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Limb prosthesis

Alexander P Decilveo, Bartlomiej W Szczech, Jacob Topfer, James C Wittig
Expandable endoprostheses have become an acceptable modality to address the issue of limb-length inequality in limb-sparing procedures for skeletally immature patients afflicted with lower extremity bone sarcomas. This study retrospectively analyzed postoperative outcomes and complications for 7 patients (8 limbs) who underwent minimally invasive or noninvasive reconstruction during a 12-year period. Musculoskeletal Tumor Society (MSTS) scores and complication rates were reported. Mean functional outcome (MSTS scores) at final follow-up was 93...
October 25, 2016: Orthopedics
Luke Osborn, Rahul Kaliki, Alcimar Soares, Nitish Thakor
Upper limb amputees lack the valuable tactile sensing that helps provide context about the surrounding environment. Here we utilize tactile information to provide active touch feedback to a prosthetic hand. First, we developed fingertip tactile sensors for producing biomimetic spiking responses for monitoring contact, release, and slip of an object grasped by a prosthetic hand. We convert the sensor output into pulses, mimicking the rapid and slowly adapting spiking responses of receptor afferents found in the human body...
April 2016: IEEE Transactions on Haptics
Valerie E Kelly, Sara J Morgan, Dagmar Amtmann, Rana Salem, Brian J Hafner
PURPOSE: This study tested the hypothesis that greater perceived cognitive concerns are associated with worse mobility in a cohort of prosthesis users with lower limb loss (LLL). METHOD: We performed a secondary analysis of cross-sectional self-report data from a volunteer sample of people with LLL due to dysvascular and non-dysvacular causes. Perceived cognitive difficulties were assessed using the Quality of Life in Neurological Disorders Applied Cognition - General Concerns (Neuro-QoL ACGC)...
October 19, 2016: Disability and Rehabilitation
Madathipat Unnikrishnan, Sidharth Viswanathan, K Balasubramaniam, C V Muraleedharan, Arthur Vijayan Lal, P V Mohanan, Meera Mohanty, Tirur Raman Kapilamoorthy
BACKGROUND & OBJECTIVES: Vascular illnesses are on the rise in India, due to increase in lifestyle diseases and demographic transition, requiring intervention to save life, organ or limbs using vascular prosthesis. The aim of this study was to develop indigenous large diameter vascular graft for treatment of patients with vascular pathologies. METHODS: The South India Textile Research Association, at Coimbatore, Tamil Nadu, India, developed seamless woven polyester (Polyethylene terephthalate) graft at its research wing...
June 2016: Indian Journal of Medical Research
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
Sara J Morgan, Janna L Friedly, Dagmar Amtmann, Rana Salem, Brian J Hafner
OBJECTIVE: To determine relationships between pain site(s) and pain intensity/interference in people with lower limb amputations. DESIGN: Cross-sectional survey. SETTING: Community. PARTICIPANTS: Lower limb prosthesis users with unilateral or bilateral amputations (n=1296, mean time since amputation = 14.1 years). INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity (1-item to assess average pain), PROMIS Pain Interference (4-item short form to assess the consequences of pain in desired activities), and questions that asked participants to rate the extent to which each of the following were a problem: residual limb pain, phantom limb pain, knee pain on the non-amputated side, back pain, and shoulder pain...
October 11, 2016: Archives of Physical Medicine and Rehabilitation
Oskar C Aszmann, Ivan Vujaklija, Aidan D Roche, Stefan Salminger, Malvina Herceg, Agnes Sturma, Laura A Hruby, Anna Pittermann, Christian Hofer, Sebastian Amsuess, Dario Farina
Critical soft tissue injuries may lead to a non-functional and insensate limb. In these cases standard reconstructive techniques will not suffice to provide a useful outcome, and solutions outside the biological arena must be considered and offered to these patients. We propose a concept which, after all reconstructive options have been exhausted, involves an elective amputation along with a bionic substitution, implementing an actuated prosthetic hand via a structured tech-neuro-rehabilitation program. Here, three patients are presented in whom this concept has been successfully applied after mutilating hand injuries...
October 10, 2016: Scientific Reports
S Raja Sabapathy, David Elliot, Hari Venkatramani
With the available microsurgical techniques, salvage of the limb can almost always provide a useful upper limb, even in the most complex combined injuries. Having a low threshold for revascularization of doubtfully viable extremities and making full use of the current armamentarium of soft tissue cover techniques, including flow through free flaps, will salvage many limbs. Secondary procedures, including free functioning muscle transfers and toe transfers, further increase the possible functional outcome. Even in the most complex combined injuries, intelligent reconstruction will obtain better outcomes than the best available prosthesis, making the efforts of salvage worthwhile...
November 2016: Hand Clinics
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...
October 3, 2016: Journal of Biomechanics
Neha Mathur, Ivan Glesk, Arjan Buis
Elevated skin temperature at the body/device interface of lower-limb prostheses is one of the major factors that affect tissue health. The heat dissipation in prosthetic sockets is greatly influenced by the thermal conductive properties of the hard socket and liner material employed. However, monitoring of the interface temperature at skin level in lower-limb prosthesis is notoriously complicated. This is due to the flexible nature of the interface liners used which requires consistent positioning of sensors during donning and doffing...
June 2016: Healthcare Technology Letters
Fan Tang, Yong Zhou, Li Min, Wenli Zhang, Rui Shi, Yi Luo, Hong Duan, Chongqi Tu
OBJECTIVE: To evaluate the medium-term outcome of limb-salvage surgery using all-polyethylene tibial endoprosthetic replacement following en-block resection for distal femoral tumors. METHODS: Forty-nine patients with distal femoral tumor were treated between June 2006 and June 2012. The follow-up period was 6-110 months (average 53.4 months). The prosthetic survival was analyzed using the Kaplan-Meier method. The classification of failure of limb salvage after reconstructive surgery for bone tumors was adapted...
2016: OncoTargets and Therapy
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
Thibaut Mirlicourtois, Tche Hong Loquineau, Pierre Yves Chagnon, Thomas Rondepierre, Serge Mirlicourtois, Jean Christophe Bonnardel
OBJECTIVE: The replacement of a mechanical knee with prosthetic class I foot fitting by an electronic knee with prosthetic class II foot was proposed to a 54-years-old schizophrenic patient, active, with right femoral and left tibial traumatic amputation. This fitting evolution was assessed both quantitatively and qualitatively. OBSERVATIONS/METHOD: Compared evaluation of electronic knee with prosthetic class II foot versus mechanical polycentric knee with prosthetic class I foot (fitting unchanged moreover) in: - functional abilities and quality of life using standardized scores (Functional Ambulation Classification, Houghton, Functional Independence Measurement, B...
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
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
Nathaly Quintero-Prigent, Frédéric Clavier, Naima Brennetot, Colina Martinot-Lagarde
Upper limbs birth defects are rare. There is an international classification of these malformations. The most frequent cause is the stop in the cross development of the forearm. The announcement of the malformation is a strong psychological trauma for parents, whether it occurs before the birth or if we find out when the baby is born. Beyond the grief of the perfect child, parents are very worried about activities of daily living, about the future of the child and his relationships with others. We have to inform and to support them during to the development and growth of the child...
September 2016: Annals of Physical and Rehabilitation Medicine
Julie Dohin, Caroline Coiffier-Leone, Prune Payre, Beatrice Bayle, Bruno Dohin, Vincent Gautheron
Congenital agenesis and acquired amputations of upper limb in children are a great traumatic experience in affected families. Patients, families and caregivers are then exposed to many functional and social difficulties. These states require accurate analysis of functional impairment, child's coping skills and therapeutic plan to implement for optimal social integration. These children and their families must be supported since early childhood by multidisciplinary teams. This can require psychological support, the use of an aesthetic and/or functional prosthesis, and occupational therapy...
September 2016: Annals of Physical and Rehabilitation Medicine
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