scholarly journals Quality benchmark for trans-tibial prostheses in low-income countries

2005 ◽  
Vol 29 (1) ◽  
pp. 53-58 ◽  
Author(s):  
J. Steen Jensen ◽  
Rune Nilsen ◽  
John Zeffer
Keyword(s):  
Patient Satisfaction ◽  
Patient Compliance ◽  
Low Income ◽  
Historical Data ◽  
Field Testing ◽  
International Committee ◽  
Low Income Countries ◽  
Red Cross ◽  
Assembly System ◽  
Technical Performance

Based on four series of patients (N = 141) participating in clinical field testing of prosthetic feet and all provided with trans-tibial prostheses in accordance with the polypropylene component and assembly system developed by the International Committee of the Red Cross (ICRC) a series of quality benchmarks was developed and tested against historical data. The patient compliance demands were set for walking > 1km at 90 ± 10%, non-users at 5 ± 5%, discomfort at 10 ± 10%, pain at 10 ± 10%, and patient satisfaction at 90 ± 10%. The technical performance demands were set for good socket fit at 60 ± 10%, misalignment at 15 ± 10%, insufficient craftsmanship at 10 ± 10%, and requirements for socket change at 10 ± 10%.

scholarly journals Quality of Polypropylene Sockets for Trans-Tibial Prostheses in Low-Income Countries

2006 ◽  
Vol 30 (1) ◽  
pp. 45-59 ◽  
Author(s):  
J. Steen Jensen ◽  
Wilfried Raab ◽  
John Fisk ◽  
Christian Hartz ◽  
Ariel Saldana ◽  
...  
Keyword(s):  
Low Income ◽  
Field Testing ◽  
Quality Measures ◽  
International Committee ◽  
Low Income Countries ◽  
Red Cross ◽  
Assembly System ◽  
Technical Performance

Based on six series of patients ( n = 198) participating in clinical field testing of prosthetic feet and all provided with trans-tibial prostheses in accordance with the polypropylene component and assembly system developed by the International Committee of the Red Cross (ICRC) follow-up studies by teams consisting of an orthopaedic surgeon and a Category-I prosthetist-orthotist were conducted. A series of quality measures were tested against previously published quality benchmarks. The polypropylene system gives a consistent product and allows for increased demands on quality benchmarks. The acceptance of discomfort and pain could be reduced to 5 ± 5%. The technical performance demands were reduced for misalignment to 10 ± 5%. In general for all quality measures the range could be reduced to ±5%. These new demands reflect what an orthopaedic workshop outside of a teaching system should be able to attain.

Clinical field testing of trans-femoral prosthetic technologies: Resin-wood and ICRC-polypropylene

2004 ◽  
Vol 28 (2) ◽  
pp. 141-151 ◽  
Author(s):  
J. S. Jensen ◽  
W. Raab
Keyword(s):  
Patient Satisfaction ◽  
Developing Country ◽  
Patient Compliance ◽  
Field Testing ◽  
Controlled Environment ◽  
Training Centre ◽  
Technical Result ◽  
Wood Resin ◽  
Conventional Design

The aim of this study was to evaluate the use of 2 different trans-femoral prosthetic systems, a conventional wood-resin design and an ICRC polypropylene design, in a developing country when implemented by teachers and their associates at an ISPO Caegory II recognised training establishment.The study was conducted at the Tanzanian Training Centre for Orthopaedic Technologists (TATCOT). Amputees were selected from a cohort of younger amputees, mostly with traumatic amputations, 27 were provided with the conventional design of prosthesis and 35 with the ICRC design.The outcome was evaluated clinically and technically after a median of 20 months (conventional) and 15 months (ICRC) respectively. For all prostheses provided the craftsmanship was considered acceptable in 71%, and patient satisfaction was assessed as 92%, patient compliance as 98%. Failures requiring a major intervention represented 32%.Both systems provided in this controlled environment were considered to give an acceptable clinical and technical result.

scholarly journals Clinical Field Testing of Vulcanized Jaipur Rubber Feet for Trans-Tibial Amputees in Low-Income Countries

2007 ◽  
Vol 31 (1) ◽  
pp. 105-115 ◽  
Author(s):  
J. Steen Jensen ◽  
Wilfried Raab
Keyword(s):  
Low Income ◽  
Field Testing ◽  
Low Income Countries

The publishers would like to apologise for an error that occured in the order of figures in the above mentioned paper in Volume 30, Issue 3 of Prosthetics and Orthotics International. The paper should appear as follows.

Clinical Field Testing of Polyurethane Feet for Trans-Tibial Amputees in Tropical Low-Income Countries

2006 ◽  
Vol 30 (2) ◽  
pp. 182-194 ◽  
Author(s):  
J. Steen Jensen ◽  
R. Nilsen ◽  
N. H. Thanh ◽  
A. Saldana ◽  
C. Hartz
Keyword(s):  
Failure Rate ◽  
Low Income ◽  
Developing World ◽  
Compliance Rate ◽  
Field Testing ◽  
Low Income Countries ◽  
Controlled Study ◽  
Tropical Areas ◽  
Prospective Controlled Study ◽  
Better Than

In a prospective controlled study, 172 polyurethane feet of different designs were fitted to 155 amputees with trans-tibial prostheses. These were followed in respect of their durability. The amputee compliance was in general good, and 87% were satisfied with their device. After 18 months the failure rate of 20% with the CIREC spring-blade foot was significantly better than the others, but poorer craftsmanship, higher complaint rate and lower compliance rate cast some doubt on the results. The results with the conventional SACH foot constructions with polyurethane as filling and covering materials were so poor after 18 months that their use cannot be recommended in tropical areas of the developing world.

scholarly journals Clinical Field Testing of Vulcanized Jaipur Rubber Feet for Trans-Tibial Amputees in Low-Income Countries

2006 ◽  
Vol 30 (3) ◽  
pp. 225-236 ◽  
Author(s):  
J. Steen Jensen ◽  
Wilfried Raab
Keyword(s):  
Low Income ◽  
Developing World ◽  
Field Testing ◽  
Low Income Countries ◽  
Prosthetic Foot ◽  
Tropical Areas ◽  
User Compliance

The purpose of this study was to check out the performance and durability of vulcanized Jaipur rubber feet in tropical areas of the developing world. Forty-one MUKTI and 40 NISHA feet were followed for 16 (8 – 17) months. The user compliance was high and nearly all were satisfied. Failure of the prosthetic foot with the need for exchange at the end of the study amounted to 27% (22/81), which is equivalent to a mixed series of rubber feet previously reported (Jensen et al. 2006b ). Failures were mostly related to skin fracture and gliding between sponge rubber layers of the heel block.

scholarly journals Clinical Field Testing of Vulcanized Rubber Feet for Trans-Tibial Amputees in Tropical Low-Income Countries

2006 ◽  
Vol 30 (2) ◽  
pp. 195-212 ◽  
Author(s):  
J. Steen Jensen ◽  
R. Nilsen ◽  
J. Zeffer ◽  
J. Fisk ◽  
C. Hartz
Keyword(s):  
Failure Rate ◽  
Low Income ◽  
Field Testing ◽  
Low Income Countries ◽  
Controlled Study ◽  
Sandwich Construction ◽  
Vulcanized Rubber ◽  
Prospective Controlled Study ◽  
Better Than

In a prospective, controlled study, 186 prosthetic rubber feet of different designs were fitted to amputees with trans-tibial prostheses. There were 158 amputees available for follow-up. The amputee compliance was good and 89% were satisfied with their device. After 18 months of use one VI-Solid rubber foot from VVAF in Cambodia had failed, as compared to 11% failures with the same foot with a heel cavity, 3% with the EB-1 sandwich construction from POF in Vietnam, all performing significantly better than the 62% encountered with the vulcanized rubber foot from ICRC in Cambodia; the latter representing half of the feet failing in amputees walking bare-footed. Nearly all failures were located at the foot-sole or the keel. The failure rate was 20% for the HI-Cambodia foot after 12 months. After 24 months of use, still only one VI-Solid rubber foot had failed and this foot design was found superior to the others in regard of durability.

Comparison of the Otto Bock solid ankle cushion heel foot with wooden keel to the low-cost CR-Equipements™solid ankle cushion heel foot with polypropylene keel: A randomized prospective double-blind crossover study assessing patient satisfaction and energy expenditure

2016 ◽  
Vol 41 (3) ◽  
pp. 258-265 ◽  
Author(s):  
Alain Lacraz ◽  
Stéphane Armand ◽  
Katia Turcot ◽  
Gorki Carmona ◽  
Richard Stern ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Energy Expenditure ◽  
Crossover Study ◽  
Low Cost ◽  
International Committee ◽  
Red Cross ◽  
Double Blind ◽  
Prosthetic Foot ◽  
Blind Crossover Study ◽  
Double Blind Crossover Study

Background:The International Committee of the Red Cross supports a worldwide program of prosthetic fitting and rehabilitation. In this context, a prosthetic foot was developed and widely distributed in least developed countries.Study design:Prospective, randomized, double-blind, controlled study.Objective:To compare patient satisfaction and energy expenditure during ambulation between a low-cost prosthetic foot designed with a polypropylene keel (CR-Equipements™solid ankle cushion heel, International Committee of the Red Cross) to a well-recognized solid ankle cushion heel foot with a wooden keel (solid ankle cushion heel foot, Otto Bock).Methods:A total of 15 participants with unilateral transtibial amputation were evaluated using the two prosthetic feet in a randomized prospective double-blind crossover study. Main outcomes were patient satisfaction questionnaires (Satisfaction with Prosthesis Questionnaire and prosthetic foot satisfaction) and energy expenditure (oxygen consumption—mL/kg/min, oxygen cost—mL/kg/m, and heart rate—bpm).Results:There were no significant differences between the two prosthetic feet for satisfaction and energy expenditure.Conclusion:The low-cost solid ankle cushion heel foot with polypropylene keel provides comparable satisfaction and similar energy expenditure as the solid ankle cushion heel foot with wooden keel.Clinical relevanceThe results of this study support the application and widespread use of the CR-Equipements™solid ankle cushion heel foot. From a cost-effectiveness standpoint, patients are well satisfied and exhibit similar outcomes at a substantially lower cost.

scholarly journals The Impact of Recycled Neonatal Incubators in Nigeria: A 6-Year Follow-Up Study

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Hippolite Onyejiaka Amadi ◽  
Jonathan C. Azubuike ◽  
Uriah S. Etawo ◽  
Uduak R. Offiong ◽  
Chinyere Ezeaka ◽  
...  
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Live Births ◽  
Technical Performance ◽  
Follow Up Study ◽  
Newborn Mortality ◽  
Retrospective Assessment ◽  
Case Files ◽  
The Impact

Nigeria has a record of high newborn mortality as an estimated 778 babies die daily, accounting for a ratio of 48 deaths per 1000 live births. The aim of this paper was to show how a deteriorating neonatal delivery system in Nigeria may have, in part, been improved by the application of a novel recycled incubator technique (RIT). Retrospective assessment of clinical, technical, and human factors in 15 Nigerian neonatal centres was carried out to investigate how the application of RIT impacted these factors. Pre-RIT and post-RIT neonatal mortalities were compared by studying case files. Effect on neonatal nursing was studied through questionnaires that were completed by 79 nurses from 9 centres across the country. Technical performance was assessed based on 10-indices scores from clinicians and nurses. The results showed an increase in neonatal survival, nursing enthusiasm, and practice confidence. Appropriately recycled incubators are good substitutes to the less affordable modern incubators in boosting neonatal practice outcome in low-income countries.

Three Cases of Joubert Syndrome in a Consanguineous Syrian Family and a Interesting Case of Multinational Collaboration

2021 ◽  
Author(s):  
Davor Petrović ◽  
Vida Čulić ◽  
Zofia Swinderek-Alsayed
Keyword(s):  
Low Income ◽  
Autosomal Recessive ◽  
Autosomal Recessive Disorder ◽  
Joubert Syndrome ◽  
Interesting Case ◽  
Low Income Countries ◽  
Ocular Motor ◽  
Quality Health Care ◽  
Quality Health ◽  
Motor Apraxia

AbstractJoubert syndrome (JS) is a rare congenital, autosomal recessive disorder characterized by a distinctive brain malformation, developmental delay, ocular motor apraxia, breathing abnormalities, and high clinical and genetic heterogeneity. We are reporting three siblings with JS from consanguineous parents in Syria. Two of them had the same homozygous c.2172delA (p.Trp725Glyfs*) AHI1 mutation and the third was diagnosed prenatally with magnetic resonance imaging. This pathogenic variant is very rare and described in only a few cases in the literature. Multinational collaboration could be of benefit for the patients from undeveloped, low-income countries that have a low-quality health care system, especially for the diagnosis of rare diseases.

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