Prosthetics and Orthotics International最新文献

{"title":"Body representation and prosthetic adjustment in upper limb amputation: Implications for reintegration to normal living.","authors":"Rabia Sarigul, Burcu Dilek","doi":"10.1097/PXR.0000000000000549","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000549","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare explicit and implicit aspects of body representation between upper limb amputees (ULA) and healthy controls, and to examine the relationships among body image, reintegration to normal living (RNL), and prosthetic adjustment in ULA.</p><p><strong>Methods: </strong>A total of 26 ULA and 26 healthy controls were included. Body image was evaluated using the Amputee Body Image Scale-Revised (ABIS-R), Multidimensional Body-Self Relations Questionnaire. The Reintegration to Normal Living Index (RNLI) was used to assess the level of RNL, and the Trinity Amputation and Prosthesis Experience Scales (TAPES) was used to assess the prosthetic adjustment. Laterality judgment and two-point discrimination (TPD) thresholds were assessed in both groups.</p><p><strong>Results: </strong>Significant correlations in between ABIS-R and TAPES (for all p < 0.05); ABIS-R and RNLI (p < 0.05); and RNLI and TAPES (for all p < 0.01) were identified. In laterality judgment, the accuracy rates of the control group were higher than those of the amputee group (mean difference = 7.94; p = 0.002); the reaction times of the ULA was higher than the control group (mean difference = 661; p < 0.001). Regarding TPD thresholds, the ULA's values were higher than the control group (mean difference = 2.24; p = 0.003); values on the ipsilateral side were higher than the contralateral side (mean difference = 1.51; p < 0.001).</p><p><strong>Conclusions: </strong>The present study highlights the multidimensional aspect of body representation in ULA and emphasizes the importance of considering both RNL and prosthetic adjustment in their life. Health care professionals may consider implementing measures that would facilitate a deeper relationship between amputees and their bodies, and increasing their social participation.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949934","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":"Temperature and moisture management and mitigation techniques in prosthetic sockets and liners: A rapid review.","authors":"Jack Hester, Max Shepherd","doi":"10.1097/PXR.0000000000000535","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000535","url":null,"abstract":"<p><p>Many prosthesis users report skin discomfort and breakdown when wearing an artificial limb, often due to the accumulation of sweat and high temperatures inside the socket. In this review, we seek to identify the existing engineering solutions that have been developed for liner and socket thermal and moisture management. A total of 174 published articles were identified for review, and 16 manuscripts met our inclusion criteria for full review. We present a summary of the aims, methods, study populations, findings, and recommended future directions from each of these manuscripts. The approaches we identified generally fall into 1 or more of the following categories: liner material, socket material, socket structure modification or attachment, suspension and sealing techniques, or perforation. At least some solutions in each of these categories showed promise, as demonstrated by participant feedback or direct measurement of socket conditions. However, while most papers used standardized questionnaires or measurement instruments, the approaches, timelines, populations, and critical appraisal results varied greatly between studies. All studies focused on lower limb prostheses. Three studies were limited to only 1 participant, and the overall population was 86.9% male. While the approaches we found in the existing literature show promise, only half the studies included commercially available liners or manufacturing materials, and there is overall a clear need for additional studies. The number of studies in this domain has been growing steadily over the past decade, hopefully indicating that this gap will be filled.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949989","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":"Does initiating brace treatment before or after menarche affect outcomes in adolescent idiopathic scoliosis?","authors":"Tuğba Kuru Çolak, Burçin Akçay, Gabriel Darricarrere Sosa, Maksym Borysov","doi":"10.1097/PXR.0000000000000540","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000540","url":null,"abstract":"<p><strong>Introduction: </strong>Brace treatment is a high-evidence treatment approach in adolescent idiopathic scoliosis. The aim of this study is to compare a premenarchal patient group with a postmenarchal group to evaluate the hypothesis that initiating brace treatment after menarche is more effective than starting it before menarche.</p><p><strong>Methods: </strong>This is a retrospective chart review of a prospective cohort with the final results of treatment with a Computer-Aided Chêneau Derivative Gensingen Brace. The available chart was divided into 2 categories: premenarchal and postmenarchal patients. The outcomes of the 2 groups were compared for Cobb angle and angle of trunk rotation (ATR).</p><p><strong>Results: </strong>The mean age of the patients (n = 87) included in the study was 12.2 years. A total of 30 patients had reached menarche, with a mean time since menarche of 6 months. In the premenarche group, 82.5% of patients had a stable or improved Cobb angle after treatment. Similarly, 90% of patients in the postmenarche group had a Cobb angle that was either stable or reduced. After treatment, the 2 groups' differences in Cobb angle and ATR measurements were similar (p > 0.05).</p><p><strong>Conclusions: </strong>According to the study's findings, patients with adolescent idiopathic scoliosis receiving brace treatment who had and had not reached menarche showed comparable changes in Cobb angle and ATR, 2 important indicators of deformity. These findings highlight the importance of considering rapid growth and the increased risk of scoliosis progression before the onset of menarche when selecting conservative treatment strategies.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949897","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":"Experiences in rehabilitation for individuals with acquired amputation: A narrative review.","authors":"Lauren A Trent, Caitlin Lisk","doi":"10.1097/PXR.0000000000000536","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000536","url":null,"abstract":"<p><p>The experiences of amputees undergoing rehabilitation are as unique as the individual. Exploring these experiences will set a more holistic foundation for clinicians to adjust care plans and goals. The purpose of this narrative review is to identify themes within the rehabilitation experience of upper and lower limb amputees. A search was completed in 4 separate databases, finding 8 appropriate articles based on inclusion criteria. The review followed Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines. Three themes were synthesized from this review: ability/normalcy, mental health, and success. These themes represent concurrent concepts of experience that amputees share in rehabilitation. Understanding the unique rehabilitation experiences supports the patient-centered approach to care. The patient's perception of success and \"normal,\" addressing and supporting their mental health, and understanding their needs to return to independent ability is pertinent to setting meaningful goals and outcomes.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950061","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":"Orthopedic treatment of neuromuscular scoliosis: Benefits of biomechanically optimized trunk orthoses using the neuroBrace system as an example.","authors":"Dino Gallo","doi":"10.1097/PXR.0000000000000534","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000534","url":null,"abstract":"<p><p>Neuromuscular diseases, categorized by muscle tone into hypotonic and hypertonic groups, frequently result in spinal deformities. Both groups exhibit similar patterns of spinal deformities, typically presenting as kyphoscoliosis or lordoscoliosis, especially in the thoracolumbar region. Trunk orthoses play an important role in the treatment of neuromuscular scoliosis. They can slow disease progression, stabilize the torso, and improve respiration. In this context, the literature often mentions the Boston brace and the Milwaukee brace, and so-called flexible trunk orthoses. These are almost always symmetrical orthoses or full-contact corsets made of flexible, semi-flexible, or rigid materials. However, these systems often fail to meet essential biomechanical requirements. This publication highlights the benefits of biomechanically optimized constructions and materials when treating neuromuscular spinal deformities using the neuroBrace system as an example.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950034","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":"Pain and functional outcomes of orthotic insoles plus rehabilitation in adolescent flatfoot: A 6-month retrospective cohort study.","authors":"Kuo Li, Liyun Zheng, Jianpeng Zheng, Zhiwei Lin, Meng Gao, Xia Wu","doi":"10.1097/PXR.0000000000000554","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000554","url":null,"abstract":"<p><strong>Background: </strong>Developmental flatfoot in children and adolescents often causes pain and reduced function. The real-world effectiveness of combining orthotic insoles with rehabilitation remains unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed 100 patients (aged 6-18) with developmental flatfoot treated between March and December 2024. Fifty received orthotic insoles plus rehabilitation; 50 received rehabilitation alone. Outcomes Visual Analog Scale (VAS) pain scores, Foot and Ankle Ability Measure function scores, plantar pressure (measured in kPa), and navicular drop (ND, mm) assessed at 12 and 24 weeks. Statistical analyses were conducted using SPSS version 26.0. Mann-Whitney U tests and chi-square tests were applied for between-group comparisons, whereas Friedman tests were used to assess changes over time. A p-value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>At 12 weeks, 84% in the intervention group had ≥2-point VAS reduction vs. 58% in controls (p = 0.006). Foot and Ankle Ability Measure scores improved more (+12.0 vs. +7.0; p = 0.009), with greater plantar pressure and navicular drop improvements. Benefits persisted at 24 weeks and were more pronounced in children aged 6-12. No serious adverse events occurred.</p><p><strong>Conclusion: </strong>Orthotic insoles combined with rehabilitation improve pain, function, and alignment in adolescent flatfoot, especially in younger patients.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876160","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":"How do ankle-foot orthoses affect slope and stair walking? A narrative review.","authors":"Niels F J Waterval, Frans Nollet, Merel-Anne Brehm","doi":"10.1097/PXR.0000000000000532","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000532","url":null,"abstract":"<p><strong>Background: </strong>The usability of ankle-foot orthoses (AFOs) during slope and stair walking is limited as these activities require different AFO properties compared with level ground walking. The development of AFOs with adaptive properties could increase their usability in daily life, but first limitations of current AFOs should be documented.</p><p><strong>Objectives: </strong>We aimed to provide an overview of (1) the biomechanical efficacy and (2) the user experiences of slope and stair walking with AFOs.</p><p><strong>Study design: </strong>Narrative review.</p><p><strong>Methods: </strong>For both aims, we searched the MEDLINE database for relevant studies on July 2, 2025. We formulated a broad search strategy including keywords and MeSH terms related to \"ankle-foot orthoses,\" \"experiences,\" \"slope,\" \"incline,\" and \"stairs.\" We included studies if they reported quantitatively on biomechanical data or qualitatively on user experience for slope, incline, or stair walking with AFOs.</p><p><strong>Results: </strong>Six studies evaluated the biomechanical effects of slope and stair walking, showing that AFOs with a high stiffness significantly reduced the ankle dorsiflexion angle, leading to compensatory knee and hip flexion and less favorable outcomes. Five other studies evaluated user experiences and reported that walking on slopes and stairs with AFOs is difficult, especially stiffer ones.</p><p><strong>Conclusions: </strong>The included biomechanical studies indicate that the restriction of ankle mechanics due to the stiffness induces inefficient compensatory movement during stair and slope walking. In addition, patients report difficulties when using AFOs for these tasks. Developments in AFO design that allow for adjustments tailored to stair and slope walking may help alleviate these difficulties.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876197","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":"Comparing low-cost monocentric and polycentric prosthetic knees: User satisfaction among persons with unilateral above- and through-knee amputations.","authors":"Diana Toderita, Clement D Favier, Vasiliki Vardakastani, Nicole Demitry-Michel, Giovanni S Milandri, David P Henson, Thearith Heang, Longini Mtalo, Harold Shangali, Sisary Kheng, Anthony M J Bull","doi":"10.1097/PXR.0000000000000538","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000538","url":null,"abstract":"<p><strong>Background: </strong>The International Committee of the Red Cross (ICRC) developed 2 low-cost prosthetic knees: monocentric (ICRC-MKJ) and polycentric (ICRC-PKJ), both intended solely for above-knee amputees. Independently, Imperial College London designed a low-cost polycentric knee (ICL-PKJ) for both above- and through-knee amputations. Because no affordable through-knee prostheses are currently available, clinics in low-to-middle-income countries often fit the ICRC-MKJ for through-knee amputees, although it is designed exclusively for above-knee amputees.</p><p><strong>Objectives: </strong>This study assesses user satisfaction with the ICRC-MKJ, ICRC-PKJ, and ICL-PKJ knees across individuals with unilateral transfemoral (UTF) and unilateral through-knee (UTK) amputations.</p><p><strong>Study design: </strong>Single arm, repeated-measures design.</p><p><strong>Methods: </strong>13 UTF (11 males, 2 females) and 5 UTK (males) consented to participate and trialed the 3 prosthetic knees. Each participant completed the Prosthesis Evaluation Questionnaire (PEQ) and Prosthesis Satisfaction Questionnaire (SAT-PRO) for each prosthesis. Results were compared.</p><p><strong>Results: </strong>For UTF participants, ICL-PKJ scored 39% lower than ICRC-PKJ (p = 0.007) in PEQ Sounds. The Prosthesis Satisfaction Questionnaire perceived risk of harm score was higher with ICRC-MKJ (mean 33.3) than ICRC-PKJ (mean 53.9, p = 0.014) and ICL-PKJ (mean 69.2, p = 0.029). Aesthetics were rated higher for ICRC-MKJ (mean 87.2) than ICRC-PKJ (mean 66.7, p = 0.046) and ICL-PKJ (mean 69.2, p = 0.047). For UTK participants, PEQ Well-being increased by 37% with ICL-PKJ compared with their own ICRC-MKJ.</p><p><strong>Conclusions: </strong>The findings emphasize the need for prosthetic solutions that meet the mobility needs and social considerations of individuals with limb loss. These results underscore the urgent need to develop affordable, dedicated through-knee prostheses to provide effective options for through-knee amputees.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943493","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":"Early to mid-career attrition and employment outcomes among prosthetists and orthotists in the United States: An observational cross-sectional cohort study.","authors":"Robert S Kistenberg","doi":"10.1097/PXR.0000000000000547","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000547","url":null,"abstract":"<p><strong>Background: </strong>For the United States or any county's Prosthetic and Orthotic profession, early to mid-career attrition and employment outcomes have not been published.</p><p><strong>Objectives: </strong>The primary objective of this study was to present a cross-sectional perspective of employment outcomes for a cohort of graduates from a single P&O graduate level training program 5 to 20 years postgraduation. The secondary objective was to calculate early to mid-career attrition rate. A tertiary objective was to measure time from graduation to certification and, for those who became certified and left clinical practice, measure the time before transitioning to other employment.</p><p><strong>Study design: </strong>This was an observational, cross-sectional cohort study design.</p><p><strong>Methods: </strong>Graduates' careers were traced 5 to 20 years postgraduation, and on May 1, 2024, the employment status of the cohort was identified. Data on certification type, additional education, time from graduation to certification, and for some, to departure from clinical practice were calculated. Attrition was measured over a 16-year period.</p><p><strong>Results: </strong>Ninety percent of graduates attained national certification. Five to 20 years postgraduation, 69% remained in clinical practice, 11% remained in the P&O profession in nonclinical roles, and 20% percent were not in P&O. Clinical practitioner timespan (CPT), the time from initiation in clinical practice until employment change, was an average 5.5 years. The early to mid-career annual attrition rate for this cohort of P&O graduates was 2.66%.</p><p><strong>Conclusions: </strong>Attrition within the US P&O profession is real, warrants further exploration and remediation. The metric of clinical practitioner timespan was introduced.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876411","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 rehabilitation of 2 missing digits using a customized ring attachment-supported device: A detailed case report.","authors":"Unnati Gedam, Uday Kiran Uppada","doi":"10.1097/PXR.0000000000000542","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000542","url":null,"abstract":"<p><p>Traumatic finger amputations are common upper-limb injuries, often resulting from accidents involving machinery, workplace incidents, motor vehicle collisions, or sports-related injuries. Epidemiological studies suggest that traumatic finger amputations constitute 3% of emergencies treated in hand clinics, with 40% of cases resulting from workplace accidents. These injuries can range in severity, sometimes requiring partial or full amputation of the affected digits. The loss of 1 or more fingers has profound functional and psychological impacts on patients, affecting hand dexterity, grip strength, and quality of life. Recent advances in prosthetic rehabilitation have enabled customized solutions that address both aesthetic and functional demands. Although myoelectric and surgically integrated prosthetic options offer advanced functionality, their cost complexity, infrastructure requirements often limit accessibility, particularly in low-resource setting. Passive silicone finger prosthesis remains a widely accepted alternative for restoring appearance and providing limited functional assistance. This case report describes the prosthetic rehabilitation of a young male with complete absence of the ring (D4) and little (D5) fingers using a customized silicone prosthesis retained by a dual-ring attachment-supported framework. The design aimed to achieve acceptable aesthetics, secure retention, reduced prosthesis weight, and limited functional support. The clinical outcome, patient's satisfaction, functional utility, and limitations of the prosthesis are discussed in comparison with existing passive, functional, and myoelectric options.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147876188","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}