Download (2013) The effect of prefabricated wrist- hand orthoses on performing activities of daily living. I PDF

Title(2013) The effect of prefabricated wrist- hand orthoses on performing activities of daily living. I
LanguageEnglish
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Total Pages278
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FREE PAPERS

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Mon, Feb 4 / 12:00 - 13.15
Prosthetics : Lower Limb - 1 / Room 1.03 Presenter Name Abstract No.

Predictors of prosthetic use in individuals with lower limb amputation
at 6 and 12 months after discharge from rehabilitation.

C. Roffman 13

Biomechanical advantages of a new microprocessor-controlled
prosthetic knee joint

M. Bellmann 47

Fall Prevention Training Program for Persons with Lower Extremity
Amputations: Early Results

K. Kaufman 52

C-leg vs. mechanical knee: Impact on functional outcomes in K2
transfemoral dysvascular amputees

A. Jayaraman 61

Socket/Liner Interface Volume and Vacuum Pressure Decay in
Persons with Transfemoral Amputations

S. Fatone 157

Orthotics: Lower Limb - 1 / Room 1.05

Do orthotic walkers affect knee and hip function during gait? J. Richards 6

A Microprocessor Stance and Swing Control Orthosis improves the
walking ability of traditional KAFO users

A. Kannenberg 30

Immediate biomechanical effects of a new microprocessor controlled
stance and swing phase KAFO system

T. Schmalz 76

Timing of ankle-foot orthoses after stroke: first Results of a
randomized longitudinal study

C. Nikamp 101

Mediolateral Foot Placement During Post-Stroke Ambulation With and
Without an Ankle-Foot Orthosis

A. Zissimopoulos 159

Evidence Based Practices - 1 / Room 1.06

Large-scale administration of shortened versions of the Prosthesis
Evaluation Questionnaire - Mobility Subscale (PEQ-MS) and Activities
Specific Balance Confidence Scale (ABC) in persons with lower limb
loss

B. Hafner 223

Effective factors influencing Evidence Based Practice in Prosthetics
and Orthotics

S. Gautam 273

Guidance on the management of post operative residuum oedema in
lower limb amputees.

M. Cole 303

The Amputee Mobility Predictor for People with Bilateral Lower-limb
Loss.

R. Gailey 352

Expectations of Rehabilitation following lower limb amputation: A
qualitative analysis

C. Ostler 234

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Date / Time: Tuesday, Feb 5 / 16:15 - 17:30
Session Name and Room: Prosthetics : Lower Limb - 8 Room 1.03
Abstract Title: Documenting The Rehabilitation Process Of Patients With Lower Limb Prosthesis
Abstract number: 509
Authors: J. Block, D. Heitzmann, S. Wolf
Presenter: D. Heitzmann

Introduction
Patients following an amputation usually try to get back to walking. Different professions are involved in this
process. Several tools are available to monitor the rehab process. But not all tests are practical for every patient
at every stage of the rehab process. In this study the rehab progress was monitored and patients passed different
tests, which were selected according to their current capabilities.

Methods
7 subjects with lower limp amputations were measured in this ongoing study (1 TT; 3 TF; 3 HipEx). Patients
spent min. two weeks near the hospital. In parallel their prosthesis was fitted, different prosthetic components
tested, adjusted and they attend gait education and/or physical therapy. Patients were asked to write a diary,
documenting their perception and activities. The LCI was asked at the beginning and end of the rehab. Depending
on their abilities they performed the 2min-walk-test, level walking, stairs, slopes and outside terrain with video
analysis. Kinematics and kinetics (when walking without aids) was captured via 3D-gait-analysis-system. Static
adjustment was documented with a LASAR posture device.

Results
Available tests can be grouped by min. required patient capabilities. Time distance parameters and left/right
symmetry are indices showing how the user gets familiar to prosthetic walking. A diary illustrates the learning
process from the patient side and is a helpful feedback for the professionals.

Discussion
Measurements at the beginning and end of the treatment are sufficient to document an improvement, but subjects
are often unable to perform the same tests at early and later stage in training.

Conclusions
Performin standardized tests at defined points in the rehab helps to document the process. It’s difficult to detect
effects of single interventions. The outcome is affected by the socket design, prosthetic parts, adjustments as well
as physiological and mental capabilities.

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Date / Time: Tuesday, Feb 5 / 16:15 - 17:30
Session Name and Room: Prosthetics : Lower Limb - 8 Room 1.03
Abstract Title: Malawian Prosthetic And Orthotic Users’ Performance And Satisfaction With Their Lower
Limb Assistive Device
Abstract number: 115
Authors: L. Magnusson, G. Ahlström, N. Ramstrand, E. Fransson
Presenter: L. Magnusson

Introduction
This study aimed to investigate patients’ performance and satisfaction with their lower limb prosthetic or orthotic
device and their satisfaction with prosthetic and orthotic service delivery in Malawi.

Method
Eighty-three patients participated in the study. Questionnaires were used to collect self- reported data.

Result
Ninety per cent of prosthetic and orthotic devices were in use. Patients were quite satisfied with their device (mean
score of 3.9 out of 5) and very satisfied with the service provided (mean score of 4.4 out of 5). The majority of
patients were able to move around the home (80%), rise from a chair (77%), walk on uneven ground (59%) and
travel by bus or car (56%). Patients had difficulties or could not walk at all on; stairs (60%) and hills (79%),Thirty-
nine percent reported pain when using the assistive device. Forty-eight percent of the devices were in use but
needed repairs and 10 % were never used or completely broken. Access to repairs and servicing were rated by
patients as most important, followed by durability of the device and follow up services. Lack of finances to pay for
transport was a common barrier to accessing the prosthetic and orthotic centre.

Discussion
Prosthetic and orthotic devices can be further improved in order to accommodate for ambulation on uneven
surfaces, hills and stairs, as well as increasing patients’ ability to walk long distances with reduced pain.

Conclusion
Patients were satisfied with the device and service received and the majority of prosthetic and orthotic patients
in this study reported increased mobility when using their assistive devices. However, patients reported pain
associated with use of the device and difficulties were experienced when walking in hills and on stairs. Costs
associated with transport to the prosthetic and orthotic facility prevented them from receiving follow-up and repair
services.

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Date / Time: Thursday, Feb 7 / 14:30 - 15:45
Session Name and Room: Rehab Medicine & Surgery - 5 Room G.06
Abstract Title: Bone Anchored Prostheses In Upper Arm Amputees: Radiologic Outcomes.
Abstract number: 178
Authors: G. Tsikandylakis, R. Brånemark, Ö. Berlin
Presenter: R. Brånemark

Introduction
Osseointegrated prostheses have been used on transhumeral amputees for the last fifteen years. This is the first
radiological report on the first 18 patients.

Methods
18 patients received 20 implants. Average age at implantation was 42 (19-69) and female/male ratio was 2/16.
The cause of amputation was either trauma (16) or tumor (2). Their x-rays were qualitatively evaluated by one
observer. An anteroposterior and a lateral view of the implant were examined for structural changes such as near
bone resorption and cancellization at bone/thread interface, cortical thinning, distal bone resorption and proximal
trabecular buttressing.

Results
Of the 18 patients treated, 2 had implant failures. 2 implants failed in the same patient and one implant failed in
another patient and was revised. Of the remaining 17 implants (in 17 patients) 2 are followed elsewhere and one is
lost to follow up. 13/14 patients are using their upper limb prosthesis. Near bone resorption was observed in 7/20
implants (35%) mainly at the distal third of the fixture. Cancellization also occurred in 7/20 implants but was more
common at the middle third of the fixture. Cortical thinning appeared in 5/20 implants (25%) mainly at the distal
third. Distal bone resorption was less common (3/20 implants, 15%) and limited without exposing the fixture. The
most common radiological change was proximal buttressing (10/20 implants, 50%).

Discussion
This study reports on up to 15 years radiological follow up on transhumeral amputees with osseointegrated
prostheses. Late implant loosening has not been observed clinically or radiologically. On the other hand 3 implants
loosened early within two years without any signs of bone resorption on the x-rays indicating the difficulty to
correlate between clinic and radiology regarding early loosening.

Conclusion
The study supports that bone anchored protsheses in upper arm amputees work satisfactory with few implant
failures.

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