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https://www.readbyqxmd.com/read/29783030/venous-conduits-have-superior-patency-compared-to-prosthetic-grafts-for-femoro-femoral-bypass
#1
Khanh Nguyen, Gregory Moneta, Gregory Landry
OBJECTIVE: To compare outcomes of externally supported polytetrafluoroethylene (PTFE) grafts and femoral vein as conduits for femoro-femoral crossover grafts. METHODS: This is a retrospective review of consecutive femoro-femoral crossover grafts at our institution between January 2005 and March 2016. Patient demographics, indications, complication rates, patency rates and survival rates were compared between femoro-femoral grafts created with either PTFE or femoral vein conduits, autogenous or cryopreserved...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29781963/comorbidities-and-mobility-in-lower-limb-prosthesis-users
#2
Shane R Wurdeman, Phillip M Stevens, James H Campbell
OBJECTIVE: To determine the impact of comorbidities on mobility in patients with lower limb prostheses. DESIGN: Cohort database chart review examining mobility in lower limb prosthesis users grouped according to comorbidities. Regression models were used to determine significant predictor comorbidities for mobility. General linear univariate models were implemented to investigate differences in mobility among cohorts (n=596). RESULTS: Patient age and history of stroke, peripheral vascular disease, and anxiety/panic disorders were predictors of decreased mobility...
May 17, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29780317/one-channel-surface-electromyography-decomposition-for-muscle-force-estimation
#3
Wentao Sun, Jinying Zhu, Yinlai Jiang, Hiroshi Yokoi, Qiang Huang
Estimating muscle force by surface electromyography (sEMG) is a non-invasive and flexible way to diagnose biomechanical diseases and control assistive devices such as prosthetic hands. To estimate muscle force using sEMG, a supervised method is commonly adopted. This requires simultaneous recording of sEMG signals and muscle force measured by additional devices to tune the variables involved. However, recording the muscle force of the lost limb of an amputee is challenging, and the supervised method has limitations in this regard...
2018: Frontiers in Neurorobotics
https://www.readbyqxmd.com/read/29779455/function-quality-of-life-and-community-integration-of-deka-arm-users-after-discharge-from-prosthetic-training-impact-of-home-use-experience
#4
Linda Resnik, Frantzy Acluche, Matthew Borgia, Jill Cancio, Gail Latlief, Nicole Sasson
BACKGROUND: Research on adaptation to advanced upper limb prostheses is needed. OBJECTIVES: To (1) examine change in function, quality of life and community integration after prosthetic training, (2) determine whether change in outcomes varied by prosthesis complexity, and (3) compare patterns of change at 1 month for those who withdrew from the study and those who did not. STUDY DESIGN: Quasi-experimental time series. METHODS: Data were analyzed for 22 participants (18 completers)...
May 1, 2018: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29777713/development-and-psychometric-validation-of-capacity-assessment-of-prosthetic-performance-for-the-upper-limb-cappful
#5
Nathan T Kearns, Jennifer K Peterson, Lisa Smurr Walters, Warren T Jackson, John M Miguelez, Tiffany Ryan
OBJECTIVES: (1) Develop a performance-based measure for adult upper limb (UL) prosthetic functioning through broad (i.e. overall performance) and functional domain-specific (e.g., control skills) assessment of commonplace activities; (2) conduct initial psychometric evaluation of the Capacity Assessment of Prosthetic Performance for the Upper Limb (CAPPFUL). DESIGN: Internal consistency of CAPPFUL and interrater reliability for task, functional domain, and full scale (sub)scores among three independent raters were estimated...
May 16, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29775130/taxonomy-of-clinical-encounters-during-the-first-90-days-post-delivery-of-an-initial-lower-limb-prosthesis
#6
Daniel Joseph Lee, Michael Wininger, David Mahler, Mark Parisi
BACKGROUND: The incidence and etiology of prosthetic services utilization is poorly understood during the first 90 days post-delivery of the initial lower limb prosthesis. This period is of critical importance, as prevailing policy dictates limits on the reimbursement for certain services provided during this time period. The first step in understanding the financial ramifications of such policy is to examine the taxonomy behind clinical encounters during this tenuous time period. OBJECTIVES: Quantify and categorize clinical encounters by incidence and etiology...
May 1, 2018: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29772315/long-term-durability-of-infrainguinal-endovascular-and-open-revascularization-for-disabling-claudication
#7
Sikandar Z Khan, Mariel Rivero, Gregory S Cherr, Linda M Harris, Maciej L Dryjski, Hasan H Dosluoglu
OBJECTIVE: Infrainguinal revascularization for disabling claudication (DC) is frequently performed but long term results are still unknown. In this study, we compared clinical outcomes of infrainguinal endovascular (EV) and open interventions for DC following failure of medical management. METHODS: 194 patients with DC (Rutherford category 3) who had open (n=53) or EV (n=141) interventions were grouped as Open-GSV (n=21), Open-Prosthetic (n=32), EV- AB (TASCII A & B) (n=48) and EV-CD (TASCII C & D) (n=93)...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772308/prostheses-as-extensions-of-the-body-progress-and-challenges
#8
REVIEW
Maria Niedernhuber, Damiano G Barone, Bigna Lenggenhager
Recent years have seen a surge of interest in the incorporation of artificial limbs. This research promises to provide individuals with sensorimotor disorders such as amputations with prostheses which feel like their own body part. While neuroscience made a leap towards uncovering the basic neurocognitive mechanisms of bodily self-consciousness, the development of incorporated prosthetic limbs still faces substantial challenges in basic neuroscience and in clinical reality. Here we critically examine recent findings on prosthesis incorporation to aid patient rehabilitation in the context of advances in cognitive and applied neuroscience as well as technology...
May 14, 2018: Neuroscience and Biobehavioral Reviews
https://www.readbyqxmd.com/read/29771620/self-reported-functional-mobility-balance-confidence-and-prosthetic-use-are-associated-with-daily-step-counts-among-individuals-with-a-unilateral-transtibial-amputation
#9
Jaclyn Megan Sions, Elisa Sarah Arch, John Robert Horne
BACKGROUND: Adults postamputation are not meeting physical activity recommendations. Physical activity is an important consideration in prosthetic prescription. The objective of this study was to determine if functional mobility, balance confidence, and prosthetic use are associated with physical activity among adults with a lower-limb amputation. METHODS: This study recruited patients aged 18-85 years with unilateral transtibial amputations. The Cumulative Illness Rating Scale was used to determine comorbidity burden...
June 1, 2018: Journal of Physical Activity & Health
https://www.readbyqxmd.com/read/29761748/transfemoral-amputation-adductor-myodesis-using-fibertape-and-knotless-anchors
#10
Andrew R Hsu
Transfemoral amputation is considered the last treatment option for severe infection, vascular disease, trauma, and malignant tumors of the lower extremity that have failed limb salvage. Unopposed pull of the hip abductors causes a flexion-abduction thigh deformity that results in abnormal biomechanics and increased oxygen consumption during ambulation. Myodesis of the adductor tendons is a critical component of transfemoral amputation that creates dynamic muscle balance, enhances prosthetic fitting and function, and improves clinical outcomes...
May 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29760647/discrimination-and-recognition-of-phantom-finger-sensation-through-transcutaneous-electrical-nerve-stimulation
#11
Mengnan Li, Dingguo Zhang, Yao Chen, Xinyu Chai, Longwen He, Ying Chen, Jinyao Guo, Xiaohong Sui
Tactile sensory feedback would make a significant contribution to the state-of-the-art prosthetic hands for achieving dexterous manipulation over objects. Phantom finger sensation, also called referred sensation of lost fingers, can be noninvasively evoked by transcutaneous electrical nerve stimulation (TENS) of the phantom finger territories (PFTs) near the stump for upper-limb amputees. As such, intuitive sensations pertaining to lost fingers could be non-invasively generated. However, the encoding of stimulation parameters into tactile sensations that can be intuitively interpreted by the users remains a significant challenge...
2018: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29756521/cost-analysis-of-initial-treatment-with-endovascular-revascularization-open-surgery-or-primary-major-amputation-in-patients-with-peripheral-artery-disease
#12
Linda Tang, Sharath C V Paravastu, Shannon D Thomas, Elaine Tan, Eric Farmer, Ramon L Varcoe
PURPOSE: To compare the total initial treatment costs for open surgery, endovascular revascularization, and primary major amputation within a single-payer healthcare system. METHODS: A multicenter, retrospective analysis was undertaken to evaluate 1138 patients with symptomatic peripheral artery disease (PAD) who underwent 1017 endovascular procedures, 86 open surgeries, and 35 major amputations between 2013 and 2016. A cost-mix analysis was performed on individual patient data generated for selected diagnosis-related groups...
May 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29754521/development-of-a-scoring-tool-blart-score-to-predict-functional-outcome-in-lower-limb-amputees
#13
Sarah Bowrey, Helen Naylor, Pip Russell, Jonathan Thompson
PURPOSE: To develop a valid preoperative scoring tool that predicts the probability of walking with a prosthetic limb after major lower limb amputation. METHODS: A retrospective review of 338 patients who had undergone lower limb amputation was conducted to identify characteristics that affected the success of rehabilitation with a prosthetic limb. These data were used to devise an assessment tool (the BLARt score), which was then tested and validated in 199 patients planned to undergo lower limb amputation in two UK regional centers...
May 12, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29752241/upper-limb-prosthesis-control-for-high-level-amputees-via-myoelectric-recognition-of-leg-gestures
#14
Kenneth R Lyons, Sanjay S Joshi
Recognition of motion intent via surface electromyography (EMG) has become increasingly practical for prosthesis control, but lacking residual muscle sites remains a major obstacle to its use by high-level amputees. Currently, there are few approaches to upper limb prosthesis control for individuals with amputations proximal to the elbow, all of which suffer from one or more of three primary problems: invasiveness, the need for intensive training, and lacking functionality. Using surface EMG sensors placed on the lower leg and a natural mapping between degrees of freedom of the leg and the arm, we tested a noninvasive control approach by which high-level amputees could control prosthetic elbow, wrist, and hand movements with minimal training...
May 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/29747672/two-ways-to-improve-myoelectric-control-for-a-transhumeral-amputee-after-targeted-muscle-reinnervation-a-case-study
#15
Yang Xu, Dingguo Zhang, Yang Wang, Juntao Feng, Wendong Xu
BACKGROUND: Myoelectric control of multifunctional prostheses is challenging for individuals with high-level amputations due to insufficient surface electromyography (sEMG) signals. A surgical technique called targeted muscle reinnervation (TMR) has achieved impressive improvements in myoelectric control by providing more sEMG control signals. In this case, some channels of sEMG signals are coupled after TMR, which limits the performance of conventional amplitude-based control for upper-limb prostheses...
May 10, 2018: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/29741966/feminine-identity-and-functional-benefits-are-key-factors-in-women-s-decision-making-about-upper-limb-prostheses-a-case-series
#16
Linda Resnik, Shana Klinger, Anisha Gill, Sarah Ekerholm Biester
PURPOSE: Although the DEKA Arm promises new abilities, it is unclear if women with upper limb amputation are willing to avail themselves of this new technology. The study purpose was to understand key factors and tradeoffs that shape women's attitudes towards the DEKA Arm. METHODS: This case series includes three women with transradial amputation. Structured surveys and semi-guided interviews were administered after completion of in-laboratory training and a home trial of the DEKA Arm...
May 9, 2018: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/29724536/ankle-and-foot-power-in-gait-analysis-implications-for-science-technology-and-clinical-assessment
#17
REVIEW
Karl E Zelik, Eric C Honert
In human gait analysis studies, the entire foot is typically modeled as a single rigid-body segment; however, this neglects power generated/absorbed within the foot. Here we show how treating the entire foot as a rigid body can lead to misunderstandings related to (biological and prosthetic) foot function, and distort our understanding of ankle and muscle-tendon dynamics. We overview various (unconventional) inverse dynamics methods for estimating foot power, partitioning ankle vs. foot contributions, and computing combined anklefoot power...
April 18, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29723652/kinetic-differences-between-level-walking-and-ramp-descent-in-individuals-with-unilateral-transfemoral-amputation-using-a-prosthetic-knee-without-a-stance-control-mechanism
#18
Yusuke Okita, Nobuya Yamasaki, Takashi Nakamura, Tsutomu Kubo, Atsuko Mitsumoto, Toru Akune
BACKGROUND: Individuals with transfemoral amputation (TFA) have difficulty in descending ramps. Although individuals with TFA who descend ramps are speculated to have greater biomechanical demands, this has not been quantified. RESEARCH QUESTION: How do individuals with TFA wearing a prosthetic knee without a stance control mechanism adapt their gait biomechanics to a slightly declined surface? METHODS: We retrospectively analyzed data of level walking and ramp descent (5° decline) from six subjects with TFA who used a prosthesis without a stance control mechanism...
April 26, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29707973/identifying-and-prioritizing-concerns-associated-with-prosthetic-devices-for-use-in-a-benefit-risk-assessment-a-mixed-methods-approach
#19
Ellen M Janssen, Heather L Benz, Jui-Hua Tsai, John Fp Bridges
OBJECTIVE: We identified and prioritized concerns reported by stakeholders associated with novel upper-limb prostheses. METHODS: An evidence review and key-informant engagement, identified 62 concerns with upper-limb prostheses with implantable components. We selected 16 concerns for inclusion in a best-worst scaling (BWS) prioritization survey. Focus groups and BWS were used to engage stakeholders at a public meeting on prostheses. In 16 BWS choice tasks, attendees selected the most and least influential concern when choosing an upper-limb prosthesis...
April 30, 2018: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29701407/creative-vascular-access-construction-in-same-patient
#20
Pedro Pinto Sousa, Paulo Almeida, Pedro Sá Pinto, Rui Almeida
INTRODUCTION: Creating and maintaining a functional vascular access(VA) is a critical factor in the survival of a dialysis patient. However, it will not function forever, implying a creative attitude from the vascular surgeon either to maintain its functionality or built a new one wherever possible, being it autologous or synthetic. METHODS: Describe the VA history of a 59years-old male with morbid obesity and end-stage chronic kidney disease. RESULTS: His VA construction started in2012 with failed attempts in both forearms until a functional brachiocephalic artery-venous fistula(AVF) in the right upper limb was achieved, but was deemed to ligation as severe venous hypertension secondary to central venous disease related to CVC use...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
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