Current issues of disability and rehabilitation of elderly and senile patients with lower limb loss due to vascular pathology

2022 ◽  
pp. 891-900
Author(s):  
Р.К. Кантемирова ◽  
З. Д. Фидарова ◽  
Е.О. Свиридова ◽  
Т.С. Чернякина ◽  
С.В. Сердюков ◽  
...  
Keyword(s):  
Lower Limb ◽  
Clinical Characteristics ◽  
Postoperative Mortality ◽  
Cardiovascular Complications ◽  
Vascular Pathology ◽  
Geriatric Syndromes ◽  
Disabled People ◽  
Rehabilitation Process ◽  
Rehabilitation Potential ◽  
Primary Disability

Большинство пациентов с ампутационным дефектом нижних конечностей являются гражданами пожилого возраста с высокой ко- и полиморбидностью, наличием нескольких гериатрических синдромов, что неблагоприятно влияет на прогноз, снижает реабилитационный потенциал, в ряде случаев приводит к развитию сердечно-сосудистых осложнений, ампутации второй конечности, тяжелой инвалидизации и высокой послеоперационной летальности. Ключевым звеном процесса реабилитации инвалидов с культей нижней конечности является обеспечение их функциональным протезом. В статье приведен анализ заболеваемости, первичной инвалидности в период 2015-2019 гг., гендерных, возрастных и клинических характеристик пациентов, проживающих в Санкт-Петербурге, которым выполнена ампутация нижней конечности вследствие сосудистой патологии. Установлено, что отсутствует информация о выживаемости пациентов после проведения ампутации в различные сроки постгоспитального периода в Санкт-Петербурге. Выявлен выраженный дисбаланс между количеством выполняемых ампутаций нижних конечностей ежегодно и количеством обращений инвалидов в бюро медико-социальной экспертизы для обеспечения техническими средствами реабилитации и направлением на первичное протезирование, реабилитацию. The majority of patients with amputation defect of the lower extremities are elderly citizens with high co- and polymorbidity, the presence of several geriatric syndromes, which adversely affects the prognosis, reduces the rehabilitation potential, in some cases leads to the development of cardiovascular complications, amputation of the second limb, severe disability and high postoperative mortality. The key link in the rehabilitation process of disabled people with a lower limb stump is to provide them with a functional prosthesis. The article provides an analysis of morbidity, primary disability in the period from 2015 to 2019, gender, age and clinical characteristics of patients living in St. Petersburg who underwent amputation of the lower limb due to obliterating artery diseases is presented. It was found that there is no information on the survival rate of patients after amputation at various times of the post-hospital period in St. Petersburg. We have identified a pronounced imbalance between the number of lower limb amputations performed and the number of applications of disabled people to the bureau of medical and social expertise for providing technical means of rehabilitation and referral to primary prosthetics.

The Muscle Myogram as a Control Signal for Use in Powered Limb Orthosis

2006 ◽  
Author(s):  
M. Antonelli ◽  
P. Beomonte Zobel ◽  
J. Giacomin
Keyword(s):  
Lower Limb ◽  
Assistive Device ◽  
Sitting Position ◽  
Test Bed ◽  
Disabled People ◽  
Test Protocol ◽  
Prosthetic Devices ◽  
Specific Device ◽  
Definition Of

The choice of the command technique to be used in orthotic and prosthetic devices is very critical for the acceptance and, finally, the success of the specific device. Many variables influence this choice: the general characteristics of the signal, the quality of the correlation between signal and specific actions of the user and the algorithm that is derived, the acceptance of the technique, as applied to the specific device, from the user, etc. Among the command techniques, MMG signal seems to be promising to command an assistive device. In this paper a test protocol for studying MMG signal, to investigate the prospective for its use as a command technique of a powered lower limb orthosis capable of raising elderly and disabled people from the sitting position, is proposed. The definition of the test protocol, including the description of the test bed and the sensors application, is presented. Finally, the experimental results are showed and discussed.

Design and fabrication of a lower limb exoskeleton to assist in stair ascending

2019 ◽  
Vol 46 (2) ◽  
pp. 290-299 ◽  
Author(s):  
Payman Joudzadeh ◽  
Alireza Hadi ◽  
Bahram Tarvirdizadeh ◽  
Danial Borooghani ◽  
Khalil Alipour
Keyword(s):  
Lower Limb ◽  
System Performance ◽  
Design Methodology ◽  
Stair Climbing ◽  
Robot Design ◽  
Disabled People ◽  
Content Type ◽  
Lower Limb Exoskeleton ◽  
Knee Braces ◽  
Novel Design

Purpose This paper aims to deal with the development of a novel lower limb exoskeleton to assist disabled people in stair ascending. Design/methodology/approach For this purpose, a novel design of a mixture of motors and cables has been proposed for users to wear them easily and show the application of the system in stair climbing. Findings One of the prominences of this study is the provided robot design where four joints are actuated with only two motors; each motor actuates either the knees or ankles. Another advantage of the designed system is that with motors placed in a backpack, the knee braces can be worn under clothes to be concealed. Finally, the system performance is evaluated using electromyography (EMG) signals showing 28 per cent reduction in energy consumption of related muscles. Originality/value This investigation deals with the development of a novel lower limb exoskeleton to assist disabled people in stair ascending.

scholarly journals PEOPLE WITH DISABILITIES IN THE ARTISTIC FIELD

2020 ◽  
Vol 73 (9) ◽  
pp. 1840-1843
Author(s):  
Mariola Żuk
Keyword(s):  
European Union ◽  
Social Integration ◽  
People With Disabilities ◽  
Social Attitudes ◽  
Disabled People ◽  
Social Attitude ◽  
Rehabilitation Process ◽  
The Social ◽  
The World ◽  
The Disabled

According to statistic reports the number of disabled people in the world is still increasing. Nowadays it’s estimated that one for six citizens in European Union is disabled. New laws are established to improve the social attitude towards the sick and the disabled. The perception of people with disabilities is widely dominated by their limitations that often take priority. Completely different social attitudes concern artists. They are admired. The aim of the paper is to discuss the extent to which the disabled people can contribute to the culture and to reflect on the importance of art for the rehabilitation process as well as for the social integration of artists with disabilities. The conclusion that it implies is, that the art for ages well serves the integration and rehabilitation cause.

Hipoterapia w usprawnianiu dziecka z mózgowym porażeniem dziecięcym

2018 ◽  
Vol 21 (2A) ◽  
Author(s):  
Bartek Czokało ◽  
Joanna Chojnowska ◽  
Wioletta Pogroszewska
Keyword(s):  
Upper Limb ◽  
Mental State ◽  
Lower Limb ◽  
Rehabilitation Process ◽  
Self Confidence ◽  
Horse Riding ◽  
Time Stage ◽  
Block Test ◽  
The Impact

Introduction. Hippotherapy is diversified therapeutic treatment using a horse. Horse riding is a final and at the same time one of the most stretched in time stage of improving athleticism. It is a replenishment of the rehabilitation process and it gives an opportunity to acquire new skills. Aim. 1. Evaluating the impact of hippotherapy on prehensile functions of an upper limb. 2. Evaluating the impact of hippotherapy on lower limb range of motion. 3. Evaluating the impact of hippotherapy on a mental state of a child with CP. Material and methods. The author of the thesis conducted a study of a 6-year-old child with CP based on: a questionnaire, Lovett’s test, Box and Block Test and the measurement of the limbs circuits. Results. The exercises conducted improved the balance and attentiveness. Marginally the quality of the exercises was improved, as well. Conclusions. Hippotherapy gives an opportunity to overcome the discouragement and the lack of self-confidence in personal movement capabilities. It has an impact on a cognitive and emotional sphere of a child.

scholarly journals Prosthetic Rehabilitation in the Lower Limb

2019 ◽  
Vol 52 (01) ◽  
pp. 134-143 ◽  
Author(s):  
Bernard O'Keeffe ◽  
Shraddha Rout
Keyword(s):  
Best Practices ◽  
Lower Limb ◽  
Medical Community ◽  
Rehabilitation Process ◽  
Amputation Level ◽  
Optimal Outcomes ◽  
The Past ◽  
Locomotor Disability ◽  
History Of ◽  
Modern Technologies

AbstractLower limb amputations form a considerable number with 5,436,000 Indians having locomotor disability. Most members of this group are young, active earning males. The major cause of amputation is trauma. Hence, this population must be rehabilitated with priority, and best concerted efforts must be made by the medical community. In this article, the authors present available modern technologies in India and share best practices from their experience of treating Indian amputees for the past 20 years. The objective is to demonstrate to the medical community the optimal outcomes that can be achieved and help them make correct decisions on behalf of patients and their families. The article discusses history of prostheses, how to select optimal amputation level, preamputation preparation, determinants of good outcomes, preprosthetic preparation, components of prosthesis, their function and significance, rehabilitation process and guidelines, prescription criteria, and also special considerations such as multiple amputees or children.

An Ally as well as a Partner in Practice

1995 ◽  
Vol 62 (5) ◽  
pp. 283-285 ◽  
Author(s):  
Bonnie Sherr Klein
Keyword(s):  
Role Models ◽  
Occupational Therapists ◽  
Health Professions ◽  
Disabled People ◽  
Rehabilitation Process ◽  
Knowledge And Skills ◽  
Personal Story ◽  
Grass Roots ◽  
Body Of Knowledge

Through her own personal story and experience the author describes herself as the ultimate client. She recounts some of the stages in her own rehabilitation process, and the ways in which the health professions helped or hindered her. Her involvement with the grass roots organizations for disabled people strengthened her convictions about the value of peers and role models for those with a disability. She urges occupational therapists, because of their unique body of knowledge and skills, to become partners, and even more importantly, allies with their clients. She encourages the profession to become truly inclusive and representative, and to take steps to bridge the power gap between the profession and its clients, with whom it seeks partnerships.

scholarly journals Light sheet microscopy-based 3-dimensional histopathology of the lymphatic vasculature in Emberger syndrome

Phlebologie ◽  
2020 ◽  
Vol 49 (04) ◽  
pp. 242-248
Author(s):  
René Hägerling
Keyword(s):  
Lower Limb ◽  
Lymphatic Vessels ◽  
Light Sheet ◽  
Lower Limbs ◽  
Vascular Pathology ◽  
Histopathological Analysis ◽  
Upper Limbs ◽  
3 Dimensional ◽  
Light Sheet Microscopy ◽  
Lymphatic Vasculature

Abstract Introduction Lymphovascular diseases represent a heterogenous group of inherited and sporadic disorders and refer to a range of possible underlying pathologies and pathogenesis.Emberger Syndrome, an inherited form of lymphedema, is characterized by bilateral lower limb lymphedema, however, upper limbs do not show any signs of swelling.To identify disease-associated histopathological alterations in patients with Emberger Syndrome and to elucidate potential histological differences between the lymphatic vasculature of upper and lower limbs, a detailed knowledge on the 3-dimensional tissue and vessel architecture is essential. However, the current gold standard in 2-dimensional histology provides only very limited spatial information. Material and methods To elucidate the underlying vascular pathology in Emberger Syndrome on the cellular level, we applied the 3-dimensional visualization and analysis approach VIPAR (volume information-based histopathological analysis by 3D reconstruction and data extraction) to entire wholemount immunofluorescence-stained human tissue samples. VIPAR is a light sheet microscopy-based imaging technique, which allows 3-dimensional reconstruction of entire tissue biopsies followed by automated and semi-automated analysis of vascular parameters in 3-dimensional space. Results Using VIPAR we could show that in Emberger Syndrome the dermal lymphatic vasculature is intact and non-disrupted.However, lower limbs showed an hypoplastic lymphatic vasculature with absence of lymphatic valves in pre-collecting and collecting vessels. In contrast to the lower limbs, the lymphatic vasculature of the upper limbs showed no morphological alterations of lymphatic vessels and lymphatic valves compared to healthy controls. Discussion Based on the 3-dimensional histopathological analysis we were able to perform a detailed phenotyping of lymphatic vessels in the upper and lower limb in Emberger Syndrome and to identify the underlying vascular pathology. In addition, we could show vascular alteration between the upper and lower limbs indicating a vascular heterogeneity of dermal lymph vessels causing the lower limb lymphedema.

scholarly journals Acute Care of Older Patients with COVID-19: Clinical Characteristics and Outcomes

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 65
Author(s):  
Zara Steinmeyer ◽  
Sara Vienne-Noyes ◽  
Marc Bernard ◽  
Armand Steinmeyer ◽  
Laurent Balardy ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Final Analysis ◽  
Geriatric Syndromes ◽  
Global Pandemic ◽  
Clinical Presentations ◽  
The Mean

(1) Background: COVID-19 has become a global pandemic and older patients present higher mortality rates. However, studies on the characteristics of this population set are limited. The objective of this study is to describe clinical characteristics and outcomes of older patients hospitalized with COVID-19. (2) Methods: This retrospective cohort study was conducted from March to May 2020 and took place in three acute geriatric wards in France. Older patients hospitalized for COVID-19 infections were included. We collected clinical, radiological, and laboratory outcomes. (3) Results: Ninety-four patients were hospitalized and included in the final analysis. Mean age was 85.5 years and 55% were female. Sixty-four (68%) patients were confirmed COVID-19 cases and 30 (32%) were probable. A majority of patients were dependent (77%), 45% were malnourished, and the mean number of comorbidities was high in accordance with the CIRS-G score (12.3 ± 25.6). The leading causes of hospitalization were fever (30%), dyspnea (28%), and geriatric syndromes (falls, delirium, malaise) (18%). Upon follow-up, 32% presented acute respiratory failure and 30% a geriatric complication. Frailty and geriatric characteristics were not correlated with mortality. Acute respiratory failure (p = 0.03) and lymphopenia (p = 0.02) were significantly associated with mortality. (4) Conclusions: Among older patients hospitalized with COVID-19, clinical presentations were frequently atypical and complications occurred frequently. Frailty and geriatric characteristics were not correlated with mortality.

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