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https://www.readbyqxmd.com/read/28741593/electro-cutaneous-stimulation-on-the-palm-elicits-referred-sensations-on-intact-but-not-on-amputated-digits
#1
Marco D'Alonzo, Leonard Frederik Engels, Marco Controzzi, Christian Cipriani
Objective Grasping and manipulation control critically depends on tactile feedback. Without this feedback, the ability for fine control of a prosthesis is limited in upper limb amputees. Early studies have shown that non-invasive electro-cutaneous stimulation (ES) can induce referred sensations that are spread to a wider and/or more distant area, with respect to the electrodes. Building on this, we sought to exploit this effect to provide somatotopically matched sensory feedback to people with partial hand (digital) amputations...
July 25, 2017: Journal of Neural Engineering
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/28736545/a-randomized-controlled-trial-of-mirror-therapy-for-upper-extremity-phantom-limb-pain-in-male-amputees
#3
Sacha B Finn, Briana N Perry, Jay E Clasing, Lisa S Walters, Sandra L Jarzombek, Sean Curran, Minoo Rouhanian, Mary S Keszler, Lindsay K Hussey-Andersen, Sharon R Weeks, Paul F Pasquina, Jack W Tsao
OBJECTIVE: Phantom limb pain (PLP) is prevalent in patients post-amputation and is difficult to treat. We assessed the efficacy of mirror therapy in relieving PLP in unilateral, upper extremity male amputees. METHODS: Fifteen participants from Walter Reed and Brooke Army Medical Centers were randomly assigned to one of two groups: mirror therapy (n = 9) or control (n = 6, covered mirror or mental visualization therapy). Participants were asked to perform 15 min of their assigned therapy daily for 5 days/week for 4 weeks...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28728802/-psychotherapies-for-the-treatment-of-phantom-limb-pain
#4
Katherine Cárdenas, Mariana Aranda
INTRODUCTION: The phantom limb pain has been described as a condition in which patients experience a feeling of itching, spasm or pain in a limb or body part that has been previously amputated. Such pain can be induced by a conflict between the representation of the visual and proprioceptive feedback of the previously healthy limb. The phantom limb pain occurs in at least 42 to 90% of amputees. Regular drug treatment of phantom limb pain is almost never effective. METHODS: A systematic review of the literature was conducted in Medline and Cochrane using the MESH terms "phantom limb pain" and "psychotherapy", published in the last 10 years, in English and Spanish, finding 49 items...
July 2017: Revista Colombiana de Psiquiatría
https://www.readbyqxmd.com/read/28723767/return-of-the-cadaver-key-role-of-anatomic-dissection-for-plastic-surgery-resident-training
#5
Swenn Maxence Krähenbühl, Paul Čvančara, Thomas Stieglitz, Raphaël Bonvin, Murielle Michetti, Marjorie Flahaut, Sébastien Durand, Lina Deghayli, Lee Ann Applegate, Wassim Raffoul
Successful Plastic Surgery Residency training is subjected to evolving society pressure of lower hourly work weeks imposed by external committees, labor laws, and increased public awareness of patient care quality. Although innovative measures for simulation training of surgery are appearing, there is also the realization that basic anatomy training should be re-enforced and cadaver dissection is of utmost importance for surgical techniques.In the development of new technology for implantable neurostimulatory electrodes for the management of phantom limb pain in amputee patients, a design of a cadaveric model has been developed with detailed steps for innovative transfascicular insertion of electrodes...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28720187/experiences-with-regional-anesthesia-for-analgesia-during-prolonged-aeromedical-evacuation
#6
Jeffrey M Carness, Melissa A Wilson, Mark J Lenart, Danny E Smith, Susan F Dukes
INTRODUCTION: There is much debate regarding the appropriate analgesic management of patients undergoing medical evacuation following combat trauma. Our primary objective was to review the utility of regional anesthetic techniques in patients undergoing aeromedical evacuation following surgical limb amputation as treatment for combat trauma. METHODS: This study was conducted as an observational retrospective cohort whereby acutely injured amputee patients were identified via the U...
August 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28718253/psychological-adjustment-to-amputation-variations-on-the-bases-of-sex-age-and-cause-of-limb-loss
#7
Shaista Ali, Syeda Kaniz Fatima Haider
BACKGROUND: Amputation is the removal of a limb or part of a limb by a surgical procedure in order to save the life of a person. The underlying reasons behind the occurrence of this tragic incidence may be varied. However, irrespective of its cause limb loss is associated with wide range of life challenges. The study was done to investigate the psychological sequel of an individual after losing a limb and to know the level of strain and pressure they experience after this traumatic event...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28716775/acute-rehabilitation-after-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-major-trauma
#8
Jessica Anne Rich, Julia Coleman, Camille Devaux, Karen Hoffman
We report a 23-year-old woman admitted post cyclist versus heavy goods vehicle accident in December 2014. This was the second case the life-saving procedure, that is, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed on at the roadside. This advanced procedure was performed due to the extensive haemorrhage from this patient's complex pelvic fracture . As a result of REBOA, the patient consequently lost her left lower limb and underwent a variety of complex pelvic and lower limb surgeries...
July 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28712989/is-amputation-a-viable-treatment-option-in-lower-extremity-trauma
#9
Manuela Barla, Bertrand Gavanier, Mickaël Mangin, Joffrey Parot, Camille Bauer, Didier Mainard
INTRODUCTION: There is currently no consensus on how to treat patients with lower extremity trauma. Should amputation be performed early on to avoid complications or should the limb be saved at any price?The goal of this study was to show that early amputation is a viable treatment option in lower extremity trauma cases. MATERIAL AND METHODS: Twenty patients who underwent early amputation and 16 patients who underwent limb-salvage were included with a minimum follow-up of 1 year...
July 13, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28707116/rotator-cuff-degeneration-of-the-healthy-shoulder-in-patients-with-unilateral-arm-amputation-is-not-worsened-by-overuse
#10
S Gumina, V Candela, L Mariani, T Venditto, C Catalano, S Castellano, V Santilli, G Giannicola, A Castagna
PURPOSE: In order to evaluate whether overuse has a significant role in rotator cuff tear (RCT) aetiology, we evaluated both shoulders of patients with old unilateral arm amputation expecting a higher rate of RC degeneration in the healthy side. METHODS: Nineteen males and six females (mean age: 57.3 ± 10.1) with an old (>20 years) unilateral arm amputation were submitted to an MRI of both shoulders. Tendon status and muscle tropism were evaluated according to Sugaya and Fuchs classifications, respectively; the acromion humeral distance was measured...
July 13, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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
#11
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
#12
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/28704428/kinematic-and-biomimetic-assessment-of-a-hydraulic-ankle-foot-in-level-ground-and-camber-walking
#13
Xuefei Bai, David Ewins, Andrew D Crocombe, Wei Xu
Improved walking comfort has been linked with better bio-mimicking of the prosthetic ankle. This study investigated if a hydraulic ankle/foot can provide enough motion in both the sagittal and frontal planes during level and camber walking and if the hydraulic ankle/foot better mimics the biological ankle moment pattern compared with a fixed ankle/foot device. Five active male unilateral trans-femoral amputees performed level ground walking at normal and fast speeds and 2.5° camber walking in both directions using their own prostheses fitted with an "Echelon" hydraulic ankle/foot and an "Esprit" fixed ankle/foot...
2017: PloS One
https://www.readbyqxmd.com/read/28697795/improved-prosthetic-hand-control-with-concurrent-use-of-myoelectric-and-inertial-measurements
#14
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/28694439/reachability-and-the-sense-of-embodiment-in-amputees-using-prostheses
#15
Adrienne Gouzien, Fréderique de Vignemont, Amélie Touillet, Noël Martinet, Jozina De Graaf, Nathanaël Jarrassé, Agnès Roby-Brami
Amputated patients are hardly satisfied with upper limb prostheses, and tend to favour the use of their contralateral arm to partially compensate their disability. This may seem surprising in light of recent evidences that external objects (rubber hand or tool) can easily be embodied, namely incorporated in the body representation. We investigated both implicit body representations (by evaluating the peripersonal space using a reachability judgement task) and the quality of bodily integration of the patient's prosthesis (assessed via questionnaires)...
July 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28691574/enhancement-of-a-prosthetic-knee-with-a-microprocessor-controlled-gait-phase-switch-reduces-falls-and-improves-balance-confidence-and-gait-speed-in-community-ambulators-with-unilateral-transfemoral-amputation
#16
Sara Agueda Fuenzalida Squella, Andreas Kannenberg, Ângelo Brandão Benetti
BACKGROUND: Despite the evidence for improved safety and function of microprocessor stance and swing-controlled prosthetic knees, non-microprocessor-controlled prosthetic knees are still standard of care for persons with transfemoral amputations in most countries. Limited feature microprocessor-control enhancement of such knees could stand to significantly improve patient outcomes. OBJECTIVES: To evaluate gait speed, balance, and fall reduction benefits of the new 3E80 default stance hydraulic knee compared to standard non-microprocessor-controlled prosthetic knees...
July 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28678699/turn-intent-detection-for-control-of-a-lower-limb-prosthesis
#17
Corey Pew, Glenn Klute
OBJECTIVE: An adaptable lower limb prosthesis with variable stiffness in the transverse plane requires a control method to effect changes in real time during amputee turning. This study aimed to identify classification algorithms that can accurately predict turning using inertial measurement unit (IMU) signals from the shank with adequate time to enact a change in stiffness during the swing phase of gait when the prosthesis is unloaded. METHODS: To identify if a turning step is imminent, classification models were developed around activities of daily living including 90? spin turns, 90? step turns, 180? turns, and straight walking using simulated IMU data from the prosthesis shank...
June 28, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28678059/peripheral-interventions-for-painful-stump-neuromas-of-the-lower-limb-a-systematic-review
#18
Stephanie Alexandra Poyntz, Milind Dalal, Nicholas Hacking, Stephen Fowler
OBJECTIVES: Painful stump neuromas in lower limb amputees are a significant burden on a person's quality of life due to interference with wearing prostheses and therefore the ability to walk. Treating painful stump neuromas is a challenge perhaps reflected by the lack of clinical guidelines both in the United Kingdom and internationally. METHODS: A systematic review was conducted to evaluate the efficacy of all treatments tried in the management of symptomatic neuromas in the lower limb amputation stump in order to establish whether one treatment is superior...
July 3, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28675376/model-based-bayesian-signal-extraction-algorithm-for-peripheral-nerves
#19
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/28667260/user-adaptation-in-myoelectric-man-machine-interfaces
#20
Janne M Hahne, Marko Markovic, Dario Farina
State of the art clinical hand prostheses are controlled in a simple and limited way that allows the activation of one function at a time. More advanced laboratory approaches, based on machine learning, offer a significant increase in functionality, but their clinical impact is limited, mainly due to lack of reliability. In this study, we analyse two conceptually different machine learning approaches, focusing on their robustness and performance in a closed loop application. A classification (finite number of classes) and a regression (continuous mapping) based projection of EMG into external commands were applied while artificially introducing non-stationarities in the EMG signals...
June 30, 2017: Scientific Reports
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