Biomechanical analysis of curb ascent in persons with Ertl and non-Ertl transtibial amputations

2019 ◽  
Vol 44 (1) ◽  
pp. 36-43
Author(s):  
Abbie E Ferris ◽  
Cory L Christiansen ◽  
Gary D Heise ◽  
David Hahn ◽  
Jeremy D Smith
Keyword(s):  
Distal Tibia ◽  
Surgical Techniques ◽  
Cross Sectional Study ◽  
Biomechanical Analysis ◽  
Cross Sectional ◽  
Transtibial Amputation ◽  
Motion Data ◽  
Stepping Pattern ◽  
Reaction Forces ◽  
Intact Limb

Background: Persons with transtibial amputation report curb negotiation is more challenging than negotiating stairs. It is unknown if amputation technique influences curb negotiation ability. Traditional transtibial amputation surgical techniques do not join the distal tibia and fibula (non-Ertl), whereas a transtibial osteomyoplastic amputation (Ertl) creates a “bone bridge” connection. The Ertl may facilitate ambulation through greater residual end load bearing. Objectives: To determine if ability to negotiate a curb differs between Ertl and non-Ertl groups. Study design: Cross-sectional study. Methods: Non-Ertl ( n = 7) and Ertl ( n = 5) participants ascended a 16-cm curb using their amputated and intact limb as the lead limb. Motion data and ground reaction forces were used to calculate ankle, knee, hip, and total limb work for ground and curb steps. Results: On the ground, the amputated limb of both groups produced less work than the intact limb. In contrast, on the curb step, the Ertl amputated limb generated more net hip work than the non-Ertl amputated limb. As a result, the net limb work of the Ertl amputated limb did not differ from the non-amputated limbs. Conclusion: Comparisons between the amputated limb of Ertl and non-Ertl groups suggest use of a different curb stepping pattern between groups. Clinical relevance These findings suggest that surgical technique may influence curb negotiation ability in individuals with transtibial amputation. Specifically, the Ertl group is able to produce more hip power than the non-Ertl group while negotiation a curb which may be attributed to the increased ability to end-load bear on the residual limb.

scholarly journals Assessment and Trends in the Methodological Quality of the Top 50 Most Cited Articles in Shoulder Instability

2020 ◽  
Vol 8 (12) ◽  
pp. 232596712096708
Author(s):  
Avinesh Agarwalla ◽  
Kaisen Yao ◽  
Anirudh K. Gowd ◽  
Nirav H. Amin ◽  
J. Martin Leland ◽  
...  
Keyword(s):  
Bone Loss ◽  
Shoulder Instability ◽  
Methodological Quality ◽  
Surgical Techniques ◽  
Case Series ◽  
Cross Sectional Study ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Number Of Citations

Background: Citation counts have often been used as a surrogate for the scholarly impact of a particular study, but they do not necessarily correlate with higher-quality investigations. In recent decades, much of the literature regarding shoulder instability is focused on surgical techniques to correct bone loss and prevent recurrence. Purpose: To determine (1) the top 50 most cited articles in shoulder instability and (2) if there is a correlation between the number of citations and level of evidence or methodological quality. Study Design: Cross-sectional study. Methods: A literature search was performed on both the Scopus and the Web of Science databases to determine the top 50 most cited articles in shoulder instability between 1985 and 2019. The search terms used included “shoulder instability,” “humeral defect,” and “glenoid bone loss.” Methodological scores were calculated using the Modified Coleman Methodology Score (MCMS), Jadad scale, and Methodological Index for Non-Randomized Studies (MINORS) score. Results: The mean number of citations and mean citation density were 222.7 ± 123.5 (range, 124-881.5) and 16.0 ± 7.9 (range, 6.9-49.0), respectively. The most common type of study represented was the retrospective case series (evidence level, 4; n = 16; 32%) The overall mean MCMS, Jadad score, and MINORS score were 61.1 ± 10.1, 1.4 ± 0.9, and 16.0 ± 3.0, respectively. There were also no correlations found between mean citations or citation density versus each of the methodological quality scores. Conclusion: The list of top 50 most cited articles in shoulder instability comprised studies with low-level evidence and low methodological quality. Higher-quality study methodology does not appear to be a significant factor in whether studies are frequently cited in the literature.

scholarly journals Survival outcomes of trachea esophageal fistula in infant

2019 ◽  
Vol 6 (4) ◽  
pp. 1680
Author(s):  
S. Prabkaran ◽  
K. Kasthuri Thilagam
Keyword(s):  
Tertiary Care ◽  
Surgical Techniques ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Esophageal Fistula ◽  
Chi Square ◽  
Cross Sectional ◽  
Cardiovascular Defects ◽  
Chi Square Test ◽  
Type 3

Background: Tracheo-esophageal fistula (TEF) is a rare congenital abnormality often associated with several other anomalies including renal, vertebral column, gastrointestinal or cardiovascular defects. This study was carried out to evaluate the outcome of trachea esophageal fistula among patients who underwent various surgeries for the anastomosis of trachea esophageal fistula.Methods: This study was conducted as a record based cross sectional study among 88 patients who were diagnosed and treated for trachea-esophageal fistula in tertiary care hospital between 2015 and 2018. Data regarding the type of anomaly, presence of associated anomalies, type of surgery and outcomes were documented. Findings of echocardiography and ultrasonography were also documented. Data was analyzed using SPSS software. Chi square test was used to evaluate the outcome of the surgical procedures for management of TEF.Results: Majority of the participants in our study belong to <1 month of age and were males (56.8%). Type 3 tracheo esophageal fistula (80.7%) was the most common type. Associated cardiovascular anomalies were present in 50% of the participants. Thoracotomy with TEF repair was most preferred surgery (76%). Present study demonstrated that surgical techniques improve the physical and physiological outcome of the patients (p <0.05).Conclusions: Trachea esophageal fistula needs to be corrected with surgical procedure. Modern techniques like thorocoscopic anastomosis, thorocosopic techniques to achieve an anastomosis can also be explored. Future studies may be directed in detecting congenital anomalies during the pre-natal period with the help of genetic techniques.

Management of maxillary impacted canines: A prospective study of practitioners’ preferences (Preprint)

2020 ◽  
Author(s):  
HAMAD ALQAHTANI
Keyword(s):  
Surgical Techniques ◽  
Cross Sectional Study ◽  
Diagnostic Methods ◽  
Cross Sectional ◽  
Joint Decision ◽  
Diagnostic Measures ◽  
Impacted Canines ◽  
Surgical Exposure ◽  
Oral And Maxillofacial Surgeon ◽  
Exposure Technique

UNSTRUCTURED Objective: To investigate orthodontists’ approach concerning managing maxillary impacted canines (MIC). Methods: A cross-sectional study comprising a comprehensive survey with 22 questions was sent to practicing orthodontists. This study explored the preferred diagnostic measures, surgical techniques, materials, and mechanics utilized to manage MIC;104 responses were returned. Results: Palatal impaction was reported to be encountered more often by 60% of the respondents. In 62% of the respondents, an oral and maxillofacial surgeon was the specialist preferred to perform the surgical exposure. In 66%, the choice of required surgical techniques was reported as a joint decision between orthodontists and other specialists who perform the surgery. Cone-beam computed tomography (CBCT) was reported to be the diagnostic X-ray of choice. The gold button with a chain was the preferred bonded attachment in 86% of cases. Less than half of the respondents bonded the attachments themselves during surgical exposure. A clear plastic retainer was the preferred retainer in 61% of the respondents, and 43% of the respondents tended to use a closed exposure technique. Coe-pakTM was the preferred surgical pack for orthodontists who prefer an open exposure technique. Piggyback (double wire) was the preferable mechanic to move a palatally impacted canine. Conclusions: Our findings indicate that there are variations among orthodontists on how to manage MICs concerning diagnostic methods, surgical management, materials, and mechanics.

Determination of Gait Events Using an Externally Mounted Shank Accelerometer

2013 ◽  
Vol 29 (1) ◽  
pp. 118-122 ◽  
Author(s):  
Jonathan Sinclair ◽  
Sarah J. Hobbs ◽  
Laurence Protheroe ◽  
Christopher J. Edmundson ◽  
Andrew Greenhalgh
Keyword(s):  
Distal Tibia ◽  
Force Platform ◽  
Biomechanical Analysis ◽  
Alternative Methods ◽  
Heel Strike ◽  
Strong Correlations ◽  
Reaction Forces ◽  
Vertical Ground ◽  
Vertical Ground Reaction Forces

Biomechanical analysis requires the determination of specific foot contact events. This is typically achieved using force platform information; however, when force platforms are unavailable, alternative methods are necessary. A method was developed for the determination of gait events using an accelerometer mounted to the distal tibia, measuring axial accelerations. The aim of the investigation was to determine the efficacy of this method. Sixteen participants ran at 4.0 m/s ±5%. Synchronized tibial accelerations and vertical ground reaction forces were sampled at 1000 Hz as participants struck a force platform with their dominant foot. Events determined using the accelerometer, were compared with the corresponding events determined using the force platform. Mean errors of 1.68 and 5.46 ms for average and absolute errors were observed for heel strike and of –3.59 and 5.00 ms for toe-off. Mean and absolute errors of 5.18 and 11.47 ms were also found for the duration of the stance phase. Strong correlations (r= .96) were also observed between duration of stance obtained using the two different methods. The error values compare favorably to other alternative methods of predicting gait events. This suggests that shank-mounted accelerometers can be used to accurately and reliably detect gait events.

scholarly journals Lower Limb and Trunk Biomechanics After Fatigue in Competitive Female Irish Dancers

2017 ◽  
Vol 52 (7) ◽  
pp. 643-648 ◽  
Author(s):  
Catherine Y. Wild ◽  
Avril Grealish ◽  
Diana Hopper
Keyword(s):  
Lower Limb ◽  
External Rotation ◽  
Plantar Flexion ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Limb Injuries ◽  
Before And After ◽  
Joint Reaction Forces ◽  
Reaction Forces ◽  
Trunk Biomechanics

Context:  Because of the increasing popularity of participation in Irish dance, the incidence of lower limb injuries is high among this competitive population. Objective:  To investigate the effects of fatigue on the peak lower limb and trunk angles as well as the peak lower limb joint forces and moments of competitive female Irish dancers during the performance of a dance-specific single-limb landing. Design:  Cross-sectional study. Setting:  Laboratory. Patients or Other Participants:  Fourteen healthy, female, competitive Irish dancers (age = 19.4 ± 3.7 years, height = 165.3 ± 5.9 cm, mass = 57.9 ± 8.2 kg). Intervention(s):  Participants performed an Irish dance–specific leap before and after a dance-specific fatigue protocol. During each landing movement, 3-dimensional lower limb kinematics (250 Hz) and ground reaction forces (1000 Hz) were collected. Paired t tests were performed to determine the differences (P ≤ .05) in lower limb and trunk biomechanics prefatigue and postfatigue. Main Outcome Measure(s):  Peak lower limb and trunk angles as well as peak lower limb joint reaction forces and external moments. Results:  Compared with the prefatigue trials, dancers landed with reduced ankle plantar flexion (P = .003) and hip external rotation (P = .007) and increased hip-adduction alignment (P = .034) postfatigue. Dancers displayed greater anterior shear (P = .003) and compressive (P = .024) forces at the ankle and greater external knee-flexion moments (P = .024) during the postfatigue compared with the prefatigue landing trials. Conclusions:  When fatigued, dancers displayed a decline in landing performance in terms of aesthetics as well as increased ankle- and knee-joint loading, potentially exposing them to a greater risk of injuries.

Altered movement strategies in sit-to-stand task in persons with transtibial amputation

2013 ◽  
Vol 38 (4) ◽  
pp. 303-309 ◽  
Author(s):  
Seher Özyürek ◽  
İlkşan Demirbüken ◽  
Salih Angın
Keyword(s):  
Weight Bearing ◽  
Cross Sectional Study ◽  
Transfer Time ◽  
Cross Sectional ◽  
Transtibial Amputation ◽  
Sit To Stand ◽  
Movement Strategies ◽  
Similar Weight ◽  
Transtibial Amputees ◽  
Weight Transfer

Background:Sit-to-stand movement is an essential function for participation in many activities of daily living. Although this movement is one of the most important functional tasks, there is limited research investigating strategies of sit-to-stand movement in transtibial amputees.Objectives:To examine movement strategies of the sit-to-stand task in persons with transtibial amputation and healthy non-amputated individuals.Study design:Cross-sectional study.Methods:A total of 12 male unilateral transtibial amputees and 19 healthy male subjects participated in this study. Sit-to-stand movement was evaluated in terms of weight transfer time, weight-bearing symmetry, sway velocity, and rising index by using Balance Master System.Results:Participants in both groups exhibited similar weight-bearing transfer time ( p > 0.05). Transtibial amputees demonstrated significantly greater weight-bearing asymmetry, higher sway velocity, and lower rising index than healthy subjects during the sit-to-stand transfer movement ( p < 0.05).Conclusions:Transtibial amputees were unable to use the same movement strategies during a sit-to-stand task as healthy individuals; therefore, they had to develop new strategies to perform this task.Clinical relevanceLittle is known about the altered movement strategies during sit-to-stand task in transtibial amputees. The results of the study might provide some new insight into the motor components of the sit-to-stand movement in persons with transtibial amputation for both clinicians and researchers.

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