Prosthetics and Orthotics International最新文献

{"title":"Changes in functional outcomes in people with high-energy ankle trauma after the use of the ReAktiv Posterior Dynamic Element™ orthosis and a rehabilitation program: A case series.","authors":"Sarah Gardner, Mike Frecklington, Kirsten Rose, Matthew R Carroll","doi":"10.1097/PXR.0000000000000291","DOIUrl":"10.1097/PXR.0000000000000291","url":null,"abstract":"<p><p>The aim of this study was to examine lower-limb function in 2 patients that received a ReAktiv Posterior Dynamic Element™ (PDE) orthosis and 6-week rehabilitation program after a high-energy trauma injury to the lower limb. Lower-limb function was assessed using the lower extremity functional score, walking performance through the 2-minute walk test, and dynamic mobility and balance through the single-leg balance, timed stair ascent, and the 4-square step test. A 6-week physiotherapy-led rehabilitation program was also implemented. Data showed improvements in lower extremity function, walking performance, mobility, and balance measures after 8 weeks of wearing the ReAktiv PDE™ orthosis and completion of the rehabilitation program. The ReAktiv PDE™ orthosis combined with a lower-limb rehabilitation program shows potential as a treatment option to improve lower-limb function and walking performance and return sufferers of high-energy trauma injury to functional levels seen in healthy cohorts.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical characteristics of transfemoral bone-anchored prostheses during gait: A review of literature.","authors":"Reihaneh Ravari, Mayank Rehani, Jacqueline S Hebert","doi":"10.1097/PXR.0000000000000263","DOIUrl":"10.1097/PXR.0000000000000263","url":null,"abstract":"<p><strong>Background: </strong>Osseointegration (OI) is an emerging technique that allows a direct connection between the bone and a titanium metal implant, allowing the direct attachment of bone-anchored prostheses (BAP) to address the problems associated with socket prostheses. This review article aims to compare the biomechanical features of gait when using a transfemoral BAP in comparison to healthy gait, and in comparison to the gait of traditional transfemoral socket prosthesis users.</p><p><strong>Methods: </strong>A computer-based literature search of electronic databases since inception (ranging from 1967 to 2004 depending on the database) to June 14, 2022, identified peer-reviewed articles focusing on the temporal-spatial, kinematic, kinetic, and electromyography data related to transfemoral BAP gait. Eight articles were included that focused on these biomechanical features of gait in adults with BAP and were compared with socket prosthesis users or healthy gait.</p><p><strong>Results: </strong>Compared with healthy participants, prosthesis users after OI surgery have slower speed and cadence, lower symmetry, longer duration of swing phase, increased pelvic and trunk motion, more hip extension, larger moments on the intact limb, and lower forces on the prosthetic side. Compared with transfemoral socket prosthesis gait, BAP gait shows faster cadence and longer duration of support phase. There are limited and inconsistent data on changes in trunk, pelvic, and hip motion with OI.</p><p><strong>Conclusion: </strong>Based on this review, transfemoral BAP improve spatial-temporal parameters closer to normal gait when compared to socket gait, but there are persisting deficits compared with healthy gait. Additional studies are needed to confirm the changes in kinematics and kinetics when walking with a BAP.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10107940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the clinical effects of a dynamic shoulder orthosis.","authors":"Claudia J W Haarman, Edsko E G Hekman, Herman van der Kooij, Johan S Rietman","doi":"10.1097/PXR.0000000000000245","DOIUrl":"10.1097/PXR.0000000000000245","url":null,"abstract":"<p><strong>Background: </strong>Shoulder orthoses reduce the gravitational pull on the shoulder by providing an upward force to the arm, which can decrease shoulder pain caused by stress on the glenohumeral structures.</p><p><strong>Objective: </strong>In this interventional study, the clinical effects of a recently developed dynamic shoulder orthosis were assessed in 10 patients with chronic shoulder pain. The shoulder orthosis provides an upward force to the arm with 2 elastic bands. These bands are arranged to statically balance the arm, such that the supportive force is always directed toward the glenohumeral joint and shoulder movements are not impeded.</p><p><strong>Study design: </strong>Clinical effect study.</p><p><strong>Methods: </strong>The study population was provided with a dynamic shoulder orthosis for 2 weeks. In the week before the orthosis fitting, the participants had no intervention. The primary outcome measures were the mean shoulder pain scores before and during the intervention, and the distance between the humeral head and the acromion without and with orthosis.</p><p><strong>Results: </strong>Ultrasound evaluation showed that the shoulder orthosis resulted in a reduction of the distance between the acromion and humeral head at different levels of arm support. In addition, it was demonstrated that the mean shoulder pain scores (range 0-10) decreased from 3.6 to 3 (in rest) and from 5.3 to 4.2 (during activities) after 2 weeks of orthosis use. In general, patients were satisfied with the weight, safety, ease in adjusting, and effectiveness of the orthosis.</p><p><strong>Conclusions: </strong>The results of this study show that the orthosis has the potential to reduce shoulder complaints in patients with chronic shoulder pain.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9630813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of long-term pain and function in individuals who received a custom dynamic orthosis and device-centric care pathway.","authors":"Jared N Williamson, Megan M Grunst, Jeffrey Lynn, Gary A Williamson, Ryan V Blanck, Jason M Wilken","doi":"10.1097/PXR.0000000000000290","DOIUrl":"10.1097/PXR.0000000000000290","url":null,"abstract":"<p><strong>Introduction: </strong>Carbon fiber custom dynamic orthoses (CDOs) have been shown to effectively reduce pain and improve function in military service members with lower-limb impairment, but data are limited for civilians.</p><p><strong>Objectives: </strong>To evaluate the long-term outcomes of individuals who completed a CDO-centric care pathway in a civilian clinic by comparing baseline pain, mobility, and function with outcomes at long-term follow-up. To identify baseline characteristics and postintervention outcomes predictive of outcomes at long-term follow-up.</p><p><strong>Methods: </strong>Records of 131 adult patients who received a CDO and CDO-centric training were reviewed. Patient-reported measures of pain and physical function and timed assessment of walking and agility collected during routine clinical care were extracted. These patients were contacted on average 4 (±1) years postintervention to complete a survey including measures of pain and physical function.</p><p><strong>Results: </strong>The 63 participants who responded reported improved or greatly improved function, maximum pain, and typical pain on average, irrespective of age or sex ( P < 0.001). Change in function from baseline to long-term follow-up was predicted by short-term change in function (35.1% of the variance; P < 0.001). Change in pain from baseline to long-term follow-up was predicted by baseline typical pain and change in four square step test time (63% of variance; P < 0.001).</p><p><strong>Conclusions: </strong>Most survey respondents reported positive outcomes. Long-term pain reduction and improved function were predicted by baseline status and by short-term changes associated with receiving a CDO and completing an intensive training program.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a range of 6 prefabricated orthotic insole designs on plantar pressure in a healthy population: A randomized, open-label crossover investigation.","authors":"Stephanie Cooper, Jennifer Hanning, Carol Hegarty, Christian Generalis, Adam Smith, Tanya Hall, Chelsea Starbuck, Jean François Kaux, Cédric Schwartz, Carolyn Buckley","doi":"10.1097/PXR.0000000000000292","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000292","url":null,"abstract":"<p><strong>Background: </strong>Prefabricated orthotic insoles are widely commercially available for self-selection to treat foot and lower-body musculoskeletal pain, without requiring advice from health care professionals. Although they are generally designed to mimic traditional design features of custom-made orthotics used in clinical practice, the effects of prefabricated insoles on plantar pressure distribution are poorly understood.</p><p><strong>Objective: </strong>This investigation aimed to evaluate and directly compare the effects of a range of 6 different commercially available prefabricated orthotic insole designs on plantar pressure in healthy individuals.</p><p><strong>Methods: </strong>This was a single-center, randomized, open-label, crossover investigation. In-shoe dynamic pressure (F-scan) was investigated in 24 healthy subjects with normal foot posture, wearing standard shoes alone and in combination with 6 different orthotic insoles, consecutively, measured on a single day. The biomechanical impact of each insole was determined by the statistical significance of changes from baseline measurements (standard shoe alone).</p><p><strong>Results: </strong>Insoles with heel cups and medial arch geometries consistently increased contact area at medial arch and whole-foot regions and reduced both plantar peak pressure (PP) and pressure time integral at medial arch and heel regions.</p><p><strong>Conclusions: </strong>This investigation has aided in further understanding the mode of action of prefabricated insoles in a healthy population. The insoles in this study redistributed plantar pressure at key regions of the foot, based on design features common to prefabricated insoles. Prefabricated orthotic insoles represent an easily accessible means of reducing lower-body musculoskeletal stress for those who spend prolonged periods of time on their feet.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and testing of a simple quick connect for a prosthetic liner tether.","authors":"Kendrick C Coburn, Mathew J Weissinger, Adam J Krout, Brian J Hafner, Joseph L Garbini, Katheryn J Allyn, Joan E Sanders","doi":"10.1097/PXR.0000000000000272","DOIUrl":"10.1097/PXR.0000000000000272","url":null,"abstract":"<p><strong>Background: </strong>A limitation of tether lanyards is that fastening and unfastening the tether from the liner, which needs to be performed to clean or replace the liner, is difficult for some users.</p><p><strong>Objective: </strong>The purpose of this research was to create a quick connect that allows users to easily attach and detach the tether from the liner.</p><p><strong>Study design: </strong>Mechanical testing and pilot study.</p><p><strong>Methods: </strong>A slide-and-lock mechanism was used. To operate the quick connect, the prosthesis user turns open the lock, slides it onto a short pin extending from the liner, and releases the mechanism, causing it to spring back to the locked position.</p><p><strong>Results: </strong>Mechanical tests demonstrated that the system well-tolerated tensile loads of 25,000 cycles at 100 N and single cycles at 350 N. Five transtibial users trialed the system and took between 2 and 30 s to fasten and unfasten the quick connect. They found the quick connect intuitive to use, secure, relatively quiet, and stable. However, they preferred their traditional pin lock over the quick connect system, mainly because the quick connect required a multistep procedure (twist-align-slide) that they considered more complex than operating the locking pin to which they were accustomed.</p><p><strong>Conclusions: </strong>In its current form, the quick connect is likely to be used by limited community ambulators who struggle with the pin lock donning procedure. It also has potential use with powered tethers that use a motor to adjust tether length.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10245512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of vibration-hinged ankle foot orthoses on gait and spasticity in children with cerebral palsy: A randomized clinical trial design.","authors":"Zahra Jiryaei, Malek Amini, Mohammad Ali Sanjari, Behnam Hajiaghaei, Roozbeh Babazadeh, Maryam Jalali","doi":"10.1097/PXR.0000000000000266","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000266","url":null,"abstract":"<p><strong>Background: </strong>Hinged ankle foot orthoses (HAFO) are commonly prescribed for children with cerebral palsy (CP) to improve their ambulatory function.</p><p><strong>Objectives: </strong>The aim of this study was to compare the effect of vibration-HAFO with that of the same orthosis without vibration on gait, function, and spasticity in hemiplegic CP children.</p><p><strong>Study design: </strong>Randomized Control Trial Design (a pilot study).</p><p><strong>Methods: </strong>Twenty-three children with hemiplegic CP participated in this study. The control group (n = 12) used HAFO, and the intervention group (n = 11) used vibration-HAFO for four weeks. Pre-post three-dimensional gait analysis was done. Calf muscle spasticity and function were also measured.</p><p><strong>Results: </strong>Results showed significant differences between the two groups in the one-minute walking test (p = 0.023) and spasticity (after intervention [p = 0.022], after follow-up [p = 0.020]). Also, significant differences were detected between the two groups in the step width (p = 0.042), maximum hip abduction (p = 0.008), stance maximum dorsiflexion (p = 0.036) and mean pelvic tilt (p = 0.004) in the barefoot condition. Gait cycle time (p = 0.005), maximum hip abduction (p = 0.042), and cadence (p = 0.001) were different between groups in the braced condition. We couldn't find any significant within and between groups differences in knee kinematic parameters. The mean time of using vibration was 16.83 minutes per day.</p><p><strong>Conclusions: </strong>The vibration-hinged AFO is feasible, safe, and acceptable for children with hemiplegic CP to be integrated into practice. Temporospatial and clinical parameters, especially spasticity, were improved. There were slight trends toward improvement in pelvic and knee kinematics. Vibration-HAFO is of benefit to ambulatory CP children with mild and moderate spasticity. It improved the walking capacity of the children.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of rehabilitation therapies on quality of life and function in individuals with phantom limb pain after lower-limb amputation: A systematic review.","authors":"Elise Gane, Phoebe Petersen, Taylor Killalea, Paige Glavinovic, Isabel Nash, Heather Batten","doi":"10.1097/PXR.0000000000000288","DOIUrl":"10.1097/PXR.0000000000000288","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the existing evidence surrounding the effect of rehabilitation therapies on quality of life (QOL) and function of individuals with a lower-limb amputation and experiencing phantom limb pain (PLP).</p><p><strong>Methods: </strong>This review followed Preferred Reporting Items for Systematic reviews and Meta-Analyses methodology. Four databases were searched with key terms that covered 4 broad areas: phantom limb, lower-limb amputation, rehabilitation interventions, and randomized controlled trial (no date limits). Outcomes of either function or QOL in people receiving rehabilitation for PLP were included. The RoB2.0 risk-of-bias tool was used to rate quality.</p><p><strong>Results: </strong>Five studies were included, reporting on QOL (n = 5) and function (n = 3), using interventions including mirror therapy, phantom exercises, and muscle relaxation. The evidence was mixed in direction and significance, and this was likely attributed to by the heterogeneity of interventions and types of outcomes as well as incomplete reporting. There was very low certainty in the effect of these rehabilitation interventions to affect QOL or function.</p><p><strong>Conclusion: </strong>The overall effect of rehabilitation interventions on QOL and function is inconclusive because of the variable results across the included randomized controlled trials. More research is needed to explore the impact of interventions beyond the outcome of pain and to establish a clearer conclusion. Including measures of QOL and function as well as pain in studies with people with PLP is encouraged.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10240249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prosthetic device and service satisfaction, quality of life, and functional performance in lower limb prosthesis clients.","authors":"Oluwagbemiga O DadeMatthews, Jaimie A Roper, Adan Vazquez, David M Shannon, JoEllen M Sefton","doi":"10.1097/PXR.0000000000000285","DOIUrl":"10.1097/PXR.0000000000000285","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to characterize the relationship between prosthetic device and service satisfaction, health-related quality of life (HRQOL), and functional movement in a diverse population of lower limb prosthesis users.</p><p><strong>Methods: </strong>An online survey was conducted on individuals with lower limb amputation between September and October 2021. Sample validated questionnaires assessing demographic and clinical features, satisfaction, functional outcomes, and quality of life were analyzed using path analysis.</p><p><strong>Results: </strong>Participants were 1736 individuals with lower limb amputation. Overall, 44% of participants reported dissatisfaction with prosthetic device, whereas 37% were dissatisfied with prosthetic service. Low functional mobility was reported by 58% of participants and 61% reported low HRQOL. Lower extremity functional status (β = 0.55), HRQOL (β = 0.08), Activities-specific Balance Scale (β = 0.22), and modified fall efficacy scale (β = -0.07) are significantly associated with prosthetic device satisfaction ( P < 0.0005, R 2 = 0.47). Satisfaction with provider service was significantly associated with lower extremity functional status (β = 0.44) and balance confidence (β = 0.18) ( P < 0.0005, R 2 = 0.34).</p><p><strong>Conclusion and clinical relevance: </strong>Civilians, veterans, and service members reported low functional mobility, low quality of life, and moderate levels of dissatisfaction with their lower extremity prosthetic device and provider service. Improvements in mobility, balance, quality of life, and fall efficacy may enhance device satisfaction. Functional mobility and balance improvements may increase ratings of provider service. This study provides feedback that may improve clinical decisions on lower limb prosthesis patient care.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standards for prosthetics and orthotics.","authors":"David Boone","doi":"10.1097/PXR.0000000000000373","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000373","url":null,"abstract":"","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}