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Sayeed MSI, Oakman J, Stuckey R. Factors influencing access to and participation in rehabilitation for people with lower limb amputation in East, South, and Southeast Asian developing countries: the perspective of rehabilitation professionals - a qualitative study. Disabil Rehabil 2024; 46:2097-2116. [PMID: 37272783 DOI: 10.1080/09638288.2023.2217383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 05/17/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE To identify barriers and enablers for access to and participation in rehabilitation for people with LLA in East, South, and Southeast Asian developing countries from the perspective of rehabilitation professionals. MATERIAL AND METHODS A mixed-method study involving an anonymous cross-sectional screening survey followed by in-depth interviews of rehabilitation professionals in these regions following the COREQ guidelines. Participants were surveyed online using convenience and snowball sampling techniques to inform a purposive heterogenic sample for semi-structured online interviews, between September 2021 to February 2022. Interview transcripts were analysed and thematically coded using the modified Health Care Delivery System Approach (HCDSA) framework. RESULTS A total of 201 quantitative survey responses shaped the interview questions and participation of 28 participants from 13 countries for the qualitative investigation. Important factors at the patient level were sex, economics, health issues, language differences, and lack of awareness; at the care team level, peer and/or family support, referrals, and the gender of the professional; at the organizational level, service availability, resources, and quality; and at the environmental level, policies, supports, and physical and/or social accessibility. CONCLUSIONS Identified interlinked factors at multiple levels of the HCDSA underpin the need for a systems approach to develop and address regional rehabilitation service provision but requires contextually adapted policy.
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Affiliation(s)
- Md Shapin Ibne Sayeed
- Ergonomics, Safety and Health, Department of Public Health, La Trobe University, Melbourne, Australia
| | - Jodi Oakman
- Ergonomics, Safety and Health, Department of Public Health, La Trobe University, Melbourne, Australia
| | - Rwth Stuckey
- Ergonomics, Safety and Health, Department of Public Health, La Trobe University, Melbourne, Australia
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Lavorato A, Aruta G, De Marco R, Zeppa P, Titolo P, Colonna MR, Galeano M, Costa AL, Vincitorio F, Garbossa D, Battiston B. Traumatic peripheral nerve injuries: a classification proposal. J Orthop Traumatol 2023; 24:20. [PMID: 37162617 PMCID: PMC10172513 DOI: 10.1186/s10195-023-00695-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 04/02/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Peripheral nerve injuries (PNIs) include several conditions in which one or more peripheral nerves are damaged. Trauma is one of the most common causes of PNIs and young people are particularly affected. They have a significant impact on patients' quality of life and on the healthcare system, while timing and type of surgical treatment are of the utmost importance to guarantee the most favorable functional recovery. To date, several different classifications of PNIs have been proposed, most of them focusing on just one or few aspects of these complex conditions, such as type of injury, anatomic situation, or prognostic factors. Current classifications do not enable us to have a complete view of this pathology, which includes diagnosis, treatment choice, and possible outcomes. This fragmentation sometimes leads to an ambiguous definition of PNIs and the impossibility of exchanging crucial information between different physicians and healthcare structures, which can create confusion in the choice of therapeutic strategies and timing of surgery. MATERIALS The authors retrospectively analyzed a group of 24 patients treated in their center and applied a new classification for PNI injuries. They chose (a) five injury-related factors, namely nerve involved, lesion site, nerve type (whether motor, sensory or mixed), surrounding tissues (whether soft tissues were involved or not), and lesion type-whether partial/in continuity or complete. An alphanumeric code was applied to each of these classes, and (b) four prognostic codes, related to age, timing, techniques, and comorbidities. RESULTS An alphanumeric code was produced, similar to that used in the AO classification of fractures. CONCLUSIONS The authors propose this novel classification for PNIs, with the main advantage to allow physicians to easily understand the characteristics of nerve lesions, severity, possibility of spontaneous recovery, onset of early complications, need for surgical treatment, and the best surgical approach. LEVEL OF EVIDENCE according to the Oxford 2011 level of evidence, level 2.
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Affiliation(s)
- Andrea Lavorato
- Neurosurgery Unit, Igea Hospital, via Marcona 69, 20129, Milan, Italy
| | - Gelsomina Aruta
- Department of Neurosciences "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Turin, Italy
| | - Raffaele De Marco
- Department of Neurosciences "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Turin, Italy
| | - Pietro Zeppa
- Department of Neurosciences "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Turin, Italy
| | - Paolo Titolo
- Traumatology-Reconstructive Microsurgery, Department of Orthopedics and Traumatology, CTO Hospital, Turin, Italy
| | - Michele Rosario Colonna
- Department Human Pathology, University of Messina, Viale Della Libertà 395, 98121, Messina, Italy.
| | - Mariarosaria Galeano
- Department of Biological Imaging and Morphology, University of Messina, Messina, Italy
| | - Alfio Luca Costa
- Clinic of Plastic Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Francesca Vincitorio
- Department of Neurosciences "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Turin, Italy
| | - Diego Garbossa
- Department of Neurosciences "Rita Levi Montalcini", Neurosurgery Unit, University of Turin, Turin, Italy
| | - Bruno Battiston
- Traumatology-Reconstructive Microsurgery, Department of Orthopedics and Traumatology, CTO Hospital, Turin, Italy
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Nolte D, Xie S, Bull AMJ. 3D shape reconstruction of the femur from planar X-ray images using statistical shape and appearance models. Biomed Eng Online 2023; 22:30. [PMID: 36964560 PMCID: PMC10039582 DOI: 10.1186/s12938-023-01093-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/09/2023] [Indexed: 03/26/2023] Open
Abstract
Major trauma is a condition that can result in severe bone damage. Customised orthopaedic reconstruction allows for limb salvage surgery and helps to restore joint alignment. For the best possible outcome three dimensional (3D) medical imaging is necessary, but its availability and access, especially in developing countries, can be challenging. In this study, 3D bone shapes of the femur reconstructed from planar radiographs representing bone defects were evaluated for use in orthopaedic surgery. Statistical shape and appearance models generated from 40 cadaveric X-ray computed tomography (CT) images were used to reconstruct 3D bone shapes. The reconstruction simulated bone defects of between 0% and 50% of the whole bone, and the prediction accuracy using anterior-posterior (AP) and anterior-posterior/medial-lateral (AP/ML) X-rays were compared. As error metrics for the comparison, measures evaluating the distance between contour lines of the projections as well as a measure comparing similarities in image intensities were used. The results were evaluated using the root-mean-square distance for surface error as well as differences in commonly used anatomical measures, including bow, femoral neck, diaphyseal-condylar and version angles between reconstructed surfaces from the shape model and the intact shape reconstructed from the CT image. The reconstructions had average surface errors between 1.59 and 3.59 mm with reconstructions using the contour error metric from the AP/ML directions being the most accurate. Predictions of bow and femoral neck angles were well below the clinical threshold accuracy of 3°, diaphyseal-condylar angles were around the threshold of 3° and only version angle predictions of between 5.3° and 9.3° were above the clinical threshold, but below the range reported in clinical practice using computer navigation (i.e., 17° internal to 15° external rotation). This study shows that the reconstructions from partly available planar images using statistical shape and appearance models had an accuracy which would support their potential use in orthopaedic reconstruction.
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Affiliation(s)
- Daniel Nolte
- Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK
| | - Shuqiao Xie
- Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK.
| | - Anthony M J Bull
- Department of Bioengineering, Imperial College London, London, SW7 2AZ, UK
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Lindgren Westlund K, Jong M. Quality of Life of People with Mobility-Related Disabilities in Sweden: A Comparative Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15109. [PMID: 36429826 PMCID: PMC9690284 DOI: 10.3390/ijerph192215109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
Little is known about the Quality of Life (QoL) and how QoL is related to the social and economic situation of people with mobility-related disabilities in Sweden. QoL and well-being do not only relate to the absence of impairments but also to the level of social inclusion and the economic situation. The objective of this study was to explore if there were differences in QoL between a group with and a group without mobility-related disabilities in Sweden. Cross-sectional data were collected through self-reported questionnaires. WHOQOL-BREF was used to assess QoL. Recruitment was conducted through social media platforms. Comparisons were made between and within groups using the Welch t-test. Generalized linear models were used to predict score change for the WHOQOL-BREF items and domains accounting for sex, age, education, social inclusion, economic situation, and presence of additional or other disability. Included in the analysis was data from 381 participants, 143 with mobility-related disabilities and 238 without. Participants in the mobility-related disability group scored significantly lower than those without on General Health, General QoL, Health Satisfaction, and the four WHOQOL-BREF domains. The group with mobility-related disabilities also reported a lower Social Inclusion Score (SIS) and a higher proportion of people without a cash margin. An increased SIS indicated higher QoL in the generalized linear model, whereas the absence of cash margin and mobility-related disability negatively influenced the QoL scores. This study indicated that a person with mobility-related disabilities has lower QoL than those without mobility-related disabilities. A lower QoL was also related to a lack of cash margin, a lower social inclusion score, and whether there were additional or other disabilities present.
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Affiliation(s)
| | - Mats Jong
- Department of Health Sciences/Public Health, Mid Sweden University, 85170 Sundsvall, Sweden
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Alswang JM, Belshe WB, Killi D, Bandawe W, Silliman ES, Bastian AC, Upchurch BK, Bastian MF, Pinal SM, Klein MB, Ndhlozi B, Silva M, Chipolombwe J, Thompson RM. Mobility impairment and life satisfaction in the Northern Region of Malawi. Afr J Disabil 2022; 11:1013. [PMID: 36262824 PMCID: PMC9575362 DOI: 10.4102/ajod.v11i0.1013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background There exist many psychosocial sequelae associated with mobility impairment, especially in low-resource settings where access to mobility assistive devices is limited. Objectives This study aims to (1) define the burden and presenting aetiologies of mobility impairment in the rural Northern Region of Malawi and (2) assess the relationship between physical disability, life satisfaction and access to mobility aids. Methods At mobility device donation clinics throughout the Northern Region of Malawi, adults living with mobility impairment were surveyed with a demographic questionnaire and a series of validated surveys to assess their physical activity levels (Global Physical Activity Questionnaire [GPAQ]), degree of mobility impairment (Washington Group Extended Set Questions on Disability) and life satisfaction (patient-reported outcomes measurement information systems satisfaction with participation in social roles and general life satisfaction). Results There were 251 participants who qualified for inclusion, of which 193 completed all surveys. Higher physical activity scores were positively correlated with increased life satisfaction: (1) satisfaction with participation in social roles (0.481, p < 0.0001) and (2) general life satisfaction (0.230, p < 0.001). Respondents who had previously used a formal mobility device reported 235.5% higher physical activity levels ([139.0%, 333.0%], p = 0.006), significantly higher satisfaction with participation in social roles ([0.21, 6.67], p = 0.037) and equivocally higher general life satisfaction ([-1.77, 3.84], p = 0.470). Conclusion Disability and mental health do not exist in isolation from one another. Given the positive correlations between formal mobility device usage and both physical activity and life satisfaction, interventions that increase access to mobility-assistive devices in undertreated populations are imperative. Contribution This study contributes to the understanding of the complex relationship between physical disability, access to mobility aids, and life satisfaction. Results from this study suggest the potential benefit that increasing access to mobility aids may have in improving the quality of life of mobility impaired persons in resource-limited settings, such as the Northern Region of Malawi.
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Affiliation(s)
- Jared M. Alswang
- Harvard Medical School, Harvard University, Boston, MA,United States of America
| | - William B. Belshe
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Dexter Killi
- Department of Physiotherapy, Mzuzu Central Hospital, Mzuzu, Malawi
| | - Weston Bandawe
- Department of Physiotherapy, St. John’s Hospital, Mzuzu, Malawi
| | - Erin S. Silliman
- School of Medicine, Boston University, Boston, MA, United States of America
| | - Aaron C. Bastian
- College of Osteopathic Medicine, New York Institute of Technology, Glen Head, NY, United States of America
| | - Brooke K. Upchurch
- Dell Medical School, University of Texas at Austin, Austin, TX, United States of America
| | - Megan F. Bastian
- School of Medicine, Saint Louis University, Saint Louis, MO, United States of America
| | - Sierra M. Pinal
- Department of Orthopedic Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America,Center for Cerebral Palsy, Orthopaedic Institute for Children, Los Angeles, CA, United States of America
| | - Mark B. Klein
- Dornsife College of Letters, Arts and Science, University of Southern California, Los Angeles, CA, United States of America
| | | | - Mauricio Silva
- Department of Orthopedic Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America,Orthopaedic Institute for Children, Los Angeles, CA, United States of America
| | - John Chipolombwe
- Department of Internal Medicine, Mzuzu Central Hospital, Mzuzu, Malawi
| | - Rachel M. Thompson
- Department of Orthopedic Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America,Center for Cerebral Palsy, Orthopaedic Institute for Children, Los Angeles, CA, United States of America
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Cazacu E, van der Grinten C, Bax J, Baeten G, Holtkamp F, Lee C. A Position Sensing Glove to Aid Ankle-Foot Orthosis Diagnosis and Treatment. SENSORS 2021; 21:s21196631. [PMID: 34640952 PMCID: PMC8512426 DOI: 10.3390/s21196631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/19/2021] [Accepted: 10/02/2021] [Indexed: 12/01/2022]
Abstract
A position sensing glove called SmartScan, which creates a 3D virtual model of a real object, is presented. The data from the glove is processed by a volume minimization algorithm to validate the position sensor data. This allows only data from the object’s surface to be retained. The data validation algorithm allows the user to progressively improve an image by repeatedly moving their hand over the object. In addition, the user can choose their own balance between feature resolution and invalid data rejection. The SmartScan glove is tested on a foot model and is shown to be robust against motion artifacts, having a mean accuracy of 2.9 mm (compared to a 3D model generated from optical imaging) without calibration.
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Affiliation(s)
- Eduard Cazacu
- Fontys Institute of Engineering, Fontys University of Applied Sciences, 5612 AR Eindhoven, The Netherlands; (E.C.); (C.v.d.G.); (J.B.); (G.B.)
| | - Coen van der Grinten
- Fontys Institute of Engineering, Fontys University of Applied Sciences, 5612 AR Eindhoven, The Netherlands; (E.C.); (C.v.d.G.); (J.B.); (G.B.)
| | - Jeroen Bax
- Fontys Institute of Engineering, Fontys University of Applied Sciences, 5612 AR Eindhoven, The Netherlands; (E.C.); (C.v.d.G.); (J.B.); (G.B.)
| | - Guus Baeten
- Fontys Institute of Engineering, Fontys University of Applied Sciences, 5612 AR Eindhoven, The Netherlands; (E.C.); (C.v.d.G.); (J.B.); (G.B.)
| | - Fred Holtkamp
- Fontys School for Allied Health Professions, Fontys University of Applied Sciences, 5612 AR Eindhoven, The Netherlands;
| | - Chris Lee
- Fontys Institute of Engineering, Fontys University of Applied Sciences, 5612 AR Eindhoven, The Netherlands; (E.C.); (C.v.d.G.); (J.B.); (G.B.)
- Correspondence:
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Idowu OP, Ilesanmi AE, Li X, Samuel OW, Fang P, Li G. An integrated deep learning model for motor intention recognition of multi-class EEG Signals in upper limb amputees. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 206:106121. [PMID: 33957375 DOI: 10.1016/j.cmpb.2021.106121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 04/14/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND OBJECTIVE Recognition of motor intention based on electroencephalogram (EEG) signals has attracted considerable research interest in the field of pattern recognition due to its notable application of non-muscular communication and control for those with severe motor disabilities. In analysis of EEG data, achieving a higher classification performance is dependent on the appropriate representation of EEG features which is mostly characterized by one unique frequency before applying a learning model. Neglecting other frequencies of EEG signals could deteriorate the recognition performance of the model because each frequency has its unique advantages. Motivated by this idea, we propose to obtain distinguishable features with different frequencies by introducing an integrated deep learning model to accurately classify multiple classes of upper limb movement intentions. METHODS The proposed model is a combination of long short-term memory (LSTM) and stacked autoencoder (SAE). To validate the method, four high-level amputees were recruited to perform five motor intention tasks. The acquired EEG signals were first preprocessed before exploring the consequence of input representation on the performance of LSTM-SAE by feeding four frequency bands related to the tasks into the model. The learning model was further improved by t-distributed stochastic neighbor embedding (t-SNE) to eliminate feature redundancy, and to enhance the motor intention recognition. RESULTS The experimental results of the classification performance showed that the proposed model achieves an average performance of 99.01% for accuracy, 99.10% for precision, 99.09% for recall, 99.09% for f1_score, 99.77% for specificity, and 99.0% for Cohen's kappa, across multi-subject and multi-class scenarios. Further evaluation with 2-dimensional t-SNE revealed that the signal decomposition has a distinct multi-class separability in the feature space. CONCLUSION This study demonstrated the predominance of the proposed model in its ability to accurately classify upper limb movements from multiple classes of EEG signals, and its potential application in the development of a more intuitive and naturalistic prosthetic control.
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Affiliation(s)
- Oluwagbenga Paul Idowu
- Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen 518055, China; Shenzhen Engineering Laboratory of Neural Rehabilitation Technology, Shenzhen 518055, China
| | - Ademola Enitan Ilesanmi
- School of ICT, Sirindhorn International Institute of Technology, Thammasat University, Thailand
| | - Xiangxin Li
- Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Shenzhen Engineering Laboratory of Neural Rehabilitation Technology, Shenzhen 518055, China
| | - Oluwarotimi Williams Samuel
- Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Shenzhen Engineering Laboratory of Neural Rehabilitation Technology, Shenzhen 518055, China
| | - Peng Fang
- Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen 518055, China; Shenzhen Engineering Laboratory of Neural Rehabilitation Technology, Shenzhen 518055, China.
| | - Guanglin Li
- Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China; Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen 518055, China; Shenzhen Engineering Laboratory of Neural Rehabilitation Technology, Shenzhen 518055, China.
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