Lower Limb Amputees
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2021 ◽  
Author(s):  
Irene Aprile ◽  
Marco Gallotti ◽  
Marco Germanotta ◽  
Pasquale Alessio Sauchelli

Introduction:Even if gait analysis is a validated outcome measure to assess the effects of a rehabilitation program on gait performance, few articles have been produced about the evaluation of a rehabilitation program in lower limb amputees using the gait analysis as a measure of outcome. Inclusion criteria:The inclusion criteria of the following narrative review is to investigate all the studies, without year limitations but only in English, whose population was lower limb adult amputees that underwent a rehabilitation process evaluated through the use of the gait analysis as a measure of outcome. Methods:Three databases will be investigated: Scopus, Pubmed and Embase, without year limitations but only in English. Study selection will be done following the inclusion and exclusion criteria, data extraction will follow the review’s objectives. Agree II scale will be used to assess the quality of guidelines, Amstar 2 scale will be used to evaluate systematic review, Pedro scale will be used to assess quality of randomized controlled trial, Stard-2015 scale will be used to assess observational studies. Two reviewers will screen the articles in blind and a third reviewer will solve the conflicts raised. Objective:The aim of this narrative review will be the investigation of the extent, type and results of evidence in relation to gait and rehabilitation in lower limb amputees.  


Symmetry ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2282
Author(s):  
Kazuki Fukui ◽  
Noriaki Maeda ◽  
Makoto Komiya ◽  
Shogo Tsutsumi ◽  
Keita Harada ◽  
...  

Virtual reality (VR)-based rehabilitation has been used in lower limb amputees; however, the extent to which VR is effective in reacquiring symmetrical gait in lower limb amputees is unclear. The purpose of this study was to confirm whether a VR intervention is effective in obtaining a simulated prosthetic gait. The participants were 24 healthy males who had never worn a simulated prosthesis. They were divided into three groups: VR, tablet, and control groups. The intervention consisted of 5 min of in situ stepping on parallel bars and watching a video of a simulated prosthetic leg walker on a head-mounted display or a tablet. Measurements included Gait Up parameters during a 10-m walk and immersion scores. After the intervention, there was a significant interaction between walking speed and leg swing speed in the VR group. The rate of improvement in walking speed and immersion scores was significantly higher in the VR group than in the other two groups, and there was a significant positive correlation between the rate of improvement and immersion scores. Compared to the tablet and control groups, the VR group showed the highest rate of immersion and improvement in walking speed.


2021 ◽  
Author(s):  
◽  
Stuart Baynes

<p>The practice of fitting and making prosthetic limbs using current techniques leaves little room for innovative research and design. Though market leaders are consistently producing more advanced components, prosthetic technicians are using traditional techniques to fabricate prosthetic limbs. New material and design technologies could enable progressive solutions to historic barriers such as fabrication time and cost.  Increasing the amputee’s accessibility to, and enjoyment of exercise may help to advocate and improve their physical and mental health. Design research was used to develop a functional 3D printed swimming prosthesis for lower limb amputees with the use of 3D scanning, parametric software and Fused Deposition Modelling. Using digital technologies has the potential to provide a platform for cost effective specialty prosthetic limbs, enabling and enriching recreational sport for amputees.  Prototypes were developed with a unilateral trans-tibial amputee using an iterative process involving material testing and user testing. These prototypes allowed him to walk independently to the pool and produced positive effects on his swimming, including a recreated anthropometric symmetry. As advances in data collection and additive manufacturing continue to be made we will be able to more closely cater to the individual’s needs whilst challenging the status quo in prosthesis craft.</p>


2021 ◽  
Author(s):  
◽  
Stuart Baynes

<p>The practice of fitting and making prosthetic limbs using current techniques leaves little room for innovative research and design. Though market leaders are consistently producing more advanced components, prosthetic technicians are using traditional techniques to fabricate prosthetic limbs. New material and design technologies could enable progressive solutions to historic barriers such as fabrication time and cost.  Increasing the amputee’s accessibility to, and enjoyment of exercise may help to advocate and improve their physical and mental health. Design research was used to develop a functional 3D printed swimming prosthesis for lower limb amputees with the use of 3D scanning, parametric software and Fused Deposition Modelling. Using digital technologies has the potential to provide a platform for cost effective specialty prosthetic limbs, enabling and enriching recreational sport for amputees.  Prototypes were developed with a unilateral trans-tibial amputee using an iterative process involving material testing and user testing. These prototypes allowed him to walk independently to the pool and produced positive effects on his swimming, including a recreated anthropometric symmetry. As advances in data collection and additive manufacturing continue to be made we will be able to more closely cater to the individual’s needs whilst challenging the status quo in prosthesis craft.</p>


2021 ◽  
pp. 154596832110566
Author(s):  
Tomoya Nakanishi ◽  
Nobuaki Mizuguchi ◽  
Kento Nakagawa ◽  
Kimitaka Nakazawa

Background. Drastic functional reorganization was observed in the ipsilateral primary motor cortex (M1) of a Paralympic long jumper with a unilateral below-knee amputation in our previous study. However, it remains unclear whether long-term para-sports are associated with ipsilateral M1 reorganization since only 1 athlete with amputation was investigated. Objective. This study aimed to investigate the relationship between the long-term para-sports and ipsilateral M1 reorganization after lower limb amputation. Methods. Lower limb rhythmic muscle contraction tasks with functional magnetic resonance imaging and T1-weighted structural imaging were performed in 30 lower limb amputees with different para-sports experiences in the chronic phase. Results. Brain activity in the ipsilateral primary motor and somatosensory areas (SM1) as well as the contralateral dorsolateral prefrontal cortex, SM1, and inferior temporal gyrus showed a positive correlation with the years of routine para-sports participation (sports years) during contraction of the amputated knee. Indeed, twelve of the 30 participants who exhibited significant ipsilateral M1 activation during amputated knee contraction had a relatively longer history of para-sports participation. No significant correlation was found in the structural analysis. Conclusions. Long-term para-sports could lead to extensive reorganization at the brain network level, not only bilateral M1 reorganization but also reorganization of the frontal lobe and visual pathways. These results suggest that the interaction of injury-induced and use-dependent cortical plasticity might bring about drastic reorganization in lower limb amputees.


BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Zaheer ◽  
Arshad Nawaz Malik ◽  
Tahir Masood ◽  
Sahar Fatima

Abstract Background The objective of the current study is to evaluate the effects of phantom exercises on phantom limb pain, mobility status, and quality of life in lower limb amputees treated with mirror therapy and routine physiotherapy. Methods It is a randomized controlled trial in which 24 unilateral lower limb amputees (above and below the knee) were randomly assigned to two equal groups i.e., control group (mirror therapy and conventional physical therapy) and experimental group in which, phantom exercises were given, additionally. Physical therapy included conventional therapeutic exercises while phantom exercises include imagining the movement of the phantom limb and attempting to execute these movements Data were collected at baseline, after 2 and 4 weeks of intervention using VAS (pain), AMP (mobility) and RAND SF-36 Version 1.0 (QOL) questionnaires. All statistical analyses were done with IBM SPSS 25.0 with 95% CI. Results Twenty-four amputees (17 males and 7 females) participated in this trial. The Mean age of the participants in experimental and control groups was 45.3 ± 11.1 years and 40.5 ± 12.5 years respectively. After the intervention, the pain (VAS score) was significantly lower in the experimental group (p = 0.003). Similarly, the experimental group demonstrated a significantly better score in the “bodily pain” domain of SF-36 (p = 0.012). Both groups significantly (p < 0.05) improved in other domains of SF-36 and ambulatory potential with no significant (p > 0.05) between-group differences. Conclusions The Addition of phantom exercises resulted in significantly better pain management in lower limb amputees treated with mirror therapy and routine physiotherapy. Trial registration This study is registered in the U.S National Library of Medicine. The clinical trials registration number for this study is NCT04285138 (ClinicalTrials.gov Identifier) (Date: 26/02/2020).


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