A Passive Polycentric Mechanism to Improve Active Mediolateral Balance in Prosthetic Walking.

Prosthetic legs are typically passive systems without active ankle control, restricting mediolateral balancing to a hip strategy. Resulting balance control impairments for persons with a lower extremity amputation may be mitigated by increasing hip strategy effectiveness, in which relatively small hip moments of force are adequate for mediolateral balancing. To increase hip strategy effectiveness we have developed a prosthetic leg prototype based on the Peaucellier mechanism, the Sideways Balance Mechanism (SBM).

Prevalence and factors associated with musculoskeletal complaints and disability in individuals with brachial plexus injury: a cross-sectional study.

Purpose: (1) To determine the prevalence of musculoskeletal complaints (MSCs) in the non-affected bodily structures in individuals with brachial plexus injury (BPI) and (2) to analyse factors associated with MSCs and disability.

Methods: Survey among individuals with BPI and a control group. Multivariable logistic and linear regression analyses were used to identify factors associated with MSCs or disability.

Frontal plane roll-over analysis of prosthetic feet.

In prosthetic walking mediolateral balance is compromised due to the lack of active ankle control, by moments of force, in the prosthetic limb. Active control is reduced to the hip strategy, and passive mechanical stability depends on the curvature of the prosthetic foot under load. Mediolateral roll-over curvatures of prosthetic feet are largely unknown.

Effect of awareness of being monitored on wearing of orthopaedic footwear.

Objective: To investigate the effect of awareness of being monitored on wearing time and adherence to wearing orthopaedic footwear. Quantitative assessment of wearing time was made using direct measurement with temperature sensors during the first 3 months after provision of footwear.

Design: Randomized controlled trial.

A toolkit for prosthetists and orthotists to facilitate progress in professional communication over the next 50 years.

Background: In this celebratory issue of , we review professional communication skills in the field of prosthetics and orthotics.

Objective: We aim to reflect on communication skills in the past 50 years, to discuss developments in the coming 50 years, and to create a toolkit and research agenda to facilitate progress in professional communication in the next 50 years.

Results: Despite being a key area in prosthetics and orthotics training programmes, we found no studies on professional communication with an experimental design published in .

Effectiveness of Mechanical Treatment for Plantar Fasciitis: A Systematic Review.

Context: Plantar fasciitis is one of the most common foot injuries. Several mechanical treatment options, including shoe inserts, ankle-foot orthoses, tape, and shoes are used to relieve the symptoms of plantar fasciitis.

Objectives: To investigate the effectiveness of mechanical treatment in the management of plantar fasciitis.

Biomechanical effects of rocker shoes on plantar aponeurosis strain in patients with plantar fasciitis and healthy controls.

Plantar fasciitis is a frequently occurring overuse injury of the foot. Shoes with a stiff rocker profile are a commonly prescribed treatment modality used to alleviate complaints associated with plantar fasciitis. In rocker shoes the apex position was moved proximally as compared to normal shoes, limiting the progression of the ground reaction forces (GRF) and peak plantarflexion moments during gait.

Mechanical Noise Improves the Vibration Perception Threshold of the Foot in People With Diabetic Neuropathy.

Background: Mechanical noise may improve somatosensation at the dorsal side of the foot, but the effect at the plantar side of the foot, the side most at risk for foot ulceration, is unknown. Moreover, techniques used in research so far have several problems that limit applicability in daily practice. Piezoelectric actuators may provide mechanical noise with better clinical applicability.

Validity and feasibility of a temperature sensor for measuring use and non-use of orthopaedic footwear.

Objective: Adherence is a prerequisite for the effectiveness of orthopaedic footwear. The aim of this study is to assess the validity of a new temperature sensor for objective assessment of footwear use and non-use.

Design: Observational study.

Development of an Ankle-Foot Orthosis That Provides Support for Flaccid Paretic Plantarflexor and Dorsiflexor Muscles.

ADJUST, a novel ankle-foot orthosis (AFO) that we have developed, allows the ankle a normal range of motion (ROM) while providing support for flaccid ankle-muscle paresis. It consists of two leaf-spring hinges that independently control plantarflexion and dorsiflexion stiffness. To evaluate whether ADJUST meets the minimum mechanical requirements, we quantified its ankle ROM and stiffness.

Diabetic Foot Australia guideline on footwear for people with diabetes.

Background: The aim of this paper was to create an updated Australian guideline on footwear for people with diabetes.

Methods: We reviewed new footwear publications, (inter)national guidelines, and consensus expert opinion alongside the 2013 Australian footwear guideline to formulate updated recommendations.

Result: We recommend health professionals managing people with diabetes should: (1) Advise people with diabetes to wear footwear that fits, protects and accommodates the shape of their feet.

Effects of flexible and rigid rocker profiles on in-shoe pressure.

Rocker profiles are commonly used in the prevention of diabetic foot ulcers. Rockers are mostly stiffened to restrict toe plantarflexion to ensure proper offloading. It is also described that toe dorsiflexion should be restricted.

Unpacking community mobility: a preliminary study into the embodied experiences of stroke survivors.

Purpose: To enrich the discussion on mobility in stroke rehabilitation by translating theoretical repertoires of mobility from the context of geography to rehabilitation.

Method: Qualitative research methodology was applied, and included in-depth interviews with stroke survivors.

Results: This study revealed: (a) social and material differences in clinical, private and public places; (b) ambivalences and shifting tensions in bodily, family and community life; (c) differences in access to resources to be used for mobility.

A user-centered qualitative study on experiences with ankle-foot orthoses and suggestions for improved design.

Background: Improving ankle-foot orthosis design can best be done by implementing a user-centered approach.

Objective: To provide insight into the ideas of ankle-foot orthosis users with flaccid ankle muscle paresis on the importance of activities and suggestions for an improved ankle-foot orthosis design.

Study Design: A focus-group discussion with eight ankle-foot orthosis users (57 ± 5 years, 50% female).

Age-related differences in women's foot shape.

Purpose: Describe age-related differences in women's foot shape using a wide range of measurements and ages.

Study Design: Cross-sectional, observational study.

Main Outcome Measurements: Six foot-shape measurements of each foot: foot lengths, ball widths, ball circumferences, low instep circumferences, high instep circumferences, and heel instep circumference.

Communication techniques for improved acceptance and adherence with therapeutic footwear.

Background And Aim: Clients' acceptance and adherence with orthoses can be influenced by a clinician's communication skills. In this clinical note, we describe two communication techniques, in the context of therapeutic footwear.

Technique: Person-centred communication involves engaging with and listening to the attitudes of the client towards their condition, as well as discussing acceptance and expectations, in a structured consultation.

Biomechanics of running with rocker shoes.

Objectives: Load reduction is an important consideration in conservative management of tendon overuse injuries such as Achilles tendinopathy. Previous research has shown that the use of rocker shoes can reduce the positive ankle power and plantar flexion moment which might help in unloading the Achilles tendon. Despite this promising implication of rocker shoes, the effects on hip and knee biomechanics remain unclear.

Staying in dynamic balance on a prosthetic limb: A leg to stand on?

With the loss of a lower limb, amputees lack the active muscle empowered control of the ankle that is important for balance control. We examined single-leg stance on prosthesis vs. sound limb balancing on narrow ridges in transtibial amputees.

Effects of ankle foot orthoses on body functions and activities in people with floppy paretic ankle muscles: a systematic review.

Background: People with floppy ankle muscles paresis use ankle foot orthoses to improve their walking ability. Ankle foot orthoses also limit ankle range of motion thereby introducing additional problems. Insight in effects of ankle foot orthoses on body functions and activities in people with floppy paretic ankle muscles aids in clinical decision making and may improve adherence.

Activities of Daily Living in Children With Developmental Coordination Disorder: Performance, Learning, and Participation.

Background: Children with developmental coordination disorder (DCD) face evident motor difficulties in daily functioning. Little is known, however, about their difficulties in specific activities of daily living (ADL).

Objective: The purposes of this study were: (1) to investigate differences between children with DCD and their peers with typical development for ADL performance, learning, and participation, and (2) to explore the predictive values of these aspects.

Combined clinical and home rehabilitation: case report of an integrated knowledge-to-action study in a Dutch rehabilitation stroke unit.

Background And Purpose: There is growing awareness that the poor uptake of evidence in health care is not a knowledge-transfer problem but rather one of knowledge production. This issue calls for re-examination of the evidence produced and assumptions that underpin existing knowledge-to-action (KTA) activities. Accordingly, it has been advocated that KTA studies should treat research knowledge and local practical knowledge with analytical impartiality.

Suitability of Kinect for measuring whole body movement patterns during exergaming.

Exergames provide a challenging opportunity for home-based training and evaluation of postural control in the elderly population, but affordable sensor technology and algorithms for assessment of whole body movement patterns in the home environment are yet to be developed. The aim of the present study was to evaluate the use of Kinect, a commonly available video game sensor, for capturing and analyzing whole body movement patterns. Healthy adults (n=20) played a weight shifting exergame under five different conditions with varying amplitudes and speed of sway movement, while 3D positions of ten body segments were recorded in the frontal plane using Kinect and a Vicon 3D camera system.

Place attachment in stroke rehabilitation: a transdisciplinary encounter between cultural geography, environmental psychology and rehabilitation medicine.

Purpose: To increase understanding of stroke survivor's needs to successfully re-establish attachment to meaningful places at home and in the community.

Methods: Qualitative research methodology including in-depth interviews with stroke survivors in the clinical, post-discharge and reintegration phases of the Rehabilitation process.

Results: Participants longed for recovery and domestic places in the clinical phase, for pre-stroke activities and roles in the post-discharge phase, and for recognition and a sense of belonging in the reintegration phase.

Functional performance, participation and autonomy after discharge from prosthetic rehabilitation: barriers, facilitators and outcomes.

Objective: To examine functional performance, participation and autonomy after discharge from prosthetic rehabilitation and to identify the barriers and facilitators affecting these outcomes.

Design: Concurrent mixed-methods design. Quantitative and qualitative data were collected at discharge from rehabilitation, and 3 and 6 months later.

Incorporating self-management in prosthetic rehabilitation: case report of an integrated knowledge-to-action process.

Background: In improvement of clinical practice, unidirectional approaches of translating evidence into clinical practice have been pinpointed as main obstacles. The concept of engaged scholarship has been introduced to guide knowledge-to-action (KTA) processes, in which research knowledge and practical knowledge derived from therapists, patients, and organizational structures mutually inform each other. Accordingly, KTA experts should engage end-users earlier in knowledge translation and work in concert with them on both knowledge creation and knowledge implementation.