摘要:

A new, adjustable, bidirectional derotation brace, developed to limit tibiofemoral rotation under applied torsional loading, was tested under both static and dynamic loading conditions using an instrumented knee surrogate. In braced versus unbraced comparisons (n = 4), the brace significantly reduced surrogate-anterior cruciate ligament (ACL) load by an average of 18% and tibiofemoral rotation by an average of 25% when physiologically relevant levels of applied femoral torque (12-70 N-m) were statically applied to the knee joint in a controlled laboratory setting. In addition, reductions in surrogate-ACL load of 34% and 27% with the brace were recorded for two levels of dynamic impact loading. The effectiveness of this new brace concept in limiting surrogate-ACL load and tibiofemoral rotation under applied axial torsion may be relevant for ACL injury prevention, and has not, to our knowledge, been demonstrated in currently available knee braces.

ISSN:1040-8800    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1040-8800    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1040-8800    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

A survey of child amputee clinics in North America explored early fitting of children with unilateral below-elbow limb absence. Responses from 45 of 80 (56%) clinics revealed that most clinics prefer to fit at 6 months and add an active control system by 18 months. These are earlier ages than had been reported in the literature. Myoelectric hands with single site controls are often applied before 1 year. Responders indicated that child development guides the timing for initial fitting and the change to an active terminal device. Independent sitting is the most-used indicator for first fitting; awareness of cause and effect indicates readiness for activation. Passive hands are most often fitted initially. Approximately equal numbers of clinics prefer to use voluntary opening and voluntary closing terminal devices in the active fitting. Myoelectric hands are increasingly used. No significant differences were found between timing and terminal device preferences among clinics in various regions of the US and Canada and between Shriners and non-Shriners Hospitals. Financial considerations were not important in selecting the terminal device except in one-third of clinics at the time of activation. Parents are doing more of the training than was reported in the past, and few clinics use objective tests to measure outcomes of fitting. Responders identified many features they would like to include in a child’s new terminal device.

ISSN:1040-8800    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1040-8800    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The purpose of this study is to evaluate the effects of hydraulic knee controller deterioration on the gait of a single transfemoral amputee subject. As such, this should be considered a preliminary study. A set of gait experiments was developed and conducted to achieve this purpose. Although the subject did feel the difference between the deteriorated hydraulic controllers, no substantial deterioration trends were isolated in the kinematic or kinetic data collected at various stages of knee controller deterioration. A large variability was observed in the baseline gait trials that were recorded on different days. To eliminate the variability, a dynamic model of transfemoral amputee gait was developed based on the experimental data. The model predictions of ground reaction forces showed good agreement with experimental data. The effectiveness of the model was validated.

ISSN:1040-8800    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Reconstruction after head and neck surgery in congenitally malformed, irradiated, or traumatized tissue may preclude the use of free-flap techniques. In these cases, pedicled flaps provide a useful alternative. Development of methods designed to ensure adequate perfusion of these flaps is essential to their survival. The present report compares two cases in which pedicled arm flaps were employed in face and head reconstruction. In the first case, incomplete immobilization allowed for flap failure, whereas complete immobilization in the second case improved patient comfort, supported persistent flow in the pedicle, and resulted in a viable flap. Follow-up examination at 1 year in the second case revealed healthy, well-vascularized tissue at the surgical site. Survival of pedicled arm to head flaps for cranial reconstruction benefits from three-way immobilization securing head to torso, torso to arm, and arm to head.

ISSN:1040-8800    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Few attempts have been made to measure with standardized tests the outcome of counseling for people with amputations. The choice of an appropriate instrument to record emotional distress without the confounding effects of physical disability is often a problem. For this article, a 12-item version of the General Health Questionnaire (GHQ) has been used to overcome this difficulty. The study investigates the distress reported on the GHQ by 58 patients on the first visit to the limb-fitting center within a few weeks of their amputation and again 4 to 6 months later. Eighteen (31%) of these patients elected to have a counseling session, and their follow-up scores are compared with those who did not opt for counseling. The scores of both groups at both time periods are compared with their reports of other problems listed in a second questionnaire. At the first appointment, the group who chose counseling showed higher GHQ scores than those who did not. There was a reliable difference in the scores of those who responded ‘Yes’ or ‘No’ to problems such as anger, depression, and effect on relatives. At follow-up, the scores of both groups had increased, suggesting more awareness of emotional distress 4 to 6 months after surgery. Counseling had not affected this result, although there was a difference in the rate of reporting of practical problems in the counseled versus the uncounseled group. The association between higher scores and reports of difficulty with other emotional issues was still apparent, suggesting some stable validity of the GHQ in this population. The GHQ has shown evidence of utility and validity in measuring the actual levels of emotional distress reported by patients in the early weeks after amputation and again some months after amputation. Those who elected to have counseling had higher scores initially. Both the counseled and the uncounseled groups showed an increase at follow up, indicating the need to target patients for possible counseling at about the 6-month point. The GHQ could then evaluate the effect of this intervention.

ISSN:1040-8800    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1040-8800    

出版商:OVID    

年代:2003

数据来源: OVID