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Koenig KD, Hall MJ, Gormley C, Kaleta M, Munger M, Laine J, Morgan SJ. Clinical outcomes measurement in pediatric lower limb prosthetics: A scoping review. J Pediatr Rehabil Med 2024; 17:147-165. [PMID: 38427511 DOI: 10.3233/prm-230014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVE This study aimed to identify clinical measures that have been used to evaluate function, health related quality of life (HRQoL), and/or satisfaction in children who use lower limb prostheses (LLP). The data reported on psychometric properties for children who use LLP were collected for each measure. METHODS First, PubMed, CINAHL, and Web of Science databases were searched using broad search terms to identify standardized outcome measures of function, HRQoL, and/or satisfaction with treatment used in pediatric LLP research published in 2001 or after. For each of the eligible measures found, a second search was performed to identify psychometric properties (e.g., validity, reliability) assessed with children who use LLP. RESULTS Forty-four standardized outcome measures were identified from 41 pediatric LLP research articles. Five measures (i.e., Gait Outcomes Assessment for Lower Limb Differences, Functional Mobility Assessment, Child Amputee Prosthetics Project- Prosthesis Satisfaction Inventory, Child Amputee Prosthetics Project- Functional Scale Index, and Lower Limb Function Questionnaire) had data on psychometric properties for children who use LLP. CONCLUSIONS Few studies report psychometric data for assessing the overall HRQoL, function, and/or satisfaction for children who use LLP. Further research is needed to validate or create new outcome measures that assess the HRQoL, satisfaction, and/or function of children who use LLP.
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Affiliation(s)
- Kevin D Koenig
- Orthotics, Prosthetics, Seating, and Casting Department, Gillette Children's Specialty Healthcare, St. Paul, MN, USA
| | - Michelle J Hall
- Orthotics, Prosthetics, Seating, and Casting Department, Gillette Children's Specialty Healthcare, St. Paul, MN, USA
| | - Caroline Gormley
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Mary Kaleta
- Physical Therapy, Rady Children's Hospital, San Diego, CA, USA
| | - Meghan Munger
- Outcomes Department, Gillette Children's Specialty Healthcare, St. Paul, MN, USA
| | - Jennifer Laine
- Department of Orthopaedic Surgery, Gillette Children's Specialty Healthcare, St. Paul, MN, USA
- Orthopedics Department, University of Minnesota, Minneapolis, MN, USA
- Research Department, Gillette Children's Specialty Healthcare, St. Paul, MN, USA
| | - Sara J Morgan
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
- Research Department, Gillette Children's Specialty Healthcare, St. Paul, MN, USA
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Guo S, Shen S, Liu M, Liu L, Xie W, Wang K, Zhang Z. Forefoot Replantation in a 3-Year-Old Boy: Case Report. J Foot Ankle Surg 2021; 59:813-815. [PMID: 32600564 DOI: 10.1053/j.jfas.2019.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/09/2019] [Accepted: 08/11/2019] [Indexed: 02/03/2023]
Abstract
Few reports about successful forefoot replantation in children have been published. In this article, we present a case of a 3-year-old boy with severe complete amputation of the left forefoot from a crushed and degloved injury in a motorcycle accident. The replantation was successfully performed, even though total ischemia time lasted 8 hours, of which 4 hours was cold ischemia time. The child was able to walk without significant difficulties from 4 months postoperatively and led a normal life in school at 2 years of follow-up. In this case, we present the replantation of a high-velocity traumatic partial foot amputation in a child with excellent function and cosmetic outcome.
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Affiliation(s)
- Shunyu Guo
- Surgeon, Hand and Reconstructive Surgery, Longgang Orthopedics Hospital of Shenzhen, Shenzhen, China
| | - Shanghang Shen
- Surgeon, Neurosurgery, Shanghai General Hospital, Shanghai, China
| | - Mingbo Liu
- Surgeon, Hand and Reconstructive Surgery, Longgang Orthopedics Hospital of Shenzhen, Shenzhen, China
| | - Liangyi Liu
- Surgeon, Hand and Reconstructive Surgery, Longgang Orthopedics Hospital of Shenzhen, Shenzhen, China
| | - Weiyong Xie
- Surgeon, Hand and Reconstructive Surgery, Longgang Orthopedics Hospital of Shenzhen, Shenzhen, China
| | - Kelie Wang
- Surgeon, Hand and Reconstructive Surgery, Longgang Orthopedics Hospital of Shenzhen, Shenzhen, China
| | - Ziqing Zhang
- Professor, Hand and Reconstructive Surgery, Longgang Orthopedics Hospital of Shenzhen, Shenzhen, China.
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Oliver J, Dixon C, Murray CD. Being the parent of a child with limb difference who has been provided with an artificial limb: an interpretative phenomenological analysis. Disabil Rehabil 2019; 42:1979-1986. [DOI: 10.1080/09638288.2018.1543462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- James Oliver
- Faculty of Health & Medicine, Lancaster University, Lancaster, United Kingdom
| | - Clare Dixon
- Faculty of Health & Medicine, Lancaster University, Lancaster, United Kingdom
| | - Craig D. Murray
- Faculty of Health & Medicine, Lancaster University, Lancaster, United Kingdom
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Eshraghi A, Safaeepour Z, Geil MD, Andrysek J. Walking and balance in children and adolescents with lower-limb amputation: A review of literature. Clin Biomech (Bristol, Avon) 2018; 59:181-198. [PMID: 30268996 DOI: 10.1016/j.clinbiomech.2018.09.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/28/2018] [Accepted: 09/12/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Children with lower limb loss face gait and balance limitations. Prosthetic rehabilitation is thus aimed at improving functional capacity and mobility throughout the developmental phases of the child amputee. This review of literature was conducted to determine the characteristics of prosthetic gait and balance among children and adolescents with lower-limb amputation or other limb loss. METHODS Both qualitative and quantitative studies were included in this review and data were organized by amputation etiology, age range and level of amputation. FINDINGS The findings indicated that the structural differences between children with lower-limb amputations and typically developing children lead to functional differences. Significant differences with respect to typically developing children were found in spatiotemporal, kinematic, and kinematic parameters and ground-reaction forces. Children with transtibial amputation place significantly larger load on their intact leg compared to the prosthetic leg during balance tasks. In more complex dynamic balance tests, they generally score lower than their typically developing peers. INTERPRETATION There is limited literature pertaining to improving physical therapy protocols, especially for different age groups, targeting gait and balance enhancements. Understanding gait and balance patterns of children with lower-limb amputation will benefit the design of prosthetic components and mobility rehabilitation protocols that improve long-term outcomes through adulthood.
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Affiliation(s)
- Arezoo Eshraghi
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.
| | - Zahra Safaeepour
- Orthotics and prosthetics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | | | - Jan Andrysek
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.
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Kerfeld C, Jirikowic T, Allyn KJ, Maitland ME. Participation in active play of children who use lower extremity prostheses: An exploratory questionnaire. Prosthet Orthot Int 2018; 42:437-445. [PMID: 29623809 DOI: 10.1177/0309364618767139] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Through play, children develop motor, cognitive, social, and other life skills. Play barriers can impede physical and psychosocial benefits. OBJECTIVES We describe participation in active play, fundamental movement skills, play environment characteristics, and potential play barriers for school-aged children (6-12 years) who use lower extremity prostheses. STUDY DESIGN Cross-sectional questionnaire study. METHODS A questionnaire was developed and administered online to parents of children 6-12 years who use lower extremity prostheses. Questions focused on children's valued play activities, participation in active play, fundamental movement skills, body positions for play, and characteristics of play environments. RESULTS Parents (n = 26) reported their children who use lower extremity prostheses participated in a range of activities including active play (e.g. playgrounds, swimming). Fundamental movement skill limitations were identified (e.g. walking long distances, running fast, hopping on one foot, and skipping). Mobility limitations with floor positions, movement transitions, and uneven or sloped surfaces were reported. Active play with equipment such as roller skating, climbing structures, and bicycling presented challenges. CONCLUSION Parents of children who use lower extremity prostheses reported participation restrictions associated with mobility limitations, activity type, and built environment characteristics (e.g. surfaces and equipment). Challenges made it difficult for children who use lower extremity prostheses to keep up with peers in schools and communities. Clinical relevance Understanding potential barriers to participation in active play of children who use lower extremity prostheses may contribute to enhanced prosthetic design, rehabilitation strategies, universal design of play and built environments, and improved outcome measures ultimately enabling these children to participate fully in active play in diverse contexts.
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Evaluation of Use of Prosthesis, Mobility, and Quality of Life in Young and Adult Persons with Unilateral Above-Knee Amputation 7 Years after the 2008 Sichuan Earthquake. ACTA ACUST UNITED AC 2018. [DOI: 10.1097/jpo.0000000000000173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Long term follow-up of a successful lower limb replantation in a 3-year-old child. Case Rep Orthop 2015; 2015:425376. [PMID: 25922776 PMCID: PMC4398936 DOI: 10.1155/2015/425376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/22/2015] [Accepted: 03/25/2015] [Indexed: 11/18/2022] Open
Abstract
Replantation of the lower extremity has controversial indications but nevertheless it may be considered in carefully selected patients who present early and are expected to show good functional recoveries. Here we present a successful replantation in a 3-year-old boy who has made excellent recovery with no functional deficit evident at 12 years of follow-up. He sustained a traumatic amputation at the level of distal tibia when he fell of a “Qing Qi” (motorcycle rickshaw). Replantation was attempted at 8 hours cold ischemia time with the tibia shortened 4 cm and all tendons, vessels, and nerves repaired. Patient required a second procedure during the same hospital stay for skin coverage. Patient made good recovery with ambulation without support at 6 months, less than 3 cm limb length discrepancy, plantar and dorsiflexion power 4/5, and recovery of sensation over the foot. Now at 12 years of follow-up patient has a normal gait and has integrated into society with no functional deficit. Considering the functional outcome of our case, replantation should be attempted whenever possible and feasible especially in children.
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Esfandiari E, Kamyab M, Yazdi HR, Foroughi N, Sanjari MA. The immediate effect of lateral wedge insoles, with and without a subtalar strap, on the lateral trunk lean motion in patients with knee osteoarthritis. Geriatr Orthop Surg Rehabil 2014; 4:127-32. [PMID: 24600533 DOI: 10.1177/2151458513512327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Orthotic interventions for knee osteoarthritis (OA) aim to reduce mechanical loading on the medial compartment of the knee and may lessen the lateral trunk lean as the most important compensatory gait strategy. The lateral wedge insole is a known orthotic intervention for knee OA. However, the question whether the addition of a subtalar strap to the wedge improves its effect has not been addressed in the literature. OBJECTIVE To compare the effects of lateral wedge insoles, with and without a subtalar strap, on the lateral trunk lean in patients with knee OA. METHODS Twenty-three patients aged over 40 years, with grade I or II OA of the medial compartment of one knee, based on the American College of Rheumatology criteria, were included in this study. The patients were diagnosed with OA based on a clinical examination, and the diagnosis was confirmed with radiographs. A 3-dimensional motion measurement system was used to collect the gait data for 3 different conditions: (1) with no insole, (2) with a lateral wedge insole, and (3) with a lateral wedge insole and a subtalar strap. The immediate effect of the 3 test conditions on the lateral trunk lean was compared during a gait cycle a stance phase and at the point of midstance. RESULTS Based on the laboratory coordinate system, the 3 conditions had no significant effect on the lateral trunk lean during a gait cycle and a stance phase and at the point of midstance in patients with knee OA. CONCLUSION The results of this study demonstrated that the lateral wedge insoles, with and without a subtalar strap, had no immediate effect on the lateral trunk lean in patients with knee OA. However, the long-term effect of lateral wedge insoles on the lateral trunk lean in these patients requires further investigation.
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Affiliation(s)
- Elham Esfandiari
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical sciences, Tehran, Iran
| | - Mojtaba Kamyab
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical sciences, Tehran, Iran
| | - Hamid Reza Yazdi
- Department of Orthopedic Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Nasim Foroughi
- Clinical and Rehabilitation Sciences, School of Physiotherapy, University of Sydney, Sydney, North South Wales, Australia
| | - Mohammad Ali Sanjari
- Rehabilitation Research Center, Department of Rehabilitation Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Affiliation(s)
- Sanjeev Sabharwal
- Department of Orthopaedics and Pediatrics, UMDNJ-New Jersey Medical School, Newark, NJ 07103, USA.
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