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Kumar S, Bhowmik S. Principles and biomechanical response of normal gait cycle to measure gait parameters for the alignment of prosthetics limb: A technical report. Prosthet Orthot Int 2024:00006479-990000000-00305. [PMID: 39692733 DOI: 10.1097/pxr.0000000000000391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 07/29/2024] [Indexed: 12/19/2024]
Abstract
The limb amputations caused due to emergent incidents of trauma injuries and vascular diseases currently represent crucial global problems. The patients/amputees with limb amputation who lost the residual limb (knee-ankle foot system) must depend on the prosthetic limb. Prosthetic clinicians and technicians have attempted to develop optimal limb prosthetics that will enhance the ability and functional elements of the patients/users. However, the amputees still do not gain the same level of comfort and functional stability as compared to normal limbs (without amputation). Thus, to provide that comfort and stability, proper construction with accurate positioning and alignment of constructed prosthetic limb is crucial to reconstitute these amputees/patients to do their activities for daily life. The objective of technical report is to provide the brief summary about basic principle and biomechanics regarding gait analysis, construction, and alignment of prosthetic limb during gait cycle. The study also summarized the kinematics and kinetic biomechanical response of prosthetic limbs to assess the biomechanics of limb prosthetics, socket assembly principle, gait parameters, and static and dynamic alignment during walking. The basic principle of positioning and alignment with different flexion and torque moment at hip, knee, and ankle joint has been analyzed.
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Affiliation(s)
- Santosh Kumar
- Department of Mechanical Engineering, National Institute of Technology Silchar, Assam, India
| | - Sumit Bhowmik
- Department of Mechanical Engineering, National Institute of Technology Silchar, Assam, India
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Milosevic S, Strange H, Morgan M, Ambler GK, Bosanquet DC, Waldron CA, Thomas-Jones E, Harris D, Twine CP, Brookes-Howell L. Rehabilitation experiences following major lower limb amputation due to complications of vascular disease: a UK qualitative study. Disabil Rehabil 2024; 46:6477-6486. [PMID: 38622944 DOI: 10.1080/09638288.2024.2329747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 02/23/2024] [Accepted: 03/08/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE Rehabilitation experiences of lower limb amputees with poorer physical health have not been fully explored. This study aimed to qualitatively explore experiences of rehabilitation amongst patients who had recently undergone amputation due to complications of vascular disease. METHODS Semi-structured, face-to-face interviews were conducted with 14 patients participating in the PLACEMENT randomised controlled feasibility trial (ISRCTN: 85710690; EudraCT: 2016-003544-37), which investigated the effectiveness of using a perineural catheter for postoperative pain relief following major lower limb amputation. Framework analysis was used to identify key themes and compare participant data. FINDINGS Three main themes and corresponding sub-themes were identified: (i) other patients as inspiration; (ii) other patients as competition; and (iii) imagined futures. Perceptions relating to other patients played a key role in rehabilitation, providing a source of motivation, support, and competition. Participants' imagined futures were uncertain, and this was compounded by a lack of information and delays in equipment and/or adaptations. CONCLUSIONS Findings highlight the importance of fellow patients in supporting rehabilitation following lower limb amputation. Enabling contact with other patients should thus be a key consideration when planning rehabilitation. There is a clear unmet need for realistic information relating to post-amputation recovery, tailored to the needs of individual patients.
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Affiliation(s)
- Sarah Milosevic
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Heather Strange
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Melanie Morgan
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Graeme K Ambler
- Department of Vascular Surgery, Aneurin Bevan University Health Board, Newport, United Kingdom; Division of Population Medicine, Cardiff University, Cardiff, United Kingdom
| | - David C Bosanquet
- Department of Vascular Surgery, Aneurin Bevan University Health Board, Newport, United Kingdom; Division of Population Medicine, Cardiff University, Cardiff, United Kingdom
| | | | - Emma Thomas-Jones
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Debbie Harris
- Centre for Trials Research, Cardiff University, Cardiff, United Kingdom
| | - Christopher P Twine
- Department of Vascular Surgery, Aneurin Bevan University Health Board, Newport, United Kingdom; Division of Population Medicine, Cardiff University, Cardiff, United Kingdom
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Wafi A, Ribeiro L, Kolli V, Azhar B, Budge J, Loftus IM, Holt PJE. Predicting Prosthetic Mobility at Discharge From Rehabilitation Following Major Amputation in Vascular Surgery. Eur J Vasc Endovasc Surg 2023; 66:832-839. [PMID: 37734438 DOI: 10.1016/j.ejvs.2023.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 07/30/2023] [Accepted: 09/14/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE This study aimed to construct a decision aid to estimate the likelihood of independence with a prosthesis following rehabilitation for limb loss secondary to advanced ischaemia (acute or chronic limb threatening ischaemia) or diabetic foot disease (DFD). A secondary aim was to determine whether prosthetic independence is a surrogate marker of long term survival. METHODS A retrospective cohort study of a prospectively maintained database of unilateral amputations due to ischaemia or DFD entering rehabilitation between 2007 and 2020 was performed. Predictors of independent prosthetic mobility (IPM) were used in construction of the IPM prediction model, which underwent bootstrap internal and criterion validation through correlation with predictors of other measures of function: Timed Up and Go (TUG) and two minute walk test. Kaplan-Meier and Cox regression analyses were performed to address the secondary aim. RESULTS Of the 771 patients included, only 49.9% of amputees achieved IPM. Independent negative predictors of IPM were age > 75 years, female sex, higher amputation level, active malignancy, cerebrovascular disease, end stage renal disease, and cognitive impairment. The model yielded high discrimination (C statistic 0.778), and internal validation was demonstrated with bootstrapping (C statistic 0.778), confirming no over optimism. There was a strong correlation between IPM, TUG, and two minute distance and their predictors, confirming strong criterion validity. The IPM group had a median survival of 93.7 (80.7, 105) months, whereas the non-IPM group fared worse with a median survival of 56.6 (48.5, 66.7) months (p < .001). CONCLUSION An internally validated decision aid for estimating the likelihood of independence with a prosthesis after major amputation was constructed. A strong association between female sex and poorer prosthetic mobility was observed. Prosthetic function was shown to be a surrogate marker of long term survival. Future research will involve external validation studies to confirm the generalisability of the decision aid in clinical practice.
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Affiliation(s)
- Arsalan Wafi
- St George's Vascular Institute, St George's University Hospital, London, UK.
| | - Luis Ribeiro
- St George's Vascular Institute, St George's University Hospital, London, UK
| | - Vijay Kolli
- Douglas Bader Rehabilitation Unit, Queen Mary's Hospital, London, UK
| | - Bilal Azhar
- St George's Vascular Institute, St George's University Hospital, London, UK
| | - James Budge
- St George's Vascular Institute, St George's University Hospital, London, UK
| | - Ian M Loftus
- St George's Vascular Institute, St George's University Hospital, London, UK
| | - Peter J E Holt
- St George's Vascular Institute, St George's University Hospital, London, UK
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Eftekari SC, Sears L, Moura SP, Garelick S, Donnelly DT, Shaffrey EC, Dingle AM. A framework for understanding prosthetic embodiment for the plastic surgeon. J Plast Reconstr Aesthet Surg 2023; 84:469-486. [PMID: 37418846 DOI: 10.1016/j.bjps.2023.06.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/17/2023] [Accepted: 06/09/2023] [Indexed: 07/09/2023]
Abstract
Plastic surgeons play a critical role in the management of amputations and are uniquely positioned to improve the lives and functional abilities of patients with limb loss. The embodiment of a prosthesis describes how effectively it replaces a missing limb and is an important aspect of patient care. Despite its importance, the current prosthetics literature lacks a formal definition of embodiment, and descriptions are often vague or incomplete. In this narrative review, we assess the current literature on prosthetic embodiment to explore the main mechanisms of embodiment and how each allows a prosthesis to interface with the human body. In doing so, we provide a comprehensive, holistic framework for understanding this concept.
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Affiliation(s)
- Sahand C Eftekari
- Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Lucas Sears
- Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Steven P Moura
- Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sydney Garelick
- Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - D'Andrea T Donnelly
- Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Ellen C Shaffrey
- Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Aaron M Dingle
- Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
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Kumar D, Mishra SR, Gupta AK, Srivastava MK, Yadav G. Psychological adjustments among lower limb amputees in North Indian population: A cross-sectional study. Ind Psychiatry J 2023; 32:323-327. [PMID: 38161455 PMCID: PMC10756608 DOI: 10.4103/ipj.ipj_199_22] [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: 11/10/2022] [Revised: 02/04/2023] [Accepted: 02/27/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Limb amputation is an extremely stressful event for an individual, following which the amputee develops inferior body image, anxiety, and changes in self-concept and identity. For holistic rehabilitation, understanding the psychosocial status of the amputee and its' predictors is of utmost importance. Objective The aim of the article is to assess the psychological adjustments in patients with lower limb amputation and determine its clinical and sociodemographic correlates. Material and Methods A observational cross-sectional study was conducted from 2020 to 2022 among lower limb amputees of a tertiary care hospital in Lucknow which serves as the only rehabilitation and artificial limb center for the whole state of Uttar Pradesh. Baseline sociodemographic and clinical data were collected. The Hospital Anxiety and Depression Scale was used to determine underlying depression and anxiety, while the Trinity Amputation and Prosthesis Experience Scale was used for understanding the psychological adjustment. Results The mean age of the amputee was 39.47 ± 16.99 years. The mean general, social adjustment, and adjustment to limitation score was 16.3 ± 3.34, 15.19 ± 3.59, and 12.76 ± 3.15, respectively. Male amputees, aged >40 years, and pensioners had significantly higher scores for general adjustment (P < 0.05). Those aged >40 years were pensioners and had no underlying depression and anxiety and had better social adjustment (P < 0.05). Those with transfemoral amputation had a significantly lesser adjustment to limitation (P = 0.003). Conclusion Young age amputees had poor general and social adjustments and more activity restriction but high prosthesis satisfaction as compared to the elderly. Those with transfemoral amputation had a poor adjustment to limitation while those wearing above-knee prosthesis had more activity restriction.
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Affiliation(s)
- Dileep Kumar
- Department of PMR, KGMU, Lucknow, Uttar Pradesh, India
| | | | | | | | - Ganesh Yadav
- Department of PMR, KGMU, Lucknow, Uttar Pradesh, India
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England DL, Miller TA, Stevens PM, Campbell JH, Wurdeman SR. GGEM: Gender, Geography, and EMployment differences based on mobility levels among lower limb prosthesis users living in the United States. Prosthet Orthot Int 2023; 47:265-271. [PMID: 36787381 PMCID: PMC10249601 DOI: 10.1097/pxr.0000000000000219] [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: 02/16/2023]
Abstract
BACKGROUND For individuals with a disability, an increase in functional mobility may improve their quality of life and well-being. Greater understanding is needed on how factors such as gender, geography, and employment may play a role in mobility levels among individuals with lower limb amputation. OBJECTIVES To assess the relationship between gender, geography, and employment status on mobility among lower limb prosthesis users. METHODS A cross-sectional analysis of 7,524 patient mobility outcomes completed across the United States was performed. The regression model included the independent variables, such as age, gender, region, employment status, and amputation level. Mobility was entered as the dependent variable. RESULTS Individuals who were employed had 3.6 times the odds of reaching increased mobility (Prosthetic Limb Users' Survey of Mobility ≥ 50) than those unemployed (odds ratio 3.56, 95% confidence interval 3.10-4.09). Gender and geography were significantly associated with mobility as well. CONCLUSIONS Being employed is associated with greater odds of reaching increased mobility. Addressing factors such as returning to employment may aid in improving mobility levels among prosthesis users.
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Affiliation(s)
- Dwiesha L. England
- Hanger Institute for Clinical Research and Education, Hanger Clinic, Austin, TX
| | - Taavy A. Miller
- Hanger Institute for Clinical Research and Education, Hanger Clinic, Austin, TX
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC
| | - Phillip M. Stevens
- Hanger Institute for Clinical Research and Education, Hanger Clinic, Austin, TX
- Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, UT
| | - James H. Campbell
- Hanger Institute for Clinical Research and Education, Hanger Clinic, Austin, TX
| | - Shane R. Wurdeman
- Hanger Institute for Clinical Research and Education, Hanger Clinic, Austin, TX
- Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE
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Karakaş G, Özçadırcı A, Topuz S. A Modified Version of the Forgotten Joint Score-12 in Lower Limb Amputees: Validity and Reliability Study. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:288-295. [PMID: 36125052 DOI: 10.1177/15394492221123521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adaptation to prosthesis is important for occupation, quality of life, and participation in social life, so it needs to be evaluated. The aim of this study was to determine the validity and reliability of the Forgotten Joint Score-12 (FJS-12) in lower limb amputees. The FJS-12 was applied to 80 amputees. Criterion-referenced validity was assessed using the activity restriction subparameter of Trinity Amputation and Prosthesis Experience Scale (TAPES). The internal consistency of the FJS-12 was high (Cronbach's α = .943). A statistically significant very good negative correlation was determined between the FJS-12 and the activity restriction subparameter of TAPES (r = -.641; p < .001). The results of this study showed that FJS-12 is a valid and reliable measurement tool that can be used to assess the adaptation to prosthesis in amputees. Evaluation of prosthesis awareness in daily living activities of amputees is important in terms of establishing occupational therapy and rehabilitation programs.
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Effects of Implementing a Self-Care Program for Adults With Lower Limb Prostheses. PLASTIC AND AESTHETIC NURSING 2023; 43:32-40. [PMID: 36583587 DOI: 10.1097/psn.0000000000000485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
An artificial replacement for a lost limb or portion of a limb, known as a prosthesis, is a tool that can assist a person to regain their independence. The aim of this project was to evaluate the effect of a self-care program for adults with lower limb prostheses. We used a quasi-experimental research design. We conducted our study at the Physical Medicine and Rehabilitation and Rheumatology Center affiliated with the Armed Forces, located in the Al-Geza Governorate of Egypt using a purposeful sample of 81 adults with lower limb prostheses. We used two tools for data collection: a structured interviewing questionnaire and the Trinity Amputation and Prosthesis Experience Scales (TAPES). The mean age of adults with lower limb prosthesis in our study was 38.91 years (10.53). A total of 64.2% of the study participants (n = 51) were men. We found that before the self-care program, 22.2% of the participants (n = 18) had a satisfactory level of knowledge about self-care, which increased to 88.9% (n = 72) after the program. Before the self-care program, the number of participants with adequate practice levels was 13.6% (n = 11), which increased to 100.0% (n = 81) after the program. We concluded that implementing the self-care program provided a significant improvement in the attendee's total satisfactory knowledge (χ2[79,81] = 72.90, p < .000) and adequate practice levels (p < .001).
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9
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A review of user needs to drive the development of lower limb prostheses. J Neuroeng Rehabil 2022; 19:119. [PMCID: PMC9636812 DOI: 10.1186/s12984-022-01097-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 10/25/2022] [Indexed: 11/08/2022] Open
Abstract
Abstract
Background
The development of bionic legs has seen substantial improvements in the past years but people with lower-limb amputation still suffer from impairments in mobility (e.g., altered balance and gait control) due to significant limitations of the contemporary prostheses. Approaching the problem from a human-centered perspective by focusing on user-specific needs can allow identifying critical improvements that can increase the quality of life. While there are several reviews of user needs regarding upper limb prostheses, a comprehensive summary of such needs for those affected by lower limb loss does not exist.
Methods
We have conducted a systematic review of the literature to extract important needs of the users of lower-limb prostheses. The review included 56 articles in which a need (desire, wish) was reported explicitly by the recruited people with lower limb amputation (N = 8149).
Results
An exhaustive list of user needs was collected and subdivided into functional, psychological, cognitive, ergonomics, and other domain. Where appropriate, we have also briefly discussed the developments in prosthetic devices that are related to or could have an impact on those needs. In summary, the users would like to lead an independent life and reintegrate into society by coming back to work and participating in social and leisure activities. Efficient, versatile, and stable gait, but also support to other activities (e.g., sit to stand), contribute to safety and confidence, while appearance and comfort are important for the body image. However, the relation between specific needs, objective measures of performance, and overall satisfaction and quality of life is still an open question.
Conclusions
Identifying user needs is a critical step for the development of new generation lower limb prostheses that aim to improve the quality of life of their users. However, this is not a simple task, as the needs interact with each other and depend on multiple factors (e.g., mobility level, age, gender), while evolving in time with the use of the device. Hence, novel assessment methods are required that can evaluate the impact of the system from a holistic perspective, capturing objective outcomes but also overall user experience and satisfaction in the relevant environment (daily life).
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Cimino SR, Vijayakumar A, MacKay C, Mayo AL, Hitzig SL, Guilcher SJT. Sex and gender differences in quality of life and related domains for individuals with adult acquired lower-limb amputation: a scoping review. Disabil Rehabil 2022; 44:6899-6925. [PMID: 34546799 DOI: 10.1080/09638288.2021.1974106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 01/13/2023]
Abstract
PURPOSE To understand what is known about sex and gender differences in quality of life (QoL) and related domains for individuals with an adult acquired lower limb amputation (LLA). METHODS A computer-assisted literature search of four online databases was completed. Articles were included if they incorporated sex or gender as part of their data analysis with a focus on QoL-related domains. Data were analyzed using descriptive numerical analysis and thematic analysis. RESULTS One hundred and eleven articles were included in this review. Women were under-represented across studies, with most of the participants being men. No articles described the inclusion of trans or non-binary persons. Differences by sex or gender were reported by 66 articles. Articles reporting on gender seldom provided descriptions of how gender was defined. Overall, women/females seemed to have worse outcomes in terms of prosthesis-related outcomes, mental health, and return to occupations. CONCLUSION Articles included in this review were not clear with how gender was defined. In order for more targeted interventions that account for sex and gender differences, studies need to be more forthcoming about how they use and define gender. Future research should seek to include gender non-conforming participants to identify additional needs.Implications for rehabilitationSex and gender are important constructs that influence outcomes following lower limb amputation.Rehabilitation professionals should consider sex and gender-specific outcomes when tailoring programs to ensure ethical clinical care.
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Affiliation(s)
- Stephanie R Cimino
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | | | - Crystal MacKay
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- West Park Health Care Centre, Toronto, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Amanda L Mayo
- St. John's Rehabilitation Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
- Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sander L Hitzig
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- St. John's Rehabilitation Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Sara J T Guilcher
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada
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Risso G, Bassolino M. Assess and rehabilitate body representations via (neuro)robotics: An emergent perspective. Front Neurorobot 2022; 16:964720. [PMID: 36160286 PMCID: PMC9498221 DOI: 10.3389/fnbot.2022.964720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/02/2022] [Indexed: 11/23/2022] Open
Abstract
The perceptions of our own body (e.g., size and shape) do not always coincide with its real characteristics (e.g., dimension). To track the complexity of our perception, the concept of mental representations (model) of the body has been conceived. Body representations (BRs) are stored in the brain and are maintained and updated through multiple sensory information. Despite being altered in different clinical conditions and being tightly linked with self-consciousness, which is one of the most astonishing features of the human mind, the BRs and, especially, the underlying mechanisms and functions are still unclear. In this vein, here we suggest that (neuro)robotics can make an important contribution to the study of BRs. The first section of the study highlights the potential impact of robotics devices in investigating BRs. Far to be exhaustive, we illustrate major examples of its possible exploitation to further improve the assessment of motor, haptic, and multisensory information building up the BRs. In the second section, we review the main evidence showing the contribution of neurorobotics-based (multi)sensory stimulation in reducing BRs distortions in various clinical conditions (e.g., stroke, amputees). The present study illustrates an emergent multidisciplinary perspective combining the neuroscience of BRs and (neuro)robotics to understand and modulate the perception and experience of one's own body. We suggest that (neuro)robotics can enhance the study of BRs by improving experimental rigor and introducing new experimental conditions. Furthermore, it might pave the way for the rehabilitation of altered body perceptions.
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Affiliation(s)
- Gaia Risso
- School of Health Sciences, Haute École spécialisée de Suisse occidentale (HES-SO) Valais-Wallis, Sion, Switzerland
- The Sense Innovation and Research Center, Sion, Switzerland
- Robotics, Brain and Cognitive Sciences (RBCS), Istituto Italiano di Tecnologia, Genoa, Italy
| | - Michela Bassolino
- School of Health Sciences, Haute École spécialisée de Suisse occidentale (HES-SO) Valais-Wallis, Sion, Switzerland
- The Sense Innovation and Research Center, Sion, Switzerland
- Laboratoire MySpace, Université de Lausanne, Lausanne, Switzerland
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12
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Sions JM, Beisheim-Ryan EH, Pohlig RT, Seth M. Adults with unilateral lower-limb amputation: greater spatial extent of pain is associated with worse adjustment, greater activity restrictions, and less prosthesis satisfaction. Scand J Pain 2022; 22:578-586. [PMID: 35107232 PMCID: PMC9262753 DOI: 10.1515/sjpain-2021-0132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 01/11/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study's primary purpose was to determine if the extent of bodily pain, as evaluated with pain body diagrams, is associated with prosthetic-related activity restrictions, adjustment, and satisfaction among adults with a major unilateral lower-limb amputation. A secondary objective was to evaluate between-days, test-retest reliability for pain body diagrams among adults with lower-limb amputation. METHODS Adults with a lower-limb amputation that occurred ≥1 year prior participated in an online, cross-sectional research study. Outcome measures included pain body diagrams and the Trinity Amputation and Prosthesis Experience Scales-Revised, which evaluates post-amputation activity restrictions, psychosocial adjustment, and prosthesis satisfaction. Linear regression modeling was used to evaluate associations between the number of painful body regions and prosthetic outcomes, after considering covariates (alpha ≤ 0.010). A subset of participants recompleted pain body diagrams to evaluate between-days, test-retest reliability. RESULTS Data from 74 participants (n = 32 female; n = 42 transtibial-level; n = 27 traumatic etiology) were available. Beyond covariates (i.e., age, sex, amputation level), the total number of painful body regions was significantly associated with all Trinity Amputation and Prosthesis Experience Scales-Revised subscales (p < 0.001-0.006), with the exception of Social Adjustment (p = 0.764). The total number of painful body regions explained 14.5, 11.8, 11.6, and 7.4% of the variance in Functional Satisfaction with the Prosthesis, Adjustment to Limitation, General Adjustment, and Activity Restriction, respectively. In a subset (n = 54), test-retest reliability for total number of painful body regions per body diagrams was good [intraclass correlation coefficient (ICC)3,1 = 0.84]. CONCLUSIONS A greater number of painful body regions is associated with greater activity restriction, worse adjustment, and lower prosthesis satisfaction, supporting the need to enhance post-amputation pain management and both amputated- and secondary-site pain prevention. ETHICAL COMMITTEE NUMBER IRB #1611862.
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Affiliation(s)
- Jaclyn Megan Sions
- University of Delaware, Department of Physical Therapy, 540
South College Avenue, Suite 210JJ, Newark, DE, 19713, USA
| | - Emma Haldane Beisheim-Ryan
- University of Delaware, Department of Physical Therapy, 540
South College Avenue, Suite 144A, Newark, DE, 19713, USA
- VA Eastern Colorado Geriatric Research, Education, and
Clinical Center (GRECC), VA Eastern Colorado Health Care System, Aurora, CO, 80045, USA
| | - Ryan Todd Pohlig
- University of Delaware, Biostatistics Core, 102B STAR
Tower, Newark, DE, 19713, USA
| | - Mayank Seth
- University of Delaware, Department of Physical Therapy, 540
South College Avenue, Suite 144A, Newark, DE, 19713, USA
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13
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The use of myoelectric prosthesis in a sample of veterans with unilateral upper extremity amputation: prosthesis satisfaction and quality of life. Ir J Med Sci 2022; 192:839-845. [PMID: 35715662 DOI: 10.1007/s11845-022-03062-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/08/2022] [Indexed: 10/18/2022]
Abstract
AIMS To determine the relationship between clinic and prosthesis-related characteristics and psychosocial adjustment, activity restriction, satisfaction with the prosthesis and quality of life in myoelectric prosthesis users with upper limb amputation. METHODS Thirty patients with myoelectric prosthesis users with upper limb amputation took part in this study. The patients' demographic and clinical information were recorded. Psychosocial adjustment, activity restriction and satisfaction with the prosthesis were assessed with Trinity Amputation and Prosthesis Experience Scales-Revised (TAPES-R). Short-Form 36 (SF-36) was used for the quality of life. RESULTS TAPES-R activity restriction score was significantly higher in patients with transhumeral or elbow disarticulation and with concomitant lower limb amputation (p = 0.009, p = 0.037, respectively). TAPES-R psychosocial adjustment subparameter score had significantly moderate correlation with daily prosthesis wearing time (p = 0.019 r = 0.425). A significant negative correlation was found between age at the time of the injury and SF-36 role limitation due to physical problem (p = 0.028 r = - 0.401). CONCLUSIONS Clarifying the factors related to psychosocial adjustment, activity restriction, prosthesis satisfaction and quality of life in individuals with upper extremity amputation and producing interventions/approaches that support patients' life are meaningful and important steps. CLINICAL TRIAL REGISTER E2-22-1416.
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Preatoni G, Valle G, Petrini FM, Raspopovic S. Lightening the Perceived Prosthesis Weight with Neural Embodiment Promoted by Sensory Feedback. Curr Biol 2021; 31:1065-1071.e4. [DOI: 10.1016/j.cub.2020.11.069] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/19/2020] [Accepted: 11/27/2020] [Indexed: 01/06/2023]
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Heneghan NR, Collacott E, Martin P, Spencer S, Rushton A. Lumbosacral injuries in elite Paralympic athletes with limb deficiency: a retrospective analysis of patient records. BMJ Open Sport Exerc Med 2021; 7:e001001. [PMID: 33500786 PMCID: PMC7813422 DOI: 10.1136/bmjsem-2020-001001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2020] [Indexed: 11/15/2022] Open
Abstract
Background Compared to injury data in able-bodied athletes, relatively little literature exists for Paralympic athletes. Injury data underpins the design and evaluation of injury prevention strategies in elite sport. The aim of this study was to investigate frequency, characteristics and management of lumbosacral injuries in elite athletes with limb deficiency. Methods A retrospective analysis of injuries in elite athletes with limb deficiency (2008 to 2017) was conducted using available data extracted from The English Institute of Sport (EIS) clinical records. Eligibility criteria: funded athletes, eligible for EIS physiotherapy support with full or partial limb deficiency. Data were analysed descriptively using frequencies. Results A total of 107 injuries from 32 athletes were included. Participants comprised 18 men (59%), from 9 sports, with mean age for index injuries of 27 years (range 18 to 38 years) and 15 with congenital limb deficiency (47%). Average number of index injuries for congenital and traumatic limb deficient groups were 13 and 19, respectively. Where injury onset was recorded (n=79), half of injuries occurred during training (40%, n=43). Arthrogenic structures accounted for 32.7% of injuries, myogenic 26.2%, with neurogenic, discogenic and osteogenic each <5%. The number of treatments delivered in each injury episode ranged from 1 to 43, with symptom resolution taking 2 to 439 days. Conclusion Elite athletes with limb deficiency experience lumbosacral injuries predominantly involving muscles and joints. While consistency and accuracy of data recording limits definitive conclusions, findings highlight the importance of precision in recording injury data as part of surveillance to enable implementation of effective injury prevention strategies.
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Affiliation(s)
- Nicola R Heneghan
- Centre for Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Esther Collacott
- Centre for Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Physiotherapy, Birmingham Royal Ballet, Birmingham, UK
| | - Paul Martin
- Physiotherapy, The English Institute of Sport, London, UK
| | - Simon Spencer
- Physiotherapy, The English Institute of Sport, Newport, UK
| | - Alison Rushton
- Centre for Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- School of Physical Therapy, Western University, London, Ontario, Canada
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Bekrater-Bodmann R. Factors Associated With Prosthesis Embodiment and Its Importance for Prosthetic Satisfaction in Lower Limb Amputees. Front Neurorobot 2021; 14:604376. [PMID: 33519413 PMCID: PMC7843383 DOI: 10.3389/fnbot.2020.604376] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/17/2020] [Indexed: 12/16/2022] Open
Abstract
Perceptual integration of a prosthesis into an amputee's body representation, that is, prosthesis embodiment, has been proposed to be a major goal of prosthetic treatment, potentially contributing to the user's satisfaction with the device. However, insufficient knowledge about individual or prosthetic factors associated with prosthesis embodiment challenges basic as well as rehabilitation research. In the present study, hierarchical multiple regression analyses on prosthesis embodiment—as assessed with the recently introduced Prosthesis Embodiment Scale—were applied to the survey data of a large sample of prosthesis-using lower limb amputees, entering relevant objective-descriptive (i.e., unbiased characteristics of the amputation or the prosthesis) and subjective-evaluative variables (i.e., the amputee's perceptions related to the amputation or the prosthesis) as first- or second-level regressors, respectively. Significant regressors identified in these analyses together explained R2 = 36.3% of prosthesis embodiment variance in the present sample, with a lower level of amputation, less intense residual limb pain, more realistic visual appearance of the device, higher prosthetic mobility, and more positive valence of prosthesis-induced residual limb stimulations representing significantly associated factors. Using the identical set of regressors hierarchically complemented by prosthesis embodiment on measures of prosthetic satisfaction—as assessed with the Trinity Amputation and Prosthesis Experience Scales—revealed that prosthesis embodiment was significantly and positively associated with aesthetic as well as functional prosthesis satisfaction. These findings emphasize the importance of psychological factors for the integration of a prosthesis into the amputee's body representation, which itself represents a crucial factor associated with prosthesis satisfaction. The results might have important implications for future prosthetic treatment; however, replication of the findings in an independent sample is required, as well as sophisticated experimental designs in order to elucidate the causality of effects.
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Affiliation(s)
- Robin Bekrater-Bodmann
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Desmond D, Gallagher P. Reflections and future directions for psychological science in Prosthetics and Orthotics International. Prosthet Orthot Int 2020; 44:402-407. [PMID: 33164660 DOI: 10.1177/0309364620967780] [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] [Indexed: 02/03/2023]
Abstract
In the inaugural edition of Prosthetics and Orthotics International in 1977, Dr Sidney Fishman identified the Psychological Sciences as one of six indispensable areas of skill and knowledge in professional prosthetic-orthotic practice. Since then, there have been substantial changes and developments in the complexity and capabilities of assistive technologies, greater emphasis on understanding the relationships between people and enabling technologies, growing recognition of the importance of the contexts and environments that support their use, and changes in both health care services and the professional development of prosthetists and orthotists. The aim of this narrative review is to reflect on the role of Prosthetics and Orthotics International in shaping the evolving understanding of psychology in prosthetics and orthotics. There remains considerable potential and opportunity for the development and application of psychology in addressing the challenges of disability globally. However, a broad interpretation and application of the principles of rehabilitation psychology are needed if we are to meaningfully incorporate psychological science into the knowledge that informs prosthetic and orthotic practice.
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Affiliation(s)
- Deirdre Desmond
- Department of Psychology and Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland
| | - Pamela Gallagher
- School of Psychology, Faculty of Science and Health, Dublin City University, Dublin, Ireland
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Clinical Practice Guidelines for the Rehabilitation of Lower Limb Amputation: An Update from the Department of Veterans Affairs and Department of Defense. Am J Phys Med Rehabil 2020; 98:820-829. [PMID: 31419214 DOI: 10.1097/phm.0000000000001213] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Between 2015 and 2017, the US Department of Veterans Affairs and the US Department of Defense developed a clinical practice guideline for rehabilitation of lower limb amputation to address key clinical questions. A multidisciplinary workgroup of US Department of Veterans Affairs and US Department of Defense amputation care subject matter experts was formed, and an extensive literature search was performed which identified 3685 citations published from January 2007 to July 2016. Articles were excluded based on established review criteria resulting in 74 studies being considered as evidence addressing one or more of the identified key issues. The identified literature was evaluated and graded using the National Academies of Science GRADE criteria. Recommendations were formulated after extensive review. Eighteen recommendations were confirmed with four having strong evidence and workgroup confidence in the recommendation. Key recommendations address patient and caregiver education, consideration for the use of rigid and semirigid dressings, consideration for the use of microprocessor knees, and managed lifetime care that includes annual transdisciplinary assessments. In conclusion, this clinical practice guideline used the best available evidence from the past 10 yrs to provide key management recommendations to enhance the quality and consistency of rehabilitation care for persons with lower limb amputation.
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Young M, McKay C, Williams S, Rouse P, Bilzon JLJ. Time-related changes in quality of life in persons with lower limb amputation or spinal cord injury: protocol for a systematic review. Syst Rev 2019; 8:191. [PMID: 31370881 PMCID: PMC6676595 DOI: 10.1186/s13643-019-1108-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 07/22/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Experiencing a lower limb amputation (LLA) or spinal cord injury (SCI) is a life-changing event, affecting physical and systemic function as well as having psychological and social impacts. However, the severity of the physical impairment and/or motor disability demonstrates a poor relationship with patient-reported quality of life, suggesting that other factors determine such outcomes. As such, holistic health-related quality of life (QoL) assessment is an important tool to monitor long-term outcomes. While there are some studies that have assessed the influence of variables such as age at time of injury occurrence and time since injury on changes in QoL, there are no systematic reviews which synthesise this evidence. METHODS/DESIGN All follow-up study designs will be included, where data from multiple time points are presented. Searches will target both SCI and LLA populations where a validated measure of QoL has been used: Medical Outcome Study Short-Form 36/12 or the World Health Organization Quality of Life instruments 100 and BREF. Studies must include adult participants (≥ 18 years at time of injury) and detail time since injury event and patient age. The primary objective is to establish the effects of participant age and time since injury on QoL scores. Secondary objectives include determining between-group effects (i.e. LLA vs. SCI). We will search PubMed, Embase and Web of Science databases, supplemented by hand-searching references within existing review articles and experimental studies. Reviewer pairs will conduct screening and quality assessment of included papers. Results will be stratified by impairment, QoL tool, age/time since injury and additional variables such as sex, race, comorbidity or disease aetiology, as appropriate. If sufficient high-quality data exist, a meta-analysis will be conducted. DISCUSSION The results of this systematic review will summarise evidence of how QoL changes across the life course, relative to both patient age and time since injury, for both LLA and SCI populations. By enabling a direct comparison of different chronic conditions, disability-specific differences in QoL changes over the life course can be identified. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018096633 .
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Affiliation(s)
- Matthew Young
- Department for Health, University of Bath, Bath, BA2 7AY UK
| | - Carly McKay
- Department for Health, University of Bath, Bath, BA2 7AY UK
| | - Sean Williams
- Department for Health, University of Bath, Bath, BA2 7AY UK
| | - Peter Rouse
- Department for Health, University of Bath, Bath, BA2 7AY UK
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Luza LP, Ferreira EG, Minsky RC, Pires GKW, da Silva R. Psychosocial and physical adjustments and prosthesis satisfaction in amputees: a systematic review of observational studies. Disabil Rehabil Assist Technol 2019; 15:582-589. [PMID: 31012753 DOI: 10.1080/17483107.2019.1602853] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background: Adjustment to amputation is a complex process because it encompasses physical and psychosocial aspects as well as satisfaction with the artificial limb.Purpose: To review the scientific production on psychosocial and physical adjustments to amputation and prosthesis use as well as prosthetic satisfaction in people with lower limb amputation in the last 10 years.Methods: This review was conducted on the MEDLINE via Pubmed, Web of Science and Scopus databases. Original and observational studies published in the last 10 years were included, with topics related to adjustment to amputation and prosthesis use as well as prosthetic satisfaction in people with lower limb amputations.Results: A total of 1042 articles were identified in the initial search, but after analysing the criteria 16 articles were used for analysis in their entirety. Regarding psychosocial adjustments, higher rates of depression, anxiety and body image disorders were observed among people with amputations. Phantom and residual limb pain, gender, employment status and daily hours of prosthesis use may influence psychosocial adjustment. Physical adjustment may be influenced by the level of amputation, educational background, age, daily prosthesis use, ambulatory assistive devices and presence of comorbidities. The areas of greatest prosthetic dissatisfaction were colour and weight.Conclusion: Considering that most of the studies related to the satisfaction and adjustment of the prosthesis are cross-sectional studies, longitudinal studies should be conducted, since monitoring individuals over the years and verifying how these variables change over time may contribute to obtaining more data on the factors that influence prosthetic fitting and satisfaction.Implications for rehabilitationAdjustment to amputation and prosthesis use involves both physical and psychosocial issues, it is important that besides physical rehabilitation, psychological interventions and education and communication activities between the patient and the health professionals are carried out.The adaptation to the prosthesis and the recovery of walking capacity are important goals in the rehabilitation process and the knowledge of the physical and psychosocial factors associated with amputation and the use of the prosthesis can help the health team to provide better care to these subjects.Well-adjusted, comfortable and easy-to-use prostheses are of great importance as they enable the patient to perform their daily activities and maintain their independence.It is important to encourage the participation of the individual in both rehabilitation and choice of prosthesis.
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Affiliation(s)
- Lisiane Piazza Luza
- Human Movement Sciences, State University of Santa Catarina, Florianópolis, Brazil
| | | | | | | | - Rudney da Silva
- Production Engineering, Federal University of Santa Catarina, Florianópolis, Brazil.,Human Movement Sciences, State University of Santa Catarina, Florianópolis, Brazil
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Darter BJ, Hawley CE, Armstrong AJ, Avellone L, Wehman P. Factors Influencing Functional Outcomes and Return-to-Work After Amputation: A Review of the Literature. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:656-665. [PMID: 29397480 PMCID: PMC6076349 DOI: 10.1007/s10926-018-9757-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose Amputation is a life changing event that can significantly impact an individual's physical and mental well-being. Our objective was to review literature exploring the impact of amputation upon a person's functioning and inclusion in the workplace. Methods Medline, CINAHL, and PsycINFO were searched using keywords related to amputation, employment and community reintegration. Eligible studies were published since 2000 and one of the following study designs: randomized controlled trial, non-randomized controlled trial, retrospective study, prospective study, concurrent cohort study, or cross sectional study. Studies for civilians with amputation as well as service members and Veterans with amputation were considered for inclusion. Results The search identified 995 articles, 25 of which met inclusion/exclusion criteria and were included in the review. While strong evidence for correlations and predictors of outcomes after amputation were limited, multiple factors were identified as contributing to physical functioning and employment after amputation. Conclusions Outcomes after amputation can vary widely with many potentially inter-related factors contributing. The factors identified may also serve to inform the development of interventions aiming to improve functional performance and reintegration after amputation. Furthermore, the review highlights the need for more high quality prospective studies.
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Affiliation(s)
- Benjamin J Darter
- Department of Physical Therapy, Virginia Commonwealth University, 1200 East Broad Street, Box 980224, Richmond, VA, 23298, USA.
- Department of Research, Hunter Holmes McGuire Veteran Affairs Medical Center, Richmond, VA, 23249, USA.
| | - Carolyn E Hawley
- Department of Rehabilitation Counseling, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Amy J Armstrong
- Department of Rehabilitation Counseling, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Lauren Avellone
- Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, VA, 23284, USA
| | - Paul Wehman
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, 23284, USA
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Baars EC, Schrier E, Dijkstra PU, Geertzen JH. Prosthesis satisfaction in lower limb amputees: A systematic review of associated factors and questionnaires. Medicine (Baltimore) 2018; 97:e12296. [PMID: 30278503 PMCID: PMC6181602 DOI: 10.1097/md.0000000000012296] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/16/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Factors influencing patient satisfaction with a transtibial prosthesis have been studied fragmentarily. The aims of this systematic review were to review the literature regarding factors of influence on patient satisfaction with a transtibial prosthesis, to report satisfaction scores, to present an overview of questionnaires used to assess satisfaction and examine how these questionnaires operationalize satisfaction. METHODS A literature search was performed in PubMed, Embase, PsycInfo, CINAHL, Cochrane, and Web of Knowledge databases up to February 2018 to identify relevant studies. RESULTS Twelve of 1832 studies met the inclusion criteria. Sample sizes ranged from 14 to 581 participants, mean age ranged from 18 to 70 years, and time since amputation ranged from 3 to 39 years. Seven questionnaires assessed different aspects of satisfaction. Patient satisfaction was influenced by appearance, properties, fit, and use of the prosthesis, as well as aspects of the residual limb. These influencing factors were not relevant for all amputee patients and were related to gender, etiology, liner use, and level of amputation. No single factor was found to significantly influence satisfaction or dissatisfaction. Significant associations were found between satisfaction and gender, etiology, liner use, and level of amputation. CONCLUSION Relevance of certain factors for satisfaction was related to specific amputee patient groups. Questionnaires assessing satisfaction use different operationalizations, making comparisons between studies difficult.
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Affiliation(s)
| | - Ernst Schrier
- Department of Rehabilitation Medicine, Center for Rehabilitation
| | - Pieter U. Dijkstra
- Department of Rehabilitation Medicine, Center for Rehabilitation
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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A Longitudinal Study of Social Participation After Dysvascular Lower Extremity Amputation. Am J Phys Med Rehabil 2017; 96:741-747. [PMID: 28368897 DOI: 10.1097/phm.0000000000000745] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study examined patterns of social participation among individuals experiencing their first dysvascular lower extremity amputation. We identified the types of social participation valued by this population and explored factors that were associated with individuals' levels of participation and their subjective satisfaction with participation. DESIGN A prospective cohort was recruited from four Veterans Administration Medical Centers and followed for 1 yr after amputation. Social participation was measured with a modified version of the Community Integration Questionnaire. Potential correlates included the Patient Health Questionnaire-9, Modified Social Support Survey, Locomotor Capability Index 5, Short Portable Mental Status Questionnaire, and self-rated health. RESULTS At 1-yr postamputation, participants indicated that the most valued aspects of social participation were maintaining close friendships, visiting loved ones, and managing finances. Levels of social participation and satisfaction with participation were modest at 1-yr postamputation. Higher levels of social participation at 1 yr were related to better baseline mental status, better premorbid mobility, and lower amputation level. Higher satisfaction with participation was related to greater baseline social support. CONCLUSIONS Individuals' social participation may be influenced by physical and cognitive factors, whereas their satisfaction with participation may be influenced by psychosocial factors. Rehabilitation specialists are encouraged to address both aspects of social participation when formulating and pursuing rehabilitation goals.
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Jefferies P, Gallagher P, Philbin M. Being "just normal": a grounded theory of prosthesis use. Disabil Rehabil 2017; 40:1754-1763. [PMID: 28395530 DOI: 10.1080/09638288.2017.1312564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Whilst research tells us about the benefits and challenges of using prostheses, little attempt has been made to account for and provide explanations for the differing experiences of prosthesis users. In this study, a core concern shared by prosthesis users and an account of how this concern is managed are explored. METHOD Data were collected and analysed according to Grounded Theory procedures, involving interviews with 24 participants, 17 weblogs, 17 autobiographical texts, and posts from 4 online forums. RESULTS Prosthesis users are primarily concerned with being "just normal": the condition of being and living in ways that persons variously perceive are "about right"; that are sufficient, fair, and generally how things "ought to be" for them. This concern is acted upon through: (i) "preserving", where persons foresee and manage threats to being "just normal", (ii) "redressing", involving rectifying things judged not to be "just normal", and (iii) "persevering", where persons keep living "just normally" despite accompanying difficulties. CONCLUSIONS "Just normal" is a new means for rehabilitation practitioners to better understand a key concern of prosthesis users and the motivations underlying behaviours in their prosthesis use. It is also relevant and transferable to broader fields of assistive technology use and disability. Implications for Rehabilitation The grounded theory of "just normal" invites practitioners to discover a key concern in prosthesis use, enabling a richer understanding of the needs and desires of service users. Being "just normal" is presented as an important motivator underlying a range of diverse actions within prosthesis use. The theory is relevant and transferable to broader areas of assistive technology use and disability.
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Affiliation(s)
- Philip Jefferies
- a School of Nursing and Human Sciences, Faculty of Science and Health , Dublin City University , Dublin , Ireland.,b Dublin Psychoprosthetics Group , Dublin, Ireland
| | - Pamela Gallagher
- a School of Nursing and Human Sciences, Faculty of Science and Health , Dublin City University , Dublin , Ireland.,b Dublin Psychoprosthetics Group , Dublin, Ireland
| | - Mark Philbin
- a School of Nursing and Human Sciences, Faculty of Science and Health , Dublin City University , Dublin , Ireland
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Azarmi S, Farsi Z. Roy's Adaptation Model-Guided Education and Promoting the Adaptation of Veterans With Lower Extremities Amputation. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e25810. [PMID: 26568861 PMCID: PMC4640056 DOI: 10.5812/ircmj.25810] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 04/11/2015] [Accepted: 04/22/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Any defect in extremities of the body can affect different life aspects. OBJECTIVES The purpose of this study was to investigate the effect of Roy's adaptation model-guided education on promoting the adaptation of veterans with lower extremities amputation. PATIENTS AND METHODS In a randomized clinical trial, 60 veterans with lower extremities amputation referring to Kowsar Orthotics and Prosthetics Center of veterans clinic in Tehran, Iran, were recruited with convenience method and were randomly assigned to intervention and control groups during 2013 - 2014. For data collection, Roy's adaptation model questionnaire was used. After completing the questionnaires in both groups, maladaptive behaviors were determined in the intervention group and an education program based on Roy's adaptation model was implemented. After two months, both groups completed the questionnaires again. Data was analyzed with SPSS software. RESULTS Independent t-test showed statistically significant differences between the two groups in the post-test stage in terms of the total score of adaptation (P = 0.001) as well as physiologic (P = 0.0001) and role function modes (P = 0.004). The total score of adaptation (139.43 ± 5.45 to 127.54 ± 14.55, P = 0.006) as well as the scores of physiologic (60.26 ± 5.45 to 53.73 ± 7.79, P = 0.001) and role function (20.30 ± 2.42 to 18.13 ± 3.18, P = 0.01) modes in the intervention group significantly increased, whereas the scores of self-concept (42.10 ± 4.71 to 39.40 ± 5.67, P = 0.21) and interdependence (16.76 ± 2.22 to 16.30 ± 2.57, P = 0.44) modes in the two stages did not have a significant difference. CONCLUSIONS Findings of this research indicated that the Roy's adaptation model-guided education promoted the adaptation level of physiologic and role function modes in veterans with lower extremities amputation. However, this intervention could not promote adaptation in self-concept and interdependence modes. More intervention is advised based on Roy's adaptation model for improving the adaptation of veterans with lower extremities.
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Affiliation(s)
- Somayeh Azarmi
- Faculty of Nursing, AJA University of Medical Sciences, Tehran, IR Iran
| | - Zahra Farsi
- Faculty of Nursing, AJA University of Medical Sciences, Tehran, IR Iran
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