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Chami S, Babaee T, Jalali M, Saeedi H, Kamali M. Lived experience of children and adolescents with lower-limb loss who used a prosthesis: A qualitative study. Prosthet Orthot Int 2024; 48:320-328. [PMID: 38018993 DOI: 10.1097/pxr.0000000000000308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 09/28/2023] [Indexed: 11/30/2023]
Abstract
PURPOSE Children's and adolescents' level of activity, the type of activity, and other features are special to them and can result in unique experiences with lower-limb prosthesis. The specific objective of this study was to explore the lived experience of children and adolescents with lower-limb loss (LLL) who used a prosthesis. METHODS We used a descriptive qualitative study design and in-depth, semistructured, face-to-face interviews. Accordingly, 35 participants, including children and adolescents with LLL who used a prosthesis, their parents, and prosthetists, were interviewed. The collected data were analyzed thematically. RESULTS One hundred sixty-eight codes about the experiences of children, parent(s), and prosthetists were extracted from the transcripts and categorized into 32 subthemes. Finally, 7 broad themes including suitability, provoke reactions, intrinsic nature, infrastructures, the school, availability, and parenting role were extracted. CONCLUSION The experiences of children and adolescents with lower-limb prosthesis are specific as each may face unique challenges and deal with different difficulties. In this study that has been conducted in a developing country, the main challenges faced by children using lower-limb prosthesis and their parents are the prosthetic components, social reactions, long distance, and costs of services. Moreover, designing a more natural prosthesis and gait training for children with LLL were the most important issues faced by prosthetists. However, close relationships with friends and family members, and children's amazing ability to adapt can aid in facilitating prosthetic management.
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Affiliation(s)
- Sara Chami
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
- Auckland Bioengineering Institute, The University of Auckland, Auckland, Auckland, New Zealand
| | - Taher Babaee
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Jalali
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hassan Saeedi
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Kamali
- Rehabilitation Research Center, Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Devin KM, Tang J, Hamilton AR, Moser D, Jiang L. Assessment of 3D printed mechanical metamaterials for prosthetic liners. Proc Inst Mech Eng H 2024; 238:348-357. [PMID: 38279687 PMCID: PMC10941651 DOI: 10.1177/09544119231225529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/21/2023] [Indexed: 01/28/2024]
Abstract
This study focuses on novel design and evaluation of Elastic 50A (EL50) mechanical metamaterials with open-cell patterns for its potential application to lower limb residuum/socket interfaces, specifically that of a transtibial (TT) amputee. Mechanical characteristics, that is, effective Young's modulus (E), was tuned by altering metamaterial porosity, which was experimentally verified. Specifically, pore radius of the unit cell was varied to achieve a range of E-values (0.05-1.71 MPa) for these 3D printed metamaterials. Finite Element Analysis (FEA) was conducted to evaluate pressure distribution across key load-bearing anatomical sites of a TT residuum. Using designed metamaterials for homogeneous liners, pressure profiles were studied and compared with a silicone liner case. Additionally, a custom metamaterial liner was designed by assigning appropriate metamaterials to four load-sensitive and tolerant anatomical sites of the TT residuum. The results suggest that lowest pressure variation (PV), as a measure of pressure distribution levels and potential comfort for amputees, was achieved by the custom metamaterial liner compared to any of the homogeneous liners included in this study. It is envisaged that this work may aid future design and development of custom liners using now commonly available 3D printing technologies and available elastomer materials to maximise comfort, tissue safety and overall rehabilitation outcomes for lower limb amputees.
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Affiliation(s)
- Kirstie M Devin
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - Jinghua Tang
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - Andrew R Hamilton
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - David Moser
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - Liudi Jiang
- School of Engineering, Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
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Valero JM, Satústegui PJ, Salavera CE, Sanz López V, Laborda AA, Hidalgo C. A systematic review on cross-cultural validations and psychometric solidity of the orthotics and prosthetics user survey. Prosthet Orthot Int 2024; 48:83-88. [PMID: 37639569 DOI: 10.1097/pxr.0000000000000268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 06/09/2023] [Indexed: 08/31/2023]
Abstract
Research is essential to reflect patients' satisfaction with their devices in the field of Prosthetics and Orthotics, record their performance and health-related quality of life. This requires culturally adapted questionnaires for each country. Periodic assessment of validity and test fit are essential elements for the long-term utility and effectiveness of psychometric tests. This article reviews the psychometric properties of the Orthotics and Prosthetics Users Survey (OPUS). The purpose, in addition to its adaptation to the Spanish-speaking population, involves a review/update of content, statistical analyses, and validity studies, until a larger number of studies are conducted. Study design: a Systematic review. A systematic literature search was carried out in specialized search engines: Alcorze (University of Zaragoza), MEDLINE (PubMed), and EMBASE of original articles published since 2000. Eleven items belonging to the OPUS were obtained, according to the language of the country where they were validated, and promising psychometric properties were confirmed (reflecting reliability values between 0.62 and 0.95; Cronbach's α scores between 0.73 and 0.98) with sample sizes between 10 and 321. The study concluded by stating that the OPUS was validated in different languages, reporting good psychometric robustness so far. Further deployment, refinement, and validation of this survey by country is warranted in view of its promising use.
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Affiliation(s)
- Julián M Valero
- PhD Candidate in Medicine, University of Zaragoza, Miguel Servet University Hospital, Professor YMCA, Zaragoza, Spain
| | | | - Carlos E Salavera
- Faculty of Education, Department of Developmental and Educational Psychology, University of Zaragoza, Zaragoza, Spain
| | - Vanessa Sanz López
- PhD Student in Health Sciences, University of Zaragoza. Professor Rey Ardid, Zaragoza, Spain
| | - Ana A Laborda
- PhD Student in Health Sciences, University of Zaragoza. Professor Rey Ardid, Zaragoza, Spain
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Küçük Öztürk G, Şimşek N. The Effect of Motivational Interview-Based Counseling in Individuals With Amputation: A Randomized Controlled Trial in Turkey. Rehabil Nurs 2023; 48:160-169. [PMID: 37669325 DOI: 10.1097/rnj.0000000000000428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
AIM This randomized controlled experimental study determined the effect of motivational interview-based counseling on the coping strategies and perceived social support levels in individuals with amputations due to chronic disease. DESIGN A randomized controlled trial was conducted. METHOD The study was completed in the orthopedics and traumatology department with 48 patients. Data were collected using a descriptive information form, the Coping Strategies Scale, and the Multidimensional Scale of Perceived Social Support. Independent samples t test, paired t test, and chi-square test were used for data analysis. RESULTS The scores of the Coping Strategies Scale and the Perceived Social Support Scale of individuals in the intervention group significantly increased in the posttest after motivational interview-based counseling compared to their pretest scores. It was determined that the Coping Strategies Scale and Perceived Social Support Scale subdimension scores and total mean scores for individuals in the intervention group in the posttest were higher than the mean scores for individuals in the control group. The difference between the groups was significant. CONCLUSION The motivational interview-based counseling given to individuals with amputation because of chronic disease increased their coping strategies and perceived social support levels.
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Affiliation(s)
- Gülhan Küçük Öztürk
- Department of Psychiatric Nursing, Semra and Vefa Küçük Faculty of Health Sciences, Nevşehir Hacı Bektaş Veli University, Nevşehir, Turkey
| | - Nuray Şimşek
- Department of Psychiatric Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey
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Olsen J, Turner S, Chadwell A, Dickinson A, Ostler C, Armitage L, McGregor AH, Dupan S, Day S. The Impact of Limited Prosthetic Socket Documentation: A Researcher Perspective. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:853414. [PMID: 36189046 PMCID: PMC9397974 DOI: 10.3389/fresc.2022.853414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/11/2022] [Indexed: 11/17/2022]
Abstract
The majority of limb prostheses are socket mounted. For these devices, the socket is essential for adequate prosthetic suspension, comfort, and control. The socket is unique among prosthetic components as it is not usually mass-produced and must instead be custom-made for individual residual limbs by a prosthetist. The knowledge of what constitutes "good" socket fit is gained by expert prosthetists and technicians over years of experience, and rarely documented. The reliance on tacit knowledge makes it difficult to standardize the criteria for a well-fitting socket, leading to difficulties understanding the impact of socket fit. Despite its importance, the workflow for socket fitting is often overlooked in literature. Due to the customized nature of sockets, if information is provided in literature, generally only the type of socket and suspension mechanism is noted, with information regarding the fitting and manufacturing processes omitted. In this article, the concerns, issues and consequences arising from lack of upper and lower limb socket documentation are discussed from a researcher perspective, supported by healthcare professionals and socket fabrication specialists. Key changes are proposed to the way socket manufacturing and evaluation are documented to assist future research.
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Affiliation(s)
- Jennifer Olsen
- Intelligent Sensing Laboratory, School of Engineering, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Shruti Turner
- Sackler MSk Laboratory, Department of Surgery and Cancer, Sir Michael Uren Hub, Imperial College London, London, United Kingdom
| | - Alix Chadwell
- Intelligent Sensing Laboratory, School of Engineering, Newcastle University, Newcastle upon Tyne, United Kingdom
- Human Movement and Rehabilitation Research Group, University of Salford, Salford, United Kingdom
| | - Alex Dickinson
- Faculty of Engineering and Physical Science, University of Southampton, Southampton, United Kingdom
| | - Chantel Ostler
- Portsmouth Enablement Centre, Portsmouth Hospital University National Health Service (NHS) Trust, St Marys Hospital, Portsmouth, United Kingdom
| | - Lucy Armitage
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW, Australia
| | - Alison H. McGregor
- Sackler MSk Laboratory, Department of Surgery and Cancer, Sir Michael Uren Hub, Imperial College London, London, United Kingdom
| | - Sigrid Dupan
- Edinburgh Neuroprosthetics Laboratory, School of Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Sarah Day
- Department of Biomedical Engineering, University of Strathclyde, Glasgow, United Kingdom
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Turner S, Belsi A, McGregor AH. Issues Faced by Prosthetists and Physiotherapists During Lower-Limb Prosthetic Rehabilitation: A Thematic Analysis. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:795021. [PMID: 36188791 PMCID: PMC9397966 DOI: 10.3389/fresc.2021.795021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022]
Abstract
Successful prosthetic rehabilitation is essential to improve the physical and mental outcomes of people with lower-limb amputation. Evaluation of prosthetic services from a prosthesis user perspective have been published and commissioned by the national bodies, however, the perspectives of clinicians working with service users during rehabilitation have not to date been sought. We sought to determine factors impacting lower-limb prosthetic rehabilitation from a clinician's perspective to inform studies focusing on prosthetic and socket design and fitting. Six clinician (2 prosthetists, 4 physiotherapists) interviewees were self-selected from a survey exploring issues and frustrations during lower-limb prosthetic rehabilitation. Semi-structured interviews explored the impactors on and frustrations with rehabilitation and the prosthetic socket. A thematic analysis was subsequently conducted to identify themes in the responses. Five themes were identified: Service Disparity, Body Impactors, Consequences of Ill-Fit, Prosthesis Irritants, and Limitations of Practice. Each theme, though distinct, relates to the others either as a cause or consequence and should be viewed as such. Addressing the themes will have benefits beyond the issues addressed but also expand into the other themes. This study provides an insight into the clinician perspectives on lower-limb prosthetic rehabilitation, which has not been formally documented to date.
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Affiliation(s)
- Shruti Turner
- Centre for Blast Injury Studies, Imperial College London, London, United Kingdom
- Sackler Musculoskeletal Laboratory, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
- *Correspondence: Shruti Turner
| | - Athina Belsi
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Alison H. McGregor
- Centre for Blast Injury Studies, Imperial College London, London, United Kingdom
- Sackler Musculoskeletal Laboratory, Department of Surgery and Cancer, Imperial College London, London, United Kingdom
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