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https://www.readbyqxmd.com/read/28736684/multimodality-imaging-approaches-for-evaluating-traumatic-extremity-injuries-implications-for-military-medicine
#1
REVIEW
Mitchel R Stacy, Christopher L Dearth
Significance: Military service members are susceptible to traumatic extremity injuries that often result in limb loss. Tremendous efforts have been made to improve medical treatment that supports residual limb function and health. Despite recent improvements in treatment and novel prosthetic devices, many patients experience a wide range of clinical problems within residual limbs that can negatively impact the progress of rehabilitation programs while also impairing functional capacity and overall quality of life...
July 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28736683/progress-toward-optimizing-prosthetic-socket-fit-and-suspension-using-elevated-vacuum-to-promote-residual-limb-health
#2
Matthew M Wernke, Ryan M Schroeder, Michael L Haynes, Lonnie L Nolt, Alexander W Albury, James M Colvin
Objective: Prosthetic sockets are custom made for each amputee, yet there are no quantitative tools to determine the appropriateness of socket fit. Ensuring a proper socket fit can have significant effects on the health of residual limb soft tissues and overall function and acceptance of the prosthetic limb. Previous work found that elevated vacuum pressure data can detect movement between the residual limb and the prosthetic socket; however, the correlation between the two was specific to each user. The overall objective of this work is to determine the relationship between elevated vacuum pressure deviations and prosthetic socket fit...
July 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28712733/long-term-outcomes-after-autogenous-versus-synthetic-lower-extremity-bypass-in-patients-on-hemodialysis
#3
Isibor Arhuidese, Caitlin W Hicks, Satinderjit Locham, Tammam Obeid, Besma Nejim, Mahmoud B Malas
BACKGROUND: Hemodialysis dependence confers unique physiologic conditions. Prior reports of outcomes after infrainguinal open bypass operations in patients on hemodialysis have been based on relatively small sample institutional series. In this study, we evaluate long-term outcomes after open bypass operations in a large contemporary population-based cohort of hemodialysis patients. We studied all hemodialysis patients who underwent infrainguinal open operation using autogenous versus prosthetic conduits in the United States Renal Data System between January 2007 and December 2011...
July 13, 2017: Surgery
https://www.readbyqxmd.com/read/28705487/amputee-locomotion-frequency-content-of-prosthetic-vs-intact-limb-vertical-ground-reaction-forces-during-running-and-the-effects-of-filter-cut-off-frequency
#4
Dovin Kiernan, Ross H Miller, Brian S Baum, Hyun Joon Kwon, Jae Kun Shim
Compared to intact limbs, running-specific prostheses have high resonance non-biologic materials and lack active tissues to damp high frequencies. These differences may lead to ground reaction forces (GRFs) with high frequency content. If so, ubiquitously applying low-pass filters to prosthetic and intact limb GRFs may attenuate veridical high frequency content and mask important and ecologically valid data from prostheses. To explore differences in frequency content between prosthetic and intact limbs we divided signal power from transtibial unilateral amputees and controls running at 2...
June 21, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28704685/dynamic-balance-changes-within-three-weeks-of-fitting-a-new-prosthetic-foot-component
#5
Jenny A Kent, Nicholas Stergiou, Shane R Wurdeman
Balance during walking is of high importance to prosthesis users and may affect walking during baseline observation and evaluation. The aim of this study was to determine whether changes in walking balance occurred during an adaptation period following the fitting of a new prosthetic component. Margin of stability in the medial-lateral direction (MOSML) and an anterior instability margin (AIM) were used to quantify the dynamic balance of 21 unilateral transtibial amputees during overground walking. Participants trialled two prosthetic feet presenting contrasting movement/balance constraints; a Higher Activity foot similar to that of their own prosthesis, and a Lower Activity foot...
July 5, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28704467/locomotor-adaptability-in-persons-with-unilateral-transtibial-amputation
#6
Benjamin J Darter, Amy J Bastian, Erik J Wolf, Elizabeth M Husson, Bethany A Labrecque, Brad D Hendershot
BACKGROUND: Locomotor adaptation enables walkers to modify strategies when faced with challenging walking conditions. While a variety of neurological injuries can impair locomotor adaptability, the effect of a lower extremity amputation on adaptability is poorly understood. OBJECTIVE: Determine if locomotor adaptability is impaired in persons with unilateral transtibial amputation (TTA). METHODS: The locomotor adaptability of 10 persons with a TTA and 8 persons without an amputation was tested while walking on a split-belt treadmill with the parallel belts running at the same (tied) or different (split) speeds...
2017: PloS One
https://www.readbyqxmd.com/read/28700180/-superior-cava-vein-stenosis-in-a-hemodialysis-patient-with-long-term-central-venous-catheter-and-vascular-graft-a-case-report
#7
Carlo Jovane, Piera Farfaglia, Anna Maria Ierardi, Laura Rimoldi, Elisabetta Sogni, Carmela Figliola, Daniela Pogliani, Matteo Tozzi, Elena Caramella, Pasquale Esposito, Alessandro Castiglioni
Recently, the use of central venous catheters (CVC) as a vascular access in patients undergoing hemodialysis is significantly increased, mainly because of the aging of this population and the presence of several comorbidities. However, the implantation and the long stay of CVC are associated with many complications. Among them, central venous stenosis represents one of the most common problems that, if not properly diagnosed, could lead to vascular thrombosis and consequent vascular access malfunction. Here, we report a case of a 38-year-old patient, who underwent hemodialysis firstly by a CVC long-term into right jugular vein and then by a prosthetic fistula in the ipsilateral limb...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28697795/improved-prosthetic-hand-control-with-concurrent-use-of-myoelectric-and-inertial-measurements
#8
Agamemnon Krasoulis, Iris Kyranou, Mustapha Suphi Erden, Kianoush Nazarpour, Sethu Vijayakumar
BACKGROUND: Myoelectric pattern recognition systems can decode movement intention to drive upper-limb prostheses. Despite recent advances in academic research, the commercial adoption of such systems remains low. This limitation is mainly due to the lack of classification robustness and a simultaneous requirement for a large number of electromyogram (EMG) electrodes. We propose to address these two issues by using a multi-modal approach which combines surface electromyography (sEMG) with inertial measurements (IMs) and an appropriate training data collection paradigm...
July 11, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28693533/classification-complexity-in-myoelectric-pattern-recognition
#9
Niclas Nilsson, Bo Håkansson, Max Ortiz-Catalan
BACKGROUND: Limb prosthetics, exoskeletons, and neurorehabilitation devices can be intuitively controlled using myoelectric pattern recognition (MPR) to decode the subject's intended movement. In conventional MPR, descriptive electromyography (EMG) features representing the intended movement are fed into a classification algorithm. The separability of the different movements in the feature space significantly affects the classification complexity. Classification complexity estimating algorithms (CCEAs) were studied in this work in order to improve feature selection, predict MPR performance, and inform on faulty data acquisition...
July 10, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28692486/standard-and-amputation-adjusted-body-mass-index-measures-comparison-and-relevance-to-functional-measures-weight-related-comorbidities-and-dieting
#10
Christopher Kevin Wong, Ryan J Wong
People with limb loss may misjudge weight-related health when not adjusting body mass index (BMI) for amputation level. This cross-sectional, community-based study compared BMI and amputation-adjusted BMI (A-BMI) and evaluated relationships among BMI categories, function, and dieting. Subjects provided self-reported demographic, functional, and medical/prosthetic data including height and weight and completed performance-based balance and gait measures. A Web-based A-BMI calculator adjusted for amputation levels...
July 7, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28676749/preliminary-evidence-for-training-induced-changes-of-morphology-and-phantom-limb-pain
#11
Sandra Preißler, Désirée Thielemann, Caroline Dietrich, Gunther O Hofmann, Wolfgang H R Miltner, Thomas Weiss
The aim of this study was to investigate whether a special prosthetic training in phantom limb pain patients aimed at increasing the functional use of the prosthesis leads to neural morphological plasticity of brain structures and a reduction in phantom limb pain. For chronic pain disorders, it was shown that morphological alterations due to pain might become at least partially reversed by pain therapies. Phantom limb pain is a chronic pain disorder that is frequently followed by neural plasticity of anatomical brain structures...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28675376/model-based-bayesian-signal-extraction-algorithm-for-peripheral-nerves
#12
Thomas Eggers, Yazan M Dweiri, Grant McCallum, Dominique M Durand
Multi-channel cuff electrodes have recently been investigated for extracting fascicular-level motor commands from mixed neural recordings. Such signals could provide volitional, intuitive control over a robotic prosthesis for amputee patients. Recent work has demonstrated success in extracting these signals in acute and chronic preparations using spatial filtering techniques. These extracted signals, however, had low signal-to-noise ratios and thus limited their utility to binary classification. In this work a new algorithm is proposed which combines previous source localization approaches to create a model based method which operates in real time...
July 4, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28657565/robotic-arm-assisted-partial-knee-arthroplasty-a-single-centre-experience
#13
Andrea Marcovigi, Francesco Zambianchi, Dario Sandoni, Elisa Rivi, Fabio Catani
BACKGROUND AND AIM OF THE WORK: UKA has proven to be an effective surgical procedure, but its survivorship is still negatively affected by inaccuracy in component component positioning, implant and limb alignment. Robotic surgery has been introduced in order to minimize such technical errors. The aim of the present paper was to evaluate clinical and surgical outcomes after a 3 years' experience of robotic assisted UKA with the Mako Robotic Arm. METHODS: Seventy-three patients undergoing  UKA with robotic instrumentation (65 medial UKAs, 8 lateral UKAs) and with a clinical follow-up of 3 -37 months were included in the present study...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28657562/patient-specific-instrumentation-in-total-knee-arthroplasty
#14
Andrea Colombelli, Alberto Belluati, Yousef Rizqallah, Giovanni Guerra, Carlo Busatto
BACKGROUND AND AIM OF THE WORK: The international literature and analysis of the prosthetic registers highlight a significant relationship between the alignment of the components and the survival of prosthetic implants of the knee. The patient specific instrumentation (PSI) technology exploits the data obtained with the MRN for the production of cutting blocks (CB) useful to a TKA. Revisiting the recent international literature, comparing the results of the conventional method and PSI, numerous studies confirm a statistically significant difference of inliers (± 3 degrees) for HKA...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28657560/understanding-the-human-knee-and-its-relationship-to-total-knee-replacement
#15
Enrico Vaienti, Giacomo Scita, Francesco Ceccarelli, Francesco Pogliacomi
The knee is the intermediate joint of the lower limb and it allows the movement between the femur, tibia and patella. Under normal conditions there is a normal distribution of the load forces on these three articular components in both the static load and during ambulation. The understanding of anatomy and knee biomechanics is important for the gait analysis, the diagnosis of joint diseases and the design and development of prosthetic implants. In the last decades comprehension of knee physiology and kinematics has led to the introduction of a wide range of enhanced prosthetic implant designs for a variety of indications...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28655549/lower-extremity-bypass-for-critical-limb-ischemia-decreases-major-adverse-limb-events-with-equivalent-cardiac-risk-compared-with-endovascular-intervention
#16
J Hunter Mehaffey, Robert B Hawkins, Anna Fashandi, Kenneth J Cherry, John A Kern, Irving L Kron, Gilbert R Upchurch, William P Robinson
OBJECTIVE: Lower extremity bypass (LEB) has traditionally been the "gold standard" in the treatment of critical limb ischemia (CLI). Infrainguinal endovascular intervention (IEI) has become more commonly performed than LEB, but comparative outcomes are limited. We sought to compare rates of major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) after LEB and IEI in a propensity score-matched, national cohort of patients with CLI. METHODS: The National Surgical Quality Improvement Program (NSQIP) vascular targeted files (2011-2014) for LEB and IEI were merged...
June 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28649911/three-dimensional-printed-upper-limb-prostheses-lack-randomised-controlled-trials-a-systematic-review
#17
Laura E Diment, Mark S Thompson, Jeroen Hm Bergmann
BACKGROUND: Three-dimensional printing provides an exciting opportunity to customise upper-limb prostheses. OBJECTIVE: This review summarises the research that assesses the efficacy and effectiveness of three-dimensional printed upper-limb prostheses. STUDY DESIGN: Systematic review. METHODS: PubMed, Web of Science and OVID were systematically searched for studies that reported human trials of three-dimensional printed upper-limb prostheses...
June 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28642109/neoaortic-xenoprosthetic-grafts-for-treatment-of-mycotic-aneurysms-and-infected-aortic-grafts
#18
Chukwudubem Anibueze, Visesh Sankaran, Umar Sadat, Kelvin Tan, Yvonne G Wilson, Robert E Brightwell, Michael S Delbridge, Philip W Stather
BACKGROUND: There is no international consensus regarding the optimum management of infected aortae (mycotic aneurysms, infected aortic grafts). Neoaortoiliac reconstruction has advantages over extra-anatomical bypass grafting; however, the use of autologous vein is associated with venous hypertension and compartment syndrome, alternatively cadaveric homografts are associated with high rates of perianastomotic hemorrhage, limb occlusion, and pseudoaneurysm. Arterial repair using xenoprosthetic patches is associated with lower infection rates compared to the use of prosthetic material...
June 20, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28639478/relation-between-capacity-and-performance-in-paediatric-upper-limb-prosthesis-users
#19
Helen Lindner, Ayako Hiyoshi, Liselotte Hermansson
BACKGROUND: The International Classification of functioning, disability and health refers capacity to what an individual can do in a standardised environment and describes performance as what an individual really does and whether the individual encounters any difficulty in the real-life environment. Measures of capacity and performance can help to determine if there is any gap between them that may restrict participation. The aim of this study was to explore the relationship between capacity scores obtained in a standardised clinical setting and proportional ease of performance obtained from a real-life environment...
June 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28637137/development-and-acceptability-testing-of-decision-trees-for-self-management-of-prosthetic-socket-fit-in-adults-with-lower-limb-amputation
#20
Daniel Joseph Lee, Diana A Veneri
PURPOSE: The most common complaint lower limb prosthesis users report is inadequacy of a proper socket fit. Adjustments to the residual limb-socket interface can be made by the prosthesis user without consultation of a clinician in many scenarios through skilled self-management. Decision trees guide prosthesis wearers through the self-management process, empowering them to rectify fit issues, or referring them to a clinician when necessary. This study examines the development and acceptability testing of patient-centered decision trees for lower limb prosthesis users...
February 21, 2017: Disability and Rehabilitation
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