ISSN:1040-8800    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1040-8800    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Evaluation of counseling services is a recent innovation but is necessary to prevent perpetuation of ineffective practices. Two studies are reported. The first study explores the nature of problems presented spontaneously to the counselor, and the second study evaluates the effect of counseling offered in the first weeks after amputation. In the first study records were kept of the problems raised and 100 consecutive patients were selected who were concerned about emotional issues. In the second study 58 patients’ responses to a questionnaire about difficulties with a number of aspects of daily living were recorded at the first interview and again 4 to 6 months later. Eighteen (31%) of these patients elected to have counseling and their follow up responses are compared with those who declined counseling. The majority of respondents saw counseling as useful or potentially useful. Depression and body image disruption were most frequently raised; these were not universally experienced but were expressed by a significant minority of the patients. The problems reported in study 2 were concerned with practical issues such as performing tasks as well as housing and emotional issues such as depression, anger, and body image. At follow-up, 4 to 6 months after amputation, the group who elected to have counseling showed an improvement in the practical problems relative to those who were not counseled. Emotional problems showed an increase in both groups. Both studies indicated that emotional problems became apparent about 6-24 months after amputation. Counseling offered in the early weeks after amputation was seen as beneficial and showed a positive effect on the experience of practical problems. However, emotional problems become more apparent at a later stage.

ISSN:1040-8800    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1040-8800    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Scheuermann’s disease manifests itself as a thoracic or thoracolumbar kyphosis classically characterized by anterior wedging of 5 degrees or more of three adjacent thoracic vertebral bodies. Bracing has been shown to be effective in controlling a progressive curve in the adolescent patient. These adolescent patients typically present for medical attention because of pain or cosmetic deformity or both. Early treatment may be limited to observation and exercises, whereas patients who have kyphosis of up to 75 degrees and growth remaining may benefit from bracing. For the more common thoracic form with apices superior to T8, the Milwaukee brace’s effectiveness has been documented and is usually the treatment of choice. This purpose of this article is to document a case for the treatment of the thoracic form of Scheuermann’s disease (apice T6–7) with an underarm thoracolumbosacral orthosis. A custom thoracolumbosacral orthosis was measured and fabricated as an alternative to the Milwaukee brace to treat a 71-degree kyphosis with an apice of T6-T7. Initial in brace correction was 49%. At a fourteen-month follow-up, out-of-brace correction was maintained at 27% of the original kyphosis. These results indicate that a thoracolumbosacral orthosis may be a viable alternative to the Milwaukee brace in treating Scheuermann’s disease with high apices.

ISSN:1040-8800    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Anterior cruciate ligament deficient knees are a common pathological condition for which a knee orthosis is used. The ability of a custom knee orthosis to prevent anterior displacement of the tibia is of critical importance when used on patients with an anterior cruciate ligament deficient knee. A mechanical test program was carried out to compare a novel orthotic fabrication platform, Composite Reinforcement Instead of Sidebars, with commercially available knee braces. The ability of the knee orthoses to prevent anterior tibial displacement served as the criterion for comparison in the test program. The Composite Reinforcement Instead of Sidebars knee orthoses were found to be the most effective of all braces studied in resisting tibial translation in a surrogate model of the knee. The orthoses were also about twice as effective as the competitive braces on a stiffness/weight basis.

ISSN:1040-8800    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The purpose of this case study was to isolate and examine the key elements in a transfemoral interface and determine their impact on the femur and the pelvis using a dynamic medium. There are many variations and theories on the most functional interface design. This case study attempts to verify the significance of certain elements of the transfemoral interface. This case study utilizes static medium (radiograph) to confirm an ideal fit of the transfemoral prosthesis. Once this is achieved the vital elements are isolated and examined using the dynamic medium of the fluoroscope. It attempts to show the reaction of the femur, ischium, and the pelvis during the stages of gait. In examining the vital elements in a dynamic medium, and determining their importance, we can place more emphasis on those elements and de-emphasize the non-vital elements. This could potentially increase comfort and function.

ISSN:1040-8800    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

A person with an upper-extremity amputation who uses prosthesis often engages in prehension activities that require the grasping and manipulation of objects. As a result of the amputation, such prehension activities are clearly performed with a significant loss of proprioceptive information. It has been shown in the psychophysical literature that losses in proprioceptive information impair both perceptual judgments (such as weight discrimination) and motor function in nonamputee participants. It is not known whether similar impairments occur with users of upper-extremity prosthetic devices, therefore two experiments were performed to investigate the ability of individuals using an upper-extremity prosthesis to discriminate weight of hand-held objects. In the first experiment, we compared weight discrimination of nonamputees using either their anatomical limb or a simulated upper-extremity prosthesis. In addition, we included a person with a congenital limb deficiency who was an experienced prosthetic user. The results revealed that weight discrimination was poorer with the simulated prosthesis than with the anatomical hand. Surprisingly, there were no significant differences between the anatomical hand condition of this group of participants and the person with a congenital limb deficiency. In the second experiment, we found that withdrawing visual information from the same person with a congenital limb deficiency did not degrade the ability to discriminate weight. These results suggest that experience using a prosthesis may overcome the initial difficulties in discriminating weight. Discrimination may improve because the experienced prosthetic user learns to rely on other sources of proprioceptive information in making perceptual judgments and/or because the user develops greater control over the prosthesis.

ISSN:1040-8800    

出版商:OVID    

年代:2002

数据来源: OVID