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Canadian Prosthetics & Orthotics Journal 2023Victoria Hand Project (VHP) is a Canadian charity with a mission to provide 3D printed prosthetic arms to people in-need across the world, by partnering with prosthetic...
Victoria Hand Project (VHP) is a Canadian charity with a mission to provide 3D printed prosthetic arms to people in-need across the world, by partnering with prosthetic care providers. This article explores the journey of VHP, sharing insights, lessons learned, ongoing directions, and the impact of 3D printing on prosthetic care for people with upper-limb amputation. Benefits such as affordability and customization are explored, as well as the challenges encountered, including quality control and the steep learning curve associated with working in the digital 3D space. Through this article, the potential of 3D printing to continue to transform the field of assistive technology and prosthetic and orthotic applications is underscored, especially when used for collaborative, humanitarian initiatives.
PubMed: 38873134
DOI: 10.33137/cpoj.v6i2.42142 -
Canadian Prosthetics & Orthotics Journal 2023Cosmetic covers provide better aesthetic appearance and may facilitate increased acceptance of the prosthesis. Traditionally, cosmetic covers aimed to achieve an... (Review)
Review
Cosmetic covers provide better aesthetic appearance and may facilitate increased acceptance of the prosthesis. Traditionally, cosmetic covers aimed to achieve an aesthetic and realistic appearance; through time, a fresh perspective has developed on cosmetic covers where traditional/realistic covers evolved into a custom-made product, which truly promotes the patient's personality. The objectives of the study were to gather information from five well-known companies in the cosmetic cover industry (UNYQ, Limb-Art, Alleles, WillowWood and Aqua-Leg), analyse and compare their design elements using the Pugh matrix, and suggest a novel design using the best performing criteria of each design. The overall results of the Pugh matrix revealed the opportunity of a new design with improved design elements mainly in terms of "cover fit/aesthetics", "ease of attachment" and "practicality". The novel design had a vast difference in total score from the second-best design, revealing the improvement possibilities such cover design may have in the future. Although the study successfully presented a theoretical novel design, it was based on data found through literature and web resources, making the overall results of the study more objective rather than subjective. Future research is encouraged to be conducted based on a more subjective approach towards cosmetic covers.
PubMed: 38873131
DOI: 10.33137/cpoj.v6i2.42176 -
Canadian Prosthetics & Orthotics Journal 2023Major limb loss can have profound physical and psychosocial implications for individuals, impacting their quality of life and well-being. Despite the effectiveness of... (Review)
Review
BACKGROUND
Major limb loss can have profound physical and psychosocial implications for individuals, impacting their quality of life and well-being. Despite the effectiveness of peer support in improving outcomes for various chronic conditions, its impact on individuals with major limb loss remains understudied.
OBJECTIVES
This review aims to explore the existing literature on peer support for individuals with major limb loss. Specifically, exploring how the literature defines peer support; examining its implementation, identifying outcomes measured in peer support interventions, assessing the benefits for individuals with major limb loss, and identifying barriers associated with peer support provision.
STUDY DESIGN
This review followed Arksey and O'Malley's methodological framework, analysing relevant literature to identify evidence, definitions, and key factors related to peer support for individuals with major limb loss.
METHODOLOGY
A comprehensive search in January 2023 utilized databases: MEDLINE, PsychInfo, Embase, and CINAHL. After a two-phase screening process, articles meeting specific criteria were included. Thematic and descriptive numerical analyses were applied to the extracted data.
FINDINGS
Twenty-two articles were reviewed. Peer support was described as an opportunity to provide education, advice, and encouragement between individuals with lived experiences. Across the two intervention-based studies investigating peer support programs, outcome measures included physical, psychological, social, and quality of life. Qualitative studies described perceived benefits as improved psychosocial well-being and the opportunity to exchange knowledge. Perceived barriers included a lack of formal training and male-dominated groups, which deterred individuals with amputation from participating.
CONCLUSION
The evidence from the findings of the review sheds light on the current understanding of peer support for individuals with amputation. Due to the limited number of studies available, future research is necessary to develop and evaluate the effectiveness of peer support interventions tailored to this population.
PubMed: 38873011
DOI: 10.33137/cpoj.v6i1.42170 -
Canadian Prosthetics & Orthotics Journal 2023The choice of prosthetic socket interface material significantly affects user comfort and satisfaction. The Affordable Ethylene-Vinyl Acetate Roll-On (AERO) liner was...
BACKGROUND
The choice of prosthetic socket interface material significantly affects user comfort and satisfaction. The Affordable Ethylene-Vinyl Acetate Roll-On (AERO) liner was created with the aim of improving functionality and streamlining the wearing process for users.
OBJECTIVE
The purpose of this study was to comprehensively assess user satisfaction, comfort, and durability of the AERO liner and compare it with the common soft Pe-Lite liner.
METHODOLOGY
Fourteen individuals with transtibial amputation participated in this three-month randomized crossover trial study. The Prosthesis Evaluation Questionnaire (PEQ), Expanded Socket Comfort Score (ESCS), and liner thickness measurements were used to comprehensively compare the AERO and Pe-Lite liner.
FINDINGS
The AERO liner demonstrated notable improvements in prosthetic comfort and functionality over Pe-Lite liner. After three months use, there was a significant reduction in reported frustration with the AERO liner (p=0.023, r=0.604) in the PEQ subscale. Specific aspects, such as walking with the prosthesis (p=0.030, r=0.601) and odor perception (p=0.024, d=0.579), favored the use of the AERO liner. The expanded socket comfort score (ESCS) revealed significant superiority for the AERO liner "at best" (p=0.04) and "on average" (p=0.02) after one and three months, respectively. Liner thickness analysis showed significant reductions at the mid-patellar tendon location for the AERO liner at one (0.57±0.48) and three months (0.90±0.69, p=0.01) and in the posterior region after three months (0.63±0.64, p=0.05).
CONCLUSION
Our study highlights the potential advantages of the AERO liner in enhancing comfort and satisfaction. Yet, durability and thinning of the liner when compared to Pe-Lite may be a concern which may eventually affect socket fit. These findings contribute to ongoing efforts to optimize prosthetic interventions and improve the quality of life of individuals with lower limb prosthesis in resource-limited environments.
PubMed: 38873010
DOI: 10.33137/cpoj.v6i1.41865 -
Canadian Prosthetics & Orthotics Journal 2023There is a dearth of literature evaluating the accuracy of Air Displacement Plethysmography (ADP) compared to Dual-energy X-ray Absorptiometry (DXA) for assessing body...
BACKGROUND
There is a dearth of literature evaluating the accuracy of Air Displacement Plethysmography (ADP) compared to Dual-energy X-ray Absorptiometry (DXA) for assessing body composition in individuals with lower limb amputations. Validity of ADP in persons with lower limb amputations must be established.
OBJECTIVE
The objective of this study was to compare body composition in persons with lower limb amputations using the BOD POD and DXA.
METHODOLOGY
Body composition was performed on eleven lower limb prosthesis users (age 53.2±14.3 years, weight 81.9±22.3kg) using ADP and DXA with and without prosthesis.
FINDINGS
Repeated measures ANOVA indicated no significant difference in body composition among and between trials, F(3,8)= 3.36, p= 0.075. There were no significant differences in Body Fat (BF) percentage with and without prostheses on the BOD POD (28.5±15.7% and 33.7±12.1%, respectively) nor the DXA (32.9±10.6% and 32.0±9.9%, respectively). Association between the BOD POD and DXA were greatest when prostheses were not worn compared to when they were worn. Bland-Altman plots indicate agreement between BOD POD and DXA was greatest while wearing the prosthesis.
CONCLUSION
This study is a first to compare total body fat percent between the BOD POD and DXA in lower limb prosthesis users. BOD POD report valid indices of BF%. Future work will utilize the BOD POD in intervention studies for monitoring body composition changes across the continuum of rehabilitation.
PubMed: 38873009
DOI: 10.33137/cpoj.v6i1.41605 -
Canadian Prosthetics & Orthotics Journal 2023Residual limb discomfort and injury is a common experience for people living with lower limb amputation. Frequently, inadequate load distribution between the prosthetic...
BACKGROUND
Residual limb discomfort and injury is a common experience for people living with lower limb amputation. Frequently, inadequate load distribution between the prosthetic device and the residual limb is the root cause of this issue. To advance our understanding of prosthetic interface fit, tools are needed to evaluate the mechanical interaction at the prosthetic interface, allowing interface designs to be evaluated and optimised.
OBJECTIVE
Present a methodology report designed to facilitate comprehension of the mechanical interaction between the prosthetic interface and the residual limb. As a pilot study, this methodology is used to compare a hands-on and hands-off interface for a single transtibial prosthesis user using secondary Magnetic Resonance Imaging (MRI) data.
METHODOLOGY
MRI data of the residual limb while wearing a prosthetic interface is segmented into a hard tissue and a skin surface model. These models are exported as stereolithography (STL) files. Two methods are used to analyse the interface designs. Firstly, CloudCompare software is used to compute the nearest vertex on the skin surface for every vertex on the compiled internal bony surface for both interface types. Secondly, CloudCompare software is used to compare registered skin surfaces of the residual limb while wearing the hands-on and hands-off interfaces.
FINDINGS
The maximum and minimum nearest distances between the internal bony surface and skin surface were similar between interface types. However, the distribution of nearest distances was different. When comparing the skin surface while wearing both interfaces, where the fit is more compressive can be visualized. For the dataset used in this study, the classic features of a hands-on Patella Tendon Bearing interface and hands-off pressure cast interface could be identified.
CONCLUSION
The methodology presented in this report may give researchers a further tool to better understand how interface designs affect the soft tissues of the residual limb.
PubMed: 38873008
DOI: 10.33137/cpoj.v6i1.42196 -
Canadian Prosthetics & Orthotics Journal 2023Effective rehabilitation after limb loss is necessary to maximize function and promote independence. Physical therapists (PT) are one of the primary drivers of the... (Review)
Review
BACKGROUND
Effective rehabilitation after limb loss is necessary to maximize function and promote independence. Physical therapists (PT) are one of the primary drivers of the rehabilitation process. While general physical therapy knowledge and abilities have been shown to be important to the rehabilitation process, it is unclear what individuals with limb loss value in their PT's.
OBJECTIVE
The purpose of this study was to understand the elements that define an ideal PT from the perspective of individuals with limb loss.
METHODOLOGY
Mixed-method design consisting of a 20-item web-based survey and semi-structured interviews that were administered to individuals 18 years or older, who spoke English, and had a history of lower limb loss.
FINDINGS
Individuals with limb loss describe an ideal PT as promoting a therapeutic alliance, having specialized knowledge, and collaborating with a prosthetist. Knowledge of the PT as it relates to limb loss was found to be both the greatest facilitator and barrier to the rehabilitation process.
CONCLUSION
From the perspective of those with limb loss, an ideal PT promotes a strong therapeutic alliance through communication, has specialized knowledge when it comes to the limb loss rehabilitation process, and collaborates with the prosthetist to problem-solve throughout the rehabilitation process.
PubMed: 38873007
DOI: 10.33137/cpoj.v6i1.42093 -
Canadian Prosthetics & Orthotics Journal 2023Despite the recent advancements in the design and manufacture of prostheses for individuals with craniofacial irregularity and amputation, these individuals tend to... (Review)
Review
BACKGROUND
Despite the recent advancements in the design and manufacture of prostheses for individuals with craniofacial irregularity and amputation, these individuals tend to become self-conscious about their appearance. The aim of this study was to investigate the reliability and validity of Persian version of the Derriford Appearance Scale24 (P-DAS24) for a sample of individuals with craniofacial irregularity and limb loss.
METHODOLOGY
Reliability of the P-DAS24 was determined by computing internal consistency and test-retest reliability utilizing Cronbach's alpha coefficient and Pearson's correlation coefficient. Discriminant validity was investigated with comparing the total score of the P-DAS24 between disfigured participants and those with no appearance problem. Known-groups validity was evaluated regarding the participants' gender and their level of involvement.
FINDINGS
The sample size comprised of 251 individuals with disfigurement and 101 without disfigurement who were deemed normal in appearance. The P-DAS24 showed satisfactory internal consistency (Cronbach's alpha = 0.89) and excellent test-retest reliability (r = 0.96). The total score of the P-DAS24 showed a statistically significant difference between individuals deemed disfigured or normal (P=0.01). The total scores P-DAS24 in individuals with different levels of involvement were significantly different (P<0.001). The scores of the DAS2, DAS18, DAS21, and DAS24 were significantly different between men and women (P<0.01, <0.01, 0.03, and 0.01, respectively).
CONCLUSION
The P-DAS24 is a valid and reliable tool that may be utilized in clinical practice and researches to assess the outcomes of prosthetic reconstructions in individuals with disfigurement.
PubMed: 38873006
DOI: 10.33137/cpoj.v6i1.41454 -
Canadian Prosthetics & Orthotics Journal 2023Objective mobility measurement of Nepali prosthesis users is lacking.
Cross-Cultural Adaptation and Validation of The Nepali Version of The Prosthetic Limb Users Survey of Mobility Short-Form (Plus-M™/Nepali-12Sf) In Lower Limb Prosthesis Users.
BACKGROUND
Objective mobility measurement of Nepali prosthesis users is lacking.
OBJECTIVE
The objective of this study was to cross-culturally adapt, translate and evaluate construct validity of the Prosthetic Limb Users Survey of Mobility (PLUS-M™/Nepali-12 Short Form (SF)) instrument in lower limb prosthesis users residing in Nepal.
METHODOLOGY
Two forward translations, review and reconciliation, back translation, expert review, developer review to create the PLUS-M™/Nepali-12SF. Psychometric testing for internal consistency, test-retest reliability and construct validity against the Two-Minute Walk Test (2MWT) and Amputee Mobility Predictor with Prosthesis (AMPPRO) were performed on sixty-six lower limb prosthesis users.
FINDINGS
The majority of populations were with transtibial amputation 45 (68%), with transfemoral amputation 15 (23%), with knee disarticulation 5 (7.5%) and with syme's amputation 1 (1.5%). The most common cause of amputation among the population was trauma and the least was tumor. Chronbach's alpha for the PLUS-M™/Nepali-12SF was 0.90, mean T-Score was 52.90, test-retest intraclass correlation coefficient (ICC) was 0.94 (95% confidence interval 0.90-0.96). Construct validity with the 2MWT was good (r = 0.62, p< 0.001) and moderately positive with the AMPPRO (r = 0.57, p< 0.001).
CONCLUSION
Our research evidenced that the PLUS-M™/Nepali-12SF had excellent reproducibility. The significance of this work is that it may allow for the measurement of mobility in austere locations of Nepal.
PubMed: 38873005
DOI: 10.33137/cpoj.v6i1.41310 -
Cureus May 2024Gefitinib is an epidermal growth factor tyrosine kinase inhibitor used as a targeted chemotherapeutic agent in the treatment of lung cancer and other solid malignancies....
Gefitinib is an epidermal growth factor tyrosine kinase inhibitor used as a targeted chemotherapeutic agent in the treatment of lung cancer and other solid malignancies. The most common adverse effects of gefitinib include dermatological side effects and gastrointestinal symptoms, with rare reports of vascular side effects such as myocardial infarction and stroke. We recently reported a case of a patient with diabetes and multiple comorbidities who developed a serious lower limb vascular adverse event after gefitinib treatment, ultimately leading to amputation surgery. This is the first reported case of lower extremity amputation following gefitinib therapy in a patient with type 2 diabetes mellitus and lung adenocarcinoma. This case highlights the potential risk of amputation in diabetic patients receiving targeted therapies like gefitinib, especially in those with vascular complications. It emphasizes the importance of exercising extra caution when dealing with these patients.
PubMed: 38872703
DOI: 10.7759/cureus.60234