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Showing 1 - 21 of 21 Journals sorted alphabetically
Archives of Osteoporosis     Hybrid Journal   (Followers: 2)
Bangladesh Heart Journal     Open Access   (Followers: 3)
Chiropractic & Manual Therapies     Open Access   (Followers: 5)
Chiropractic Journal of Australia     Full-text available via subscription  
Clinical Chiropractic     Hybrid Journal   (Followers: 2)
Current Osteoporosis Reports     Hybrid Journal   (Followers: 4)
DO - Deutsche Zeitschrift für Osteopathie     Hybrid Journal   (Followers: 1)
Homeopathy     Hybrid Journal   (Followers: 8)
International Journal of Osteopathic Medicine     Hybrid Journal   (Followers: 2)
Journal of Chiropractic Humanities     Hybrid Journal  
Journal of Chiropractic Medicine     Hybrid Journal   (Followers: 4)
Journal of Osteoporosis     Open Access   (Followers: 4)
La Revue d'Homéopathie     Full-text available via subscription  
Musculoskeletal Science and Practice     Hybrid Journal   (Followers: 2)
Osteopathische Medizin     Full-text available via subscription   (Followers: 1)
Osteopatía Científica     Full-text available via subscription   (Followers: 2)
Osteoporosis International     Hybrid Journal   (Followers: 14)
Prosthetics and Orthotics International     Hybrid Journal   (Followers: 10)
Revista de Osteoporosis y Metabolismo Mineral     Open Access   (Followers: 2)
Revista Médica de Homeopatía     Full-text available via subscription  
Zeitschrift für Klassische Homöopathie     Hybrid Journal  
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Prosthetics and Orthotics International
Journal Prestige (SJR): 0.448
Citation Impact (citeScore): 1
Number of Followers: 10  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0309-3646 - ISSN (Online) 1746-1553
Published by Sage Publications Homepage  [1097 journals]
  • A walking bout reveals altered foot thermodynamics associated with
           unilateral transtibial amputation among individuals with type 2 diabetes
    • Authors: Kyle R Leister, Shane R Wurdeman
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Increased foot temperature among individuals with type 2 diabetes can be predictive of diabetic foot ulcer development. A combination of physiological and mechanical deficiencies may contribute to elevations in intact foot temperature during gait for individuals with type 2 diabetes and transtibial amputation.Objective:This study evaluated plantar foot temperature differences between individuals with type 2 diabetes with and without transtibial amputation. We hypothesized that individuals with transtibial amputation maintain increased foot temperature compared to those without amputation.Study Design:Cross-sectional, case control.Methods:A sample of 16 participants with type 2 diabetes and transtibial amputation, and 16 age- and sex-matched participants with type 2 diabetes without amputation were recruited. Foot temperatures were measured during resting, walking, and cooldown periods. Peak temperature, mean temperature, and rate of temperature change were analyzed for each period, and compared between cohorts.Results:Participants with amputation exhibited increased mean foot temperature while at rest and during walking. Participants without amputation exhibited increased rate of change of foot temperature during walking. No differences in peak temperature or rate of temperature change were observed during the baseline or cooldown periods.Conclusion:The current findings of altered foot temperature for individuals with transtibial amputation and type 2 diabetes suggest a possible reason for the high rates of contralateral limb ulceration and amputation among this population.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-12-07T08:03:12Z
      DOI: 10.1177/0309364620968642
       
  • Global prevalence of traumatic non-fatal limb amputation
    • Authors: Cody L McDonald, Sarah Westcott-McCoy, Marcia R Weaver, Juanita Haagsma, Deborah Kartin
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Reliable information on both global need for prosthetic services and the current prosthetist workforce is limited. Global burden of disease estimates can provide valuable insight into amputation prevalence due to traumatic causes and global prosthetists needed to treat traumatic amputations.Objectives:This study was conducted to quantify and interpret patterns in global distribution and prevalence of traumatic limb amputation by cause, region, and age within the context of prosthetic rehabilitation, prosthetist need, and prosthetist education.Study design:A secondary database descriptive study.Methods:Amputation prevalence and prevalence rate per 100,000 due to trauma were estimated using the 2017 global burden of disease results. Global burden of disease estimation utilizes a Bayesian metaregression and best available data to estimate the prevalence of diseases and injuries, such as amputation.Results:In 2017, 57.7 million people were living with limb amputation due to traumatic causes worldwide. Leading traumatic causes of limb amputation were falls (36.2%), road injuries (15.7%), other transportation injuries (11.2%), and mechanical forces (10.4%). The highest number of prevalent traumatic amputations was in East Asia and South Asia followed by Western Europe, North Africa, and the Middle East, high-income North America and Eastern Europe. Based on these prevalence estimates, approximately 75,850 prosthetists are needed globally to treat people with traumatic amputations.Conclusion:Amputation prevalence estimates and patterns can inform prosthetic service provision, education and planning.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-12-04T12:39:39Z
      DOI: 10.1177/0309364620972258
       
  • The effect of custom carbon ankle-foot orthosis alignment on roll-over
           shape and center of pressure velocity
    • Authors: Elizabeth Russell Esposito, Mitchell D Ruble, Andrea J Ikeda, Jason M Wilken
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Maintaining an optimal rolling of the foot over the ground is thought to increase the stability and efficiency of pathologic gait. Ankle-foot orthoses are often prescribed to improve gait mechanics in individuals with lower extremity injuries; however, their design may compromise how the foot rolls over the ground.Objectives:The aim of this study was to investigate the effects of the sagittal plane ankle-foot orthosis alignment on roll-over shape and center of pressure velocity in individuals with lower limb reconstructions.Study design:Randomized cross-over study with a control group comparison.Methods:In total, 12 individuals with lower limb reconstruction who used a custom carbon ankle-foot orthosis and 12 uninjured controls underwent gait analysis. Ankle-foot orthosis users were tested in their clinically-provided ankle-foot orthosis alignment, with an alignment that was 3° more plantarflexed, and with an alignment that was 3° more dorsiflexed. Components of roll-over shape and center of pressure velocity were calculated from heel strike on the ankle-foot orthosis limb to contralateral heel strike.Results:Roll-over shape radius was not affected by 3° changes to alignment and was not significantly different from controls. Aligning the ankle-foot orthosis in more dorsiflexion than clinically provided resulted in a smaller peak center of pressure velocity that occurred later in stance.Conclusion:Individuals using custom carbon ankle-foot orthoses can accommodate 3° alterations in the dorsiflexion or plantarflexion alignment.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-11-21T10:24:12Z
      DOI: 10.1177/0309364620971407
       
  • Key considerations for finite element modelling of the
           residuum–prosthetic socket interface
    • Authors: JW Steer, PR Worsley, M Browne, Alex Dickinson
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Finite element modelling has long been proposed to support prosthetic socket design. However, there is minimal detail in the literature to inform practice in developing and interpreting these complex, highly nonlinear models.Objectives:To identify best practice recommendations for finite element modelling of lower limb prosthetics, considering key modelling approaches and inputs.Study design:Computational modelling.Methods:This study developed a parametric finite element model using magnetic resonance imaging data from a person with transtibial amputation. Comparative analyses were performed considering socket loading methods, socket–residuum interface parameters and soft tissue material models from the literature, to quantify their effect on the residuum’s biomechanical response to a range of parameterised socket designs.Results:These variables had a marked impact on the finite element model’s predictions for limb–socket interface pressure and soft tissue shear distribution.Conclusions:All modelling decisions should be justified biomechanically and clinically. In order to represent the prosthetic loading scenario in silico, researchers should (1) consider the effects of donning and interface friction to capture the generated soft tissue shear stresses, (2) use representative stiffness hyperelastic material models for soft tissues when using strain to predict injury and (3) interrogate models comparatively, against a clinically-used control.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-11-12T05:22:46Z
      DOI: 10.1177/0309364620967781
       
  • The prevalence of lower limb loss in children and associated costs of
           prosthetic devices: A national study of commercial insurance claims
    • Authors: Mitra McLarney, Liliana E Pezzin, Emily L McGinley, Laura Prosser, Timothy R Dillingham
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Although the incidence of major pediatric lower limb loss secondary to either congenital deficiencies or acquired amputations is relatively low, the prevalence of lower limb loss among children in the United States (US) remains unknown.Objectives:To estimate the prevalence of major lower limb loss, and the associated prosthetic services use and costs among commercially-insured children in the US.Study design:Observational, retrospective, longitudinal cohort study.Methods:The IBM MarketScan® Commercial Database was used to identify children (
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-11-07T07:08:10Z
      DOI: 10.1177/0309364620968645
       
  • Contribution of Achilles tendon mechanical properties to torque steadiness
           in persons with transfemoral amputation
    • Authors: Anis Toumi, Rowan Smart, Dimitri Elie, Jennifer Bassement, Sébastien Leteneur, Emilie Simoneau-Buessinger, Jennifer Jakobi
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:How Achilles tendon mechanics and plantar flexion strength and torque steadiness are altered in the intact leg of persons with trauma-related amputation is unknown. Understanding Achilles tendon mechanics following amputation will further inform rehabilitation approaches to enhance posture, balance, and force control.Objective:Conduct a pilot study to quantify plantar flexion maximal voluntary contraction torque, torque steadiness, and Achilles tendon mechanics in persons with unilateral trauma-related transfemoral amputation and controls without amputation.Study design:Cross-sectional study.Methods:Isometric plantar flexion maximal voluntary contractions were performed with the intact leg of ten males with transfemoral amputation (48 ± 14 years) and the dominant leg of age-matched male controls without amputation. Torque steadiness was calculated as the coefficient of variation in torque over 6 s during submaximal tracking tasks (5%, 10%, 25%, 50%, and 75% maximal voluntary contraction). Achilles tendon elongation and cross-sectional area were recorded with ultrasound to calculate strain, stress, and stiffness.Results:Maximal voluntary contraction and torque steadiness did not differ between persons with amputation (90.6 ± 31.6 N m, 3.7 ± 2.0%) and controls (95.8 ± 26.8 N m, 2.9 ± 1.2%; p > 0.05). Tendon stiffness (21.1 ± 18.2 N/mm) and strain (5.2 ± 1.3%) did not differ between groups (p > 0.05). Tendon cross-sectional area was 10% greater in persons with amputation leading to 29% lower stress (p = 0.021). Maximal voluntary contraction was a predictor of a lower coefficient of variation in torque (R2 = 0.11, p 
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-11-07T07:06:30Z
      DOI: 10.1177/0309364620966431
       
  • Response to ‘Letter to the editor regarding: In-brace alterations of
           pulmonary functions in adolescents wearing a brace for idiopathic
           scoliosis by Yagci et al.’
    • Authors: Gozde Yagci, Gokhan Demirkiran, Yakut Yavuz
      Abstract: Prosthetics and Orthotics International, Ahead of Print.

      Citation: Prosthetics and Orthotics International
      PubDate: 2020-11-04T10:49:00Z
      DOI: 10.1177/0309364620967508
       
  • Letter to the editor regarding: In-brace alterations of pulmonary
           functions in adolescents wearing a brace for idiopathic scoliosis
    • Authors: Matthew ABJ Potts
      Abstract: Prosthetics and Orthotics International, Ahead of Print.

      Citation: Prosthetics and Orthotics International
      PubDate: 2020-11-04T10:48:21Z
      DOI: 10.1177/0309364620967510
       
  • The Comprehensive Lower limb Amputee Socket Survey: Reliability and
           validity of the Persian version
    • Authors: Naeimeh Rouhani, Elham Esfandiari, Taher Babaee, Mobina Khosravi, Vahideh Moradi, Behrad Balouchkayvan, Hamid Pezham
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:The Comprehensive Lower limb Amputee Socket Survey (CLASS) is a self-reported measure developed to assess prosthetic socket fit in individuals with lower limb amputation.Objective:To assess the reliability and validity of the Persian version of the CLASS.Study Design:Cross-sectional and repeated-measures.Methods:We evaluated the translation and back translation of the CLASS and made the required changes according to expert committee feedback. Then, we recruited 124 participants with unilateral lower limb amputation (89.5% men). Internal consistency was analyzed with Cronbach’s alpha and test–retest reliability using intra-class correlation coefficients. Convergent construct validity was assessed by comparing the CLASS scores with the Persian version of the Trinity Amputation and Prosthesis Experience Scales (TAPES) scores. In addition, known groups construct validity was assessed by comparing CLASS scores between groups with different causes and levels of amputation.Results:Cronbach’s alpha coefficient represented a very good internal consistency for all domains of the Persian CLASS (ranged from 0.86 to 0.92). The intra-class correlation coefficient for test–retest reliability for the Persian CLASS was good to excellent (ranged from 0.73 to 0.97). There was a significant correlation between the subscales of the Persian CLASS and satisfaction subscales of the Persian TAPES (p 
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-10-29T10:13:01Z
      DOI: 10.1177/0309364620958526
       
  • Defining the design requirements for an assistive powered hand
           exoskeleton: A pilot explorative interview study and case series
    • Authors: Quinn A Boser, Michael R Dawson, Jonathon S Schofield, Gwen Y Dziwenko, Jacqueline S Hebert
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Powered hand exoskeletons are an emerging technology that have shown promise in assisting individuals with impaired hand function. A number of hand exoskeleton designs have been described in the literature; however, the majority have not been supported by patient-oriented criteria.Objective:The aim of this study was to define preliminary end-user needs and expectations for an assistive hand exoskeleton.Study design:Explorative interview and case series.Methods:Six clinicians and eight individuals with impaired hand function were interviewed in small groups or individually. A standardized list of questions was used to elicit feedback on specific design criteria or promote the discovery of new criteria. In addition, three participants with impaired hand function returned for a second session where hand characteristics, such as range of motion and force required to flex/extend fingers, were recorded to further quantify design requirements.Results:Interview responses indicated that there was general consensus among participants on criteria relating to important grasp patterns, grip strength, wear time, and acceptable bulk/weight. However, interview responses and hand characteristics also revealed important differences between individuals with impaired hand function.Conclusion:Qualitative and quantitative data were collected to develop an understanding of end-user design requirements for assistive hand exoskeletons. Although the data collected were helpful in identifying some preliminary criteria, differences between participants exist and identifying a universal set of criteria applicable across individuals with impaired hand function is challenging. This work reinforces the importance of involving users of rehabilitation technology in the device development process.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-10-29T10:12:41Z
      DOI: 10.1177/0309364620963943
       
  • Evaluation of a passive pediatric leg exoskeleton during gait
    • Authors: Jessica Zistatsis, Keshia M Peters, Daniel Ballesteros, Heather A Feldner, Kristie Bjornson, Katherine M Steele
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Children with hemiparesis are commonly prescribed ankle foot orthoses to help improve gait; however, these orthoses often result in only small and variable changes in gait. Research with adult stroke survivors has suggested that orthoses that extend beyond the ankle using long, passive tendon-like structures (i.e. exotendons) can improve walking.Objectives:The aim of this study was to quantify the impact of an exotendon-based exoskeleton on pediatric gait.Study design:Repeated-measures study.Methods:Two typically-developing children and two children with hemiparesis completed a gait analysis, walking without and with the exoskeleton. The exotendon was tested at three stiffness levels.Results:All children were able to walk comfortably with the exoskeleton, with minimal changes in step width. Walking speed increased and lower limb joint symmetry improved for the children with hemiparesis with the exoskeleton. Each participant had changes in muscle activity while walking with the exoskeleton, although the impact on specific muscles and response to exotendon stiffness varied.Conclusion:Exotendon-based exoskeletons may provide an alternative solution for optimizing gait in therapy and in the community for children with hemiparesis. Determining the optimal stiffness and configuration for each child is an important area of future research.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-10-23T11:59:58Z
      DOI: 10.1177/0309364620956868
       
  • Evaluation of different Jaipur foot–ankle assemblies using infrared
           thermography
    • Authors: Natali Olaya Mira, Carolina Viloria Barragán, Jesus Alberto Plata
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Mechanical behavior is difficult to monitor in experimental environments, usually because of geometric or technology implementation limitations. Nevertheless, thermography has been shown to overcome these issues.Objectives:The aim of this study was to evaluate four types of assemblies between a Jaipur foot and a polyethylene tube using infrared thermography in order to find the best mechanical configuration in terms of thermal behavior.Study Design:Mechanical testing.Technique:An infrared camera captured short videos every 5 min over 10 h in six different positions (three in the back and three in front of the Jaipur foot) around a prosthesis subjected to repetitive stresses (axial force 980 N) simulating kinematic variables like joint angles. We established a region of interest around the foot–ankle assemblies and calculated maximum temperatures and thermographic indices.Results:In this study, the best foot–ankle assembly used epoxy adhesive because it presented the lowest temperature in the six positions and the lowest thermal index.Conclusions:Thermographic techniques can be used to study mechanical behaviors in complex experimental situations.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-10-08T06:25:43Z
      DOI: 10.1177/0309364620958510
       
  • Longitudinal study of prosthesis use in veterans with upper limb
           amputation
    • Authors: Linda Resnik, Matthew Borgia, Sarah Biester, Melissa A Clark
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Little is known about the patterns of prosthesis use and satisfaction of those who cease use or begin to use upper limb prostheses.Objectives:Among a longitudinal sample of Veterans with upper limb amputation, (1) describe changes in prosthesis use over 1 year, (2) examine rates of receipt of new prostheses, and (3) compare prosthesis satisfaction in respondents who received a new prosthesis to those who did not.Study Design:Longitudinal survey.Methods:808 Veterans who had participated in a baseline interview 1 year earlier were invited to participate in structured telephone interviews.Results:A total of 562 persons with unilateral and 23 with bilateral amputation participated in the interviews (Response rate = 72.4% and 85.2%, respectively). Prosthesis use, frequency and intensity of use, and types of prostheses used were stable over 1 year. About 24% reported using a different primary terminal device type at follow-up than baseline. Prosthesis use was less frequent/intense at baseline among those who discontinued use compared with those who did not (P 
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-10-07T06:54:07Z
      DOI: 10.1177/0309364620957920
       
  • Information access and sharing among prosthetics and orthotics faculty in
           Ghana and the United States
    • Authors: Cody L McDonald, Henry Larbi, Sarah Westcott McCoy, Deborah Kartin
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Information access is essential for quality healthcare provision and education. Despite technological advances, access to prosthetics and orthotics information in low- and middle-income countries is not ubiquitous. The current state of information access, availability, and exchange among prosthetics and orthotics faculty is unknown.Objectives:Describe information exchange networks and access at two prosthetics and orthotics programs in Ghana and the United States.Study design:Cross-sectional survey, social network analysis.Methods:An online survey of faculty at two prosthetics and orthotics programs using REDCap. The survey included a social network analysis, demographics, and prosthetics and orthotics information resources and frequency of use. Descriptive statistics were calculated.Results:Twenty-one faculty members completed the survey (84% response). Ghanaian faculty were on average younger (median Ghana: 27 years, United States: 43 years), had less teaching experience, and had less education than US faculty. Textbooks were the most commonly used resource at both programs. The Ghanaian network had more internal connections with few outside sources. The US network had fewer internal connections, relied heavily upon four key players, and had numerous outside contacts.Conclusion:Ghana and US faculty have two distinct information exchange networks. These networks identify key players and barriers to dissemination among faculty to promote successful knowledge translation of current scientific literature and technology development. Social network analysis may be a useful method to explore information sharing among prosthetics and orthotics faculty, and identify areas for further study.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-10-07T06:53:47Z
      DOI: 10.1177/0309364620958828
       
  • Finger orthoses for management of joint hypermobility disorders: Relative
           effects on hand function and cognitive load
    • Authors: Anne-Mette Jensen, Joan Quist Andersen, Lena Quisth, Nerrolyn Ramstrand
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Joint hypermobility refers to joints that move beyond their normal limits. Individuals with hypermobility of the fingers experience difficulties in activities of daily living. Finger orthoses are available for managing hypermobility of the fingers, but their effectiveness has received little attention in scholarly literature.Objectives:To determine if use of custom fit finger orthoses leads to improvements in time needed to perform standardised hand function tests, and attentional demand required to perform these tests, in individuals with joint hypermobility syndrome, Hypermobile Ehlers-Danlos syndrome or Classical Ehlers-Danlos syndrome.Study design:Repeated-measures study.Methods:Fourteen participants performed three different hand function tests (target box and block test, writing and picking up coins), with and without their finger orthoses. Time to complete each test was recorded as a measure of functional performance. Brain activity was recorded in the pre-frontal cortices as a measure of attentional demand.Results:Functional performance significantly improved for all but one test (picking up coins with non-dominant hand) when participants wore finger orthoses (p 
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-09-30T09:19:28Z
      DOI: 10.1177/0309364620956866
       
  • A modified Gritti-Stokes amputation technique as a solution for recurring
           aseptic loosening of a knee arthroplasty: A single-patient case study
    • Authors: Willemijn MJ van Rooij, Karin CM Maas-van Weert, Robin WTM van Kempen, Fred A de Laat, Jan HB Geertzen
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Case Description:A 56-year-old man with persistent knee pain and poor physical functioning due to recurring loosening of a (revised) total knee arthroplasty, was treated with a modified Gritti-Stokes amputation.Objectives:to describe the modified Gritti-Stokes amputation technique as an ultimate therapy for failed total knee arthroplasty and to assess the functional outcome for one patient 1 year post-surgery.Study design:a single patient case study.Treatment:a modified Gritti-Stokes amputation, with removal of the overlying cartilage and subchondral surfaces of both the patella and femur after removing the total knee arthroplasty.Outcomes:After rehabilitation, the patient has a fully end-bearing residual limb, is able to walk without pain (with a prosthesis) and perform his daily activities.Conclusions:In cases of recurring loosening of a (revised) total knee arthroplasty, a modified Gritti-Stokes amputation can create an end-bearing residual limb without pain and with good functional outcome.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-09-15T07:19:31Z
      DOI: 10.1177/0309364620946913
       
  • Successful salvage via re-osseointegration of a loosened implant in a
           patient with transtibial amputation
    • Authors: Clemens Gstoettner, Stefan Salminger, Agnes Sturma, Veith Moser, Thomas Hausner, Rickard Brånemark, Oskar C Aszmann
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Case Description:Osseointegration is a relatively new technique for prosthetic limb attachment that offers various improvements for patients with amputation and facilitates joint preservation. We present a case of implant loosening during rehabilitation in a patient with transtibial amputation that was successfully managed through a combination of measures, aiming to promote re-osseointegration of the implant.Objectives:Not much is known about structured management of adverse events after osseointegration. Septic or aseptic loosening is currently regarded as implant failure, prompting removal and possible re-implantation at a later stage. The objective of this case report was to evaluate the feasibility of salvaging a loosened implant.Study Design:Case report.Treatment:A novel treatment approach was employed to enable renewed osseointegration of the implant. First, the bone-implant interface was disrupted and renewed through axial rotation and distal repositioning of the implant. Afterwards, extracorporal shockwave therapy and antibiotic treatment were administered. Prosthetic rehabilitation was then started anew. Regular follow-up x-rays and clinical evaluations were conducted, including standardized outcome tests.Outcomes:These combined measures led to a successful re-osseointegration of the implant. In a 21-month follow-up, the patient regained a stable and secure gait pattern, using his prosthesis every day for 15 hours and scoring above average on standardized outcome measures.Conclusion:This represents the first report of implant salvage after failed primary osseointegration. As the associated risks of this novel treatment are very low, investigations are warranted to evaluate this approach on a larger scale.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-09-15T07:18:10Z
      DOI: 10.1177/0309364620953985
       
  • Content analysis of child user and carer perspectives of ankle–foot
           orthoses
    • Authors: David Lahoud, Christine HE Teng, Erez Nusem, Joshua Burns, Cara Wrigley, Tegan L Cheng
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:The evaluation of ankle–foot orthoses is primarily focused on biomechanical performance, with comparatively less studies pertaining to users’ quality of life and experiential factors.Objectives:To investigate how child users regard acquisition and use of ankle–foot orthoses through the perspectives of child users, parents/carers and practitioners.Study design:Inductive content analysis of secondary data.Methods:Child user and parent/carer perspectives, as communicated by them and by practitioners, were collected from online platforms and formal publications. Data and themes were analysed through an inductive approach. Investigator triangulation was used to increase trustworthiness and reduce bias.Results:We found and analysed 223 data points from 30 informal online platforms and 15 formal publications. These data clustered into five key themes relating to user experience with ankle–foot orthoses, including materials, structure, aesthetics, service and impact. Child users had mixed opinions about ankle–foot orthoses, reporting satisfaction with the functional improvements resulting from ankle–foot orthosis wear, while noting negative feelings from the experience of acquiring and using the device.Conclusion:This research suggests that considering the five themes in ankle–foot orthosis provision could improve the child user experience, inform future ankle–foot orthosis design, and improve clinical outcomes.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-09-12T11:31:59Z
      DOI: 10.1177/0309364620952906
       
  • Mechanical evaluation of the “Hüfner hand” prosthesis
    • Authors: Gerwin Smit
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Current body-powered hands have very low acceptance rates. They also require high activation forces. In the past, a high acceptance rate was reported for the then-available Hüfner hand, a hand which could be controlled by relatively low activation forces.Objective:The aim of this study was to measure and quantify the mechanical performance of the Hüfner hand.Study design:Mechanical evaluation.Methods:Two versions of the Hüfner hand were tested using a mechanical test bench. Forces and displacements were measured under four different glove conditions (no glove, leather, polyvinyl chloride (PVC), silicone). The measured results were compared to data from currently available voluntary-closing hands.Results:The Hüfner hand required 132–170 Nmm of work and 78–104 N cable force to pinch 15 N. The overall mechanical performance of the Hüfner hands is better than currently available body-powered hands.Conclusion:The mechanical performance of the Hüfner hand was measured and quantified. Mechanical testing results show that the Hüfner hand has better mechanical performance than current body-powered hands. This may have contributed to its reported high acceptance rates. The design of the Hüfner hand, combined with data presented in this study, can serve as guidelines for the design of a new generation of body-powered hands.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-09-10T06:38:36Z
      DOI: 10.1177/0309364620952900
       
  • Quality of life of persons with transfemoral amputation: Comparison of
           socket prostheses and osseointegrated prostheses
    • Authors: Philip Thomas Pospiech, Robert Wendlandt, Horst-Heinrich Aschoff, Sibylle Ziegert, Arndt Peter Schulz
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Until recently, no study had compared the quality of life of persons with transfemoral amputation treated with osseointegration to socket prosthesis users.Objectives:Comparison of quality of life in two types of prostheses users: a cohort of patients with osseointegration and patients equipped with a socket prosthesis who were group-matched for age, body mass index and mobility grade.Study design:A cross-sectional study that comparedMethods:The quality of life of 39 participants (22 in the osseointegration group and 17 in the socket prosthesis group) was measured using the Questionnaire for Persons with Transfemoral Amputation (Q-TFA) and European Questionnaire 5-dimension 3-level (EQ-5D-3L) surveys.Results:Compared with the socket prosthesis group, the osseointegration group had a significantly higher ‘Global’ score (p = 0.022) and a significantly lower ‘Problem’ score (p 
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-08-26T06:21:00Z
      DOI: 10.1177/0309364620948649
       
  • Innovative alignment of sprinting prostheses for persons with transfemoral
           amputation: Exploratory study on a gold medal Paralympic athlete
    • Authors: Gian Luca Migliore, Nicola Petrone, Hiroaki Hobara, Ryu Nagahara, Kenji Miyashiro, Gian Fabio Costa, Antonio Gri, Andrea G Cutti
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Recommendations for the alignment of the socket and foot in the sprinting prosthesis of athletes with transfemoral amputation are either based on walking biomechanics or lack public scientific evidence.Objectives:To explore the biomechanical changes and the sensations of a gold medal Paralympic sprinter, while running with three bench alignments: a conventional reference (A0), an innovative alignment based on the biomechanics of elite able-bodied sprinters (A2), and an intermediate alignment (A1).Study design:Single subject with repeated measures.Methods:A1 and A2 feature a progressively greater socket tilt and a plantar-flexed foot compared to A0. The 30-year-old female athlete trained with three prostheses, one per alignment, for at least 2 months. We administered a questionnaire to collect her impressions. Then, she ran on a treadmill at full speed (5.5 m/s). We measured the kinematics and moments of the prosthetic side, and the ground reaction forces of both sides.Results:A2 reduced the prosthetic side hip extension at foot-off while preserving hip range of motion, decreased the impulse of the hip moment, and increased the horizontal propulsion, leaving sufficient margin to prevent knee buckling without increasing sound side braking forces. Biomechanical outcomes matched well with subjective impressions.Conclusions:A2 appears promising to improve the performance and comfort of sprinters with transfemoral amputation, without compromising safety.Clinical relevancebservation of elite able-bodied sprinters led to the definition of a new specific alignment for the sprinting prosthesis of athletes with transfemoral amputation, which appears promising to improve performance and comfort, without compromising safety. This may constitute a major improvement compared to alignments based on walking biomechanics.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-08-26T06:20:30Z
      DOI: 10.1177/0309364620946910
       
  • Design and development of a novel 3D-printed non-metallic self-locking
           prosthetic arm for a forequarter amputation
    • Authors: Trevor Binedell, Eugene Meng, Karupppasamy Subburaj
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Upper limb, in particular forequarter amputations, require highly customised devices that are often expensive and underutilised.Objectives:The objective of this study was to design and develop a comfortable 3D-printed cosmetic forequarter prosthetic device, which was lightweight, cool to wear, had an elbow that could lock, matched the appearance of the contralateral arm and was completely free of metal for a specific user’s needs.Study Design:Device design.Technique:An iterative user-centred design approach was used for digitising, designing and developing a functional 3D-printed prosthetic arm for an acquired forequarter amputation, while optimising the fit and function after each prototype.Results:The cost of the final arm was 20% less expensive than a traditionally-made forequarter prostheses in Singapore. The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) 2.0 survey was administered, with results indicating that the 3D-printed arm was preferred due to its overall effectiveness, accurate size, ease of use and suspension. However, durability had a lower score, and the weight of the arm was 100 g heavier than the user’s current prosthesis. The technique described resulted in a precise fitting and shaped forequarter prosthesis for the user. Using the user’s feedback in the iterations of the design resulted in improved QUEST survey results indicating the device was effective, easy to use, perceived as lighter and more secure than the user’s traditionally-made device.Conclusion:A fully customised cosmetic forequarter prosthesis was designed and developed using digital scanning, computer-aided design modelling and 3D printing for a specific user. These technologies enable new avenues for highly complex prosthetic design innovations.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-08-26T06:20:30Z
      DOI: 10.1177/0309364620948290
       
  • Innovative approaches to designing and manufacturing a prosthetic thumb
    • Authors: Branko Štefanovič, Monika Michalíková, Lucia Bednarčíková, Marianna Trebuňová, Jozef Živčák
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Case description:Conventional methods for producing custom prosthetic fingers are time-consuming, can be uncomfortable for the patient, and require a skilled prosthetist. The subject was a 40-year-old male with congenital absence of the thumb and related metacarpal bone on the right non-dominant hand, anomaly of the lengths of individual upper limb segments, and contracture of the elbow joint. This hand presentation made it impossible for him to perform thumb opposition, which is a very important function for common daily activities.Objective:The goal was to design an individual passive thumb prosthesis using free open-source software, 3D scanning technology, and additive manufacturing methods (i.e., fused filament fabrication).Study design:Case report.Treatment:Artificial thumb prostheses with two types of bases and fastening interfaces were designed and manufactured. One combination was chosen as the best alternative.Outcomes:The shape, positioning, firmness, and fastening of the prosthesis were compliant enough for the patient to be able to hold objects with his healthy fingers and artificial thumb. This innovative approach to fabrication of a custom thumb prosthesis provided considerable advantages in terms of custom sizing, manufacturing time, rapid production, iteration, comfort, and costs when compared to conventional methods of manufacturing a hand prosthesis.Conclusion:The methodology of designing and manufacturing a prosthetic thumb using 3D scanning and additive manufacturing technologies have been demonstrated to be adequate from a practical point of view. These technologies show potential for use in the practice of prosthetics.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-08-26T06:20:30Z
      DOI: 10.1177/0309364620949717
       
  • A novel, low-cost transradial socket fabrication method using
           mass-producible components and expanding rigid foam
    • Authors: Laura A Miller, Thomas Pickerill, Todd A Kuiken
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:Millions of people in low- and middle-income countries lack access to prosthetic care. A well-fitting, durable socket is important for prosthesis comfort and function, but conventional fabrication techniques require highly trained clinicians and specialized equipment.Objectives:To increase access to prosthetic care by developing a simple, low-cost socket fabrication method that does not require specialized equipment or electricity, and can be performed by persons with minimal prosthetic training.Study Design:Socket fabrication methods and socket function were evaluated in a pilot feasibility study.Technique:We describe a rapid method for fabricating a rigid foam socket directly over the residual limb, with a mass producible, strong, cosmetically appealing plastic outer shell. We fabricated sockets for four individuals with unilateral transradial amputations and evaluated socket function.Results:An individual with no formal prosthetic training was able to fabricate sockets and assemble a functional, comfortable prosthesis system within 90 min. All necessary supplies can be provided in a kit for under US$100.Discussion:Further work is required to determine durability, assess comfort, refine suspension methods, and to develop instructional materials.Conclusions:We developed a simplified, inexpensive method to fabricate sockets on the residual limb using expandable foam with an integrated cosmetic/structural covering (i.e. an exoskeletal system), for persons with transradial amputation. A transradial prosthesis socket can be fabricated in around 90 min. and all necessary materials, tools, and written instructions for fabrication and fitting can be provided in a kit. Specialized equipment and electricity are not required. Instructions for fabrication and fitting can be provided in multiple languages using online videos.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-08-26T06:19:04Z
      DOI: 10.1177/0309364620950850
       
  • A systematic review of health economic evaluations in orthotics and
           prosthetics: Part 1 – prosthetics
    • Authors: Leigh Clarke, Michael P Dillon, Alan Shiell
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:The extent to which current prosthetic health economic evaluations inform healthcare policy and investment decisions is unclear. To further the knowledge in this area, existing evidence gaps and method design issues must be identified, thereby informing the design of future research.Objectives:The aim of this systematic review was to identify evidence gaps, critical method design and reporting issues and determine the extent to which the literature informs a wide range of policy and investment decisions.Study Design:Systematic review.Methods:A range of databases were searched using intervention- and health economic evaluation-related terms. Issues with methodological design and reporting were evaluated using the Consolidated Health Economic Checklist – Extended and the Checklist for Health Economic Evaluation Reporting Standards.Results:The existing health economic evaluation literature was narrowly focused on informing within-participant component decisions. There were common method design (e.g. time horizon too short) and reporting issues (e.g. competing intervention descriptions) that limit the extent to which this literature can inform policy and investment decisions.Conclusion:There are opportunities to conduct a wider variety of health economic evaluations to support within- and across-sector policy and investment decisions. Changes to aspects of the method design and reporting are encouraged for future research in order to improve the rigour of the health economic evaluation evidence.Clinical relevanceThis systematic review will inform the clinical focus and method design of future prosthetic health economic evaluations. It will also guide readers and policy-makers in their interpretation of the current literature and their understanding of the extent to which the current literature can be used to inform policy and investment decisions.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-08-17T06:19:56Z
      DOI: 10.1177/0309364620935310
       
  • Validation and revision of the questionnaire to explore human factors and
           their technical potential for lower limb prosthetics
    • Authors: Jonathan Herbst, Lucas MT Polanski-Schräder, Joachim Vogt, Tim Schürmann, Philipp Beckerle
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:A variety of instruments exist to measure human factors for lower limb amputation and prosthesis research yet, there is no valid or reliable tool available that focuses on technical potentials.Objective:This study aimed to validate and revise the Questionnaire to Explore Human Factors and their Technical Potential.Study Design:Cross-sectional studyMethods:A total of 150 persons with lower limb amputation from Germany participated in the study. Statistical properties, including Cronbach’s alpha, item difficulty, item-total correlation, and distribution of missing values were calculated. Thresholds for acceptable psychometric properties were defined, unsuitable items were removed, and problematic items were reviewed regarding formulation.Results:The Cronbach’s alpha for subscales within the Questionnaire to Explore Human Factors and their Technical Potential were between 0.72 and 0.89. A total of 56 items showed acceptability, and 14 items had problematic item property values. Four of those items were reformulated, five were excluded, six were left in the scale, and an additional one was added to the scale.Conclusion:Evaluation of the Questionnaire to Explore Human Factors and their Technical Potential indicates it exhibits good internal consistency and acceptable psychometric properties. The scale was revised and is recommended to explore aspects of technical prosthesis development.Clinical relevanceOur results show that the revised Questionnaire to Explore Human Factors and their Technical Potential may serve as a reliable and valid means, when designing prostheses, both during development and clinical evaluations and fittings, to assess the technical potential of lower limb prostheses directly according to the needs of users with lower-limb amputations.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-08-03T09:34:14Z
      DOI: 10.1177/0309364620931991
       
  • Celebrating 50 years of the International Society for Prosthetics and
           Orthotics: Past, present, and future
    • Authors: Sarah Anderson, Cleveland T Barnett, David F Rusaw
      First page: 365
      Abstract: Prosthetics and Orthotics International, Ahead of Print.

      Citation: Prosthetics and Orthotics International
      PubDate: 2020-11-07T07:09:10Z
      DOI: 10.1177/0309364620969225
       
  • Prosthetists and orthotists: An evolution from mechanic to clinician
    • Authors: David Boone
      First page: 368
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Fifty years ago, the International Society for Prosthetics and Orthotics was founded in recognition that this unique niche in rehabilitation would benefit from multidisciplinary interactions between specialists in engineering, therapy, and medicine.Since then, field evolved from having a craft orientation toward a technology and clinical specialty. This anniversary provides an opportunity to look back on advances in prosthetics and orthotics, and the clear impact they have had on changing the skills needed by the prosthetist/orthotist as new technology and techniques have emerged. The balance has clearly shifted from mechanical skills to clinical care. The training and skills of the prosthetist/orthotist remain unique and valued in the rehabilitation team, and the primary motivation remains the same as it has been since the creation of the International Society for Prosthetics and Orthotics: the application of external devices where they are suitable to address the many varied needs of persons with disability. This historical perspective puts into context why and how the profession has changed, while also reinforcing that it is the goals set for restoring patient functions that best defines what it is to be a prosthetist/orthotist, not the means we use.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-11-07T07:06:50Z
      DOI: 10.1177/0309364620968643
       
  • Physical sciences
    • Authors: Phillip M Stevens
      First page: 373
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      In the original edition of Prosthetics and Orthotics International, Dr Sidney Fishman identified what he anticipated as foundational educational needs for the emerging field of clinical prosthetics and orthotics. Within the broader construct of the physical sciences, this included mathematics, physics, chemistry, biomechanics, and material sciences. The clinical application of these disciplines to expanding the collective understanding within the field is described, including the biomechanics of able-bodied and prosthetic gait, the material science of socket construction, the physics of suspension and load distribution, and the engineering of prosthetic components to mimic human biomechanics. Additional applications of the physical sciences to upper limb prosthetics and lower limb orthotics are also described. In contemplating the continued growth and maturation of the field in the years to come, mechatronics and statistics are suggested as future areas where clinical proficiency will be required.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-11-07T07:09:30Z
      DOI: 10.1177/0309364620969994
       
  • Lower limb prosthetic interfaces: Clinical and technological advancement
           and potential future direction
    • Authors: Reza Safari
      First page: 384
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      The human–prosthesis interface is one of the most complicated challenges facing the field of prosthetics, despite substantive investments in research and development by researchers and clinicians around the world. The journal of the International Society for Prosthetics and Orthotics, Prosthetics and Orthotics International, has contributed substantively to the growing body of knowledge on this topic. In celebrating the 50th anniversary of the International Society for Prosthetics and Orthotics, this narrative review aims to explore how human–prosthesis interfaces have changed over the last five decades; how research has contributed to an understanding of interface mechanics; how clinical practice has been informed as a result; and what might be potential future directions. Studies reporting on comparison, design, manufacturing and evaluation of lower limb prosthetic sockets, and osseointegration were considered. This review demonstrates that, over the last 50 years, clinical research has improved our understanding of socket designs and their effects; however, high-quality research is still needed. In particular, there have been advances in the development of volume and thermal control mechanisms with a few designs having the potential for clinical application. Similarly, advances in sensing technology, soft tissue quantification techniques, computing technology, and additive manufacturing are moving towards enabling automated, data-driven manufacturing of sockets. In people who are unable to use a prosthetic socket, osseointegration provides a functional solution not available 50 years ago. Furthermore, osseointegration has the potential to facilitate neuromuscular integration. Despite these advances, further improvement in mechanical features of implants, and infection control and prevention are needed.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-11-09T06:18:44Z
      DOI: 10.1177/0309364620969226
       
  • Reflections and future directions for psychological science in Prosthetics
           and Orthotics International
    • Authors: Deirdre Desmond, Pamela Gallagher
      First page: 402
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      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.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-11-09T06:15:24Z
      DOI: 10.1177/0309364620967780
       
  • A toolkit for prosthetists and orthotists to facilitate progress in
           professional communication over the next 50 years
    • Authors: Jaap J Van Netten, Gustav Jarl, Klaas Postema, Anita E Williams
      First page: 408
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      Background:In this celebratory issue of Prosthetics and Orthotics International, we review professional communication skills in the field of prosthetics and orthotics.Objective:We aim to reflect on communication skills in the past 50 years, to discuss developments in the coming 50 years, and to create a toolkit and research agenda to facilitate progress in professional communication in the next 50 years.Results:Despite being a key area in prosthetics and orthotics training programmes, we found no studies on professional communication with an experimental design published in Prosthetics and Orthotics International. As an alternative, we provide clinical reflections on the changes in professional communication in the past 50 years, and we discuss questionnaire-based and qualitative studies that provide evidence for the importance of communication in pedorthic footwear provision. In the coming 50 years, professional communication in the field of prosthetics and orthotics may be impacted by aging populations, global mobility, information technology, technological advances and emphasis on prevention. We discuss each of these topics. To facilitate progress in professional communication, we have created a toolkit with resources for prosthetics and orthotics professionals, prosthetics and orthotics students and other interested professionals.Conclusions:We hope this toolkit will inspire others to use, extend and implement it in their daily practice. As a research agenda, we strongly recommend undertaking research on interventions to improve professional communication and to study its effect on clinically meaningful outcomes.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-10-13T06:51:18Z
      DOI: 10.1177/0309364620962325
       
  • Education in prosthetic and orthotic training: Looking back 50 years and
           moving forward
    • Authors: Susan Ewers Spaulding, Sisary Kheng, Susan Kapp, Carson Harte
      First page: 416
      Abstract: Prosthetics and Orthotics International, Ahead of Print.
      There is a long history of prosthetic and orthotic services helping to mitigate the impact of physical impairment by restoring function, and enabling and equipping the user. The training of health professionals who design, fit, and maintain prosthetic and orthotic devices has evolved over the centuries, reflecting an increase in knowledge, technology, understanding, and social attitudes in each era. Improvements in pedagogical thinking and biomechanical understanding, as well as the advent of new integrated technologies, have driven the profession over the past 50 years to modernize, evolve training and service delivery models in line with new attitudes toward clients, and search for new ways to improve users’ quality of life. In this narrative review, the authors examined the evolution of prosthetic and orthotic education, the impact of changing educational techniques and technologies, and the impact of the International Society for Prosthetics and Orthotics in that process. Through conversations with experts and review of peer-reviewed literature, accreditation documents, and the International Society for Prosthetics and Orthotics records and databases, the authors identified three areas of change in prosthetics and orthotics education over the past 50 years: (1) prosthetic/orthotic curriculum content, (2) pedagogy and course delivery, and (3) internships/residencies. This narrative review is a snapshot of a growing profession and we can only speculate where the next 50 years will lead us as we strive to serve patients, ever placing their needs and aspirations at the center of this professional service.
      Citation: Prosthetics and Orthotics International
      PubDate: 2020-11-09T06:12:44Z
      DOI: 10.1177/0309364620968644
       
 
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