Amputee

BACKGROUND: Myoelectric prostheses have become the accepted standard of care for pediatric upper-limb amputees. OBJECTIVES: To describe the clinical characteristics and patterns of prosthesis use and to analyze the changes that occur during the growth process of these patients. STUDY DESIGN: This is a longitudinal retrospective study comparing the results of surveys carried out in 2015 and 2022. METHODS: The variables measured included clinical and demographic characteristics, patterns of use, and satisfaction with the prosthesis...

This study presents a mechanical model of a novel medical device designed to optimize the osseointegration process in upper and lower limb amputees, leading to the promotion of optimal rehabilitation. The medical device is developed to reduce the risk of implant failure, leading to re-amputation above the implant. The proposed model serves several purposes: 1) to guide the osseointegration process by providing electrical endo-stimulation directly to the bone-implant contact site, using an invasive electrical stimulation system, which is implanted in the bone permanently, 2) to locally transmit stem cells after implantation, without the need for opening the skin or perforating the bone, which is particularly useful for regenerative medicine after partial healing of the implant, 3) to transmit necessary nutrients from the bone, also without opening the skin or puncturing the bone, and 4) to combat infections by locally administering drugs after implantation...

A prosthetic knee is designed to replace the functionality of an anatomical knee in transfemoral amputees. The purpose of a prosthetic knee is to restore mobility and compensate amputees for their impairment. In the present research numerical modelling and simulation of a carbon fabric reinforced polymer made polycentric prosthetic knee with four-bar mechanism was performed. Virtual prototyping with computer-aided design and computer-aided engineering software ensured geometric and structural stability of the knee design...

PURPOSE: Rehabilitation experiences of lower limb amputees with poorer physical health have not been fully explored. This study aimed to qualitatively explore experiences of rehabilitation amongst patients who had recently undergone amputation due to complications of vascular disease. METHODS: Semi-structured, face-to-face interviews were conducted with 14 patients participating in the PLACEMENT randomised controlled feasibility trial (ISRCTN: 85710690; EudraCT: 2016-003544-37), which investigated the effectiveness of using a perineural catheter for postoperative pain relief following major lower limb amputation...

BACKGROUND: The therapeutic benefits of motor imagery (MI) are now well-established in different populations of persons suffering from central nervous system impairments. However, research on similar efficacy of MI interventions after amputation remains scarce, and experimental studies were primarily designed to explore the effects of MI after upper-limb amputations. OBJECTIVES: The present comparative study therefore aimed to assess the effects of MI on locomotion recovery following unilateral lower-limb amputation...

BACKGROUND: With the in-depth development of assistive treatment devices, the application of artificial knee joints in the rehabilitation of amputees is becoming increasingly mature. The length of residual limbs and muscle strength of patients have individual differences, and the current artificial knee joint lacks certain adaptability in the personalized rehabilitation of patients. PURPOSE: In order to deeply analyze the impact of different types of artificial knee joints on the walking function of unilateral thigh amputees, improve the performance of artificial knee joints, and enhance the rehabilitation effect of patients, this article combines image processing technology to conduct in-depth research on the walking gait analysis of different artificial knee joints of unilateral thigh amputees...

This study aimed to investigate the contemporary status and influencing factors of foot self-care behavior in diabetic foot amputation patients. A total of 250 patients with diabetic foot amputation were included. The general information questionnaire, Chinese Version of the Nottingham Assessment of Function Footcare (CNAFF), Knowledge of Diabetic Foot Questionnaire, and The Third Version of the Diabetes Attitude Scale were used to investigate the status and influencing factors of foot self-care behavior in patients with diabetic foot amputation...

The prognostic nutritional index (PNI) is a new marker used to assess a patient's nutritional and immune status. It is calculated using serum albumin levels and total lymphocyte count. The aim of this study was to investigate the relationship between PNI and amputation in patients with diabetic foot ulcer (DFU). Patients with DFU were enrolled in this retrospective study. In our study, a total of 386 patient data, of 110 (28.5%) amputated and 276 (71.5%) non-amputated patients, were statistically analyzed. PNI values were significantly lower in the amputated patient group than in the non-amputee patient group ( p < 0...

OBJECTIVE: Clinical outcomes after major lower limb amputation have been historically poor. The current care provided to most amputees is often disorganized and without physician supervision. The primary purpose of this study is to examine rates of post-amputation mobility achieved with a prosthesis by patients with chronic limb-threatening ischemia (CLTI) and/or diabetes who required major lower limb amputation and were treated under an established physician-led collaborative care pathway...

BACKGROUND: Globally, over 1 million lower limb amputations are performed annually, with approximately 75% of patients experiencing significant pain, profoundly impacting their quality of life and functional capabilities. Targeted muscle reinnervation (TMR) has emerged as a surgical solution involving the rerouting of amputated nerves to specific muscle targets. Originally introduced to enhance signal amplification for myoelectric prosthesis control, TMR has expanded its applications to include neuroma management and pain relief...

AIM: Early mobilization of patients with a major lower extremity amputation (LEA) is often a challenge because of lack of compliance. Therefore, we investigated factors limiting independent mobility and physiotherapy on the first day with physiotherapy (PTDay1) and the following 2 days after LEA. METHODS: A total of 60 consecutive patients, mean age 73.7 years (SD 12.1 years), undergoing LEA were included over a period of 7 months. The Basic Amputee Mobility Score was used to assess basic mobility...

OBJECTIVE: On 6 February 2023, 2 earthquakes with magnitudes of 7.7 and 7.6 mW occurred in Pazarcık and Elbistan districts of Kahramanmaraş province (Turkey) and affected 11 provinces in total, especially Hatay, Malatya, and Adıyaman. Here, we report 3 earthquake victims in order to define patients profiles. CASE REPORTS: Three patients who were taken to the orthopedic and neurological rehabilitation program in our inpatient Physical Medicine and Rehabilitation unit after the earthquake are presented...

Existing controllers for robotic powered prostheses regulate the prosthesis speed, timing, and energy generation using predefined position or torque trajectories. This approach enables climbing stairs step-over-step. However, it does not provide amputees with direct volitional control of the robotic prosthesis, a functionality necessary to restore full mobility to the user. Here we show that proportional electromyographic (EMG) control of the prosthesis knee torque enables volitional control of a powered knee prosthesis during stair climbing...

Quantitative gait analysis is important for understanding the non-typical walking patterns associated with mobility impairments. Conventional linear statistical methods and machine learning (ML) models are commonly used to assess gait performance and related changes in the gait parameters. Nonetheless, explainable machine learning provides an alternative technique for distinguishing the significant and influential gait changes stemming from a given intervention. The goal of this work was to demonstrate the use of explainable ML models in gait analysis for prosthetic rehabilitation in both population- and sample-based interpretability analyses...

OBJECTIVES: Adaptation of upper-limb impedance (stiffness, damping, inertia) is crucial for humans to physically interact with the external environment during grasping and manipulation tasks. Here, we present a novel framework for Adaptive Impedance Control of Upper-limb Prosthesis (AIC-UP) based on surface electromyography (sEMG) signals. METHODS: AIC-UP uses muscle-tendon models driven by sEMG signals from agonist-antagonist muscle groups to estimate the human motor intent as joint kinematics, stiffness and damping...

PURPOSE: Lower limb loss can result in an altered body image, leading to changes in self-esteem, mental health and quality of life. This scoping review explored how body image has been evaluated among people with lower limb loss. MATERIALS AND METHODS: Five databases (Embase, Medline, PsychINFO, CINHAL, and Nursing and Allied Health Database) were searched from inception until March 19, 2023. Inclusion criteria: 1) people with lower limb loss; 2) evaluated a body image outcome or theme; and 3) a qualitative, quantitative or mixed methods design...

Powered lower-limb prostheses have the potential to improve amputee mobility by closely imitating the biomechanical function of the missing biological leg. To accomplish this goal, powered prostheses need controllers that can seamlessly adapt to the ambulation activity intended by the user. Most powered prosthesis control architectures address this issue by switching between specific controllers for each activity. This approach requires online classification of the intended ambulation activity. Unfortunately, any misclassification can cause the prosthesis to perform a different movement than the user expects, increasing the likelihood of falls and injuries...

INTRODUCTION: Plantar cutaneous augmentation is a promising approach in balance rehabilitation by enhancing motion-dependent sensory feedback. The effect of plantar cutaneous augmentation on balance has been mainly investigated in its passive form (e.g., textured insole) or on lower-limb amputees. In this study, we tested the effect of plantar cutaneous augmentation on balance in its active form (i.e., electrical stimulation) for individuals with intact limbs. METHODS: Ten healthy subjects participated in the study and were instructed to maintain their balance as long as possible on the balance board, with or without electrotactile feedback evoked on the medial side of the heel, synched with the lateral board sway...

OBJECTIVE: To determine if lower limb prosthesis (LLP) sophistication is associated with patient-reported mobility and/or mobility satisfaction, and if these associations differ by amputation level. DESIGN: Cohort study that identified participants through a large national database and prospectively collected self-reported patient outcomes. SETTING: The Veterans Administration (VA) Corporate Data Warehouse, the National Prosthetics Patient Database, participant mailings and phone calls...

PURPOSE: Osseointegration (OI) is a novel alternative to traditional socket-suspended prostheses for lower-limb amputees, eliminating the socket-skin interface and allowing for weight bearing directly on the skeletal system. However, the stoma through which the implant attaches to the external prosthesis creates an ingress route for bacteria, and infection rates as high as 66% have been reported. The aims of this study are to classify infection management and long-term outcomes in this patient population to maximize implant salvage...