670 results match your criteria Lower Limb Prosthetics


Prosthetic Rehabilitation in Practice: An Exploration of Experiential Knowledge in the Multidisciplinary Team.

Qual Health Res 2020 Jul 1:1049732320933272. Epub 2020 Jul 1.

St Mary's University, Twickenham, United Kingdom.

The aim of this research was to explore the experiential knowledge of patient-facing staff working in a prosthetic rehabilitation center in the United Kingdom. Eleven members of staff with varied roles and levels of experience took part in semi-structured interviews. Transcripts were analyzed using thematic analysis. Read More

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http://dx.doi.org/10.1177/1049732320933272DOI Listing

Three-dimensional printing in prosthetics: Method for managing rapid limb volume change.

Prosthet Orthot Int 2020 Jun 25:309364620934340. Epub 2020 Jun 25.

Minneapolis VA Health Care System, Minneapolis, MN, USA.

Background And Aim: During post-amputation recovery or rapid body mass change, residual limb volume can change quickly, requiring frequent adjustments or replacement of the socket to maintain fit. The aim of this pilot test was to evaluate the feasibility of using a three-dimensional-printed insert to extend the service life of a prosthetic socket after substantial residual limb volume loss.

Technique: One research subject with a well-fitting transtibial prosthetic socket had an oversized socket fabricated to simulate substantial limb volume loss. Read More

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http://dx.doi.org/10.1177/0309364620934340DOI Listing

Pelvic obliquity as a compensatory mechanism leading to lower energy recovery: Characterization among the types of prostheses in subjects with transfemoral amputation.

Gait Posture 2020 Jun 12;80:280-284. Epub 2020 Jun 12.

Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Via Franco Faggiana 1668, 04100, Latina, Italy; Movement Analysis Laboratory, Policlinico Italia, Piazza del Campidano, 6, 00162, Rome, Italy.

Background: Subjects with transfemoral amputation (TFA) show an asymmetric gait pattern associated with a decreased ability to recover mechanical energy and an increased metabolic cost of walking.

Research Question: This study aimed to identify the spatio-temporal and kinematic gait variables correlated with mechanical energy values in subjects with TFA and to observe the ability of the identified parameters to discriminate between TFA and controls according to the type of prosthesis.

Methods: The gait of 40 subjects with TFA was evaluated with a motion 3-D optoelectronic system. Read More

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http://dx.doi.org/10.1016/j.gaitpost.2020.06.013DOI Listing

Using mechanical testing to assess texturing of prosthetic sockets to improve suspension in the transverse plane and reduce rotation.

PLoS One 2020 11;15(6):e0233148. Epub 2020 Jun 11.

Northwestern University Prosthetics-Orthotics Center, Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, United States of America.

Creating a secure and comfortable linkage between the residual limb and prosthetic socket in persons with lower limb amputation is a critical factor for successful rehabilitation, including ambulation and other activities of daily living. Unwanted rotation within the socket can be a clinical problem for prosthesis users. One way of addressing issues experienced with transverse plane control of the socket may be through increased friction interface forces. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0233148PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289418PMC

Syme Amputation: Function, Satisfaction, and Prostheses.

J Pediatr Orthop 2020 Jul;40(6):e532-e536

Departments of Orthopaedics.

Background: Syme amputation (SA) is a term used to describe an amputation at the level of the ankle joint in which the heel pad is preserved. It is performed for a number of indications in a pediatric population. SA is purported to hold the advantage of allowing weight bearing without a prosthesis. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001430DOI Listing

Are consumers satisfied with the use of prosthetic sports feet and the provision process? A mixed-methods study.

Med Hypotheses 2020 May 23;143:109869. Epub 2020 May 23.

University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.

Background: Special feet connected to a prosthesis, prosthetic sports feet, enable athletes with a lower limb amputation to run. The selection of a prosthetic sports feet is usually based on body weight and preferred sports performance. The selection of a prosthetic sport feet is also based on clinicians who likely have limited experience due to a small number of athletes with a lower limb amputation. Read More

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http://dx.doi.org/10.1016/j.mehy.2020.109869DOI Listing

Targeted Muscle Reinnervation Improves Residual Limb Pain, Phantom Limb Pain, and Limb Function: A Prospective Study of 33 Major Limb Amputees.

Clin Orthop Relat Res 2020 May 20. Epub 2020 May 20.

L. M. Mioton, G. A. Dumanian, N. Shah, C. S. Qiu, J. H. Ko, S. W. Jordan, Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA W. J. Ertl, The Department of Orthopedic Surgery, The University of Oklahoma, Oklahoma City, OK, USA B. K. Potter, J. M. Souza, Department of Surgery, Walter Reed National Military Medical Center, Uniformed Services University of Health Sciences, Bethesda, MD, USA I. L. Valerio, The Department of Plastic Surgery, The Ohio State University, Columbus, OH, USA.

Background: Targeted muscle reinnervation is an emerging surgical technique to treat neuroma pain whereby sensory and mixed motor nerves are transferred to nearby redundant motor nerve branches. In a recent randomized controlled trial, targeted muscle reinnervation was recently shown to reduce postamputation pain relative to conventional neuroma excision and muscle burying.

Questions/purposes: (1) Does targeted muscle reinnervation improve residual limb pain and phantom limb pain in the period before surgery to 1 year after surgery? (2) Does targeted muscle reinnervation improve Patient-reported Outcome Measurement System (PROMIS) pain intensity and pain interference scores at 1 year after surgery? (3) After 1 year, does targeted muscle reinnervation improve functional outcome scores (Orthotics Prosthetics User Survey [OPUS] with Rasch conversion and Neuro-Quality of Life [Neuro-QOL])?

Methods: Data on patients who were ineligible for randomization or declined to be randomized and underwent targeted muscle reinnervation for pain were gathered for the present analysis. Read More

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http://dx.doi.org/10.1097/CORR.0000000000001323DOI Listing

Physical activity guidelines and promotion: An online survey of United Kingdom's prosthetic rehabilitation healthcare professionals.

Prosthet Orthot Int 2020 May 24:309364620920109. Epub 2020 May 24.

Physical Activity for Health, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK.

Background: Healthcare professionals play a key role in supporting physical activity participation for people with lower limb absence.

Objectives: The objectives of this study were to survey healthcare professionals' views of people with lower limb absence in the United Kingdom, explore their awareness and knowledge of physical activity recommendations and investigate their current and desirable practice towards physical activity promotion.

Study Design: Cross-sectional study. Read More

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http://dx.doi.org/10.1177/0309364620920109DOI Listing

The Relationship Between Vestibular Sensory Integration and Prosthetic Mobility in Community Ambulators With Unilateral Lower Limb Amputation.

Phys Ther 2020 May 13. Epub 2020 May 13.

Department of Physical Therapy, Miller School of Medicine, University of Miami, 5915 Ponce de Leon Boulevard, Coral Gables, FL 33146 (USA).

Objective: The modified Clinical Test of Sensory Interaction and Balance (mCTSIB) is used to clinically assess vestibular sensory integration (VSI), the process by which the central nervous system integrates vestibular afference to maintain balance. The rate and effects of impaired VSI (IVSI) on prosthetic mobility in people with lower limb amputation (LLA) is unknown. The objective of this study was to use the mCTSIB to classify VSI in active community ambulators with LLA and to examine the relationship between IVSI and prosthetic mobility, as measured by the Component Timed "Up and Go" (cTUG) Test. Read More

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http://dx.doi.org/10.1093/ptj/pzaa091DOI Listing

Effectiveness of a crossover prosthetic foot in active children with a congenital lower limb deficiency: an explorative study.

Prosthet Orthot Int 2020 May 6:309364620912063. Epub 2020 May 6.

Pediatric Department, De Hoogstraat Revalidatie, Utrecht, The Netherlands.

Background: Children with lower limb prostheses cannot always keep up with their peers during active play. A pediatric crossover foot may be a promising prosthetic alternative for children engaging in high-intensity movements necessary for active play.

Objectives: To compare children's walking performance, running performance, experienced competence, and cosmesis using their prescribed prosthesis compared with the crossover foot. Read More

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http://dx.doi.org/10.1177/0309364620912063DOI Listing

Increased prefrontal cortical activation during challenging walking conditions in persons with lower limb amputation - an fNIRS observational study.

Physiother Theory Pract 2020 May 5:1-11. Epub 2020 May 5.

Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.

: Lower limb amputation (LLA) alters the sensorimotor control systems. Despite the self-reports of increased attention during mobility, the interaction between mobility and cognitive control mechanisms is not fully understood.: Concurrently evaluate walking performance and prefrontal cortical (PFC) activity in persons with and without LLA during different walking conditions. Read More

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http://dx.doi.org/10.1080/09593985.2020.1758979DOI Listing

Asymmetry of mass and motion affects the regulation of whole-body angular momentum in individuals with upper limb absence.

Clin Biomech (Bristol, Avon) 2020 Jun 23;76:105015. Epub 2020 Apr 23.

Northwestern University Prosthetics-Orthotics Center, Dept. of Physical Medicine & Rehabilitation, Feinberg School of Medicine, 680 North Lake Shore Drive, Suite 1100, Chicago, IL 60611, USA; Jesse Brown VA Medical Center, 820 S Damen Ave, Chicago, IL 60612, USA. Electronic address:

Background: There is a high fall prevalence in individuals with upper limb absence, which may be related to a momentum imbalance resulting from the loss of all or part of one arm. The purpose of this study was to characterise whole-body angular momentum in individuals with upper limb absence during walking, and determine the effect of restoring the mass and inertial properties of the impaired side with a mock prosthesis.

Methods: Ten individuals with unilateral upper limb absence walked at self-selected speeds, with and without a mock prosthesis. Read More

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http://dx.doi.org/10.1016/j.clinbiomech.2020.105015DOI Listing

SwedeAmp-the Swedish Amputation and Prosthetics Registry: 8-year data on 5762 patients with lower limb amputation show sex differences in amputation level and in patient-reported outcome.

Acta Orthop 2020 Apr 22:1-7. Epub 2020 Apr 22.

Centre for Advanced Reconstruction of Extremities and Department for Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, and Institute of Clinical Sciences, Department of Orthopedics, Sahlgrenska Academy, Gothenburg, Sweden.

Background and purpose - For want of national guidelines for lower limb amputation (LLA) the quality registry SwedeAmp was started in 2011 to increase knowledge around LLA and prosthetic rehabilitation. We now present data from the first 8 years of registration.Patients and methods - We present descriptive data from the first 8 years (2011-2018) of registration. Read More

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http://dx.doi.org/10.1080/17453674.2020.1756101DOI Listing

Method for positioning and rehabilitation training with the ExoAtlet ® powered exoskeleton.

MethodsX 2020 19;7:100849. Epub 2020 Mar 19.

Center for Interdisciplinary Research in Health, Institute of Health Sciences, Universidade Católica Portuguesa, Porto, Portugal.

Exoskeletons for locomotion, support, or other uses are becoming more common. An increasing number of studies are demonstrating relevant results in rehabilitation. Here we describe the steps required to properly place and train patients in ExoAtlet ® powered exoskeletons (Moscow, Russia), for which there is currently limited information available. Read More

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http://dx.doi.org/10.1016/j.mex.2020.100849DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152710PMC

The effect of a lateral wedge insole and a subtalar strap on gait parameters in knee osteoarthritis.

Med J Islam Repub Iran 2019 30;33:157. Epub 2019 Dec 30.

Biomedical Engineering School, Amir Kabir University of Technology, Tehran, Iran.

Lateral wedge insole (LWI) aims to reduce loading on medial compartment of tibiofemoral joint in mild knee osteoarthritis (KOA). This effect may be augmented by concomitant use of subtalar strap to fix the ankle joint. Moreover, longitudinal arch support embedded in insoles can cause foot comfort and may be beneficial for people with KOA. Read More

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http://dx.doi.org/10.34171/mjiri.33.157DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137820PMC
December 2019

Walking kinematics in young children with limb loss using early versus traditional prosthetic knee prescription protocols.

PLoS One 2020 10;15(4):e0231401. Epub 2020 Apr 10.

Division of Prosthetics and Orthotics, Department of Orthopedics, Children's Healthcare of Atlanta, Atlanta, Georgia, United States of America.

The traditional treatment protocol for young children with congenital or acquired amputations at or proximal to the knee prescribes a prosthesis without a working knee joint, based in part on the assumption that a child learning to walk cannot properly utilize a passively flexing prosthetic knee component. An alternative to this Traditional Knee (TK) protocol is an "Early Knee" (EK) protocol, which prescribes an articulating prosthetic knee in the child's first prosthesis, during development of crawling and transitioning into and out of upright positions. To date, no study has compared samples of children with limb loss at or proximal to the knee using TK and EK protocols. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0231401PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147787PMC
April 2020
3.234 Impact Factor

Optical coherence tomography for the investigation of skin adaptation to mechanical stress.

Skin Res Technol 2020 Mar 29. Epub 2020 Mar 29.

Department of Bioengineering, University of Washington, Seattle, Washington.

Background: Skin breakdown due to limb-socket interface stress is a significant problem for lower limb prosthesis users. While it is known that skin can adapt to stress to become more resistant to breakdown, little is understood about skin adaptation and few methods exist to noninvasively investigate it. In this study, we present novel, noninvasive imaging methods using Optical Coherence Tomography (OCT) to assess key features of the cutaneous microvasculature that may be involved in skin adaptation. Read More

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http://dx.doi.org/10.1111/srt.12843DOI Listing

Effectiveness of elevated vacuum and suction prosthetic suspension systems in managing daily residual limb fluid volume change in people with transtibial amputation.

Prosthet Orthot Int 2020 Jun 18;44(3):155-163. Epub 2020 Mar 18.

Department of Bioengineering, University of Washington, Seattle, WA, USA.

Background: Previous studies investigating limb volume change with elevated vacuum have shown inconsistent results and have been limited by out-of-socket volume measurements and short, single-activity protocols.

Objectives: To evaluate the effectiveness of elevated vacuum for managing limb fluid volume compared to suction suspension with an in-socket measurement modality during many hours of activity.

Study Design: Fixed-order crossover design with a standardized out-of-laboratory activity protocol. Read More

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http://dx.doi.org/10.1177/0309364620909044DOI Listing

Current Trends and Confounding Factors in Myoelectric Control: Limb Position and Contraction Intensity.

Sensors (Basel) 2020 Mar 13;20(6). Epub 2020 Mar 13.

Department of Electrical and Computer Engineering, University of New Brunswick, Canada.

This manuscript presents a hybrid study of a comprehensive review and a systematic(research) analysis. Myoelectric control is the cornerstone ofmany assistive technologies used in clinicalpractice, such as prosthetics and orthoses, and human-computer interaction, such as virtual reality control.Although the classification accuracy of such devices exceeds 90% in a controlled laboratory setting,myoelectric devices still face challenges in robustness to variability of daily living conditions. Read More

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http://dx.doi.org/10.3390/s20061613DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146367PMC

Advanced technologies for intuitive control and sensation of prosthetics.

Biomed Eng Lett 2020 Feb 8;10(1):119-128. Epub 2019 Aug 8.

6National Institute of Biomedical Imaging and Bioengineering, National Institute of Health, Bethesda, MD 20817 USA.

The Department of Defense, Department of Veterans Affairs and National Institutes of Health have invested significantly in advancing prosthetic technologies over the past 25 years, with the overall intent to improve the function, participation and quality of life of Service Members, Veterans, and all United States Citizens living with limb loss. These investments have contributed to substantial advancements in the control and sensory perception of prosthetic devices over the past decade. While control of motorized prosthetic devices through the use of electromyography has been widely available since the 1980s, this technology is not intuitive. Read More

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http://dx.doi.org/10.1007/s13534-019-00127-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7046895PMC
February 2020

Design and Evaluation of an Articulated Ankle Foot Orthosis with Plantarflexion Resistance on the Gait: a Case Series of 2 Patients with Hemiplegia.

J Biomed Phys Eng 2020 Feb 1;10(1):119-128. Epub 2020 Feb 1.

PhD, International University of Health and Welfare, Tokyo, Japan.

Ankle-foot orthoses (AFOs) have been described to have positive effects on the gait biomechanics in stroke patients. The plantarflexion resistance of an AFO is considered important for hemiplegic patients, but the evidence is still limited. The purpose of this case series was to design and evaluate the immediate effect of an articulated AFO on kinematics and kinetics of lower-limb joints in stroke patients. Read More

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http://dx.doi.org/10.31661/jbpe.v0i0.1159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036417PMC
February 2020

Efficacy of a topical formulation of henna (Lawsonia inermis L.) in contact dermatitis in patients using prosthesis: A double-blind randomized placebo-controlled clinical trial.

Complement Ther Med 2020 Mar 15;49:102316. Epub 2020 Jan 15.

Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran. Electronic address:

Background: Contact dermatitis is a common complication in prosthetic limb users. There are no effective, available and cheap treatments for skin problems of these patients. In traditional Iranian medicine, henna (Lawsonia inermis L. Read More

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http://dx.doi.org/10.1016/j.ctim.2020.102316DOI Listing

Development of Bilateral Heterotopic Ossification After Survival of Life Threatening Purpura Fulminans.

Cureus 2020 Jan 21;12(1):e6731. Epub 2020 Jan 21.

Plastic Surgery, The Johns Hopkins University School of Medicine, Baltimore, USA.

Heterotopic ossification has been reported in patients who have undergone traumatic amputations, burn injuries, and total hip arthroplasty; however, the incidence of heterotopic ossification following purpura fulminans has only been reported in one case with unilateral involvement. Here we present a bilateral lower extremity case of heterotopic ossification as sequelae of purpura fulminans.  A 34-year-old male smoker with a past medical history of stab wounds to the chest and abdomen requiring emergent exploratory laparotomy, diaphragmatic repair, and splenectomy 15 years ago presented to the emergency department with a rapid onset of high fevers, chills and myalgia. Read More

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http://dx.doi.org/10.7759/cureus.6731DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7034744PMC
January 2020

Load response of an osseointegrated implant used in the treatment of unilateral transfemoral amputation: An early implant loosening case study.

Clin Biomech (Bristol, Avon) 2020 Mar 20;73:201-212. Epub 2020 Jan 20.

Department of Biomedical Engineering, The University of Melbourne, Victoria, Australia. Electronic address:

Background: Osseointegrated implants for transfemoral amputees facilitate direct load transfer between the prosthetic limb and femur; however, implant loosening is a common complication, and the associated implant-bone loads remain poorly understood. This case study aimed to use patient-specific computational modeling to evaluate bone-implant interface loading during standing and walking in a transfemoral amputee with an osseointegrated implant prior to prosthesis loosening and revision surgery.

Methods: One male transfemoral amputee with an osseointegrated implant was recruited (age: 59-yrs, weight: 83 kg) and computed tomography (CT) performed on the residual limb approximately 3 months prior to implant failure. Read More

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http://dx.doi.org/10.1016/j.clinbiomech.2020.01.017DOI Listing

Relevance of medical comorbidities for functional mobility in people with limb loss: retrospective explanatory models for a clinical walking measure and a patient-reported functional outcome.

Physiotherapy 2020 Jun 10;107:133-141. Epub 2020 Jan 10.

Program in Physical Therapy, College of Physicians and Surgeons, Columbia University, New York, NY, USA.

Objectives: Various modifiable and non-modifiable factors affect functional mobility, but subjective patient-reported and objective performance-based measures are rarely combined in explanatory analyses of functional mobility in people with limb loss. This study determined separate explanatory models for patient-reported function using the Prosthetic Evaluation Questionnaire Mobility Subscale (PEQ-MS), and performance-based 2-Minute Walk Test (2MWT).

Design: Retrospective cross-sectional observational analysis. Read More

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http://dx.doi.org/10.1016/j.physio.2020.01.002DOI Listing

Periprosthetic osseointegration fractures are infrequent and management is familiar.

Bone Joint J 2020 Feb;102-B(2):162-169

Department of Orthopaedic Surgery, Macquarie University Hospital, Macquarie University, Macquarie Park, Australia.

Aims: Osseointegrated prosthetic limbs allow better mobility than socket-mounted prosthetics for lower limb amputees. Fractures, however, can occur in the residual limb, but they have rarely been reported. Approximately 2% to 3% of amputees with socket-mounted prostheses may fracture within five years. Read More

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http://dx.doi.org/10.1302/0301-620X.102B2.BJJ-2019-0697.R2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7002843PMC
February 2020

Long-Term Outcomes of Rotationplasty patients in the treatment of lower extremity sarcomas with cost analysis.

J Clin Orthop Trauma 2020 Feb 5;11(Suppl 1):S149-S152. Epub 2019 Jun 5.

University of Nebraska Medical Center, Department of Orthopaedic Surgery & Rehabilitation, 985640 Nebraska Medical Center, Omaha, NE, 68198-5640, USA.

Objective: There are many options for restoration of function in treating lower extremity sarcomas in young children. The trend has moved towards the use of expandable prosthetics for treatment; however, this has been fraught with complications and expense. The aim of this study was to assess long-term functional outcome scores and emotional satisfaction of rotationplasty and megaprosthesis patients compared to the general population. Read More

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http://dx.doi.org/10.1016/j.jcot.2019.06.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6977185PMC
February 2020

Novel passive ankle-foot prosthesis mimics able-bodied ankle angles and ground reaction forces.

Clin Biomech (Bristol, Avon) 2020 Feb 23;72:202-210. Epub 2019 Dec 23.

Rehabilitation Engineering and Electromechanical Design Lab, Department of Mechanical Engineering, University of South Florida, United States. Electronic address:

Background: During gait, the human ankle both bends with ease and provides push-off forces that facilitate forward motion. The ankle is crucial for support, stabilization, and adapting to different slopes and terrains. Individuals with lower limb amputation require an ankle-foot prosthesis for basic mobility. Read More

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http://dx.doi.org/10.1016/j.clinbiomech.2019.12.016DOI Listing
February 2020

Prosthesis satisfaction in a national sample of Veterans with upper limb amputation.

Prosthet Orthot Int 2020 Apr 21;44(2):81-91. Epub 2020 Jan 21.

Brown University, Providence, RI, USA.

Background: Many persons with upper limb amputation reject prostheses, and many are not satisfied with their devices. Research is needed to understand modifiable factors related to device satisfaction. Myoelectric devices with multiple degrees of freedom are now available; however, no studies have examined whether they lead to greater device satisfaction. Read More

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http://dx.doi.org/10.1177/0309364619895201DOI Listing
April 2020
1.073 Impact Factor

Prediction of Smooth Gait Transitioning for Active Lower Limb Prosthetics.

Conf Proc IEEE Eng Med Biol Soc 2019 07;2019:2424-2429

Amputation is the major cause of gait impairment in our society and is due to several factors and conditions such as war injuries or diabetes lower limb complication, often resulting in a gait impairment. Active prosthetics have been considered to remedy this mobility loss. These devices have the potential to enhance significantly the quality of life of patients. Read More

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http://dx.doi.org/10.1109/EMBC.2019.8856870DOI Listing

Combining physical therapy and cognitive behavioral therapy techniques to improve balance confidence and community participation in people with unilateral transtibial amputation who use lower limb prostheses: a study protocol for a randomized sham-control clinical trial.

Trials 2019 Dec 30;20(1):812. Epub 2019 Dec 30.

Dr. William M. Scholl College of Podiatric Medicines' Center for Lower Extremity Ambulatory Research (CLEAR), Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL, 60064, USA.

Background: Low balance confidence is a prevalent yet overlooked issue among people who use lower limb prostheses (LLP) that can diminish community integration and quality of life. There is a critical need to develop rehabilitation programs that specifically target balance confidence in people who use LLP. Previous research has shown that multicomponent interventions including cognitive-behavioral therapy (CBT) techniques and exercise are feasible and effective for improving balance confidence in older adults. Read More

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http://dx.doi.org/10.1186/s13063-019-3929-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937857PMC
December 2019

A Pilot Study Testing a Novel 3D Printed Amphibious Lower Limb Prosthesis in a Recreational Pool Setting.

PM R 2019 Nov 20. Epub 2019 Nov 20.

The Feinstein Institute for Medical Research, Manhasset, NY.

Introduction: Adults with limb amputation and other physical disabilities are less likely to participate in physical activity than adults in the general population and have elevated risk of heart disease and stroke. Swimming is a physical activity often recommended for persons with limb amputation. However, a standard economical swim prosthesis that facilitates easy transition from land to water does not exist. Read More

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http://dx.doi.org/10.1002/pmrj.12293DOI Listing
November 2019

Subject- and Environment-Based Sensor Variability for Wearable Lower-Limb Assistive Devices.

Sensors (Basel) 2019 Nov 8;19(22). Epub 2019 Nov 8.

Neural Engineering for Prosthetics and Orthotics Lab (NEPOL), Center of Bionic Medicine, Shirley Ryan AbilityLab (formerly RIC), Chicago, IL 60611, USA.

Significant research effort has gone towards the development of powered lower limb prostheses that control power during gait. These devices use forward prediction based on electromyography (EMG), kinetics and kinematics to command the prosthesis which locomotion activity is desired. Unfortunately these predictions can have substantial errors, which can potentially lead to trips or falls. Read More

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http://dx.doi.org/10.3390/s19224887DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6891559PMC
November 2019

Effect of cycling and functional electrical stimulation with linear and interval patterns of timing on gait parameters in patients after stroke: a randomized clinical trial.

Disabil Rehabil 2019 Nov 10:1-7. Epub 2019 Nov 10.

Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.

Patients in the chronic phase after a stroke are an underrepresented group in the literature. Therefore, the aim of this study was to compare the effects of cycling and functional electrical stimulation with linear versus interval patterns of timing on gait parameters in patients after stroke. A double blinded, parallel, randomized clinical trial. Read More

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http://dx.doi.org/10.1080/09638288.2019.1685600DOI Listing
November 2019
1.837 Impact Factor

Analysis of Pressure Distribution in Transfemoral Prosthetic Socket for Prefabrication Evaluation via the Finite Element Method.

Bioengineering (Basel) 2019 Oct 24;6(4). Epub 2019 Oct 24.

Department of Science and Engineering, Tokyo Denki University, Tokyo 120-8551, Japan.

In this study, we estimated and validated the pressure distribution profile between the residuum and two types of prosthetic sockets for transfemoral amputees by utilizing a finite element analysis. Correct shaping of the socket for an appropriate load distribution is a critical process in the design of lower-limb prosthesis sockets. The pressure distribution profile provides an understanding of the relationship between the socket design and the level of subject comfortability. Read More

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http://dx.doi.org/10.3390/bioengineering6040098DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6956391PMC
October 2019

A characterisation of established unilateral transfemoral amputee gait using 3D kinematics, kinetics and oxygen consumption measures.

Gait Posture 2020 01 3;75:98-104. Epub 2019 Oct 3.

West of Scotland Rehabilitation and Mobility Centre, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, 1345 Govan Road, Glasgow, G51 4TF, UK. Electronic address:

Background: Persons with unilateral transfemoral (UTF) amputation are known to walk with less efficiency than able-bodied individuals, therefore understanding the gait deviations that drive this inefficiency was considered to be important.

Research Questions: What are the differences in gait outcomes between persons with UTF amputation and able-bodied persons? What is the prevalence of specific gait deviations within this group?

Methods: Using a cross-sectional study design, the level over ground gait of established prosthetics service users with UTF amputation using mechanical knee joints (n=60) were compared with able-bodied persons (n=10). Gait profile score, walking velocity, step length, step length symmetry ratio, step time symmetry ratio, vertical ground reaction force symmetry index, base of support, centre of mass deviation and metabolic energy expenditure were measured. Read More

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http://dx.doi.org/10.1016/j.gaitpost.2019.09.029DOI Listing
January 2020
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A modified walk-in clinic for shoe insoles: Follow-up of non-attendants.

Prosthet Orthot Int 2019 Dec 17;43(6):597-600. Epub 2019 Oct 17.

Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

Background: In a previous study ( = 1286), we found that a modified walk-in system reduced waiting times for prescription of shoe insoles by 40 days compared to scheduled appointments but resulted in a non-attendance rate of 17% compared to 6% for scheduled appointments.

Objectives: To investigate the reasons for non-attendance at the modified walk-in clinic.

Study Design: This is a cross-sectional survey. Read More

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http://dx.doi.org/10.1177/0309364619879285DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6900566PMC
December 2019
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Functional evaluation of a non-assembly 3D-printed hand prosthesis.

Proc Inst Mech Eng H 2019 Nov 6;233(11):1122-1131. Epub 2019 Sep 6.

Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands.

In developing countries, the access of amputees to prosthetic devices is very limited. In a way to increase accessibility of prosthetic hands, we have recently developed a new approach for the design and 3D printing of non-assembly active hand prostheses using inexpensive 3D printers working on the basis of material extrusion technology. This article describes the design of our novel 3D-printed hand prosthesis and also shows the mechanical and functional evaluation in view of its future use in developing countries. Read More

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http://dx.doi.org/10.1177/0954411919874523DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6790990PMC
November 2019
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Enhancing functional abilities and cognitive integration of the lower limb prosthesis.

Sci Transl Med 2019 10;11(512)

Laboratory for Neuroengineering, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, 8092 Zürich, Switzerland.

Lower limb amputation (LLA) destroys the sensory communication between the brain and the external world during standing and walking. Current prostheses do not restore sensory feedback to amputees, who, relying on very limited haptic information from the stump-socket interaction, are forced to deal with serious issues: the risk of falls, decreased mobility, prosthesis being perceived as an external object (low embodiment), and increased cognitive burden. Poor mobility is one of the causes of eventual device abandonment. Read More

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http://dx.doi.org/10.1126/scitranslmed.aav8939DOI Listing
October 2019
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Assessing mobility for persons with lower limb amputation: the Figure-of-Eight Walk Test with the inclusion of two novel conditions.

Disabil Rehabil 2019 Sep 17:1-10. Epub 2019 Sep 17.

Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University , Oslo , Norway.

To investigate the internal consistency, convergent and known-groups construct validity of the Figure-of-Eight Walk Test with two novel conditions in persons with lower limb amputation, and to examine differences in walking performance between the three conditions within a group of persons with transtibial amputation and transfemoral amputation/knee disarticulation. Fifty adults with unilateral amputation participated, 28 of whom had undergone a transtibial amputation and 22 a transfemoral amputation/knee disarticulation. Three Figure-of-Eight Walk Test conditions were investigated: 1) walking at a self-selected walking speed, 2) walking while carrying a tray with two cups of water, and 3) walking on uneven terrain. Read More

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http://dx.doi.org/10.1080/09638288.2019.1662495DOI Listing
September 2019
3 Reads

Prosthetic Rehabilitation in the Lower Limb.

Indian J Plast Surg 2019 Jan 29;52(1):134-143. Epub 2019 Apr 29.

Otto Bock Health Care India, Mumbai, Maharashtra, India.

Lower limb amputations form a considerable number with 5,436,000 Indians having locomotor disability. Most members of this group are young, active earning males. The major cause of amputation is trauma. Read More

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http://dx.doi.org/10.1055/s-0039-1687919DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6664837PMC
January 2019
2 Reads

Regional variations of in vivo surface stiffness of soft tissue layers of musculoskeletal extremities.

J Biomech 2019 Oct 8;95:109307. Epub 2019 Aug 8.

Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address:

Surface stiffness of bulk soft tissue in musculoskeletal extremities is important to consider in the design of prosthetics, exoskeletons, and protective gear. This knowledge is also foundational for surgical simulation and clinical interventions leveraging manipulation of the musculoskeletal surfaces. Injuries to musculoskeletal extremities are common and surgical and preventive interventions require interactions between various objects such as surgical tools and support surfaces with tissue boundaries. Read More

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http://dx.doi.org/10.1016/j.jbiomech.2019.08.001DOI Listing
October 2019
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3D printing and amputation: a scoping review.

Disabil Rehabil Assist Technol 2019 Aug 16:1-20. Epub 2019 Aug 16.

b St. John's Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute , Toronto , Canada.

Three-dimensional (3D) printing is an innovative technology being utilized to create prostheses for individuals with limb loss. However, there is a paucity of research on the feasibility of using this technology to fabricate prostheses. A scoping review was conducted to map the literature on 3D printing and its applications in the field of amputation. Read More

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https://www.tandfonline.com/doi/full/10.1080/17483107.2019.1
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http://dx.doi.org/10.1080/17483107.2019.1646825DOI Listing
August 2019
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Syme Amputation: Function, Satisfaction, and Prostheses.

J Pediatr Orthop 2019 Aug 9. Epub 2019 Aug 9.

Departments of Orthopaedics.

Background: Syme amputation (SA) is a term used to describe an amputation at the level of the ankle joint in which the heel pad is preserved. It is performed for a number of indications in a pediatric population. SA is purported to hold the advantage of allowing weight bearing without a prosthesis. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001430DOI Listing
August 2019
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Predicting Transitioning Walking Gaits: Hip and Knee Joint Trajectories From the Motion of Walking Canes.

IEEE Trans Neural Syst Rehabil Eng 2019 09 8;27(9):1791-1800. Epub 2019 Aug 8.

In recent years, wearable exoskeletons and powered prosthetics have been considered key elements to remedy mobility loss. One of the main challenges pertaining to this field is the prediction of the wearer's desired motion. In this paper, we perform a human locomotion analysis, and we investigate the accuracy of predicting the angular position of the lower limb joints from the motion of walking canes. Read More

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http://dx.doi.org/10.1109/TNSRE.2019.2933896DOI Listing
September 2019
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Cycling of people with a lower limb amputation in Thailand.

PLoS One 2019 2;14(8):e0220649. Epub 2019 Aug 2.

University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.

Aim: To investigate cycling participation and barriers, and facilitators in adults with a lower limb amputation in Thailand.

Method: Questionnaires were given to 424 adults with uni/bilateral lower limb amputation from midfoot to hip disarticulation level at five public hospitals in Bangkok and prosthetic mobile units in Thailand. Participant characteristics were summarized using descriptive statistics. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220649PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6677311PMC
March 2020
3 Reads

Amputations in patients with diabetic foot ulcer: a retrospective study from a single centre in the Northern Territory of Australia.

ANZ J Surg 2019 07 10;89(7-8):874-879. Epub 2019 Jul 10.

Department of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, Australia.

Background: Lower extremity amputations (LEAs) in diabetic patients are common in the indigenous population. There is no published data from the Northern Territory.

Methods: All patients with diabetic foot ulcer, presenting for the first time to the multi-disciplinary foot clinic at Royal Darwin Hospital, between January 2003 and June 2015, were included. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1111/ans.15351
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http://dx.doi.org/10.1111/ans.15351DOI Listing
July 2019
3 Reads

Clinic Use at the Departments of Defense and Veterans Affairs Following Combat Related Amputations.

Mil Med 2020 02;185(1-2):e244-e253

VA San Diego Healthcare System, 3350 La Jolla Village Dr, San Diego, CA 92161.

Introduction: Little population-based research has described the transition from Department of Defense (DoD) to Department of Veterans Affairs (VA) healthcare following combat related amputations. The objectives were to describe (1) to what extent patients used either DoD only facilities, both DoD and VA facilities, or VA only facilities during the first 5 years postinjury, (2) which specific clinics were used and (3) clinic use among patients with different levels of amputation (upper versus lower), and among patients with early or late amputation.

Materials And Methods: This was a retrospective analysis of health data extracted from the expeditionary medical encounter database (EMED) and national DoD and VA databases. Read More

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http://dx.doi.org/10.1093/milmed/usz149DOI Listing
February 2020
10 Reads

Comparison of lower limb segment forces during running on artificial turf and natural grass.

J Rehabil Assist Technol Eng 2019 Jan-Dec;6:2055668319835701. Epub 2019 May 13.

Department of Rehabilitation Science and Technology, University of Pittsburgh, PA, USA.

Introduction: Artificial turf, soon after being introduced in the 1980s, became associated with an increased injury incidence in football players. While more recent generations of artificial turf have mitigated the problem, perception of the material is still widely negative. So, the decision to play the 2015 Fe'de'ration Internationale de Football Association Women s World Cup in Canada on artificial turf was met with vocal criticism by many players. Read More

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http://dx.doi.org/10.1177/2055668319835701DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582296PMC
May 2019
5 Reads