scholarly journals Northwestern University Flexible Subischial Vacuum Socket for persons with transfemoral amputation: Part 2 Description and Preliminary evaluation

2017 ◽  
Vol 41 (3) ◽  
pp. 246-250 ◽  
Author(s):  
Stefania Fatone ◽  
Ryan Caldwell
Keyword(s):  
Gait Analysis ◽  
Outcome Measures ◽  
Case Series ◽  
Step Test ◽  
Preliminary Evaluation ◽  
Transfemoral Amputation ◽  
Northwestern University ◽  
Four Square ◽  
And Performance ◽  
Transfemoral Prosthesis

Background:Current transfemoral prosthetic sockets are problematic as they restrict function, lack comfort, and cause residual limb problems. Development of a subischial socket with lower proximal trim lines is an appealing way to address this problem and may contribute to improving quality of life of persons with transfemoral amputation.Objectives:The purpose of this study was to illustrate the use of a new subischial socket in two subjects.Study design:Case series.Methods:Two unilateral transfemoral prosthesis users participated in preliminary socket evaluations comparing functional performance of the new subischial socket to ischial containment sockets. Testing included gait analysis, socket comfort score, and performance-based clinical outcome measures (Rapid-Sit-To-Stand, Four-Square-Step-Test, and Agility T-Test).Results:For both subjects, comfort was better in the subischial socket, while gait and clinical outcomes were generally comparable between sockets.Conclusion:While these evaluations are promising regarding the ability to function in this new socket design, more definitive evaluation is needed.Clinical relevanceUsing gait analysis, socket comfort score and performance-based outcome measures, use of the Northwestern University Flexible Subischial Vaccum Socket was evaluated in two transfemoral prosthesis users. Socket comfort improved for both subjects with comparable function compared to ischial containment sockets.

scholarly journals Preliminary Evaluation of a New Orthotic for Patellofemoral and Multicompartment Knee Osteoarthritis

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Aleksandra R. Budarick ◽  
Emily L. Bishop ◽  
Marcia L. Clark ◽  
Christopher D. Cowper-Smith
Keyword(s):  
Physical Activity ◽  
Knee Osteoarthritis ◽  
Physical Function ◽  
Outcome Measures ◽  
Case Series ◽  
Secondary Outcome ◽  
Preliminary Evaluation ◽  
Activity Levels ◽  
Knee Oa ◽  
Before And After

Purpose. Traditional knee osteoarthritis (OA) braces are usually indicated for a minority of patients with knee OA, as they are only suitable for those with unicompartmental disease affecting the tibiofemoral joint. A new assistive brace design is intended for use in a wider range of knee OA patients with heterogeneous symptoms characteristic of patellofemoral, tibiofemoral, or multicompartmental knee OA. The purpose of this case series was to explore whether the use of this novel “tricompartment offloader” (TCO) brace was associated with clinically relevant improvements in pain and function. Materials and Methods. A retrospective analysis of individuals with knee OA ( n = 40 ) was conducted to assess pain, function, physical activity, and use of medication and other treatments before and after brace use. Validated outcome measures including the Visual Analog Scale (VAS) and Lower Extremity Functional Scale (LEFS) were used to assess pain and physical function (primary outcome measures). Exploratory measures were used to quantify physical activity levels and use of medication and other treatments (secondary outcome measures). Results. Average total pain (VAS) scores decreased by 36.6 mm and physical function (LEFS) scores increased by 16.0 points following the use of the TCO brace. Overall, 70% of the participants indicated increased weekly physical activity and 60% reported a decrease in their use of at least one other treatment. Conclusions. Results from this case series suggest that the TCO brace shows strong potential to fill a conservative treatment gap for patients with heterogeneous symptoms of knee OA that are characteristic of patellofemoral or multicompartment disease. Further investigation is warranted.

scholarly journals Instrumented Four Square Step Test in Adults with Transfemoral Amputation: Test-Retest Reliability and Discriminant Validity between Two Types of Microprocessor Knees

Sensors ◽  
2020 ◽  
Vol 20 (17) ◽  
pp. 4782
Author(s):  
Arnaud Gouelle ◽  
Michael Jason Highsmith
Keyword(s):  
Discriminant Validity ◽  
Intraclass Correlation ◽  
Step Test ◽  
Functional Improvement ◽  
Minimal Detectable Change ◽  
Transfemoral Amputation ◽  
Detailed Measurement ◽  
Retest Reliability ◽  
Four Square ◽  
Test Retest Reliability

Technology-based outcomes have recently been proposed to complement the standard Four Square Step Test (FSST) by providing a decomposition of the sequences and information about the stepping pattern. A test-retest study and a randomized crossover design have been used to determine immediate test-retest reliability and to assess discriminant validity, in persons with a unilateral transfemoral amputation, for the parameters computed by an instrumented version of the Four Square Step Test. Twenty adults, independent and unlimited community ambulators, with a unilateral transfemoral amputation, performed two Four Square Step Tests on a pressure mat first with a microprocessor knee, then, a few weeks later with another one. One of these prosthetic knees was acknowledged to be superior and to provide functional improvement. Test-retest, intraclass correlation coefficients and minimal detectable change at 95% confidence level were calculated for each variable. Paired samples t-tests were then used to identify differences between the two microprocessor knee systems. The test-retest reliability of most outcome measures was good to excellent. Few variables showed a systematic difference and a trend to improve between test 1 and test 2. When comparing both microprocessor knees, significant differences in the expected direction were observed, with interpretation in accordance with a functional improvement. Importantly, we highlighted that various strategies to improve the performance in the test might complexify the interpretation of the most detailed measurement. The instrumented Four Square Step test provides reliable measures with satisfactory test-retest reliability and discriminant validity in persons with unilateral transfemoral amputation.

scholarly journals Vestibular Rehabilitation After Traumatic Brain Injury: Case Series

2016 ◽  
Vol 96 (6) ◽  
pp. 839-849 ◽  
Author(s):  
Ingerid Kleffelgaard ◽  
Helene Lundgaard Soberg ◽  
Kari A. Bruusgaard ◽  
Anne L. Tamber ◽  
Birgitta Langhammer
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Outcome Measures ◽  
Case Series ◽  
Vestibular Rehabilitation ◽  
Minimal Detectable Change ◽  
Perceived Disability ◽  
And Performance ◽  
The Impact ◽  
Balance Problems

Background and Purpose There has been an increasing focus on vestibular rehabilitation (VR) after traumatic brain injury (TBI) in recent years. However, detailed descriptions of the content of and patient responses to VR after TBI are limited. The purposes of this case series are (1) to describe a modified, group-based VR intervention and (2) to examine changes in self-reported and performance-based outcome measures. Case Description Two women and 2 men (aged 24–45 years) with mild TBI, dizziness, and balance problems participated in an 8-week intervention consisting of group sessions with guidance, individually modified VR exercises, a home exercise program, and an exercise diary. Self-reported and performance-based outcome measures were applied to assess the impact of dizziness and balance problems on functions related to activity and participation. Outcomes The intervention caused no adverse effects. Three of the 4 patients reported reduced self-perceived disability because of dizziness, diminished frequency and severity of dizziness, improved health-related quality of life, reduced psychological distress, and improved performance-based balance. The change scores exceeded the minimal detectable change, indicating a clinically significant change or improvement in the direction of age-related norms. The fourth patient did not change or improve in most outcome measures. Discussion A modified, group-based VR intervention was safe and appeared to be viable and beneficial when addressing dizziness and balance problems after TBI. However, concurrent physical and psychological symptoms, other neurological deficits, and musculoskeletal problems might influence the course of central nervous system compensation and recovery. The present case series may be useful for tailoring VR interventions to patients with TBI. Future randomized controlled trials are warranted to evaluate the short- and long-term effects of VR after TBI.

Functional Recovery After Hip Resurfacing and Rehabilitation

2012 ◽  
Vol 21 (2) ◽  
pp. 167-174 ◽  
Author(s):  
Maria Grazia Benedetti ◽  
Lisa Berti ◽  
Antonio Frizziero ◽  
Donata Ferrarese ◽  
Sandro Giannini
Keyword(s):  
Gait Analysis ◽  
Functional Outcome ◽  
Outcome Measures ◽  
Case Series ◽  
Hip Resurfacing ◽  
Harris Hip Score ◽  
Control Group ◽  
Rehabilitation Protocol ◽  
Active Patients

Context:Surface replacement of the hip is aimed especially at active patients, and it seems to achieve optimal functional results in a short time if associated with a tailored rehabilitation protocol.Objective:To assess the functional outcome in a group of active patients after hip resurfacing.Design:Clinical measurement and controlled laboratory study in a case series.Setting:Gait-analysis laboratory.Participants:8 patients and a control group of 10 subjects.Interventions:Patients treated with Birmingham hip-resurfacing system and a tailored rehabilitation protocolMain Outcome Measures:Clinical assessment (Harris Hip Score [HHS]) and instrumented gait analysis including muscular electromyographic assessment. Patients were assessed preoperatively and at 3 and 9 mo follow-up after surgery.Results:HHS showed a significant increase from the baseline to 3- (P = .008) and 9-month (P = .014) follow-up; 5 patients returned to sport. Gait pattern in the presented case series of patients improved substantially 3 mo postoperatively, and minimal further changes were present 9 months postoperatively. Residual abnormalities of time-distance and hip-kinematics parameters were consistent with a slow gait. A complete restoration of the muscle-activation pattern during gait was achieved.Conclusion:Hip resurfacing associated with a rehabilitation protocol based on the characteristics of the implant provides excellent clinical and functional outcome, especially for very active patients.

Force Plate Analysis of Dogs with Bilateral Hip Dysplasia Treated with a Unilateral Triple Pelvic Osteotomy: A Long-term Review of Cases

1998 ◽  
Vol 11 (02) ◽  
pp. 85-93 ◽  
Author(s):  
Joanne R. Cockshutt ◽  
H. Dobson ◽  
C. W. Miller ◽  
D. L. Holmberg ◽  
Connie L. Taves ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Hip Dysplasia ◽  
Weight Bearing ◽  
Force Plate ◽  
Case Series ◽  
Pelvic Osteotomy ◽  
Vertical Force ◽  
Long Term Outcome ◽  
Case Series Study

SummaryA retrospective case series study was done to determine the long-term outcome of operations upon dogs treated for canine hip dysplasia by means of a triple pelvic osteotomy (TPO). Twentyfour dogs with bilateral hip dysplasia, that received a unilateral TPO between January 1988 and June 1995, were re-examined at the Ontario Veterinary College. The assessment included physical, orthopedic and lameness examinations, standard blood work, pelvic radiographs and force plate gait analysis. They were compared to bilaterally dysplastic dogs that had not been treated, and also to normal dogs. Force plate data analysis demonstrated a significant increase in peak vertical force (PVF) and mean vertical force over stance (MVF) in the limb that underwent surgical correction by means of a TPO, when compared to the unoperated hip. It was determined that performing a unilateral TPO on a young dysplastic dog resulted in greater forces and weight bearing being projected through the TPO corrected limb when compared to the unoperated limb.Dogs with bilateral hip dysplasia treated with a unilateral triple pelvic osteotomy (TPO) were assessed by force plate gait analysis, radiographs and orthopedic examination. There was a significant increase in hip Norberg angles over time, although degenerative changes did progress. Limbs that had been operated upon had significantly greater peak and mean ground reaction forces than limbs that had not received an operation.

scholarly journals Factors associated with dynamic balance in people with Persistent Postural Perceptual Dizziness (PPPD): a cross-sectional study using a virtual-reality Four Square Step Test

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Moshe M. H. Aharoni ◽  
Anat V. Lubetzky ◽  
Liraz Arie ◽  
Tal Krasovsky
Keyword(s):  
Virtual Reality ◽  
Trait Anxiety ◽  
Dynamic Balance ◽  
Step Test ◽  
Simulator Sickness ◽  
Balance Confidence ◽  
Task Duration ◽  
Head Kinematics ◽  
Perceived Disability ◽  
Four Square

Abstract Background Persistent postural-perceptual dizziness (PPPD) is a condition characterized by chronic subjective dizziness and exacerbated by visual stimuli or upright movement. Typical balance tests do not replicate the environments known to increase symptoms in people with PPPD—crowded places with moving objects. Using a virtual reality system, we quantified dynamic balance in people with PPPD and healthy controls in diverse visual conditions. Methods Twenty-two individuals with PPPD and 29 controls performed a square-shaped fast walking task (Four-Square Step Test Virtual Reality—FSST-VR) using a head-mounted-display (HTC Vive) under 3 visual conditions (empty train platform; people moving; people and trains moving). Head kinematics was used to measure task duration, movement smoothness and anterior–posterior (AP) and medio-lateral (ML) ranges of movement (ROM). Heart rate (HR) was monitored using a chest-band. Participants also completed a functional mobility test (Timed-Up-and-Go; TUG) and questionnaires measuring anxiety (State-Trait Anxiety Inventory; STAI), balance confidence (Activities-Specific Balance Confidence; ABC), perceived disability (Dizziness Handicap Inventory) and simulator sickness (Simulator Sickness Questionnaire). Main effects of visual load and group and associations between performance, functional and self-reported outcomes were examined. Results State anxiety and simulator sickness did not increase following testing. AP-ROM and HR increased with high visual load in both groups (p < 0.05). There were no significant between-group differences in head kinematics. In the high visual load conditions, high trait anxiety and longer TUG duration were moderately associated with reduced AP and ML-ROM in the PPPD group and low ABC and  high perceived disability were associated with reduced AP-ROM (|r| =  0.47 to 0.53; p < 0.05). In contrast, in controls high STAI-trait, low ABC and longer TUG duration were associated with increased AP-ROM (|r| = 0.38 to 0.46; p < 0.05) and longer TUG duration was associated with increased ML-ROM (r = 0.53, p < 0.01). Conclusions FSST-VR may shed light on movement strategies in PPPD beyond task duration. While no main effect of group was observed, the distinct associations with self-reported and functional outcomes, identified using spatial head kinematics, suggest that some people with PPPD reduce head degrees of freedom when performing a dynamic balance task. This supports a potential link between spatial perception and PPPD symptomatology.

scholarly journals Return to Sport After Hip Resurfacing Arthroplasty

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110035
Author(s):  
Kyle W. Morse ◽  
Ajay Premkumar ◽  
Andrew Zhu ◽  
Rachelle Morgenstern ◽  
Edwin P. Su
Keyword(s):  
Case Series ◽  
Hip Resurfacing ◽  
High Impact ◽  
Professional Athletes ◽  
Hip Resurfacing Arthroplasty ◽  
Resurfacing Arthroplasty ◽  
Elite Level ◽  
Performance Statistics ◽  
And Performance ◽  
End Stage

Background: Femoroacetabular impingement and degenerative hip osteoarthritis (OA) affect athletes across a wide variety of sports. Hip resurfacing arthroplasty (HRA) has emerged as a surgical treatment for active individuals with end-stage hip OA to provide pain relief and allow return to high-impact activities. Return to professional sports after HRA has not been well characterized. Purpose/Hypothesis: The aim of this study was to report on a series of elite athletes in a variety of sports who underwent HRA. We hypothesized that professional and elite-level athletes would be able to return to sports after HRA for end-stage hip OA. Study Design: Case series; Level of evidence, 4. Methods: A retrospective case series was conducted on professional athletes who underwent HRA at a single institution between 2007 and 2017. All surgeries were performed by a single surgeon using the posterolateral approach. Athletes’ return to play and sport-specific performance statistics were obtained using self-reported and publicly available data sources. Athletes were matched to an age- and performance-based cohort to determine changes in performance-based metrics. Results: Eight professional athletes were identified, including 2 baseball pitchers, 1 ice hockey defenseman, 1 foil fencer, 1 men’s doubles tennis player, 1 basketball player, 1 ultramarathoner, and 1 Ironman triathlete. All 8 patients returned to sports; 6 of 8 (75%) patients were able to return for at least 1 full season at a professional level after surgery. There were no significant differences between performance statistics for athletes who returned to play and their preoperative performance measures for the years leading up to surgery or the age- and performance-matched cohort. Conclusion: HRA remains a surgical alternative for end-stage hip OA in young, high-impact, active patients. While the primary goals of surgery are pain control and quality of life improvement, it is possible to return to elite-level sporting activity after HRA.

Word Recognition in Multitalker Babble Measured with Two Psychophysical Methods

2005 ◽  
Vol 16 (08) ◽  
pp. 622-630 ◽  
Author(s):  
Richard H. Wilson ◽  
Christopher A. Burks ◽  
Deborah G. Weakley
Keyword(s):  
Word Recognition ◽  
Background Noise ◽  
Pure Tone ◽  
Recognition Performance ◽  
Random Presentation ◽  
Presentation Level ◽  
Significant Difference ◽  
Northwestern University ◽  
And Performance ◽  
The Relationship

The purpose of this experiment was to determine the relationship between psychometric functions for words presented in multitalker babble using a descending presentation level protocol and a random presentation level protocol. Forty veterans (mean = 63.5 years) with mild-to-moderate sensorineural hearing losses were enrolled. Seventy of the Northwestern University Auditory Test No. 6 words spoken by the VA female speaker were presented at seven signal-to-babble ratios from 24 to 0 dB (10 words/step). Although the random procedure required 69 sec longer to administer than the descending protocol, there was no significant difference between the results obtained with the two psychophysical methods. There was almost no relation between the perceived ability of the listeners to understand speech in background noise and their measured ability to understand speech in multitalker babble. Likewise, there was a tenuous relation between pure-tone thresholds and performance on the words in babble and between recognition performance in quiet and performance on the words in babble.

Sign in / Sign up

Export Citation Format

Share Document