Canadian Prosthetics Orthotics Journal最新文献

{"title":"Exploring the need for lower limb prosthetic guidelines in South Africa's private healthcare sector.","authors":"B Theron, S Visagie","doi":"10.33137/cpoj.v7i2.44450","DOIUrl":"https://doi.org/10.33137/cpoj.v7i2.44450","url":null,"abstract":"<p><strong>Background: </strong>Evidence based guidelines can assist with prosthetic component selection and clinical intervention. There is limited evidence on lower limb prosthetic prescription guidelines in the South African private health care sector.</p><p><strong>Objective: </strong>To explore the need for lower limb prosthetic prescription guidelines in the South African private healthcare sector.</p><p><strong>Methodology: </strong>Three main funders of lower limb prosthetics in the South African private healthcare sector (Road Accident Fund (RAF), Workmen's Compensation Fund (WCA), and Council of Medical Schemes (CMS)) were explored using a case study design. Data were collected from six regulatory documents, sixteen purposively sampled prosthetic users, who received services from these funders, and seven key informants. Documents were assessed with the Appraisal of Guidelines for Research & Evaluation II (AGREE II), across six domains. Data from users and key informants were collected with telephonic, semi-structured interviews guided by interview schedules. Interview schedules were self-developed and tailored for each participant group. AGREE II data were analyzed descriptively. Inductive thematic analysis was used for interview data.</p><p><strong>Findings: </strong>Across cases, the \"Scope and Purpose\" domain scored the highest: 50% (WCA), 47% (CMS), and 22% (RAF). \"Editorial Independence\" scored 0% for all three cases. Other challenging domains were \"Applicability\" (WCA: 17%, CMS: 6%, RAF: 6%) and \"Rigour of Development\" (WCA: 8%, CMS: 25%, RAF: 0%). The following three cross-case themes emerged from the interviews: \"Guideline Availability and Necessity\" showed that guidelines were seldom used and that guidelines could be beneficial; \"Purpose of a Lower Limb Prosthetic Guideline\" indicated that guidelines can support accessible, equitable, ethical, and transparent services; and \"Guideline Development Requirements\" explained that an evidence based collaborative process, facilitated by an independent body should underscore guideline development.</p><p><strong>Conclusion: </strong>Evidence based, standardized, transparent guidelines will be beneficial to direct prosthetic service delivery in the South African private healthcare sector. The guidelines must be applicable, rigorously developed, and show editorial independence.</p>","PeriodicalId":32763,"journal":{"name":"Canadian Prosthetics Orthotics Journal","volume":"7 2","pages":"44450"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and evaluation of an anteriorly mounted microprocessor-controlled powered hip joint prosthesis.","authors":"K Brannen, N Baddour, L Cho, D Langlois, P Dumond, E D Lemaire","doi":"10.33137/cpoj.v7i2.44494","DOIUrl":"https://doi.org/10.33137/cpoj.v7i2.44494","url":null,"abstract":"<p><strong>Background: </strong>Prosthetic solutions for individuals with hip disarticulation and hemipelvectomy amputations currently rely exclusively on passive hip joint mechanisms. Although powered knee and ankle joint prostheses have improved gait in people with amputation, no powered hip joint options are commercially available.</p><p><strong>Objective: </strong>To develop and validate the mechanism, structural integrity, and design of an anteriorly mounted powered hip joint prosthesis.</p><p><strong>Methodology: </strong>A microprocessor-controlled powered hip joint prosthesis (PHP) was developed, incorporating a cable-and-pulley transmission system. Stress calculations and Finite Element Analysis (FEA) were performed to ensure that the device can withstand the forces from daily activities. The prototype underwent mechanical strength testing in accordance with International Organization for Standardization (ISO) 15032:2000 standards, ensuring suitability for user loads of up to 100 kg. For functional testing, three able-bodied individuals were video recorded while walking with the power hip in a prosthesis simulator. For each participant, hip angles and stride parameters during level walking were assessed by analyzing five gait cycles.</p><p><strong>Findings: </strong>The novel PHP met most of the design criteria; however, it protruded 56 mm anteriorly from the lamination plate, exceeding the specified criterion of 20 mm. The joint's range of motion included 22° of extension and 145° of flexion. The joint prototype's height was 347 mm, and it weighed 3.9 kg. Furthermore, it passed ISO 15032:2000 strength tests, withstanding a 3360 Newton (N) load without failure. The device successfully enabled able-bodied individuals to walk using a hip disarticulation simulator and supported a 98 kg user during level walking.</p><p><strong>Conclusion: </strong>The microprocessor-controlled PHP exhibited successful performance in both mechanical strength and functional testing. Future work is needed to optimize and assess the design, which could reduce the device's weight and size. A complex control system to adjust gait based on pelvic motion is currently under development.</p>","PeriodicalId":32763,"journal":{"name":"Canadian Prosthetics Orthotics Journal","volume":"7 2","pages":"44494"},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of work-related musculoskeletal disorders among Iranian orthotists and prosthetists: A study on work-related quality of life.","authors":"S Azizi, V Moradi, B Hajiaghaei, T Babaee","doi":"10.33137/cpoj.v7i2.44064","DOIUrl":"https://doi.org/10.33137/cpoj.v7i2.44064","url":null,"abstract":"<p><strong>Background: </strong>Work-related musculoskeletal injuries are prevalent globally and can impact both work efficiency and the quality of services offered to patients.</p><p><strong>Objectives: </strong>This study investigated the prevalence of work-related musculoskeletal disorders among Iranian orthotists and prosthetists and its relationship with work-related quality of life.</p><p><strong>Methodology: </strong>In this cross-sectional study, the Persian versions of the Nordic Musculoskeletal Questionnaire (NMQ) and Work-Related Quality of Life (WRQoL) scale were used to identify disorders of different body parts and occupational quality of life. A group of 263 orthotists and prosthetists were invited to complete the questionnaires using a simple random sampling method. The data from 188 respondents were analyzed. The association between WRQoL and the following variables: gender, work experience, age, presence of musculoskeletal disorder, and income level, was assessed using Spearman's rho correlation coefficient.</p><p><strong>Findings: </strong>There was an 82% prevalence of work-related musculoskeletal disorders among the participants. The most common areas involved were the lower back (35%) and neck (28%). There was a statistically significant relationship between gender (<i>r_s</i> (188) = 0.16, <i>p</i> = 0.031) and weight (<i>r_s</i> (188) = 0.15, <i>p</i> = 0.045) and work-related musculoskeletal disorders, however, the strength of the correlation was very small. Moreover, the WRQoL had a statistically significant but small to negligible relationship with gender (<i>r_s</i> (188) = 0.17, <i>p</i> = 0.016), work experience (<i>r_s</i> (188) = 0.18, <i>p</i> = 0.011), age (<i>r_s</i> (188) = 0.15, <i>p</i> = 0.039), and income (<i>r_s</i> (178) = 0.17, <i>p</i> = 0.025). There was no significant relationship between work-related musculoskeletal disorders and the total score of WRQoL scale.</p><p><strong>Conclusions: </strong>While the prevalence of work-related musculoskeletal disorders is high among Iranian orthotists and prosthetists, the average WRQoL presents an opportunity for improvement. The findings indicate associations between work-related disorders and factors such as gender, work experience, age, and income, emphasizing the need for plans to improve working conditions and prevent these disorders. Conducting ergonomic assessments of workstations, increasing employee income, and implementing training programs that focus on proper lifting techniques, posture, and the use of ergonomic tools may help reduce work-related musculoskeletal disorders in orthotists and prosthetists.</p>","PeriodicalId":32763,"journal":{"name":"Canadian Prosthetics Orthotics Journal","volume":"7 2","pages":"44064"},"PeriodicalIF":0.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prosthetist Knowledge and 3D Printing.","authors":"M Ratto, D Southwick","doi":"10.33137/cpoj.v7i2.42175","DOIUrl":"https://doi.org/10.33137/cpoj.v7i2.42175","url":null,"abstract":"<p><p>In this paper we briefly explored the history of 3D printing in prosthetics. We provided details of our own work developing 3D printing design tools from 2014-2020 noting how claims around prosthetist experience and knowledge have been supported and/or questioned in the development of new device production techniques. We ended by arguing for deeper attention to prosthetist knowledge and experience in the design of the growing 3D printing ecosystem, seeing this focus as necessary and important to preserve and support clinical prosthetist in the production of well-fitting and appropriate devices for patients.</p>","PeriodicalId":32763,"journal":{"name":"Canadian Prosthetics Orthotics Journal","volume":"7 2","pages":"42175"},"PeriodicalIF":0.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming barriers to cycling for knee disarticulation and transfemoral prosthesis users: A pilot study in The Netherlands.","authors":"F A de Laat, S W M Kühne, W C A J de Vos, J H B Geertzen","doi":"10.33137/cpoj.v7i2.44191","DOIUrl":"https://doi.org/10.33137/cpoj.v7i2.44191","url":null,"abstract":"<p><strong>Background: </strong>Cycling has a number of benefits, especially for individuals with a knee disarticulation or transfemoral prosthesis. However, the barriers they face in cycling are not well understood.</p><p><strong>Objectives: </strong>To explore the barriers in cycling experienced by users with a knee disarticulation or transfemoral prosthesis, and to gather solutions to overcome these barriers.</p><p><strong>Methodology: </strong>A qualitative research approach was used. In-depth, semi-structured, self-developed interviews were conducted with experienced prosthetic users (N=8) and an adapted version was used for certified prosthetists/orthotists (CPOs) (N=3). The interview included physical, psychological, prosthetic, and bicycle-related items.</p><p><strong>Findings: </strong>Based on the findings from the interviews, the following barriers and corresponding recommendations were identified:Physical barriers: Exertion, skin damage in the groin area and discomfort in the back and hip.Recommendation: Use of an electric bicycle and use of a crank shortener or saddle adjustment to overcome asymmetry in cycling.Psychological barriers: Fear of falling or fear of balance disturbances.Recommendation: Task- and context-specific training, or graded exposure to cycling during prosthetic training, along with potentially using a more advanced bike with improved balance.Prosthetic barriers: Problems with switching the knee prosthesis mode for cycling; challenges with prosthetic suspension; and discomfort caused by the socket brim design.Recommendation: Manufacturers should integrate automatic detection of cycling in microprocessor prosthetic knee joints; use of a total elastic suspension belt (TES-belt); and lowering the ventral edge of the socket.Bicycle-related barriers: Slipping of the prosthetic foot off the pedal.Recommendation: Use of anti-slip pedals or a block heel under the shoe.</p><p><strong>Conclusion: </strong>By addressing the challenges and barriers, we aim to promote greater engagement in cycling, which offers significant physical and psychological benefits for persons with knee disarticulation or transfemoral amputation. Eventually, this can enhance their quality of life and foster greater independence.</p>","PeriodicalId":32763,"journal":{"name":"Canadian Prosthetics Orthotics Journal","volume":"7 2","pages":"44191"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wound management, healing, and early prosthetic rehabilitation: Part 2 - A scoping review of physical biomarkers.","authors":"H Williams-Reid, A Johannesson, A Buis","doi":"10.33137/cpoj.v7i2.43716","DOIUrl":"https://doi.org/10.33137/cpoj.v7i2.43716","url":null,"abstract":"<p><strong>Background: </strong>The timely provision of load-bearing prostheses significantly reduces healthcare costs and lowers post-amputation mortality risk. However, current methods for assessing residuum health remain subjective, underscoring the need for standardized, evidence-based approaches incorporating physical biomarkers to evaluate residual limb healing and determine readiness for prosthetic rehabilitation.</p><p><strong>Objectives: </strong>This review aimed to identify predictive, diagnostic, and indicative physical biomarkers of healing of the tissues and structures found in the residual limbs of adults with amputation.</p><p><strong>Methodology: </strong>A scoping review was conducted following Joanna Briggs Institute (JBI) and PRISMA-ScR guidance. Searches using \"biomarkers\", \"wound healing\", and \"amputation\" were performed on May 6, 2023, on Web of Science, Ovid MEDLINE, Ovid Embase, Scopus, Cochrane, PubMed, and CINAHL databases. Inclusion criteria were: 1) References to physical biomarkers and healing; 2) Residuum tissue healing; 3) Clear methodology with ethical approval; 4) Published from 2017 onwards. Articles were assessed for quality (QualSyst tool) and evidence level (JBI system), and categorized by study, wound, and model type. Physical biomarkers that were repeated not just within categories, but across more than one of the study categories were reported on.</p><p><strong>Findings: </strong>The search strategy identified 3,306 sources, 157 of which met the inclusion criteria. Histology was the most frequently repeated physical biomarker used in 64 sources, offering crucial diagnostic insights into cellular healing processes. Additional repeated indicative and predictive physical biomarkers, including ankle-brachial index, oxygenation measures, perfusion, and blood pulse and pressure measurements, were reported in 25, 19, 13, and 12 sources, respectively, providing valuable data on tissue oxygenation and vascular health.</p><p><strong>Conclusion: </strong>Ultimately, adopting a multifaceted approach that integrates a diverse array of physical biomarkers (accounting for physiological factors and comorbidities known to influence healing) may substantially enhance our understanding of the healing process and inform the development of effective rehabilitation strategies for individuals undergoing amputation.</p>","PeriodicalId":32763,"journal":{"name":"Canadian Prosthetics Orthotics Journal","volume":"7 2","pages":"43716"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the SwedeAmp database: Focus on coverage and amputation level rates.","authors":"A G Johannesson, R Scheving, K L Westlund, T Fridriksson","doi":"10.33137/cpoj.v7i2.44089","DOIUrl":"https://doi.org/10.33137/cpoj.v7i2.44089","url":null,"abstract":"<p><strong>Background: </strong>The National Board of Health and Welfare manages several national registers in Sweden. This includes the Swedish National Inpatient Register (IPR), covering all surgical operations, and SwedeAmp, focusing on outcomes after lower limb amputations (LLA). However, coverage rates of amputation levels between these registers have not been externally analyzed.</p><p><strong>Objective: </strong>To compare SwedeAmp's coverage with IPR for LLA cases and to assess SwedeAmp's accuracy in capturing LLA data. The goal of this study was also to identify potential discrepancies and establish benchmarks for common amputation levels.</p><p><strong>Methodology: </strong>Data from both registers, covering the years 2018 to 2023, were compared regarding the amputation levels and patient demographics. The coverage rate of the SwedeAmp register was calculated using SwedeAmp data as the numerator and IPR data as the denominator.</p><p><strong>Findings: </strong>The IPR registry recorded 10,788 LLAs across 21 regions (67 hospitals). The SwedeAmp documented 5,246 LLAs covering 17 regions (36 hospitals), leaving 5,542 amputations unaccounted for, mainly due to regions or hospitals not participating in the SwedeAmp registry and lower registration rates in some areas. Key findings include:Achieving full coverage in SwedeAmp (17 regions) would require registering 9,305 LLAs.Both men and women over 85 years were significantly underrepresented.Thirteen regions in SwedeAmp obtained more than 40% coverage rate.5 regions had more than 50% rate of above-knee amputations (range: 50.9% - 68.2%).8 regions reporting more than 50% rate of below-knee amputations (range: 53.1% - 88.9%).Among the 67 hospitals performing LLAs, 36 reported to SwedeAmp. Six of these hospitals performed fewer than 10 LLAs over a six-year period.</p><p><strong>Conclusion: </strong>SwedeAmp captured 48.6% of initial LLAs in Sweden, highlighting the need for improved data completeness in LLA records, especially as only 13 regions achieved over 40% Coverage. For hospitals performing regular amputation, the proposed benchmark-coverage of ≥60%, with ≤36.3% for transfemoral amputation (TF), ≤8.4% for knee disarticulations (KD), and ≥55.3% for transtibial amputations (TT) - could serve as a target to enhance consistency and accuracy in reporting. Expanding coverage can improve the register's utility in tracking outcomes, setting national standards, aiding research, and supporting clinical decision-making.</p>","PeriodicalId":32763,"journal":{"name":"Canadian Prosthetics Orthotics Journal","volume":"7 2","pages":"44089"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wound management, healing, and early prosthetic rehabilitation: Part 1 - A scoping review of healing and non-healing definitions.","authors":"H Williams-Reid, A Johannesson, A Buis","doi":"10.33137/cpoj.v7i2.43715","DOIUrl":"https://doi.org/10.33137/cpoj.v7i2.43715","url":null,"abstract":"<p><strong>Background: </strong>Following lower limb amputation, timely prosthetic fitting enhances mobility and quality of life. However, inconsistent definitions of surgical site healing complicate prosthesis readiness assessment and highlight the need for objective wound management measures.</p><p><strong>Objective: </strong>This review aimed to compile definitions of healing and non-healing provided in the literature investigating biomarkers of healing of the tissues and structures found in the residual limbs of adults with amputation.</p><p><strong>Methodology: </strong>A scoping review was conducted following JBI and PRISMA-ScR guidance. Searches using \"biomarkers,\" \"wound healing,\" and \"amputation\" were performed on May 6, 2023, on Web of Science, Ovid MEDLINE, Ovid Embase, Scopus, Cochrane, PubMed, and CINAHL databases. Inclusion criteria were: 1) References to biomarkers and healing; 2) Residuum tissue healing; 3) Clear methodology with ethical approval; 4) Published from 2017 onwards. Articles were assessed for quality (QualSyst tool) and evidence level (JBI system).</p><p><strong>Findings: </strong>Of 3,306 articles screened, 219 met the inclusion criteria and are reviewed in this article, with 77% rated strong quality. 43% of all included sources did not define healing, while the remainder used specific criteria including epithelialization (14%), wound size reduction (28%), gradings scales (3%), scarring (1%), absence of wound complications (2%), hydroxyproline levels (0.5%), no amputation (0.5%), or neovascularization (0.5%). 84% of included sources did not provide definitions of non-healing. Studies defining non-healing used criteria like wound complications (4%), the need for operative interventions (4%), or lack of wound size reduction (1%). For 10% of included sources, healing and non-healing definitions were considered not applicable given the research content. Total percentages exceed 100% for both healing and non-healing definitions because some sources used two definition classifications, such as epithelialization and wound size reduction. The findings indicate a lack of standardized definitions irrespective of study type.</p><p><strong>Conclusion: </strong>This review reveals significant gaps in current definitions of healing and non-healing, often based on superficial assessments that overlook deeper tissue healing and mechanical properties essential for prosthesis use. It emphasizes the need for comprehensive definitions incorporating biomarkers and psychosocial factors to improve wound management and post-amputation recovery.</p>","PeriodicalId":32763,"journal":{"name":"Canadian Prosthetics Orthotics Journal","volume":"7 2","pages":"43715"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11844765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Active, Actuated, and Assistive: a Scoping Review of Exoskeletons for the Hands and Wrists.","authors":"A Galbert, A Buis","doi":"10.33137/cpoj.v7i1.43827","DOIUrl":"10.33137/cpoj.v7i1.43827","url":null,"abstract":"<p><strong>Background: </strong>Assistive technology is often incorporated into rehabilitation and support for those impacted by upper limb impairments. When powered, these devices provide additional force to the joints of users with muscle weakness. Actuated devices allow dynamic movement compared to splints, therefore improving the ability to complete activities of daily living. However, these devices are not often prescribed and are underrepresented in research and clinical settings.</p><p><strong>Objective: </strong>This review examined the existing literature on devices developed to support hand and wrist functionality in daily activities. Focusing on active, powered, and actuated devices, to gain a clearer understanding of the current limitations in their design and prescription.</p><p><strong>Methodology: </strong>The scoping review was conducted using the PRISMA-ScR guidelines. A systematic search was done on MEDLINE, EMBASE, Scopus, Web of Science, and NHS the Knowledge Network from inception to May 2023. Articles were included if the device was portable; supported the hands and wrist actively using an actuator; and could be used for assistive living during or post-rehabilitation period.</p><p><strong>Findings: </strong>A total of 135 studies were included in the analysis of which 34 were clinical trials. The design and control methods of 121 devices were analyzed. Electrical stimulation and direct mechanical transmission were popular actuation methods. Electromyography (EMG) and joint movement detection were highly used control methods to translate user intentions to device actuation. A total of 226 validation methods were reported, of which 44% were clinically validated. Studies were often not conducted in operational environments with 69% at technology readiness levels ≤ 6, indicating that further development and testing is required.</p><p><strong>Conclusion: </strong>The existing literature on hand and wrist exoskeletons presents large variations in validation methods and technical requirements for user-specific characteristics. This suggests a need for well-defined testing protocols and refined reporting of device designs. This would improve the significance of clinical outcomes and new assistive technology.</p>","PeriodicalId":32763,"journal":{"name":"Canadian Prosthetics Orthotics Journal","volume":"7 1","pages":"43827"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of a Modified Tenodesis Wrist-hand Orthosis on Hand Function in Patients With Tetraplegia.","authors":"S P Sonune, A Saha, N G Joshi, S Pathak, P Bhadra, G Goel","doi":"10.33137/cpoj.v7i1.42879","DOIUrl":"10.33137/cpoj.v7i1.42879","url":null,"abstract":"<p><strong>Background: </strong>An individual experiencing tetraplegia faces functional limitations due to impaired hand function. The use of an affordable tenodesis wrist-hand orthosis (WHO) can enable finger flexion with active wrist extension, thereby enhancing the three-jaw chuck grasp and overall hand functionality.</p><p><strong>Objectives: </strong>To assess hand function and satisfaction in patients with tetraplegia using a modified tenodesis wrist-hand orthosis (WHO), utilizing the Duruöz Hand Index (DHI) and the Orthotics and Prosthetics User Survey (OPUS) satisfaction with device and services subscales.</p><p><strong>Methodology: </strong>The study was conducted at a tertiary care center in central India, enrolling patients with tetraplegia admitted to the Department of Physical Medicine and Rehabilitation. A modified tenodesis wrist-hand orthosis (WHO) was designed using low-temperature thermoplastic components. Twenty-two individuals with a minimum wrist extensor power of grade 3/5 were included in the study. These patients were provided with the modified tenodesis WHO and underwent daily training sessions for a period of 2 weeks. Duruöz Hand Index (DHI) scores were assessed at baseline, 6 weeks, and 12 weeks postenrolment. Patient satisfaction was evaluated using the Orthotics and Prosthetics User's Survey (OPUS) satisfaction with device and services subscales.</p><p><strong>Findings: </strong>The analysis of the DHI scores indicated a significant enhancement in functional abilities at both 6-week and 12-week follow-ups compared to the baseline assessment. Notably, the most substantial progress at 6 weeks follow-up was observed in tasks such as buttoning a shirt, while significant improvement at the 12-week mark was noted in activities like turning a key in a lock. The median OPUS device satisfaction score was 50, corresponding to a Rasch score of 68.8. Additionally, the median OPUS satisfaction score for services stood at 46, with a Rasch score of 72.7. Patients expressed the highest satisfaction levels with the courteous demeanor of the staff, prompt scheduling of appointments, and accurate fitting of the orthosis.</p><p><strong>Conclusion: </strong>The study findings indicate that the modified tenodesis WHO is an effective and satisfactory therapeutic device for improving hand function in patients with tetraplegia. The findings encourage further investigation and application of the modified tenodesis WHO in clinical practice.</p>","PeriodicalId":32763,"journal":{"name":"Canadian Prosthetics Orthotics Journal","volume":"7 1","pages":"42879"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}