Observational study. METHODS: Nine individuals with bilateral traumatic amputations attending rehabilitation at the Defence Medical Rehabilitation Centre during a 4-month period were invited to participate in the study (two bilateral transfemoral, two bilateral transfemoral/knee disarticulation, two transfemoral/transtibial, one bilateral transfemoral plus transradial, one bilateral transfemoral plus transhumeral and one transfemoral/transtibial/transradial)...
October 30, 2018: Prosthetics and Orthotics International
Lucy Armitage, Li Khim Kwah, Lauren Kark
BACKGROUND: Residual limb volume is often measured as part of routine care for people with amputations. These measurements assist in the timing of prosthetic fitting or replacement. In order to make well informed decisions, clinicians need access to measurement tools that are valid and reliable. OBJECTIVES: To assess the reliability and criterion validity of the iSense optical scanner in measuring volume of transtibial residual limb models. STUDY DESIGN: Three assessors performed two measurements each on 13 residual limb models with an iSense optical scanner (3D systems, USA)...
October 22, 2018: Prosthetics and Orthotics International
Marc El Beaino, Jiayong Liu, Patrick P Lin
BACKGROUND: For transfemoral amputations, the residual femoral length is critically important to prosthetic function. The aim of this report is to describe a novel method of extending femoral length and to assess its stability over time. Case Description and Methods: A 57-year-old woman with recurrent parosteal osteosarcoma was treated with above-knee amputation. A portion of the distal femoral endoprosthesis, which included uncemented fixation with a Compress® stem, was retained in an effort to extend the short femoral remnant and maximize stump length...
October 15, 2018: Prosthetics and Orthotics International
Tariq A Kwaees, Jim Richards, Gill Rawlinson, Charalambos Panayiotou Charalambous, Ambreen Chohan
BACKGROUND: Use of proprioceptive knee braces to control symptomology by altering neuromuscular control mechanisms has been shown in patellofemoral pain. Although their potential in patients with knee osteoarthritis is vast, little research has examined their efficacy. OBJECTIVES: This study examines the effect of a proprioceptive knee brace on lower limb kinematics and kinetics in healthy participants and in participants with OA. METHODS: Thirteen healthy participants were asked to perform a 10-cm step-down task with and without a proprioceptive brace...
October 4, 2018: Prosthetics and Orthotics International
Ryan Caldwell, Stefania Fatone
BACKGROUND AND AIM: Development of a passive suction version of the Northwestern University Flexible Sub-Ischial Vacuum socket would expand application of sub-ischial sockets to a larger proportion of persons with transfemoral amputation. While active vacuum suspension provides more positive coupling of the residual limb to the prosthetic socket, there are circumstances when use of active vacuum is not appropriate or feasible. Therefore, this technical note describes the technique modifications required to cast, fabricate, and fit a passive suction version of the Northwestern University Flexible Sub-Ischial Vacuum socket (i...
September 17, 2018: Prosthetics and Orthotics International
Mayank Kalra, Ryan Bakker, Sebastian S Tomescu, Anna M Polak, Micah Nicholls, Naveen Chandrashekar
BACKGROUND: A medial meniscal tear is a common knee injury, especially following an anterior cruciate ligament injury. Decreasing the compressive force on the medial meniscus during dynamic activities using an unloader knee brace could reduce meniscal strain, effectively reducing injury risk and/or severity. OBJECTIVES: To investigate the efficacy of two unloader knee braces on medial meniscus strain during dynamic activities in intact & deficient anterior cruciate ligament states...
September 10, 2018: Prosthetics and Orthotics International
Chen He, Michael Kai-Tsun To, Chi-Kwan Chan, Man Sang Wong
BACKGROUND: Prediction of in-orthosis curvature at pre-orthosis stage is valuable for the treatment planning for adolescent idiopathic scoliosis, while the position of spinal curvature assessment that is effective for this prediction is still unknown. OBJECTIVES: To compare the spinal curvatures in different body positions for predicting the spinal curvature rendered by orthosis. STUDY DESIGN: A prospective cohort study. METHODS: Twenty-two patients with adolescent idiopathic scoliosis (mean Cobb angle: 28...
September 7, 2018: Prosthetics and Orthotics International
Saad Jawaid Khan, Soobia Saad Khan, Juliana Usman, Abdul Halim Mokhtar, Noor Azuan Abu Osman
BACKGROUND: Knee osteoarthritis is a major contributor to the global burden of disease. There is a need of reducing knee joint load and to improve balance and physical function among knee osteoarthritis patients. OBJECTIVES: To test the hypothesis that toe-out gait will reduce second peak knee adduction moment further and increase fall risk when combined with knee brace and laterally wedged insole in knee osteoarthritis patients. STUDY DESIGN: Single visit study with repeated measures...
September 7, 2018: Prosthetics and Orthotics International
Gerda Strutzenberger, Nathalie Alexander, Alan De Asha, Hermann Schwameder, Cleveland Thomas Barnett
BACKGROUND: An inverted pendulum model represents the mechanical function of able-bodied individuals walking accurately, with centre of mass height and forward velocity data plotting as sinusoidal curves, 180° out of phase. OBJECTIVES: This study investigated whether the inverted pendulum model represented level gait in individuals with a unilateral transfemoral amputation. STUDY DESIGN: Controlled trial. METHODS: Kinematic and kinetic data from 10 individuals with unilateral transfemoral amputation and 15 able-bodied participants were recorded during level walking...
August 31, 2018: Prosthetics and Orthotics International
Mary E Matsumoto, Joseph M Czerniecki, Ali Shakir, Pradeep Suri, Michael Orendurff, David C Morgenroth
BACKGROUND: Low back pain is a common secondary disabling condition in the transfemoral amputee population. Transfemoral amputees are at risk of excessive lumbar lordosis; it has been suggested that increased lumbar lordosis may be associated with low back pain. However, the relationship between lumbar lordosis angle and low back pain has not yet been studied in this population. OBJECTIVE: To determine whether the extent of lumbar lordosis is associated with low back pain in transfemoral amputees...
August 18, 2018: Prosthetics and Orthotics International
Shane R Wurdeman, Phillip M Stevens, James H Campbell
BACKGROUND: While rehabilitation professionals are historically trained to place emphasis on the restoration of mobility following lower limb amputation, changes in healthcare dynamics are placing an increased emphasis on the limb loss patient's quality of life and general satisfaction. Thus, the relationship between these constructs and mobility in the patient with lower limb loss warrants further investigation. OBJECTIVES: To determine the relationship between mobility of the patient with lower limb loss and both (1) general satisfaction and (2) quality of life...
October 2018: Prosthetics and Orthotics International
Gustav Jarl, Liselotte Hermansson
BACKGROUND: Waiting is common in health care, delays intervention, and has negative effects on satisfaction with services. OBJECTIVES: To evaluate effects of a modified walk-in system, where patients were invited consecutively from the waiting list to attend the clinic on a walk-in basis, on waiting times, services, and work environment. STUDY DESIGN: Parallel-group trial. METHODS: In all, 1286 consecutive patients in need of shoe insoles were randomized to waiting lists for modified walk-in ( n = 655) or a scheduled appointment ( n = 631)...
October 2018: Prosthetics and Orthotics International
Gustav Jarl, Nerrolyn Ramstrand
BACKGROUND: The International Classification of Functioning, Disability and Health is a classification of human functioning and disability and is based on a biopsychosocial model of health. As such, International Classification of Functioning, Disability and Health seems suitable as a basis for constructing models defining the clinical P&O process. The aim was to use International Classification of Functioning, Disability and Health to facilitate development of such a model. Proposed model: A model, the Prosthetic and Orthotic Process (POP) model, is proposed...
October 2018: Prosthetics and Orthotics International
Dagmar Amtmann, Alyssa M Bamer, Jiseon Kim, Fraser Bocell, Hyewon Chung, Ryoungsun Park, Rana Salem, Brian J Hafner
BACKGROUND: New health status instruments can be administered by computerized adaptive test or short forms. The Prosthetic Limb Users Survey of Mobility (PLUS-MTM ) is a self-report measure of mobility for prosthesis users with lower limb loss. This study used the PLUS-M to examine advantages and disadvantages of computerized adaptive test and short forms. OBJECTIVES: To compare scores obtained from computerized adaptive test to scores obtained from fixed-length short forms (7-item and 12-item) in order to provide guidance to researchers and clinicians on how to select the best form of administration for different uses...
October 2018: Prosthetics and Orthotics International
Christopher Kevin Wong, William Brooks Gibbs
BACKGROUND: Wellness activities can benefit health, yet committed adherence is challenging. OBJECTIVES: Identify factors associated with committed participation in an amputee wellness-walking program and determine benefits of committed participation. STUDY DESIGN: Prospective longitudinal cohort. METHODS: Two former Paralympians led the wellness-walking sessions. Participants provided medical history and self-reported balance confidence and prosthetic functional measures...
August 16, 2018: Prosthetics and Orthotics International
Francesco Paradisi, Eugenio Di Stanislao, Aurora Summa, Stefano Brunelli, M Traballesi, Giuseppe Vannozzi
BACKGROUND: The observation of upper body movement is gaining interest in the gait analysis community. Recent studies involved the use of body-worn motion sensors, allowing translation of laboratory measurements to real-life settings in the context of patient monitoring and fall prevention. OBJECTIVES: It was shown that amputee persons demonstrate altered acceleration patterns due to the presence of prosthetic components, while no information is available on how accelerations propagate upwards to the head during level walking...
August 16, 2018: Prosthetics and Orthotics International
Heather R Batten, Steven M McPhail, Allison M Mandrusiak, Paulose N Varghese, Suzanne S Kuys
BACKGROUND: The relationship between gait speed and prosthetic potential (K-level classifications) and function has not been explored among people transitioning from hospital rehabilitation to the community. OBJECTIVES: To examine gait speed at discharge from inpatient rehabilitation among people prescribed a prosthetic leg after unilateral lower limb amputation, and associations between gait speed, prosthetic potential and functional ability. STUDY DESIGN: Cohort...
August 16, 2018: Prosthetics and Orthotics International
Douglas John Matthews, Mateen Arastu, Maggie Uden, John Paul Sullivan, Kristina Bolsakova, Kingsley Robinson, Sellaiah Sooriakumaran, David Ward
BACKGROUND: Amputation of a limb impacts on patients' self-perception and quality of life. Prostheses directly anchored to the skeleton are being investigated, aiming to avoid soft tissue complications. OBJECTIVES: We report outcome data for the UK trial of the Osseointegrated Prosthesis for the Rehabilitation of Amputees Implant System with a minimum of 9-year follow-up. METHODS: Eighteen transfemoral amputees received unilateral implants between 1997 and 2008...
August 16, 2018: Prosthetics and Orthotics International
Liezel Ennion, Sarah Manig
BACKGROUND: Ambulation with a prosthesis is the ultimate goal of rehabilitation for a person with a major lower limb amputation. Due to challenges with prosthetic service delivery in rural settings, many patients with amputations are not benefitting from prosthetic interventions. Inaccessibility to prosthetic services results in worse functional outcomes and quality of life. Learning from the experiences of current prosthetic users in this setting can assist to improve prosthetic service delivery...
August 16, 2018: Prosthetics and Orthotics International
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