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amputee AND prosthesis

Robert D Gregg, Anne E Martin
Recent work has extended the control method of virtual constraints, originally developed for autonomous walking robots, to powered prosthetic legs for lower-limb amputees. Virtual constraints define desired joint patterns as functions of a mechanical phasing variable, which are typically enforced by torque control laws that linearize the output dynamics associated with the virtual constraints. However, the output dynamics of a powered prosthetic leg generally depend on the human interaction forces, which must be measured and canceled by the feedback linearizing control law...
July 2016: Proceedings of the ... American Control Conference
Corey Pew, Glenn K Klute
Amputees often experience soft tissue breakdown and discomfort from the high transverse plane shear stresses between the residual limb and prosthesis. To evaluate the effects of varying the transverse plane stiffness, a small sample population of lower limb amputees wore a novel variable stiffness torsion adapter (VSTA). Peak transverse plane moments were evaluated for three fixed stiffness levels (compliant: 0.30Nm/°, intermediate: 0.57Nm/°, stiff: 0.91Nm/°) while participants traversed five tasks of daily living that emphasize transverse plane motion including: straight walking for reference, 90° turns, 180° turns, a static reach test, and the L-Test of functional mobility...
October 4, 2016: Gait & Posture
Roberto E Quesada, Joshua M Caputo, Steven H Collins
Amputees using passive ankle-foot prostheses tend to expend more metabolic energy during walking than non-amputees, and reducing this cost has been a central motivation for the development of active ankle-foot prostheses. Increased push-off work at the end of stance has been proposed as a way to reduce metabolic energy use, but the effects of push-off work have not been tested in isolation. In this experiment, participants with unilateral transtibial amputation (N=6) walked on a treadmill at a constant speed while wearing a powered prosthesis emulator...
September 21, 2016: Journal of Biomechanics
Viviana Rota, Maria Grazia Benedetti, Yusuke Okita, Marco Manfrini, Luigi Tesio
Knee rotationplasty (KRP) is a type of surgery in which the rotated ankle serves as a new knee after being removed for bone tumor. Although this limb salvage surgery is rarely indicated in properly selected patients, it may offer functional advantages over transfemoral amputation, and more durable results compared with a prosthesis. The walking mechanics of adult patients after KRP is believed to be close to that of below-knee amputees. In this study, we evaluated steady-state walking of KRP patients from the viewpoint of the overall muscle power needed to keep the body centre of mass in motion...
September 28, 2016: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Houda Migaou Miled, Hichem Ben Brahim, Yafa Hadj Hassine, Soumaya Boudokhane, Nesrine Abdelkafi, Aymen Haj Salah, Sana Salah, Anis Jellad, Zohra Ben Salah Frih
OBJECTIVE: Assess satisfaction of lower limb amputees towards their device. PATIENTS AND METHODS: Prospective study of device-fitted lower limb amputees followed at the Physical Medicine and Rehabilitation department at the University Hospital of Monastir. Epidemiological and clinical parameters were assessed with evaluation of fitted patients' satisfaction towards their prosthesis (survey on the satisfaction of patients with lower limb amputations towards their prosthesis) (SAT-PRO)...
September 2016: Annals of Physical and Rehabilitation Medicine
Koffi Benjamin Manou, Ndoula Espérance Kounkou, Romaric Toe, Awo Dorcas Akadje, Cisse Ali, Amonso Daniel Alloh, Manse Béatrice Nandjui
OBJECTIVE: The quality of the residual limb of the amputations in the consequences of a ballistic trauma often was compromised and limits the success of a good equipment for a satisfactory locomotive function. The objective of the study is to describe the various anomalies of the residual limb and their difficulty of equipment of the traumatic amputations by bal PATIENTS AND METHODS: A descriptive retrospective study concerned patients amputated of lower limbs in the consequences of a ballistic trauma during the military crisis in Ivory Coast from 2010 to 2012 and dealt in the center of equipment "Vivre Debout" in the Teacher Hospital of Yopougon...
September 2016: Annals of Physical and Rehabilitation Medicine
Lluis Guirao Cano
OBJECTIVE: Following a transfemoral (TF) amputation, the ability to walk with a prosthesis is the main objective of rehabilitation. The achieved speed of walking is considered a determining factor in the amputee's perception of quality of life. This experimental before-after study evaluates the walking abilities and improvement of important parameters such as gait, walking speed, pain and hours of prosthesis use in transfemoral amputees after placing a novel femoral implant that permits distal weight bearing of the residuum within a socket, adapted for distal load bearing...
September 2016: Annals of Physical and Rehabilitation Medicine
Chloé Blum, Solange Ehrler, Marie-Eve Isner
OBJECTIVE: Therapeutic patient education (TPE) is a continuous process for chronic disease. TPE enables patients to improve and acquire the skills that are necessary for self-care and self-management. We wanted to determine the place of self-care in patients following lower limb amputation by evaluating prosthetic and limb management and prosthesis use. MATERIAL/PATIENTS AND METHODS: To this aim, we involved 135 trans-tibial amputees between May 2011 and December 2013 who were fitted with contact silicone socket prosthesis with distal lock...
September 2016: Annals of Physical and Rehabilitation Medicine
Jessie Barbin, Vanessa Seetha, Jean-Marie Casillas, Jean Paysant, Dominic Perennou
OBJECTIVE: Phantom limb pain (PLP) is a major problem after limb amputation. Mirror therapy (MT) is a non-pharmacological treatment using representations of movement, the efficacy of which in reducing PLP remains to be clarified. Here, we present the first systematic review on MT efficacy in phantom limb pain (PLP) and phantom limb movement (PLM) in amputees (lower or upper limb). MATERIAL/PATIENTS AND METHODS: A search on MEDLINE, COCHRANE DATABASE and EMBASE, crossing the key words "phantom limb" and "mirror therapy" found studies which were read and analyzed according the PRISMA statement...
September 2016: Annals of Physical and Rehabilitation Medicine
Stefan Salminger, Andreas Gradischar, Richard Skiera, Aidan D Roche, Agnes Sturma, Christian Hofer, Oskar C Aszmann
BACKGROUND: The stump-socket interface is of utmost importance for prosthetic function in transhumeral amputees. Stability of this connection may be improved using a newly designed subcutaneous implant. OBJECTIVES: The purpose was to determine the effect of the implant together with customized socket designs on the range of motion of the shoulder and the prosthetic function compared to conventional fitting. STUDY DESIGN: Case series. METHODS: The range of motion was measured with scaled metrics and the prosthetic function evaluated with the Southampton Hand Assessment Procedure and the Box and Block Test...
September 16, 2016: Prosthetics and Orthotics International
E Pröbsting, S Blumentritt, A Kannenberg
Background: It is often assumed that leg amputations result in a greater risk of degenerative changes to the locomotor system. This paper analysed the extent to which this assumption is supported by the scientific literature. In particular, the study analysed the level of risk of various degenerative diseases in amputees. Method: A systematic literature search was conducted in scientific databases on degenerative changes caused by amputations. All pertinent articles were qualitatively analysed; the available quantitative results were summarised and compared to data for the able bodied population...
September 15, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Brian J Hafner, Ignacio A Gaunaurd, Sara J Morgan, Dagmar Amtmann, Rana Salem, Robert S Gailey
OBJECTIVE: To assess construct validity of the Prosthetic Limb Users Survey of Mobility (PLUS-M), a self-report mobility measure for people with lower limb amputation (LLA). DESIGN: Cross-sectional study. SETTING: Private prosthetic clinics (n=37) in the United States. PARTICIPANTS: Current lower limb prosthesis users (n=199, mean age=55.4±14.3 years, 71.4% male) were assessed before receiving a replacement prosthesis, prosthetic socket, and/or prosthetic knee...
August 30, 2016: Archives of Physical Medicine and Rehabilitation
Shu Imaizumi, Tomohisa Asai, Shinichi Koyama
Senses of ownership (this arm belongs to me) and agency (I am controlling this arm) originate from sensorimotor system. External objects can be integrated into the sensorimotor system following long-term use, and recognized as one's own body. We examined how an (un)embodied prosthetic arm modulates whole-body control, and assessed the components of prosthetic embodiment. Nine unilateral upper-limb amputees participated. Four frequently used their prosthetic arm, while the others rarely did. Their postural sway was measured during quiet standing with or without their prosthesis...
October 2016: Consciousness and Cognition
Meike A Schweisfurth, Marko Markovic, Strahinja Dosen, Florian Teich, Bernhard Graimann, Dario Farina
OBJECTIVE: A drawback of active prostheses is that they detach the subject from the produced forces, thereby preventing direct mechanical feedback. This can be compensated by providing somatosensory feedback to the user through mechanical or electrical stimulation, which in turn may improve the utility, sense of embodiment, and thereby increase the acceptance rate. APPROACH: In this study, we compared a novel approach to closing the loop, namely EMG feedback (emgFB), to classic force feedback (forceFB), using electrotactile interface in a realistic task setup...
October 2016: Journal of Neural Engineering
Stacey M Rigney, Anne Simmons, Lauren Kark
Lower-limb amputees commonly utilize non-articulating energy storage and return (ESAR) prostheses for high impact activities such as sprinting. Despite these prostheses lacking an articulating ankle joint, amputee gait analysis conventionally features a two-link segment model of the prosthetic foot. This paper investigated the effects of the selected link segment model׳s marker-set and geometry on a unilateral amputee sprinter׳s calculated lower-limb kinematics, kinetics and energetics. A total of five lower-limb models of the Ottobock(®) 1E90 Sprinter were developed, including two conventional shank-foot models that each used a different version of the Plug-in-Gait (PiG) marker-set to test the effect of prosthesis ankle marker location...
August 9, 2016: Journal of Biomechanics
André Thevenon, Marguerite Preud'homme, Philippe Patenotre, Benoit Catteau, Anne Blanchard-Dauphin, Valérie Wieczorek, Vincent Tiffreau
OBJECTIVE: Dystrophic epidermolysis bullosa is a rare disease characterized by widespread blistering of the skin and mucous membranes, which may ultimately prompt limb amputation. In this context, the outcome of fitting a prosthesis to a chronically wounded stump is not well known. Our patient's experience (with 15 years of follow-up) should contribute to better knowledge of this topic. CASE REPORT: A 37-year-old man presented with severe dystrophic epidermolysis bullosa...
October 12, 2016: Journal of Rehabilitation Medicine
Daniel C Norvell, Rhonda M Williams, Aaron P Turner, Joseph M Czerniecki
OBJECTIVE: This study describes the development and psychometric evaluation of a novel patient-reported single-item mobility measure. DESIGN: Prospective cohort study. SETTING: Four Veteran's Administration Medical Centers. SUBJECTS: Individuals undergoing their first major unilateral lower extremity amputation; 198 met inclusion criteria; of these, 113 (57%) enrolled. INTERVENTIONS: None. MAIN MEASURES: The Amputee Single Item Mobility Measure, a single item measure with scores ranging from 0 to 6, was developed by an expert panel, and concurrently administered with the Locomotor Capabilities Index-5 (LCI-5) and other outcome measures at six weeks, four months, and 12 months post-amputation...
September 2016: Clinical Rehabilitation
Ali Seker, Adnan Kara, Savas Camur, Melih Malkoc, Mehmet Mesut Sonmez, Mahir Mahirogullari
INTRODUCTION: This study aimed to compare mortality rates and functional results of transtibial and transfemoral amputations in elderly patients with diabetes. METHODS: 87 amputees [54 (62.1%) transtibial and 33 (37.9%) transfemoral] were included. Mean ages were 70.7 and 69.3 years in transfemoral and transtibial groups, respectively. Mean follow up time was 41.8 months. Amputee Mobility Predictor scores (with and without prosthesis) and Barthel Daily Living Index were used for functional evaluation of the survivors...
September 2016: International Journal of Surgery
Laura Williams, Nikta Pirouz, J C Mizelle, William Cusack, Rob Kistenberg, Lewis A Wheaton
OBJECTIVE: Upper extremity loss presents immediate and lasting challenges for motor control. While sensory and motor representations of the amputated limb undergo plasticity to adjacent areas of the sensorimotor homunculus, it remains unclear whether laterality of motor-related activity is affected by neural reorganization following amputation. METHODS: Using electroencephalography, we evaluated neural activation patterns of formerly right hand dominant persons with upper limb loss (amputees) performing a motor task with their residual right limb, then their sound left limb...
September 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Rafi Ayub, Dario Villarreal, Robert D Gregg, Fan Gao
BACKGROUND: Transradial body-powered prostheses are extensively used by upper-limb amputees. This prosthesis requires large muscle forces and great concentration by the patient, often leading to discomfort, muscle fatigue, and skin breakdown, limiting the capacity of the amputee to conduct daily activities. Since body-powered prostheses are commonplace, understanding their optimal operation to mitigate these drawbacks would be clinically meaningful. OBJECTIVES: To find the optimal operation of the prosthesis where the activation force is minimized and the grip force is maximized...
July 28, 2016: Prosthetics and Orthotics International
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