Changes in activities-specific balance confidence of active unilateral transtibial prosthesis users after provision of a self-aligning ankle foot.

Background: Self-aligning ankle feet have an increased range of motion and are marketed to improve compliance over uneven terrain and increase function and balance; however, much of the existing literature focuses on the biomechanical aspect of these prostheses as opposed to patient-reported measures.

Objective: To compare activities-specific balance confidence (ABC), health-related quality of life (HR-QoL), perceived mobility, gait speed, and step length before and after provision of a self-aligning ankle foot in the active unilateral transtibial prosthesis user.

Study Design: Retrospective analysis of prospectively collected data.

Absent loading response knee flexion: The impact on gait kinetics and centre of mass motion in individuals with unilateral transfemoral amputation, and the effect of microprocessor controlled knee provision.

Background: Individuals with unilateral transfemoral amputation walk with increased levels of asymmetry, and this is associated with reduced gait efficiency, back pain and overuse of the intact limb. This study investigated the effect of walking with a unilateral absence of loading response knee flexion on the symmetry of anterior-posterior kinetics and centre of mass accelerations.

Methods: A retrospective cohort study design was used, assessing three-dimensional gait data from individuals with unilateral transfemoral amputation (n = 56).

Functional quadriceps reconstruction: 3D gait analysis, EMG and environmental simulator outcomes.

Object: Limited objective evidence exists on the benefits of functional muscle transfers following quadriceps resection in sarcoma. In particular, no studies have compared patients with functional transfers to those without. In this study, objective and subjective assessments were performed with 3D Gait Analysis, Environmental Simulator, Electromyography (EMG) and Patient-Reported Outcomes.

Comparison of patient-reported and functional outcomes after transition from traditional upper limb prosthetics to multiarticulating hands in the user with a unilateral transradial amputation.

Background: Multiarticulating hands (MAHs) have been commercially available for over 15 years. Despite this, their cost remains significantly higher than traditional electric hands, and they are not routinely available in many countries. The Scottish Specialist Prosthetic Service within the National Health Service has been prescribing MAHs since 2014.

Minimal clinically important difference in walking velocity, gait profile score and two minute walk test for individuals with lower limb amputation.

Background: Individuals with lower limb amputation are routinely assessed with a variety outcome measures, however there is a lack of published data to indicate minimal clinically important differences (MCID) for many of these outcome measures. Three such important gait-specific outcome measures include walking velocity, gait profile score (GPS) and the two minute walk test (2MWT).

Research Question: Determine the MCIDs for walking velocity, GPS and 2MWT for individuals with lower limb amputation.

Comparison of patient-reported and functional outcomes following transition from mechanical to microprocessor knee in the low-activity user with a unilateral transfemoral amputation.

Background: The Scottish Specialist Prosthetics Service has provided microprocessor knees (MPKs) through the National Health Service since 2014, predominantly to high-activity transfemoral amputations (TFAs). Benefits of MPKs to the lower-activity TFA are less established in the literature.

Objectives: This study aimed to compare patient-reported and functional measures in low-activity TFAs transitioning from a mechanical knee to a MPK.

Evaluation of gait outcomes for individuals with established unilateral transfemoral amputation following the provision of microprocessor controlled knees in the context of a clinical service.

Background: Microprocessor controlled knees (MPKs) have been shown to improve gait outcomes for individuals with unilateral transfemoral amputation (TFA); however, previous studies have limitations, which may affect their applicability.

Objectives: To compare gait outcomes between non-MPK and MPK conditions within a large and diverse cohort of established TFAs in the pragmatic context of an operational clinical service and to identify any demographic variables that correlate with changes in gait outcomes.

Study Design: This is a retrospective cohort study.

A characterisation of established unilateral transfemoral amputee gait using 3D kinematics, kinetics and oxygen consumption measures.

Background: Persons with unilateral transfemoral (UTF) amputation are known to walk with less efficiency than able-bodied individuals, therefore understanding the gait deviations that drive this inefficiency was considered to be important.

Research Questions: What are the differences in gait outcomes between persons with UTF amputation and able-bodied persons? What is the prevalence of specific gait deviations within this group?

Methods: Using a cross-sectional study design, the level over ground gait of established prosthetics service users with UTF amputation using mechanical knee joints (n=60) were compared with able-bodied persons (n=10). Gait profile score, walking velocity, step length, step length symmetry ratio, step time symmetry ratio, vertical ground reaction force symmetry index, base of support, centre of mass deviation and metabolic energy expenditure were measured.

The immediate effects of fitting and tuning solid ankle-foot orthoses in early stroke rehabilitation.

Background: Ankle-foot orthoses are known to have a generally positive effect on gait in stroke, however the specifc type of AFO and the time point at which it is provided are highly variable in the currently available literature.

Objective: The objective was to determine the immediate spatiotemporal and kinematic effect of custom-made solid ankle-foot orthoses in early stroke rehabilitation, compared to shod walking.

Methods: Five male and three female participants were recruited to the study (n = 8), with a mean age of 57 (16) years who were 3.

Affordable clinical gait analysis: an assessment of the marker tracking accuracy of a new low-cost optical 3D motion analysis system.

Background: 3D motion analysis represents a method of collecting objective, accurate and repeatable gait data, however the high cost of equipment inhibits its widespread use in routine clinical practice.

Objective: To determine the marker tracking accuracy of a new low-cost optical 3D motion analysis system.

Design: Comparative between-system study.

Developing visualisation software for rehabilitation: investigating the requirements of patients, therapists and the rehabilitation process.

This article describes the ongoing process of engaging with users in the development and evaluation of prototype visualisation software, which aims to assist in the understanding and improvement of appropriate movements during rehabilitation. The value of the process is illustrated in the article with a discussion of the key findings of pre-pilot focus groups with stroke survivors and therapists. The article describes how the design of the visualisation software is being adapted to meet the emerging understanding of the needs of patients and professionals, and of the rehabilitation process.

Visualisation to enhance biomechanical tuning of ankle-foot orthoses (AFOs) in stroke: study protocol for a randomised controlled trial.

Background: There are a number of gaps in the evidence base for the use of ankle-foot orthoses for stroke patients. Three dimensional motion analysis offers an ideal method for objectively obtaining biomechanical gait data from stroke patients, however there are a number of major barriers to its use in routine clinical practice. One significant problem is the way in which the biomechanical data generated by these systems is presented.

A novel device for evaluating forces during the dynamic jar opening action--do older and younger adults do things differently?

Package opening tasks have been identified as some of the most challenging that individuals need to perform to access food. There is little previous study of the 3D hand loading that is required to open these products. A novel load measuring device was used to characterise torque, squeeze and compression forces during the dynamic action of jar opening for young and older adults.