scholarly journals 298 Review of Rapid Implementation of Virtual Hand Therapy Clinics During COVID-19

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
C Timon ◽  
B O'Ceallaigh ◽  
E Siney ◽  
N McInerney
Keyword(s):  
Patient Satisfaction ◽  
Upper Limb ◽  
Assessment Tool ◽  
Environmental Benefits ◽  
University Hospital ◽  
Trauma Patients ◽  
Hand Therapy ◽  
Social Distancing ◽  
Virtual Hand ◽  
Limb Injuries

Abstract Aim The COVID-19 pandemic led to the introduction of movement restrictions and the concept of social distancing in Ireland, beginning suddenly on March 12th 2020 (1). Following this, virtual consultation via video-call have been identified and integrated as an alternative to in-person consultation. To follow national recommendations and reduce the risk of patient attendance, video consultations were rapidly integrated by the hand therapy team at University Hospital Galway. This service provides a service to 730,513 people across eight counties (2) and was utilised for a range of upper limb injuries, providing vital care to trauma patients post-operatively and to minor injury cases. We wanted to retrospectively assess the implementation of these virtual clinics and how it affected patients. Method Patients were offered virtual hand therapy appointments. Patients were sent a link with their virtual appointment time and date via email. The patient could accept or decline the option of a virtual appointment at this stage. Patient satisfaction was measured via a bespoke survey. Functional outcomes were assessed via the QuickDASH assessment tool (3). Results 44/74 ( 59.5%) of patients responded to the survey. Subjectively, the vast found the service user-friendly, convenient and beneficial. Objectively, the QuickDash score demonstrated low disability and high upper limb function return post injury. Conclusions Implementation of virtual hand therapy was integrated into practise without major issues. Patient satisfaction was very high. Virtual health services have obvious economic and environmental benefits and are essential to providing safe patient care in a social distancing society.

Development and Usability Testing of a Web-Based and Therapist-Assisted Coping Skills Program for Managing Psychosocial Problems in Individuals With Hand and Upper Limb Injuries: Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Folarin Omoniyi Babatunde ◽  
Joy MacDermid ◽  
Ruby Grewal ◽  
Luciana Macedo ◽  
Mike Szekeres
Keyword(s):  
Upper Limb ◽  
Coping Skills ◽  
Usability Testing ◽  
Psychosocial Problems ◽  
Skills Training ◽  
Hand Therapy ◽  
Web Based ◽  
Coping Skills Training ◽  
Limb Injuries ◽  
Prolonged Pain

BACKGROUND Ineffective coping has been linked to prolonged pain, distress, anxiety, and depression after a hand and upper limb injury. Evidence shows that interventions based on cognitive behavioral therapy (CBT) may be effective in improving treatment outcomes, but traditional psychological interventions are resource intensive and unrealistic in busy hand therapy practices. Developing web-based, evidence-based psychological interventions specifically for hand therapy may be feasible in clinical practice and at home with reduced training and travel costs. Hand Therapy Online Coping Skills (HOCOS) is a program developed to supplement traditional hand therapy with therapist-assisted coping skills training based on principles from CBT and the Technology Acceptance Model. OBJECTIVE This study aimed to describe the development and assess the usability of HOCOS to support hand therapists in the management of psychosocial problems. METHODS The ADDIE model (Analysis, Design, Development, Implementation, and Evaluation) of system design was applied to create HOCOS. The usability testing of HOCOS involved a 2-stage process. In the first step, heuristic testing with information and communications technology (ICT) experts was completed using two sets of heuristics: Monkman heuristics and the Health Literacy Online (HLO) checklist. The second step involved user testing with hand therapists performing a series of online and face-to-face activities, completing 12 tasks on the website using the think-aloud protocol, completing the system usability scale (SUS) questionnaire, and a semistructured feedback interview in 2 iterative cycles. Descriptive statistics and content analyses were used to organize the data. RESULTS In total, 4 ICT experts and 12 therapists completed usability testing. The heuristic evaluation revealed 15 of 35 violations on the HLO checklist and 5 of 11 violations on the Monkman heuristics. Initially, hand therapists found 5 tasks to be difficult but were able to complete all 12 tasks after the second cycle of testing. The cognitive interview findings were organized into 6 themes: task performance, navigation, design esthetics, content, functionality and features, and desire for future use. Usability issues identified were addressed in two iterative cycles. There was good agreement on all items of the SUS. Overall, therapists found that HOCOS was a detailed and helpful learning resource for therapists and patients. CONCLUSIONS We describe the development and usability testing of HOCOS; a new web-based psychosocial intervention for individuals with a hand and upper limb injuries. HOCOS targets psychosocial problems linked to prolonged pain and disability by increasing access to therapist-guided coping skills training. We actively involved target users in the development and usability evaluation of the website. The final website was modified to meet the needs and preferences of the participants.

scholarly journals Manipulation Practice for Upper-Limb Amputees Using Virtual Reality

2005 ◽  
Vol 14 (2) ◽  
pp. 175-182 ◽  
Author(s):  
Manjuladevi Kuttuva ◽  
Grigore Burdea ◽  
James Flint ◽  
William Craelius
Keyword(s):  
Virtual Reality ◽  
Upper Limb ◽  
Assessment Tool ◽  
Pressure Sensors ◽  
Training Environment ◽  
Java 3D ◽  
Virtual Objects ◽  
Virtual Hand ◽  
Hand Model ◽  
Challenging Environment

We developed a novel interface that gives upper-limb amputees a virtual hand that can manipulate objects in a challenging environment. The interface registers specific myokinetic activity of the residual limbs, and encodes the intended voluntary movements that are then actualized as virtual hand motions. The composite myokinetic interface-virtual reality (MKI-VR) system consists of an array of pressure sensors mounted in an arm sleeve, sensors of elbow- and shoulder-joint angles, a trained filter derived from the pseudoinverse of a response matrix, and a virtual hand model, programmed in Java 3D. Users can manipulate virtual objects such as balls and pegs in a 3D training environment, while their performance at various difficulty levels is scored. In preliminary tests, upper-limb amputees readily gained the ability to grasp and release virtual objects. We propose the utility of the MKI-VR system both as an assessment tool for rehabilitation engineers, and as a motivator for amputees to exercise and thereby maintain their residual motor ability.

Arterial Reconstruction after Mangled Extremity: Injury Severity Scoring Systems Are Not Predictive of Limb Salvage

Vascular ◽  
2005 ◽  
Vol 13 (2) ◽  
pp. 114-119 ◽  
Author(s):  
Mohamed Amin Elsharawy
Keyword(s):  
Prospective Study ◽  
Limb Salvage ◽  
Upper Limb ◽  
Injury Severity ◽  
University Hospital ◽  
Secondary Patency ◽  
Arterial Reconstruction ◽  
Mangled Extremity ◽  
Limb Injuries ◽  
A Prospective Study

The Vascular Unit at Suez Canal University Hospital in Egypt covers a wide area with high rates of severe injuries. This is a prospective study of mangled extremities to identify risk factors associated with limb loss in these patients. Between December 2000 and August 2003, a prospective study on all patients with arterial injuries in mangled extremities was undertaken. All patients were scored using the Mangled Extremity Severity Score (MESS) and the Mangled Extremity Severity Index (MESI). During this period, arterial reconstruction was performed in 62 patients. Primary patency, secondary patency, and limb salvage rates were 81%, 85.5%, and 93.5%, respectively. The only factor affecting limb salvage (statistical trend) was the site of trauma (upper limb 100% vs lower limb 89%; p = .08%). There was no significant effect related to the mechanism of trauma (blunt 90% vs stab 100%; p = .125), MESS (< 7, 100% vs > 7, 91%; p = .22), and MESI (< 20, 100% vs > 20, 90.5%; p = .154). Upper limb injuries were the least likely to lead to amputation. We recommend that all injuries, whatever their score, should be surgically explored before treatment decisions are made.

scholarly journals Development and Usability Testing of a Web-Based and Therapist-Assisted Coping Skills Program for Managing Psychosocial Problems in Individuals With Hand and Upper Limb Injuries: Mixed Methods Study

10.2196/17088 ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e17088
Author(s):  
Folarin Omoniyi Babatunde ◽  
Joy MacDermid ◽  
Ruby Grewal ◽  
Luciana Macedo ◽  
Mike Szekeres
Keyword(s):  
Upper Limb ◽  
Coping Skills ◽  
Usability Testing ◽  
Psychosocial Problems ◽  
Skills Training ◽  
Hand Therapy ◽  
Web Based ◽  
Coping Skills Training ◽  
Limb Injuries ◽  
Prolonged Pain

Background Ineffective coping has been linked to prolonged pain, distress, anxiety, and depression after a hand and upper limb injury. Evidence shows that interventions based on cognitive behavioral therapy (CBT) may be effective in improving treatment outcomes, but traditional psychological interventions are resource intensive and unrealistic in busy hand therapy practices. Developing web-based, evidence-based psychological interventions specifically for hand therapy may be feasible in clinical practice and at home with reduced training and travel costs. Hand Therapy Online Coping Skills (HOCOS) is a program developed to supplement traditional hand therapy with therapist-assisted coping skills training based on principles from CBT and the Technology Acceptance Model. Objective This study aimed to describe the development and assess the usability of HOCOS to support hand therapists in the management of psychosocial problems. Methods The ADDIE model (Analysis, Design, Development, Implementation, and Evaluation) of system design was applied to create HOCOS. The usability testing of HOCOS involved a 2-stage process. In the first step, heuristic testing with information and communications technology (ICT) experts was completed using two sets of heuristics: Monkman heuristics and the Health Literacy Online (HLO) checklist. The second step involved user testing with hand therapists performing a series of online and face-to-face activities, completing 12 tasks on the website using the think-aloud protocol, completing the system usability scale (SUS) questionnaire, and a semistructured feedback interview in 2 iterative cycles. Descriptive statistics and content analyses were used to organize the data. Results In total, 4 ICT experts and 12 therapists completed usability testing. The heuristic evaluation revealed 15 of 35 violations on the HLO checklist and 5 of 11 violations on the Monkman heuristics. Initially, hand therapists found 5 tasks to be difficult but were able to complete all 12 tasks after the second cycle of testing. The cognitive interview findings were organized into 6 themes: task performance, navigation, design esthetics, content, functionality and features, and desire for future use. Usability issues identified were addressed in two iterative cycles. There was good agreement on all items of the SUS. Overall, therapists found that HOCOS was a detailed and helpful learning resource for therapists and patients. Conclusions We describe the development and usability testing of HOCOS; a new web-based psychosocial intervention for individuals with a hand and upper limb injuries. HOCOS targets psychosocial problems linked to prolonged pain and disability by increasing access to therapist-guided coping skills training. We actively involved target users in the development and usability evaluation of the website. The final website was modified to meet the needs and preferences of the participants.

scholarly journals Injury patterns in patients with QINGQI motorcycle rickshaw related road traffic accidents presenting at accident and emergency department of Mayo Hospital, Lahore.

2020 ◽  
Vol 27 (07) ◽  
pp. 1476-1481
Author(s):  
Waseem Sadiq Awan ◽  
Arslan Ahmed ◽  
Umme Bilqees ◽  
Unaiza Malik ◽  
M. Kashaf Naseer ◽  
...  
Keyword(s):  
Emergency Department ◽  
Upper Limb ◽  
Lower Limb ◽  
Soft Tissues ◽  
Road Traffic ◽  
Trauma Patients ◽  
Cross Sectional ◽  
Accident And Emergency ◽  
Limb Injuries ◽  
Accident And Emergency Department

Objectives: The objective of this study was to determine the patterns of the injuries in patients of Qingqi rickshaw related accidents. Study Design: Descriptive Cross-Sectional study. Setting: Accident and Emergency Department of Mayo Hospital, Lahore. Period: Six months from 1st of March, 2019 to 31st of August, 2019. Material & Methods: Non-probability consecutive sampling technique was used and all tri-wheeler Qingqi related trauma patients fulfilling the inclusion and exclusion criteria were included. Frequency and percentages were calculated for patterns of injuries and presented as tables. Results: A total of 356 Qingqi rickshaw related injured patients presented in six months study period. There were 243 (68.3%) males and 113 (31.7%) females and a mean age of 32.5 +2.5 years. Soft tissues injuries like subcutaneous edema, abrasions and lacerations were noticed in 206 patients (57.9%). Most common region involved was lower limb in 98 (27.5%) cases followed by upper limb trauma in 65 (18.2%) cases. Ploy trauma was present in 58 (16.3%) and head and spinal injuries were noticed in 27 (7.6%) and13 (3.7%) cases, respectively. The turning over of the rickshaw due to different reasons (47.2%) and head on collision (38.4%) were the leading cause of serious injuries. None of the Qingqi rickshaw drivers (0%) were wearing helmet. A total of 46 (12.9%) cases were pedestrians. Three patients had to undergo amputation for mangled limb injuries. Conclusion: The common pattern of injuries related to Qingqi accidents include lower limb injuries followed by upper limb and poly trauma comprising of head injuries. Males in their younger age group are most commonly injured. These accidents can result in serious morbidity and even mortality. It is now time to consider measures for safety of three-wheelers to reduce such incidents.

scholarly journals Technique of Papineau in the Management of Chronic Osteomyelitis in a Low Setting Area. A 12 Years’ Experience

2020 ◽  
Vol 5 (2) ◽  
pp. p19
Author(s):  
Stanislas Ntungila Nkama ◽  
Michel Lelo Tshikwela
Keyword(s):  
Upper Limb ◽  
Low Income ◽  
Lower Limb ◽  
Chronic Osteomyelitis ◽  
Central Africa ◽  
Economic Cost ◽  
University Hospital ◽  
Limb Injuries ◽  
Dead Bone ◽  
Drying Up

Introduction: Chronic osteomyelitis, a bone infectious pathology is difficult to treat. The authors report their experience in a series of patients treated in a low-income country.Methods: We report a prospective study of 53 patients suffering of chronic osteomyelitis for a long time, covering our experience between January 1998 to December 2010 at the Kinshasa University Hospital in central Africa. We used the technique described by Papineau with success, until the consolidation of the bones and the drying up of the wounds.The following elements were analyzed and taken into account: age and sex of the patients, sites involved, germs, surgical technique, length of stay in the hospital and estimated cost of the treatment.Result: The majority of patients were between 26 and 35 years old with extremes between 15 and 80 years old, with 34 males and 19 females with a sex ratio of 1.7/1. Upper limb was involved with 7 humerus, 6 radius, 6 cubitus and the lower limb with 14 femurs and 20 tibias. Staphylococcus aureus was the germ most found in cultures from dead bone from intraoperative technique. Stay in hospital on average was 17 weeks for upper limb and 28 weeks for the management of lower limb injuries. The average cost for the treatment was estimated for 700 to 800 dollars. Conclusion: Chronic osteomyelitis is a tenacious condition for long-term evolution, but it is nevertheless encouraging to dry up foci, which were the toughest challenges for orthopedics and plastic surgeons. In a low setting region, the management of the disease remains a condition with a high economic cost and it is absolutely useless to begin a Papineau treatment if the patients do not have enough money.

Mangling upper limb injuries in industry

Injury ◽  
1999 ◽  
Vol 30 ◽  
pp. S
Author(s):  
D RING
Keyword(s):  
Upper Limb ◽  
Limb Injuries

Computed tomography angiography and microsurgical flaps for traumatic wounds: What is the added value?

2021 ◽  
pp. 1-9
Author(s):  
Lucas Sousa Macedo ◽  
Renato Polese Rusig ◽  
Gustavo Bersani Silva ◽  
Alvaro Baik Cho ◽  
Teng Hsiang Wei ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Upper Limb ◽  
Computed Tomography Angiography ◽  
Lower Limb ◽  
High Energy ◽  
Lower Limbs ◽  
Added Value ◽  
Vascular Lesions ◽  
Limb Injuries ◽  
Significant Difference

BACKGROUND: Microsurgical flaps are widely used to treat complex traumatic wounds of upper and lower limbs. Few studies have evaluated whether the vascular changes in preoperative computed tomography angiography (CTA) influence the selection of recipient vessel and type of anastomosis and the microsurgical flaps outcomes including complications. OBJECTIVE: The aim of this study was to evaluate if preoperative CTA reduces the occurrence of major complications (revision of the anastomosis, partial or total flap failure, and amputation) of the flaps in upper and lower limb trauma, and to describe and analyze the vascular lesions of the group with CTA and its relationship with complications. METHODS: A retrospective cohort study was undertaken with all 121 consecutive patients submitted to microsurgical flaps for traumatic lower and upper limb, from 2014 to 2020. Patients were divided into two groups: patients with preoperative CTA (CTA+) and patients not submitted to CTA (CTA–). The presence of postoperative complications was assessed and, within CTA+, we also analyzed the number of patent arteries on CTA and described the arterial lesions. RESULTS: Of the 121 flaps evaluated (84 in the lower limb and 37 in the upper limb), 64 patients underwent preoperative CTA. In the CTA+ group, 56% of patients with free flaps for lower limb had complete occlusion of one artery. CTA+ patients had a higher rate of complications (p = 0.031), which may represent a selection bias as the most complex limb injuries and may have CTA indicated more frequently. The highest rate of complications was observed in chronic cases (p = 0.034). There was no statistically significant difference in complications in patients with preoperative vascular injury or the number of patent arteries. CONCLUSIONS: CTA should not be performed routinely, however, CTA may help in surgical planning, especially in complex cases of high-energy and chronic cases, since it provides information on the best recipient artery and the adequate level to perform the microanastomosis, outside the lesion area.

scholarly journals The myth of pre-operative isolation during the COVID-19 pandemic

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110261
Author(s):  
Filip Mijovic ◽  
Stuart James ◽  
Bindhiya Thomas ◽  
Mohit Bhatia ◽  
Guillaume Lafaurie ◽  
...  
Keyword(s):  
Mental Health ◽  
Adverse Effect ◽  
Patient Satisfaction ◽  
National Health Service ◽  
Patient Adherence ◽  
Elective Surgery ◽  
University Hospital ◽  
Evidence Based ◽  
Retrospective Data ◽  
Second Wave

The SARS-CoV-2 (COVID-19) pandemic called for the restructuring of National Health Service (NHS) surgical departments across the country. Initial guidance advised that patients undergoing elective surgery isolate for 14 days prior to their operation. As we learnt more about COVID-19 and its incubation period, at the Princess Royal University Hospital this guidance has been decreased to 72 h. We collected retrospective data for two patient cohorts that underwent elective surgery in June and September 2020, isolating for 14 days and 72 h, respectively. We followed-up these patients with several questions allowing us to categorise the cohorts into three groups based on their compliance with isolation measures and also to assess their satisfaction with the isolation process. Our data shows that only 16% of the June cohort and 53% of the September cohort isolated in accordance with the guidelines whilst patient satisfaction was 16% and 64% respectively. These results highlight a suboptimal compliance to pre-operative guidelines as well as an adverse effect on patient mental health and raise the issue of both patient and NHS staff safety. With the possibility of a COVID-19 second wave and for future pandemics, a clear evidence-based plan for pre-operative isolation is vital. Furthermore, consideration of patient adherence and satisfaction is key in deciding which guideline will be most effective.

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