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Amputee Rehabilitation

Fiona M Z van den Heiligenberg, Tanya Orlov, Scott N Macdonald, Eugene P Duff, David Henderson Slater, Christian F Beckmann, Heidi Johansen-Berg, Jody C Culham, Tamar R Makin
The human brain contains multiple hand-selective areas, in both the sensorimotor and visual systems. Could our brain repurpose neural resources, originally developed for supporting hand function, to represent and control artificial limbs? We studied individuals with congenital or acquired hand-loss (hereafter one-handers) using functional MRI. We show that the more one-handers use an artificial limb (prosthesis) in their everyday life, the stronger visual hand-selective areas in the lateral occipitotemporal cortex respond to prosthesis images...
March 9, 2018: Brain: a Journal of Neurology
Sellaiah Sooriakumaran, Maggie Uden, Sarah Mulroy, David Ewins, Thomas Collins
BACKGROUND: Substantial improvements have been perceived in surgical results following major lower limb amputation, but there remains observed variation in amputation quality for patients referred for prosthetic rehabilitation from different hospitals. OBJECTIVES: To assess various elements that influence residual limb quality and evaluate their impact on progress through initial prosthetic rehabilitation and mobility outcome after rehabilitation. STUDY DESIGN: Clinical survey...
February 1, 2018: Prosthetics and Orthotics International
Susan W Hunter, Courtney Frengopoulos, Jeffrey Holmes, Ricardo Viana, Michael W C Payne
BACKGROUND: The improvement of gait and mobility are major rehabilitation goals following lower extremity amputations. However, when living in the community many daily activities require the multitasking of motor and cognitive tasks. The dual-task paradigm can be used to evaluate the concurrent performance of mobility and cognitive tasks. RESEARCH QUESTION: The purpose of this study was to evaluate the effects of dual-task gait testing in older adults with trans-tibial amputations...
February 13, 2018: Gait & Posture
James P Reichmann, Kimberly R Bartman
Medical literature is replete with evidence regarding physical rehabilitation of the amputee; however, scant attention has been paid to psychological rehabilitation. The objective was to perform an integrative review of the published medical evidence regarding amputee peer support in the civilian population and provide an evidence-based clinical practice recommendation. This study was based on an exhaustive examination of the civilian amputee peer support medical evidence, bibliographic search, and on the experience of the authors when performing this integrative review...
March 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
Rayyan Azam Khan, Noman Naseer, Nauman Khalid Qureshi, Farzan Majeed Noori, Hammad Nazeer, Muhammad Umer Khan
BACKGROUND: In this paper, a novel functional near-infrared spectroscopy (fNIRS)-based brain-computer interface (BCI) framework for control of prosthetic legs and rehabilitation of patients suffering from locomotive disorders is presented. METHODS: fNIRS signals are used to initiate and stop the gait cycle, while a nonlinear proportional derivative computed torque controller (PD-CTC) with gravity compensation is used to control the torques of hip and knee joints for minimization of position error...
February 5, 2018: Journal of Neuroengineering and Rehabilitation
Guisheng Xu, Liang Gao, Ke Tao, Shengxiang Wan, Yuning Lin, Ao Xiong, Bin Kang, Hui Zeng
RATIONALE: For traumatic upper limb amputees, the prohibitive cost of a custom-made prosthesis brings an insufferable financial burden for their families in developing countries. Three-dimensional (3D) printing allows for creating affordable, lightweight, customized, and well-fitting prosthesis, especially for the growing children. PATIENT CONCERNS: We presented a case of an 8-year-old boy, who suffered a traumatic right wrist amputation as result of a mincing machine accident...
December 2017: Medicine (Baltimore)
Vida Maame Kissiwaa Amoah, Reindolf Anokye, Enoch Acheampong, Helina Rubby Dadson, Mary Osei, Alberta Nadutey
OBJECTIVE: Lower limb amputation not only causes major disfigurement, but renders people less mobile and at risk of loss of independence. Yet with appropriate rehabilitation, many people can learn to walk or function again and live high quality lives. This study sought to explore the experiences of patients with diabetes-related lower limb amputation at the Komfo Anokye Teaching Hospital. An exploratory study design was adopted using a qualitative approach and a purposive sampling to select 10 participants for the study...
January 24, 2018: BMC Research Notes
Piotr Prochor, Eugeniusz Sajewicz
Nowadays, numerous internal bone remodelling concepts are under development, in order to estimate long-term functionality of implants by evaluating the intensity of stress-shielding effect. This effect is also analysed for the implants for direct skeletal attachment, considered as a better exoprosthesis fixation method than prosthetic sockets. Most of bone remodelling approaches are based on basic concepts, differing with certain assumptions, which may affect the accuracy of the results. This article compares commonly used internal bone remodelling concepts and evaluates the functionality of the proposed Limb Prosthesis Osseointegrated Fixation System for direct skeletal attachment of limb prosthesis in comparison with two currently available implants: the Intraosseous Transcutaneous Amputation Prosthesis and the Osseointegrated Prostheses for the Rehabilitation of Amputees...
January 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Mohit Sharma, Subramania Iyer, P Kishore, Jimmy Mathew, Sundeep Vijayaraghavan, Ravi Sankaran, Arun N Nair, R Janarthanan, Abhijeet Wakure, Raghuveer Reddy, S M Chetan Mali, Visakh Varma, Ashish Chaudhari, Swapnil Dhake, Akshay Omkumar
Introduction: This report covers the strategies adopted for rehabilitation for the first and second dual hand transplants performed in India. Materials and Methods: The team, under a trained physiatrist, including physiotherapy and occupational therapy personnel, was involved in the management of both these patients. The management protocol was developed considering previous reports as well as our management strategies in the rehabilitation of the replanted hands...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Zala Kuret, Helena Burger, Gaj Vidmar, Tomaz Maver
PURPOSE: Finger amputations are the most common amputations of upper limbs. They influence hand function, general functioning and quality of life. One of the possibilities for rehabilitation after finger amputation is fitting a silicone finger prosthesis. We wanted to evaluate the adjustment to amputation and prosthesis use in patients after finger amputation. METHODS: We included 42 patients with partial or complete single or multiple finger amputation of one hand who visited the outpatient clinic for prosthetics and orthotics at our institute and received a silicone prosthesis...
January 11, 2018: Disability and Rehabilitation
Rudwina Braaksma, Pieter U Dijkstra, Jan H B Geertzen
BACKGROUND: In the decision-making process toward an amputation of the lower extremity, knowledge about patient-related outcomes after amputation and rehabilitation is important. We have not found a systematic review that provides this knowledge for Syme amputation. The aim of this study was to present an overview of outcomes after a Syme amputation grouped according to the International Classification of Functioning, Disability and Health (ICF) model, focusing on body structures and functions, activities, and participation...
January 1, 2018: Foot & Ankle International
Susan W Hunter, Courtney Frengopoulos, Jeff Holmes, Ricardo Viana, Michael W Payne
OBJECTIVE: To determine the relative and absolute reliability of a dual-task functional mobility assessment. DESIGN: Cross-sectional study. SETTING: Academic rehabilitation hospital. PARTICIPANTS: Individuals (N=60) with lower extremity amputation attending an outpatient amputee clinic (mean age, 58.21±12.59y; 18, 80% male) who were stratified into 3 groups: (1) transtibial amputation of vascular etiology (n=20); (2) transtibial amputation of nonvascular etiology (n=20); and (3) transfemoral or bilateral amputation of any etiology (n=20)...
January 6, 2018: Archives of Physical Medicine and Rehabilitation
Jennifer Langford, Michael P Dillon, Catherine L Granger, Chris Barr
PURPOSE: To examine physical activity participation amongst individuals with lower limb amputation. METHOD: Adults with lower limb amputation were convenience-sampled from a major metropolitan hospital outpatient amputee service and completed the International Physical Activity Questionnaire. RESULTS: Seventy-two individuals (65% male), mean age 53.6 (SD = 16.8) years, who were 10.8 (SD = 12.6) years post amputation (60% transtibial) participated in the study...
January 5, 2018: Disability and Rehabilitation
James A Sturk, Edward D Lemaire, Emily H Sinitski, Nancy L Dudek, Markus Besemann, Jacqueline S Hebert, Natalie Baddour
PURPOSE: Describe and quantify how people with transfemoral amputations (TFA) maintain stable gait over a variety of surfaces; including, downhill and uphill, top and bottom-cross-slopes, medial-lateral translations, rolling hills and simulated rocky surfaces. METHODS: Ten TFA and ten matched people without amputations (NA) walked in a virtual environment with level, sloped and simulated uneven surfaces on a self-paced treadmill. Stability was quantified using medial-lateral margin of stability (ML-MoS), step parameters, and gait variability (standard deviations for speed, temporal-spatial parameters, foot clearance and root-mean-square of medial-lateral trunk acceleration)...
December 24, 2017: Disability and Rehabilitation. Assistive Technology
Alex J Drew, Morgan T Izykowski, Kent N Bachus, Heath B Henninger, K Bo Foreman
Percutaneous osseointegrated (OI) implants for direct skeletal attachment of upper extremity prosthetics represent an alternative to traditional socket suspension that may yield improved patient function and satisfaction. This is especially true in high-level, transhumeral amputees where prosthetic fitting is challenging and abandonment rates remain high. However, maintaining mechanical integrity of the bone-implant interface is crucial for safe clinical introduction of this technology. The collection of population data on the transhumeral loading environment will aid in the design of compliance and overload protection devices that mitigate the risk of periprosthetic fracture...
2017: PloS One
Seth Messinger, Sayeh Bozorghadad, Paul Pasquina
OBJECTIVE: To explore how the social context of the clinic influenced the way former patients with lower limb loss in the Military Advanced Training Center at Walter Reed National Military Medical Center evaluated their outcomes. DESIGN: Cross-sectional phenomenological-based interviews and observations. PATIENTS: Twenty individuals with lower limb amputation were recruited from a multidisciplinary military treatment programme for patients with lower-extremity traumatic limb-loss injured in Afghanistan or Iraq...
January 10, 2018: Journal of Rehabilitation Medicine
Akira Tiele, Shivam Soni-Sadar, Jack Rowbottom, Shilen Patel, Edward Mathewson, Samuel Pearson, David Hutchins, John Head, Stephen Hutchins
The rise in popularity of the Paralympics in recent years has created a need for effective, low-cost sports-prosthetic devices for upper-limb amputees. There are various opportunities for lower-limb amputees to participate in cycling; however, there are only few options for those with upper-limb amputations. If the individual previously participated in cycling, a cycling-specific prosthesis could allow these activities to be integrated into rehabilitation methods. This article describes the processes involved with designing, developing and manufacturing such a prosthesis...
November 16, 2017: Bioengineering
Terje Gjovaag, Peyman Mirtaheri, Inger Marie Starholm
BACKGROUND: Studies suggest that the energy expenditure of healthy persons (control) during walking with the preferred walking speed in steady-state conditions is dominated by fat oxidation. Conversely, carbohydrate and fat oxidation during walking is little investigated in transfemoral amputees. OBJECTIVES: To investigate carbohydrate and fat oxidation, energy cost of walking, and percent utilization of maximal aerobic capacity [Formula: see text]during walking...
November 1, 2017: Prosthetics and Orthotics International
Breno Boueri Affonso, Joaquim Maurício da Motta Leal Filho, Rafael Noronha Cavalcante, Priscila Mina Falsarella, Francisco Leonardo Galastri, Rodolfo Souza Cardoso, Felipe Nasser
Preservation of the knee joint has enormous advantages in terms of mobility and rehabilitation of an amputee. Any cause of breakdown requiring revision to an above-knee amputation is a major setback because it reduces the patient's rehabilitative potential. We report a case of intra-arterial thrombolysis use to save a below-knee amputation stump with acute ischemia. A 56-year-old man who sought the emergency department with 1-day history of acute pain on his right below-knee stump. The angiography confirmed popliteal artery occlusion...
October 23, 2017: Einstein
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 (1) general satisfaction and (2) quality of life...
October 1, 2017: Prosthetics and Orthotics International
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