Pub Date : 2022-10-19DOI: 10.1097/JPO.0000000000000448
Faisal S Alqusaiyer, Abdullah H Alsergani, Fayez G Aldarsouni, Abdulrahman Aldawood, Yazeed Alkhayyal, Homoud Alzaid, Ali M. Al-hazmi
ABSTRACT Introduction Quality of life (QoL) has been advocated for as an outcome measure for assessing the effect of treatment and quality of care given to prosthetic users. As such, it is necessary to assess the factors that play a role in influencing QoL to achieve better outcomes. Unfortunately, QoL has not been adequately studied in Saudi Arabia, which warranted further research. The objectives of this study were to estimate the QoL of prosthetic users in Riyadh and determine its association with Ambulation (AM), Social Burden (SB), and Appearance (AP). Methods A cross-sectional study design was used to achieve our objectives. Our participants were asked to fill out our self-administered questionnaire, which was composed of the Arabic versions of the Well-being (WB), AP, AM, and SB scales of the Prosthesis Evaluation Questionnaire (PEQ). Results A sample of 62 prosthetic users due to unilateral amputations were randomly selected from our sampling frame, 10 of which acted as outliers from the 95% confidence interval of QoL (CI) (56.13–67.94) and were omitted. The WB scale was shown to have a median of 57.5, whereas QoL had a mean of 62.58. In addition, a positive relationship was found between QoL and SB (P < 0.001; Rs = 0.657), AP (P < 0.001; R = 0.547), and AM (P < 0.001; R = 0.634). Conclusion Prosthetic users in Riyadh suffer from low QoL and satisfaction. Moreover, QoL was shown to be a multifactorial concept with many different elements and constituents. This suggests that a more comprehensive and inclusive method of prosthetic rehabilitation is required. Clinical Relevance There is a scarcity of QoL and well-being studies in Saudi Arabia regarding individuals with amputation and prosthetic users, given the number of prosthetic users, estimated to be around 2092 individuals. By estimating their QoL, we could identify what improvements are to be made to improve their lives.
{"title":"Quality of Life and Well-being in Patients with Lower-limb Amputation Using a Prosthetic Limb: A Cross-sectional Study in a Major Center in Riyadh, Saudi Arabia","authors":"Faisal S Alqusaiyer, Abdullah H Alsergani, Fayez G Aldarsouni, Abdulrahman Aldawood, Yazeed Alkhayyal, Homoud Alzaid, Ali M. Al-hazmi","doi":"10.1097/JPO.0000000000000448","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000448","url":null,"abstract":"ABSTRACT Introduction Quality of life (QoL) has been advocated for as an outcome measure for assessing the effect of treatment and quality of care given to prosthetic users. As such, it is necessary to assess the factors that play a role in influencing QoL to achieve better outcomes. Unfortunately, QoL has not been adequately studied in Saudi Arabia, which warranted further research. The objectives of this study were to estimate the QoL of prosthetic users in Riyadh and determine its association with Ambulation (AM), Social Burden (SB), and Appearance (AP). Methods A cross-sectional study design was used to achieve our objectives. Our participants were asked to fill out our self-administered questionnaire, which was composed of the Arabic versions of the Well-being (WB), AP, AM, and SB scales of the Prosthesis Evaluation Questionnaire (PEQ). Results A sample of 62 prosthetic users due to unilateral amputations were randomly selected from our sampling frame, 10 of which acted as outliers from the 95% confidence interval of QoL (CI) (56.13–67.94) and were omitted. The WB scale was shown to have a median of 57.5, whereas QoL had a mean of 62.58. In addition, a positive relationship was found between QoL and SB (P < 0.001; Rs = 0.657), AP (P < 0.001; R = 0.547), and AM (P < 0.001; R = 0.634). Conclusion Prosthetic users in Riyadh suffer from low QoL and satisfaction. Moreover, QoL was shown to be a multifactorial concept with many different elements and constituents. This suggests that a more comprehensive and inclusive method of prosthetic rehabilitation is required. Clinical Relevance There is a scarcity of QoL and well-being studies in Saudi Arabia regarding individuals with amputation and prosthetic users, given the number of prosthetic users, estimated to be around 2092 individuals. By estimating their QoL, we could identify what improvements are to be made to improve their lives.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"35 1","pages":"203 - 207"},"PeriodicalIF":0.6,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44641524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-16DOI: 10.1097/JPO.0000000000000452
Ashley H Mullen, Sally Kenworthy, K. Ewing, M. Forbus, Regan Hoelscher Thompson
ABSTRACT Introduction Flexible flatfeet are commonly treated with functional foot orthoses (FFOs) and University of California Berkeley Laboratory (UCBL) designs. This study sought to evaluate the immediate effects of low-profile FFOs and high-profile UCBL orthoses on Foot Posture Index (FPI), spatiotemportal measures of gait, and perceived comfort and compliance in adults with flexible flatfeet. Materials and Methods Fourteen individuals with self-reported asymptomatic flexible flatfeet participated in this randomized cross-sectional study. Custom FFOs and UCBL orthoses were fabricated for each participant, who then walked at a self-selected speed in each condition on a Zeno Mat. Foot Posture Index, perceived comfort and compliance, and spatiotemporal parameters were collected across conditions. Results There were no significant differences in velocity, cadence, step length, stride width, toe-in/toe-out, or stance center of pressure distance percentage. Stance phase duration significantly increased from baseline to UCBL condition. There was a statistically significant decrease bilaterally in FPI from baseline to FFO and from baseline to UCBL orthosis, but not between FFO and UCBL orthosis. There were no significant differences in comfort and compliance ratings between FFOs and UCBL orthoses. Conclusions With regard to immediate effects, both the UCBL and FFO designs improve foot posture without significant impact on spatiotemporal gait patterns or perceived comfort and compliance. Additional research is needed to determine the longevity of these effects. Clinical Relevance The results of this study support the use of both FFOs and UCBL orthoses when trying to provide foot posture correction for adults with asymptomatic flexible flatfeet.
{"title":"Immediate Impacts of Two Foot Orthotic Designs on Foot Posture Index, Gait, and Comfort in Adults With Asymptomatic, Flexible Pes Planus","authors":"Ashley H Mullen, Sally Kenworthy, K. Ewing, M. Forbus, Regan Hoelscher Thompson","doi":"10.1097/JPO.0000000000000452","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000452","url":null,"abstract":"ABSTRACT Introduction Flexible flatfeet are commonly treated with functional foot orthoses (FFOs) and University of California Berkeley Laboratory (UCBL) designs. This study sought to evaluate the immediate effects of low-profile FFOs and high-profile UCBL orthoses on Foot Posture Index (FPI), spatiotemportal measures of gait, and perceived comfort and compliance in adults with flexible flatfeet. Materials and Methods Fourteen individuals with self-reported asymptomatic flexible flatfeet participated in this randomized cross-sectional study. Custom FFOs and UCBL orthoses were fabricated for each participant, who then walked at a self-selected speed in each condition on a Zeno Mat. Foot Posture Index, perceived comfort and compliance, and spatiotemporal parameters were collected across conditions. Results There were no significant differences in velocity, cadence, step length, stride width, toe-in/toe-out, or stance center of pressure distance percentage. Stance phase duration significantly increased from baseline to UCBL condition. There was a statistically significant decrease bilaterally in FPI from baseline to FFO and from baseline to UCBL orthosis, but not between FFO and UCBL orthosis. There were no significant differences in comfort and compliance ratings between FFOs and UCBL orthoses. Conclusions With regard to immediate effects, both the UCBL and FFO designs improve foot posture without significant impact on spatiotemporal gait patterns or perceived comfort and compliance. Additional research is needed to determine the longevity of these effects. Clinical Relevance The results of this study support the use of both FFOs and UCBL orthoses when trying to provide foot posture correction for adults with asymptomatic flexible flatfeet.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"35 1","pages":"260 - 265"},"PeriodicalIF":0.6,"publicationDate":"2022-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48264915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-12DOI: 10.1097/JPO.0000000000000450
R. Anitha Kumari, Sakshi Saharawat
ABSTRACT Introduction Rheumatoid arthritis (RA) causes structural damage that causes joint deformity including metacarpophalangeal (MCP) joint ulnar drift (UD), thus hindering the pinch strength and the functional ability of the hand. Orthosis or splints are designed to maintain the hand’s function, improve joint alignment, restore biomechanical balance, and reduce tissue stress. Limited studies have been done on the effects of dynamic splint on pinch strength and functional ability. Therefore, the purpose of this study was to evaluate and quantify the effects of dynamic MCP splint in treatment of ulnar deviation of RA on pinch strength and functional ability in women. Methods Twenty women with RA were recruited and completed a 4-week intervention period with dynamic MCP splint. Pinch strength and functional ability score were measured at baseline and after 4 weeks. Results The results showed a significant improvement in pinch strength (mean ± SD, 11.68 ± 2.14 to 13.53 ± 2.14; P = 0.000) and functional ability score (mean ± SD, 22.70 ± 9.12 to 19.70 ± 8.14; P = 0.000). Conclusion The results of this study show that the dynamic MCP splint had a positive impact on rheumatoid hands that align the joints in their functional position. The dynamic MCP splint improved the mechanical stability of the hand, thus reducing pain and stress on joints, which in turn improves the pinch strength and functional ability of rheumatoid hand. Clinical Relevance To increase patient acceptance and use of the splint, the splint designed and used in this study was compact and only covered the affected areas and joints of the hand. Because there was no involvement of the wrist joint and the fingertips were free, the splint was lightweight and allowed the patient to perform activity while wearing it.
{"title":"Effectiveness of Dynamic Metacarpophalangeal Splint in Treatment of Ulnar Deviation of Rheumatoid Arthritis on Pinch Strength and Functional Ability in Women","authors":"R. Anitha Kumari, Sakshi Saharawat","doi":"10.1097/JPO.0000000000000450","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000450","url":null,"abstract":"ABSTRACT Introduction Rheumatoid arthritis (RA) causes structural damage that causes joint deformity including metacarpophalangeal (MCP) joint ulnar drift (UD), thus hindering the pinch strength and the functional ability of the hand. Orthosis or splints are designed to maintain the hand’s function, improve joint alignment, restore biomechanical balance, and reduce tissue stress. Limited studies have been done on the effects of dynamic splint on pinch strength and functional ability. Therefore, the purpose of this study was to evaluate and quantify the effects of dynamic MCP splint in treatment of ulnar deviation of RA on pinch strength and functional ability in women. Methods Twenty women with RA were recruited and completed a 4-week intervention period with dynamic MCP splint. Pinch strength and functional ability score were measured at baseline and after 4 weeks. Results The results showed a significant improvement in pinch strength (mean ± SD, 11.68 ± 2.14 to 13.53 ± 2.14; P = 0.000) and functional ability score (mean ± SD, 22.70 ± 9.12 to 19.70 ± 8.14; P = 0.000). Conclusion The results of this study show that the dynamic MCP splint had a positive impact on rheumatoid hands that align the joints in their functional position. The dynamic MCP splint improved the mechanical stability of the hand, thus reducing pain and stress on joints, which in turn improves the pinch strength and functional ability of rheumatoid hand. Clinical Relevance To increase patient acceptance and use of the splint, the splint designed and used in this study was compact and only covered the affected areas and joints of the hand. Because there was no involvement of the wrist joint and the fingertips were free, the splint was lightweight and allowed the patient to perform activity while wearing it.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"35 1","pages":"266 - 271"},"PeriodicalIF":0.6,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49124082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-05DOI: 10.1097/JPO.0000000000000441
Ketut B. Putra, Heather Wood, J. Wensman, J. Leonard, A. Shih
ABSTRACT Introduction Patients with partial foot amputations are prone to skin breakdown due to concentrated contact stress and shearing. A custom silicone foot orthosis (FO) can be used to redistribute the concentrated stress and reduce the shearing and discomfort of the skin of a patient with partial calcanectomy. This study presents a custom silicone FO, which is molded using a 3D-printed mold. Methods The subject's left (amputated) partial foot and right (intact) foot were scanned using a 3D scanner. A custom silicone FO was designed by modifying the models of both feet. A mold for the FO was designed using computer-aided design software and fabricated by 3D printing. Room temperature vulcanization silicone was molded to fabricate the FO. The fit of the FO was clinically evaluated by the subject walking with the FO. Results A custom silicone FO was fabricated using a 3D-printed mold. Conclusions The custom silicone FO follows the contour of the residual foot to distribute pressure away from bony prominences during standing and ambulation. 3D printing of the mold can reduce labor time and material cost while facilitating the digital record when compared with a conventional plaster casting approach. Clinical Relevance The 3D printing approach used to fabricate the custom silicone FO may be applied to develop custom silicone orthotic/prosthetic devices for other types of partial foot amputations.
{"title":"A Custom Silicone Foot Orthosis for Partial Calcanectomy Fabricated Using a 3D-Printed Mold","authors":"Ketut B. Putra, Heather Wood, J. Wensman, J. Leonard, A. Shih","doi":"10.1097/JPO.0000000000000441","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000441","url":null,"abstract":"ABSTRACT Introduction Patients with partial foot amputations are prone to skin breakdown due to concentrated contact stress and shearing. A custom silicone foot orthosis (FO) can be used to redistribute the concentrated stress and reduce the shearing and discomfort of the skin of a patient with partial calcanectomy. This study presents a custom silicone FO, which is molded using a 3D-printed mold. Methods The subject's left (amputated) partial foot and right (intact) foot were scanned using a 3D scanner. A custom silicone FO was designed by modifying the models of both feet. A mold for the FO was designed using computer-aided design software and fabricated by 3D printing. Room temperature vulcanization silicone was molded to fabricate the FO. The fit of the FO was clinically evaluated by the subject walking with the FO. Results A custom silicone FO was fabricated using a 3D-printed mold. Conclusions The custom silicone FO follows the contour of the residual foot to distribute pressure away from bony prominences during standing and ambulation. 3D printing of the mold can reduce labor time and material cost while facilitating the digital record when compared with a conventional plaster casting approach. Clinical Relevance The 3D printing approach used to fabricate the custom silicone FO may be applied to develop custom silicone orthotic/prosthetic devices for other types of partial foot amputations.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"35 1","pages":"224 - 228"},"PeriodicalIF":0.6,"publicationDate":"2022-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46451353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-12DOI: 10.1097/JPO.0000000000000438
Ashley H Mullen, C. Horn
ABSTRACT Introduction Orthotic and prosthetic clinicians need to self-assess their performance and make decisions about practice limitations and continuing education throughout their careers. The objectives of this study were to evaluate the internal consistency of a self-assessment survey, examine the latent common factors and responsiveness of the survey, and use the results of the analysis to develop a shortened self-assessment survey. Methods Residents completed a self-assessment 29-item survey based on the six domains of the American Board for Certification in Orthotics, Prosthetics, and Pedorthics (ABC) Practice Analysis of Certified Practitioners in the Disciplines of Orthotics and Prosthetics at multiple times during the clinical residency. Internal consistency was examined through Cronbach α. Confirmatory and exploratory factor analysis were used to examine latent common factors and inform item reduction. Responsiveness was examined through repeated-measures analysis of variance (ANOVA). Results Analysis revealed a Cronbach α of 0.927. Confirmatory factor analysis indicated a poor fit of the six-factor model. The final and best-fitting model suggested four latent common factors: patient centeredness, regulatory awareness, device evaluation, and professional responsibility. Review and revision of the items resulted in a 14-item instrument. The instrument was responsive to changes over time. Conclusions The results indicate a need to reexamine current clinical practice framework in orthotics and prosthetics, particularly as it relates to clinical competence. Future research should evaluate the performance of the shortened self-assessment survey and consider implications for educational standards. Clinical Relevance The use of validated educational tools can strengthen the efficacy of assessments in clinical education and residency. Improved clinical education assessments may result in standardization of competency and improved graduate preparedness.
{"title":"Analysis of a Resident Competence Self-Assessment Survey","authors":"Ashley H Mullen, C. Horn","doi":"10.1097/JPO.0000000000000438","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000438","url":null,"abstract":"ABSTRACT Introduction Orthotic and prosthetic clinicians need to self-assess their performance and make decisions about practice limitations and continuing education throughout their careers. The objectives of this study were to evaluate the internal consistency of a self-assessment survey, examine the latent common factors and responsiveness of the survey, and use the results of the analysis to develop a shortened self-assessment survey. Methods Residents completed a self-assessment 29-item survey based on the six domains of the American Board for Certification in Orthotics, Prosthetics, and Pedorthics (ABC) Practice Analysis of Certified Practitioners in the Disciplines of Orthotics and Prosthetics at multiple times during the clinical residency. Internal consistency was examined through Cronbach α. Confirmatory and exploratory factor analysis were used to examine latent common factors and inform item reduction. Responsiveness was examined through repeated-measures analysis of variance (ANOVA). Results Analysis revealed a Cronbach α of 0.927. Confirmatory factor analysis indicated a poor fit of the six-factor model. The final and best-fitting model suggested four latent common factors: patient centeredness, regulatory awareness, device evaluation, and professional responsibility. Review and revision of the items resulted in a 14-item instrument. The instrument was responsive to changes over time. Conclusions The results indicate a need to reexamine current clinical practice framework in orthotics and prosthetics, particularly as it relates to clinical competence. Future research should evaluate the performance of the shortened self-assessment survey and consider implications for educational standards. Clinical Relevance The use of validated educational tools can strengthen the efficacy of assessments in clinical education and residency. Improved clinical education assessments may result in standardization of competency and improved graduate preparedness.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"35 1","pages":"242 - 249"},"PeriodicalIF":0.6,"publicationDate":"2022-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47014972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-28DOI: 10.1097/JPO.0000000000000431
Shamsher Singh, H. Mali
ABSTRACT Introduction Clubfoot, mainly CTEV, is a complex three-dimensional deformity challenging physicians from ancient times. Among a thousand babies born, one to six suffer from clubfoot deformity; that is, in India alone, around 35,000 need treatment for clubfoot annually. This review summarizes the various practices of clubfoot assessment, noninvasive treatment, and engineering aspects of clubfoot treatment. The shortcomings of assessment methods and challenges with implementation of treatment methods are also presented. Methods A narrative review of all related research papers available to authors was carried out. Results Various clubfoot assessment methods have been developed to help physicians understand the severity of the problem and predict treatment parameters. The Pirani score and Dimeglio score are used predominantly for the assessment of deformity. However, these methods suffer from implementation-related limitations. Noninvasive methods, namely, Kite's method, functional physiotherapy method, and Ponseti method, are used in practice for treatment. The Ponseti method is the most popular with parents and physicians and is considered the gold standard for the treatment of clubfoot. However, it also suffers from various implementation issues, like treatment cost and lack of experts, particularly in low- and middle-income countries (LMICs). Engineers are using various technologies like computer-aided design (CAD)/computer-aided engineering (CAE) and additive manufacturing for modeling and analysis of clubfoot. Engineers have also attempted to develop corrective and maintenance orthosis for CTEV treatment. Conclusions Because newer and newer technologies are becoming accessible for interdisciplinary use, there is a need to apply contemporary technologies, especially to develop a corrective orthosis so that the current challenges of clubfoot assessment and treatment are addressed. The corrective orthosis should be based on Dr Ponseti's insights into clubfoot biomechanics. Clinical Relevance There is a need to explore contemporary technologies like data acquisition and CAD/CAE to address CTEV assessment–related issues. A corrective orthosis based on the understanding of the foot biomechanics for treatment can solve the various implementation-related challenges of the Ponseti method, particularly in low-resource settings.
{"title":"Clubfoot: Review on Assessment, Treatment, Challenges, and Engineering Aspects","authors":"Shamsher Singh, H. Mali","doi":"10.1097/JPO.0000000000000431","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000431","url":null,"abstract":"ABSTRACT Introduction Clubfoot, mainly CTEV, is a complex three-dimensional deformity challenging physicians from ancient times. Among a thousand babies born, one to six suffer from clubfoot deformity; that is, in India alone, around 35,000 need treatment for clubfoot annually. This review summarizes the various practices of clubfoot assessment, noninvasive treatment, and engineering aspects of clubfoot treatment. The shortcomings of assessment methods and challenges with implementation of treatment methods are also presented. Methods A narrative review of all related research papers available to authors was carried out. Results Various clubfoot assessment methods have been developed to help physicians understand the severity of the problem and predict treatment parameters. The Pirani score and Dimeglio score are used predominantly for the assessment of deformity. However, these methods suffer from implementation-related limitations. Noninvasive methods, namely, Kite's method, functional physiotherapy method, and Ponseti method, are used in practice for treatment. The Ponseti method is the most popular with parents and physicians and is considered the gold standard for the treatment of clubfoot. However, it also suffers from various implementation issues, like treatment cost and lack of experts, particularly in low- and middle-income countries (LMICs). Engineers are using various technologies like computer-aided design (CAD)/computer-aided engineering (CAE) and additive manufacturing for modeling and analysis of clubfoot. Engineers have also attempted to develop corrective and maintenance orthosis for CTEV treatment. Conclusions Because newer and newer technologies are becoming accessible for interdisciplinary use, there is a need to apply contemporary technologies, especially to develop a corrective orthosis so that the current challenges of clubfoot assessment and treatment are addressed. The corrective orthosis should be based on Dr Ponseti's insights into clubfoot biomechanics. Clinical Relevance There is a need to explore contemporary technologies like data acquisition and CAD/CAE to address CTEV assessment–related issues. A corrective orthosis based on the understanding of the foot biomechanics for treatment can solve the various implementation-related challenges of the Ponseti method, particularly in low-resource settings.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"34 1","pages":"e114 - e130"},"PeriodicalIF":0.6,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42195238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-28DOI: 10.1097/JPO.0000000000000433
B. Lonner, C. Toombs, Suken A. Shah, T. Bastrom, Phedra Penn, K. Bright, Carrie Stern, M. Roy-Beaudry, M. Beauséjour, Geraldine I. Neiss, Andrea Castillo, S. Parent
ABSTRACT Introduction Self-image and body shape are important to adolescent idiopathic scoliosis (AIS) patients. The impact of scoliosis on anterior trunk shape has been incompletely studied. The Truncal Anterior Asymmetry Scoliosis Questionnaire (TAASQ) was developed to assess anterior truncal appearance concerns and mental preoccupation and behavioral modification related to those concerns. The purpose of this study is to validate TAASQ in AIS. Methods A total of 105 female surgical AIS patients (average age, 14.9 years; mean Cobb, 53°) completed the TAASQ, Spinal Appearance Questionnaire (SAQ), and Scoliosis Research Society Questionnaire (SRS-22) questionnaires. TAASQ was developed with breast cancer researchers and piloted in 13 perioperative adolescent and adult idiopathic scoliosis patients. TAASQ contains 14 questions, both response scale and free response. Questions are categorized into three domains: breast, appearance, and clothing. Internal consistency/reliability (Cronbach's α) and concurrent validity were determined. Results Internal consistency was 0.86, 0.77, and 0.84 for clothing, appearance, and breast domains, respectively (good to excellent). Domains and subdomains of the TAASQ correlate well with the image domain of the SRS-22 but not with the SAQ. However, given that the TAASQ was designed to assess concerns with anterior appearance, the correlation with the image domain establishes concurrent validity of the questionnaire. Conclusions TAASQ is a reliable and valid measure of the concerns and behavioral modifications related to anterior truncal appearance in female AIS patients. Further study of TAASQ will help clinicians counsel patients on the impact of surgery on anterior truncal deformity. Clinical Relevance There is a clinical lack of knowledge about the significant self-image and anterior body shape concerns of adolescent females with AIS. The TAASQ has been developed to assess concerns related to anterior truncal appearance and mental preoccupation and behavioral modification.
{"title":"What a Patient Sees in the Mirror: Validation of the Truncal Anterior Asymmetry Scoliosis Questionnaire","authors":"B. Lonner, C. Toombs, Suken A. Shah, T. Bastrom, Phedra Penn, K. Bright, Carrie Stern, M. Roy-Beaudry, M. Beauséjour, Geraldine I. Neiss, Andrea Castillo, S. Parent","doi":"10.1097/JPO.0000000000000433","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000433","url":null,"abstract":"ABSTRACT Introduction Self-image and body shape are important to adolescent idiopathic scoliosis (AIS) patients. The impact of scoliosis on anterior trunk shape has been incompletely studied. The Truncal Anterior Asymmetry Scoliosis Questionnaire (TAASQ) was developed to assess anterior truncal appearance concerns and mental preoccupation and behavioral modification related to those concerns. The purpose of this study is to validate TAASQ in AIS. Methods A total of 105 female surgical AIS patients (average age, 14.9 years; mean Cobb, 53°) completed the TAASQ, Spinal Appearance Questionnaire (SAQ), and Scoliosis Research Society Questionnaire (SRS-22) questionnaires. TAASQ was developed with breast cancer researchers and piloted in 13 perioperative adolescent and adult idiopathic scoliosis patients. TAASQ contains 14 questions, both response scale and free response. Questions are categorized into three domains: breast, appearance, and clothing. Internal consistency/reliability (Cronbach's α) and concurrent validity were determined. Results Internal consistency was 0.86, 0.77, and 0.84 for clothing, appearance, and breast domains, respectively (good to excellent). Domains and subdomains of the TAASQ correlate well with the image domain of the SRS-22 but not with the SAQ. However, given that the TAASQ was designed to assess concerns with anterior appearance, the correlation with the image domain establishes concurrent validity of the questionnaire. Conclusions TAASQ is a reliable and valid measure of the concerns and behavioral modifications related to anterior truncal appearance in female AIS patients. Further study of TAASQ will help clinicians counsel patients on the impact of surgery on anterior truncal deformity. Clinical Relevance There is a clinical lack of knowledge about the significant self-image and anterior body shape concerns of adolescent females with AIS. The TAASQ has been developed to assess concerns related to anterior truncal appearance and mental preoccupation and behavioral modification.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"35 1","pages":"172 - 179"},"PeriodicalIF":0.6,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48324117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-28DOI: 10.1097/JPO.0000000000000432
Senay Cerezci Duygu, Bahar Anaforoğlu, F. Erbahçeci
ABSTRACT Introduction Suspension systems are essential components for a lower-limb prosthesis, as they provide sufficient prosthetic fit. Although various adverse and positive effects have been reported for suspension systems, it is important to determine the effects on the prosthesis users in detail. Objective The aim of this study was to compare the pin suspension system (PSS) with the vacuum-assisted suspension system (VASS) in terms of parameters including walking capacity, functional mobility, weight bearing on the operated side, prosthesis satisfaction, and body image perception. Study Design This is an original research report. Methods Nine individuals with transtibial amputation were evaluated. Both suspension systems were applied consecutively. Initially, participants used the PSS for 3 months after fabrication and adjustment of the prosthesis and a prosthetic training period. They then used the VASS for 3 months after a similar training period. After both prosthetic systems had been adjusted, L.A.S.A.R. Posture was used to determine weight bearing on the prosthetic side. The 6-minute walk test was applied for walking capacity, the timed up-and-go test was used to determine functional mobility, the Prosthetic Satisfaction Index was used for prosthetic satisfaction, and the Amputee Body Image Scale was used for body image perception. Results Significant differences were observed between PSS and VASS in terms of prosthetic side weight-bearing ratios, walking capacity, functional mobility, and prosthetic satisfaction (P < 0.05), all in favor of VASS. No significant difference was determined in terms of body image scores (P > 0.05). Conclusion In terms of function and prosthetic satisfaction in individuals with transtibial amputation, VASS was determined to be superior. The available evidence suggests that if there is no contraindication for the use of VASS, it may contribute to the individual with amputation functionally and increase the satisfaction with the prosthesis. Clinical Relevance Vacuum systems can make a positive contribution to reaching the goals for prosthesis users who are targeted to have high physical activity levels. This positive contribution includes increased weight transfer to the prosthetic side, an increase in mobility determinants, and increased prosthesis satisfaction, which has many dimensions.
{"title":"A Comparison of the Effects of Pin and Vacuum-Assisted Suspension Systems in Individuals With Transtibial Amputation","authors":"Senay Cerezci Duygu, Bahar Anaforoğlu, F. Erbahçeci","doi":"10.1097/JPO.0000000000000432","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000432","url":null,"abstract":"ABSTRACT Introduction Suspension systems are essential components for a lower-limb prosthesis, as they provide sufficient prosthetic fit. Although various adverse and positive effects have been reported for suspension systems, it is important to determine the effects on the prosthesis users in detail. Objective The aim of this study was to compare the pin suspension system (PSS) with the vacuum-assisted suspension system (VASS) in terms of parameters including walking capacity, functional mobility, weight bearing on the operated side, prosthesis satisfaction, and body image perception. Study Design This is an original research report. Methods Nine individuals with transtibial amputation were evaluated. Both suspension systems were applied consecutively. Initially, participants used the PSS for 3 months after fabrication and adjustment of the prosthesis and a prosthetic training period. They then used the VASS for 3 months after a similar training period. After both prosthetic systems had been adjusted, L.A.S.A.R. Posture was used to determine weight bearing on the prosthetic side. The 6-minute walk test was applied for walking capacity, the timed up-and-go test was used to determine functional mobility, the Prosthetic Satisfaction Index was used for prosthetic satisfaction, and the Amputee Body Image Scale was used for body image perception. Results Significant differences were observed between PSS and VASS in terms of prosthetic side weight-bearing ratios, walking capacity, functional mobility, and prosthetic satisfaction (P < 0.05), all in favor of VASS. No significant difference was determined in terms of body image scores (P > 0.05). Conclusion In terms of function and prosthetic satisfaction in individuals with transtibial amputation, VASS was determined to be superior. The available evidence suggests that if there is no contraindication for the use of VASS, it may contribute to the individual with amputation functionally and increase the satisfaction with the prosthesis. Clinical Relevance Vacuum systems can make a positive contribution to reaching the goals for prosthesis users who are targeted to have high physical activity levels. This positive contribution includes increased weight transfer to the prosthetic side, an increase in mobility determinants, and increased prosthesis satisfaction, which has many dimensions.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"35 1","pages":"25 - 31"},"PeriodicalIF":0.6,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42258041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-13DOI: 10.1097/JPO.0000000000000424
Gila Baer, S. Fatone
ABSTRACT Introduction Lower-limb amputations account for most cases seen by certified prosthetists in the United States. Fundamental to the success of a lower-limb prosthesis is the socket, and fundamental to the success of a socket is safety and durability. Currently, there are no standards specific to ensuring the safety and durability of lower-limb prosthetic sockets. The purpose of this scoping review was to describe the mechanical testing procedures used to date to assess the structural and material properties of lower-limb prosthetic sockets, with a view to informing the development of future standards. Methods A systematic search was conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature, and Scopus databases and the Canadian Prosthetics & Orthotics Journal website to identify relevant articles. Articles published in English were included if they used mechanical testing to assess the socket and/or socket material and presented those test results. Results Fourteen articles were included in this review. They described 30 different mechanical test protocols, consisting of 12 different types of mechanical tests. The most common mechanical tests conducted were tensile, static load, and cyclic load testing. Of the 30 test protocols, 20 referenced current standards that do not include sockets within their scope and modified them in various ways to allow testing of sockets. Of the 14 included articles, 8 described using a mock residual limb during testing, all of which were unique in their composition. Conclusion Individual researchers modified existing, nonsocket standards in varying ways to adopt them for use in testing lower-limb prosthetic sockets. This scoping review describes information that may inform the development of socket-specific test protocols. Clinical Relevance Future research is needed to determine which tests are good indicators of clinical safety and durability in order to link quantitative results of mechanical testing to the safety and durability of everyday socket use.
摘要简介:在美国，下肢截肢占认证假肢医生所见病例的大多数。下肢假体成功的基础是关节窝，而关节窝成功的基础是安全性和耐久性。目前，还没有专门的标准来保证下肢假肢插座的安全性和耐用性。本综述的目的是描述迄今为止用于评估下肢假肢窝结构和材料特性的机械测试程序，以期为未来标准的制定提供信息。方法系统检索PubMed、Cumulative Index to Nursing and Allied Health Literature、Scopus数据库和Canadian Prosthetics & Orthotics Journal网站的相关文章。用英文发表的文章，如果使用机械测试来评估插座和/或插座材料，并提供这些测试结果，则包括在内。结果共纳入14篇文献。他们描述了30种不同的机械测试方案，包括12种不同类型的机械测试。最常见的机械试验是拉伸、静载荷和循环载荷试验。在30个测试协议中，有20个参考了现行标准，这些标准不包括套接字，并以各种方式对其进行了修改，以允许对套接字进行测试。在纳入的14篇文章中，有8篇描述了在测试期间使用模拟残肢，所有这些文章在组成上都是独一无二的。结论个别研究者以不同的方式修改了现有的非关节套标准，将其用于下肢假肢关节套的测试。此范围审查描述了可能告知开发特定于套接字的测试协议的信息。为了将机械测试的定量结果与日常插座使用的安全性和耐久性联系起来，需要进一步的研究来确定哪些测试是临床安全性和耐久性的良好指标。
{"title":"Scoping Review of Mechanical Testing of the Structural and Material Properties of Lower-Limb Prosthetic Sockets","authors":"Gila Baer, S. Fatone","doi":"10.1097/JPO.0000000000000424","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000424","url":null,"abstract":"ABSTRACT Introduction Lower-limb amputations account for most cases seen by certified prosthetists in the United States. Fundamental to the success of a lower-limb prosthesis is the socket, and fundamental to the success of a socket is safety and durability. Currently, there are no standards specific to ensuring the safety and durability of lower-limb prosthetic sockets. The purpose of this scoping review was to describe the mechanical testing procedures used to date to assess the structural and material properties of lower-limb prosthetic sockets, with a view to informing the development of future standards. Methods A systematic search was conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature, and Scopus databases and the Canadian Prosthetics & Orthotics Journal website to identify relevant articles. Articles published in English were included if they used mechanical testing to assess the socket and/or socket material and presented those test results. Results Fourteen articles were included in this review. They described 30 different mechanical test protocols, consisting of 12 different types of mechanical tests. The most common mechanical tests conducted were tensile, static load, and cyclic load testing. Of the 30 test protocols, 20 referenced current standards that do not include sockets within their scope and modified them in various ways to allow testing of sockets. Of the 14 included articles, 8 described using a mock residual limb during testing, all of which were unique in their composition. Conclusion Individual researchers modified existing, nonsocket standards in varying ways to adopt them for use in testing lower-limb prosthetic sockets. This scoping review describes information that may inform the development of socket-specific test protocols. Clinical Relevance Future research is needed to determine which tests are good indicators of clinical safety and durability in order to link quantitative results of mechanical testing to the safety and durability of everyday socket use.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"35 1","pages":"e37 - e47"},"PeriodicalIF":0.6,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48136646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-11DOI: 10.1097/JPO.0000000000000434
L. Resnik, Matthew L. Borgia, Melissa A. Clark
ABSTRACT Introduction Individuals with upper-limb amputation (ULA) have increased risk for contralateral limb pain (CLP), and further study of CLP in ULA is needed. Study objectives were to: (1) describe CLP frequency, intensity, and 1-year change; (2) identify factors associated with CLP; and (3) quantify associations between CLP, health-related quality of life (HRQoL), and disability (QuickDASH). Methods A total of 776 veterans with unilateral ULA were surveyed at baseline, and 562 were surveyed again at 1 year. Participants reported CLP frequency and intensity and nonamputated limb conditions. Multivariable models examined factors associated with CLP, as well as associations between CLP intensity and HRQOL (physical component score and mental component score) and disability (QuickDASH). Results Contralateral limb pain prevalence was 72.7% (baseline) and 71.6% (follow-up); 59.8% had persistent pain. Contralateral limb conditions and neck and residual limb pain were associated with higher odds of CLP. Black race (vs White), back pain (vs without), and age 45 to 65 years (vs 18–45 years) were associated with greater CLP intensity. Female sex (vs male) and use of cosmetic prostheses (vs body-powered) were associated with lower intensity. The mental component scores were 2.7 and 6.6 points lower for moderate and severe CLP, respectively; the physical component scores were 4.2 and 8.4 points lower for moderate and severe CLP; and QuickDASH scores were 9.4 and 20.7 point higher for moderate and severe CLP, compared with none to mild pain. Conclusions Findings suggest that overreliance on the nonamputated limb, leading to CLP, occurs regardless of amputation level or prosthesis use. Further research is needed to understand whether disparities in pain treatment exist by race. Contralateral limb pain is prevalent and persistent in veterans with ULA. Moderate to severe CLP is associated with worse HRQOL and greater disability. Efforts are needed to prevent and treat ULA CLP pain. Clinical Relevance Clinicians caring for persons with unilateral ULA should evaluate the contralateral upper limb and refer patients to appropriate therapies to address painful conditions. Persons with ULA should be educated about the risks of development of CLP and be provided with strategies to minimize overuse when possible.
{"title":"Contralateral Limb Pain Is Prevalent, Persistent, and Impacts Quality of Life of Veterans with Unilateral Upper-Limb Amputation","authors":"L. Resnik, Matthew L. Borgia, Melissa A. Clark","doi":"10.1097/JPO.0000000000000434","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000434","url":null,"abstract":"ABSTRACT Introduction Individuals with upper-limb amputation (ULA) have increased risk for contralateral limb pain (CLP), and further study of CLP in ULA is needed. Study objectives were to: (1) describe CLP frequency, intensity, and 1-year change; (2) identify factors associated with CLP; and (3) quantify associations between CLP, health-related quality of life (HRQoL), and disability (QuickDASH). Methods A total of 776 veterans with unilateral ULA were surveyed at baseline, and 562 were surveyed again at 1 year. Participants reported CLP frequency and intensity and nonamputated limb conditions. Multivariable models examined factors associated with CLP, as well as associations between CLP intensity and HRQOL (physical component score and mental component score) and disability (QuickDASH). Results Contralateral limb pain prevalence was 72.7% (baseline) and 71.6% (follow-up); 59.8% had persistent pain. Contralateral limb conditions and neck and residual limb pain were associated with higher odds of CLP. Black race (vs White), back pain (vs without), and age 45 to 65 years (vs 18–45 years) were associated with greater CLP intensity. Female sex (vs male) and use of cosmetic prostheses (vs body-powered) were associated with lower intensity. The mental component scores were 2.7 and 6.6 points lower for moderate and severe CLP, respectively; the physical component scores were 4.2 and 8.4 points lower for moderate and severe CLP; and QuickDASH scores were 9.4 and 20.7 point higher for moderate and severe CLP, compared with none to mild pain. Conclusions Findings suggest that overreliance on the nonamputated limb, leading to CLP, occurs regardless of amputation level or prosthesis use. Further research is needed to understand whether disparities in pain treatment exist by race. Contralateral limb pain is prevalent and persistent in veterans with ULA. Moderate to severe CLP is associated with worse HRQOL and greater disability. Efforts are needed to prevent and treat ULA CLP pain. Clinical Relevance Clinicians caring for persons with unilateral ULA should evaluate the contralateral upper limb and refer patients to appropriate therapies to address painful conditions. Persons with ULA should be educated about the risks of development of CLP and be provided with strategies to minimize overuse when possible.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"35 1","pages":"3 - 11"},"PeriodicalIF":0.6,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44306867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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