[Update of the Amputation Registry Germany (AMP-Registry)].

Background: Medical registries are used to collect valuable patient data in order to check and control the quality and effectiveness of treatment approaches. National registries in the field of amputation and patient care, such as the Swedish Amputation and Prosthetics Registry (SwedeAmp) and the Limb Loss and Preservation Registry (LLPR) in the USA, gather information on prosthetic devices, materials, procedures and patient-related outcomes such as mobility and quality of life. Since 2011 SwedeAmp could generate significant insights into long-term outcomes after amputations and improve prosthetic care in Sweden.

Functional electrical stimulation in adult patients with cerebral palsy and foot drop-outcome in gait.

Background: Foot drop is a common condition for patients with upper motor neuron syndrome such as cerebral palsy (CP). This study aimed to investigate the effects of functional electrical stimulation (FES) on gait function, quality of life, and FES satisfaction in adults with CP and foot drop. To analyze effects over time, an observational, longitudinal study was performed.

[Motion analysis in lower limb exoprosthetics-possibilities and limitations].

Background: Gait analysis is of high relevance in prosthetics as it is an essential part of the fitting process. The documentation of movement by means of videos and instrumented methods is becoming increasingly important in prosthetics as benefits of a complex prosthesis can best be shown by structured observation.

Procedure: A movement analysis should always be preceded by an anamnesis and clinical examination in order to detect functional limitations of the examined person and thus to establish correlations to gait deviations.

Biomechanical comparison of a 3D-printed prosthetic foot with conventional feet in people with transtibial amputation: A prospective cohort study.

Introduction: The method of 3D printing is increasingly gaining utilization in clinical applications and may support prosthetic fitting. The aim was to compare biomechanical outcomes of people with a transtibial amputation using a novel, individualizable, 3D-printed prosthetic foot (ComfyStep, Mecuris) with two conventional, widely used prosthetic feet during level ground walking using a 3D motion analysis system.

Methods: Ten individuals with an unilateral transtibial amputation were fitted with 3 prosthetic feet (ComfyStep, Assure/Össur, DynamicMotion/Ottobock) using their current, well-fitting socket.

Focusing on functional knee parameter determination to develop a better clinical gait analysis protocol.

Background: Attempts to improve protocol standards of marker-based clinical gait analysis (CGA) have been one of the main focuses of research to enhance robustness and reliability outcomes since the 1990s. Determining joint centres and axes constitutes an important aspect of those protocols. Although the hip joint is more prominent in such studies, knee joint center (KJC) and axis (KJA) directly affect all outcomes.

The influence of hip muscle strength on gait in individuals with a unilateral transfemoral amputation.

Introduction: A unilateral transfemoral amputation (TFA) has a major impact on function. A leg-length discrepancy is the primary structural change, accompanied by the loss of lower-limb muscle volume and function. Prostheses can help individuals with a TFA to regain function, but such individuals still do not reach the functional level of unimpaired peers and exhibit gait deviations.

Biomechanical analysis of stair ascent in persons with Chopart amputation.

Background: Compared to walking on level ground, ascending stairs requires a large range of motion not only of the hip and knee joint, but also of the ankle joint. The prosthesis often worn by persons with partial foot amputation largely prevents the ankle motion needed during stair ascent.

Objectives: Aim of this study was to assess subjects with a Chopart amputation utilizing a clamshell device during stair ascent to identify potential biomechanical deficits.

Estimation of ankle joint parameters in typically developed adults using functional calibration methods.

Background: Despite of many attempts to determine or correct hip and knee joint parameters via non-invasive techniques such as regression or functional methods, in conventional gait models the position of the ankle joint center still is assumed at the center point between malleoli.

Research Question: The aim of this study was to estimate the ankle joint parameters using a functional approach.

Methods: To this aim, we used data of 23 typically developed adults performing two different calibration motions.

Prosthetic restoration of the forefoot lever after Chopart amputation and its consequences onto the limb during gait.

Background: In subjects with Chopart amputation the foot lever is clearly diminished. Usually high or low profile prostheses are routinely utilized to re-establish the lost forefoot lever.

Research Question: The aim of this study was to investigate to what extent the proposed prostheses were able to replace the forefoot lever in chopart-amputees.

[Expert assessment of lower extremity prosthetics].

Although the number of major amputations is declining throughout Germany, more than 57,000 surgical procedures for amputation still take place. As a consequence of high prosthetic care costs, these often lead to disputes before the social court in which expert medical opinions are required. With knowledge of the legal norms, the remit of the expert opinion can be fulfilled.

The added value of orthotic management in the context of multi-level surgery in children with cerebral palsy.

Background: Treatment of cerebral palsy includes an interdisciplinary concept and in more severe cases the well-established multi-level surgery (MLS). Different kinds of orthoses are typically part of postoperative treatment but there is a lack of knowledge about their additional benefit.

Research Question: Do ankle foot orthoses lead to an additional, measurable improvement of gait after MLS?

Methods: 20 children with bilateral spastic cerebral palsy (9 retrospective, 11 in a postoperative clinical routine) were included.

Benefits of an increased prosthetic ankle range of motion for individuals with a trans-tibial amputation walking with a new prosthetic foot.

Background: Individuals with trans-tibial amputation show a greater peak prosthetic ankle power (push- off) when using energy storing and returning (ESAR) prosthetic feet as compared to solid-ankle cushion-heel feet. ESAR feet further contribute to the users' body support and thus limit prosthetic ankle motion. To improve ankle motion, articulating prosthetic feet have been introduced.

Sound side joint contact forces in below knee amputee gait with an ESAR prosthetic foot.

The incidence of knee and hip joint osteoarthritis in subjects with below knee amputation (BK) appears significantly higher compared to unimpaired subjects, especially in the intact side. However, it is controversial if constant higher loads on the sound side are one of the major factors for an increased osteoarthritis (OA) incidence in subjects with BK, beside other risk factors, e.g.

Abnormal respiration under hyperoxia in TASK-1/3 potassium channel double knockout mice.

Despite intensive research, the exact function of TASK potassium channels in central and peripheral chemoreception is still under debate. In this study, we investigated the respiration of unrestrained TASK-3 (TASK-3) and TASK-1/TASK-3 double knockout (TASK-1/3) adult male mice in vivo using a plethysmographic device. Ventilation parameters of TASK-3 mice were normal under control condition (21% O) and upon hypoxia and hypercapnia they displayed the physiological increase of ventilation.

Knee-ankle-foot orthosis with powered knee for support in the elderly.

A prototype of a powered knee orthotic device was developed to determine whether fractional external torque and power support to the knee relieves the biomechanical loads and reduces the muscular demand for a subject performing sit-to-stand movements. With this demonstrator, consisting of the subsystems actuation, kinematics, sensors, and control, all relevant sensor data can be acquired and full control is maintained over actuator parameters. A series-elastic actuator based on a direct current motor provides up to 30 Nm torque to the knee via a hinge joint with an additional sliding degree of freedom.

Structural changes in the thigh muscles following trans-femoral amputation.

Introduction: Early ambulation is the principal objective in trans-femoral amputees. Postamputation modifications complicate the rehabilitation process due to a reduced control at the interface between stump and prosthesis. The aim of this study is to determine whether magnetic resonance imaging depicts the amount of fatty degeneration of the thigh muscles after trans-femoral amputation (TFA).

Distal femoral extension and shortening osteotomy as a part of multilevel surgery in children with cerebral palsy.

Background: There are several reports describing an increase in anterior pelvic tilt after hamstring lengthening in children with cerebral palsy (CP). Distal femoral extension and shortening osteotomy (DFESO) is an alternative treatment for correction of flexed knee gait, but investigations analyzing outcome and influence on adjacent joint are few in the literature. The purpose of this study was to analyze the influence of DFESO on knee and pelvis in children with CP.

Sex-dependent differences in the in vivo respiratory phenotype of the TASK-1 potassium channel knockout mouse.

TASK-1 potassium channels have been implicated in central and peripheral chemoreception; however, the precise contribution of TASK-1 for the control of respiration is still under debate. Here, we investigated the respiration of unrestrained adult and neonatal TASK-1 knockout mice (TASK-1) using a plethysmographic device. Respiration in adult female TASK-1 mice under control (21% O), hypoxia and hypercapnia was unaffected.

Cavovarus deformity in Charcot-Marie-Tooth disease: is there a hindfoot equinus deformity that needs treatment?

Background: Charcot-Marie-Tooth disease (CMT), one of the most common hereditary neurologic disorders, often results in debilitating cavovarus foot deformities. The deformities are still not fully understood, and the treatment recommendations are consequently heterogeneous, often including calf muscle or Achilles tendon lengthening.

Methods: We examined 40 patients (80 feet) with CMT and bilateral cavovarus deformities (19 men and 21 women, mean age 33.

The influence of timing of knee recurvatum on surgical outcome in cerebral palsy.

Recent reports have shown that timing of genu recurvatum (GR) might be caused by different underlying factors and that equinus leads to GR especially during early stance. The purpose of this study was to investigate the reduction of GR after surgical correction of equinus in children with bilateral spastic cerebral palsy and whether the children with early and late type GR show differences in reduction of knee hyperextension after a surgery. In 24 limbs (mean age 10.

The in vivo respiratory phenotype of the adenosine A1 receptor knockout mouse.

The nucleoside adenosine has been implicated in the regulation of respiration, especially during hypoxia in the newborn. In this study the role of adenosine A1 receptors for the control of respiration was investigated in vivo. To this end, respiration of unrestrained adult and neonatal adenosine A1 receptor knockout mice (A1R(-/-)) was measured in a plethysmographic device.

[Femoral Derotation in Children with Cerebral Palsy - Does the Result Depend on the Age at Operation and the Kind of Surgery?].

Introduction: Patients with spastic cerebral palsy GMFCS I-III often develop gait dysfunctions. One of the most prevalent gait dysfunctions is the intoeing gait. Femoral derotation osteotomy is the common treatment for internal rotation gait in cerebral palsy.