ISSN:1040-8800    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1040-8800    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1040-8800    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1040-8800    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The purpose of this study was to determine the effectiveness of an off-the-shelf functional knee brace on preventing anterior tibial translation in anterior cruciate ligament-deficient knees (ACL-d) with greater than 6 mm of side-to-side difference, and the effect of a 50% maximal voluntary hamstring contraction on knee joint laxity. A therapist experienced in using the Knee Signature System (KSS) screened 14 patients who had been diagnosed arthroscopically with ACL deficiency. Nine patients (8 men, 1 woman; mean age, 32.9 years; mean mass, 75 kg; mean height, 177 cm) met the inclusion criteria. All participants were 240 ± 42 days post injury. Participants in the study were tested with no brace, with brace, and 50% maximal voluntary contraction (MVC) of the hamstrings. The uninjured limb was tested only in the unbraced condition. Repeated measures ANOVA (p≤ .05) and a Bonferronipost hocanalysis was used to detect specific differences between conditions. Results indicate that a 50% hamstring contraction provided better control of anterior tibial displacement than a functional knee brace under the same loading conditions, but a brace may contribute significantly to reducing anterior displacement when the hamstring force is not sufficient.

ISSN:1040-8800    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1040-8800    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The purpose of the study was to determine the feasibility of quantifying pressure-related socket discomfort by using psychophysical methods. The first experiment involved the application of known uniform pressure to the residual limbs of three transtibial amputees. Category ratio scales were used to measure sensations of pressure, pain, and perceived discomfort. The second experiment involved altering the geometry at the fibula head and distal tibia of the subjects’ fitted PTB sockets with wafers of varying thickness and use of the same three scales to measure response to the variations in local point-specific pressures. Two of the subjects had more than 32 years of experience with PTB sockets, whereas the third subject had just been fitted with a temporary prosthesis. Results indicated that response functions for global uniform pressure varied among the subjects but were similar for the modifications at specific locations. Both experienced amputees reported constant pressure sensations between 10 and 40 mm Hg of applied uniform global pressure, whereas the inexperienced subject reported a linear increase in pressure sensation over the same range. Pressure and discomfort sensations appeared to be isolated subjectively and assigned different magnitudes among subjects, creating unique response functions for each subject. Possible explanations for unique uniform global pressure response functions could involve years of experience using a PTB socket, residual limb tissue thickness, and morphology or the way in which the amputation surgery was performed. For pressure variations at the fibula head and distal tibia, pressure sensation and perceived discomfort were highly correlated and appeared not to be distinct sensations. Response functions were similar among subjects. Psychophysical measurement could be adapted for use in a clinical setting during the fitting process and offer researchers additional tools for evaluating alternative socket designs and materials. The methods permit the patient to communicate discomfort sensations more precisely and provide the prosthetist with additional insight into the patient’s perception of quality of socket fit.

ISSN:1040-8800    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The purpose of the study was to demonstrate how the psychophysical theory of signal detection (SDT) can be applied to the process of fitting sockets and used to model the ability of patients to make judgments concerning the expectation of discomfort problems when uncertainty exists. For experimental purposes, a signal was defined as the ability of a patient to detect aspects of socket geometry that could lead to discomfort or tissue breakdown after initial fitting. An experiment was designed that consisted of varying the check socket geometries for three transtibial amputees by inserting 1.6-mm and 2.6-mm thick wafers at the distal tibia and fibula head and asking the subjects to report the degree of certainty they had regarding the discomfort the socket might produce after a day of use. In addition, psychophysical category ratio scales were used to measure the magnitudes of the pressure, discomfort, and pain perceived by the subjects for each experimental condition. Two of the subjects were experienced prosthesis users, and the third was an inexperienced individual in the process of being fitted for a first temporary prosthesis. One experienced subject indicated with maximum certainty that any alteration which reduced relief at the distal tibia and fibula head by even 0.6 mm, the thinnest insert in the experiment (a pressure-sensing element), would produce intolerable discomfort. However, the other two subjects provided good experimental data representing a range of uncertainties, and receiver operating characteristic (ROC) curves were fitted to their responses. The curves for the inexperienced subject for the weakest signals presented (1.6-mm thickness) indicated performance no better than pure guessing, but performance improved for the thicker wafers (2.6-mm thickness). The ROC curves for the remaining experienced subject indicated much less uncertainty with the thinnest wafer and nearly perfect signal detection for the thicker wafer. Possible explanations for these results are presented. The paper also discusses how the probabilities associated with the four possible outcomes of the judgment task—hit, miss, correct rejection, and false alarm—are dependent on the relative costs and benefits of the outcomes.

ISSN:1040-8800    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Myelomeningocele, a congenital neural tube defect, is the most serious form of spina bifida. Many children with myelomeningocele use lower extremity orthoses, mostly ankle-foot orthoses (AFOs), for ambulation and socialization. However, as children with myelomeningocele enter their teens and early adulthood, many find the use of orthoses to be too consuming, cumbersome, and uncomfortable and prefer to use a wheelchair as their principal or exclusive mode of mobility. A research study at Rancho Los Amigos National Rehabilitation Center explored the use of advanced composite materials as an option for AFOs by children with myelomeningocele. To better understand the use of existing orthosis designs and materials, and to better determine which aspects of current orthosis technology needed improving most critically, two different surveys were constructed: one to certified orthotists (COs) in the United States and one to children with myelomeningocele. The surveys investigated issues including prescription criteria, materials and designs used, orthosis comfort, durability, cosmesis, and peer response.Completed and returned survey totals included 26 child responses and 32 CO responses. Results showed that the most common orthosis fitted to children with myelomeningocele was the polypropylene posterior solid-ankle AFO followed by the polypropylene floor-reaction AFO and that most children wore bilateral AFOs. Children with myelomeningocele associated skin irritation as the most troublesome factor of an unsuccessful treatment and felt that shoewear options were limited. COs stated that a critical step in the orthotic treatment process was user compliance and observed that the compliance declined with age. Overall, there was common agreement between the two surveyed groups. Data from both surveys indicated that although polypropylene was commonly used, it was not without its limitations in providing adequate ankle support and comfort to children with myelomeningocele.

ISSN:1040-8800    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1040-8800    

出版商:OVID    

年代:2001

数据来源: OVID