The relationship of hip strength to walking and balance performance in unilateral lower limb prosthesis users differs by amputation level.

Background: Safe and efficient locomotion is a frequently stated goal of lower limb prosthesis users, for which hip strength may play a central yet poorly understood role. Additional research to identify associations between hip strength, balance, and mobility among transtibial and transfemoral prosthesis users is required.

Objective: To test whether residual and/or intact limb isometric hip strength was associated with lower limb prosthesis users' walking speed, endurance, and balance.

Proportionate mortality following dysvascular partial foot amputation and how this compares to transtibial amputation: a systematic review.

Purpose: A large proportion of people die in the years following dysvascular partial foot amputation (PFA) or transtibial amputation (TTA) given the long-term consequences of peripheral vascular disease and/or diabetes. A critical appraisal of recent research is needed to understand the underlying cause of variation and synthesise data for use in consultations about amputation surgery and patient-facing resources. This systematic review aimed to describe proportionate mortality following dysvascular PFA and to compare this between PFA and TTA.

Accuracy, Repeatability, and Reproducibility of a Hand-Held Structured-Light 3D Scanner across Multi-Site Settings in Lower Limb Prosthetics.

The aim of this work was to assess the accuracy, repeatability, and reproducibility of a hand-held, structured-light 3D scanner (EINScan Pro 2X Plus with High Definition Prime Pack, SHINING 3D Tech. Co., Ltd.

Development and alpha testing of a patient shared decision aid for prosthesis design for new lower limb prosthesis users.

Background: After lower limb amputation, several prosthesis design options exist. However, prosthesis design decisions do not always reflect a prosthesis user's needs, values, and preferences.

Objective: To develop a patient decision aid (PDA) prototype for prosthetists and new prosthesis users facing prosthesis design decisions after lower limb amputation, and to assess its usability, accuracy, and comprehensibility.

Individualized orthotic alignment and footwear for balance and mobility in children with bilateral spastic cerebral palsy: A randomized trial.

Aim: To examine whether designed-to-be-rigid ankle-foot orthoses and footwear combinations with individualized alignment and footwear designs (AFO-FC/IAFD) would be more effective than designed-to-be-rigid AFO with non-individualized alignment and footwear designs (AFO-FC/NAFD) in children with cerebral palsy (CP).

Method: Nineteen children with bilateral spastic CP were randomized to AFO-FC/NAFD (n = 10) or AFO-FC/IAFD (n = 9) groups. Fifteen were male, average age 6 years 11 months (range 4 years 2 months-9 years 11 months), classified in Gross Motor Function Classification System levels II (n = 15) and III (n = 4).

After scaling to body size hip strength of the residual limb exceeds that of the intact limb among unilateral lower limb prosthesis users.

Background: Hip muscles play a prominent role in compensating for the loss of ankle and/or knee muscle function after lower limb amputation. Despite contributions to walking and balance, there is no consensus regarding hip strength deficits in lower limb prosthesis (LLP) users. Identifying patterns of hip muscle weakness in LLP users may increase the specificity of physical therapy interventions (i.

Development of an item bank for measuring prosthetic mobility in people with lower limb amputation: The Prosthetic Limb Users Survey of Mobility (PLUS-M).

Background: Achieving mobility with a prosthesis is a common post-amputation rehabilitation goal and primary outcome in prosthetic research studies. Patient-reported outcome measures (PROMs) available to measure prosthetic mobility have practical and psychometric limitations that inhibit their use in clinical care and research.

Objective: To develop a brief, clinically meaningful, and psychometrically robust PROM to measure prosthetic mobility.

Mechanical testing of transtibial prosthetic sockets: A discussion paper from the American Orthotic and Prosthetic Association Socket Guidance Workgroup.

Background: The advent of novel manufacturing technologies, materials, and socket design concepts could introduce risks to prosthetic limb users, as the existing knowledge base for safe fabrication may not apply. Moreover, although structural test standards exist for mass-produced prosthetic components, they are not applicable to prosthetic sockets.

Methods: The "AOPA Socket Guidance Workgroup" was formed in 2020 to provide the prosthetic community with evidence-based clinical best practices and methods in the field of prosthetic socket structural analysis.

Normalization alters the interpretation of hip strength in established unilateral lower limb prosthesis users.

Background: Valid comparisons of muscle strength between individuals or legs that differ in size requires normalization, often by simple anthropometric variables. Few studies of muscle strength in lower-limb prosthesis users have normalized strength data by any anthropometric variable, potentially confounding our understanding of strength deficits in lower-limb prosthesis users. The objective of this pilot study was to determine the need for as well as effectiveness and impact of normalizing hip strength in lower-limb prosthesis users.

Correction: Using mechanical testing to assess texturing of prosthetic sockets to improve suspension in the transverse plane and reduce rotation.

[This corrects the article DOI: 10.1371/journal.pone.

Improving shared decision-making for prosthetic care: A qualitative needs assessment of prosthetists and new lower-limb prosthesis users.

Background: Prosthesis design is complex and multiple appropriate options exist for any individual with lower-limb amputation. However, there is insufficient evidence for guiding decision-making. Shared decision-making (SDM) offers an opportunity to incorporate patient-specific values and preferences where evidence is lacking for prosthesis design decisions.

Comparison of Ischial Containment and Subischial Sockets Effect on Gait Biomechanics in People With Transfemoral Amputation: A Randomized Crossover Trial.

Objective: To compare gait biomechanics of the Northwestern University Flexible Sub-Ischial Vacuum (NU-FlexSIV) Socket to the ischial containment (IC) socket.

Design: Randomized crossover trial with 2, 7-week periods.

Setting: Private prosthetic clinics and university research laboratory.

Comparison of Sagittal Plane Stiffness of Nonarticulated Pediatric Ankle-Foot Orthoses Designed to be Rigid.

Introduction: When studying the effect of ankle-foot orthoses (AFOs) on gait, it is important to know their sagittal plane stiffness. However, there are no established thresholds for stiffness of non-articulated AFOs designed to be rigid. If wanting to implement published algorithms for ankle-foot orthosis-footwear combinations (AFO-FCs), the AFOs must be equally as stiff as those of the developer of the published AFO-FC algorithms.

Myoelectric Arm Orthosis in Motor Learning-Based Therapy for Chronic Deficits After Stroke and Traumatic Brain Injury.

Background: Technologies that enhance motor learning-based therapy and are clinically deployable may improve outcome for those with neurological deficits. The MyoPro™ is a customized myoelectric upper extremity orthosis that utilizes volitionally generated weak electromyographic signals from paretic muscles to assist movement of an impaired arm. Our purpose was to evaluate MyoPro as a tool for motor learning-based therapy for individuals with chronic upper limb weakness.

Comparison of Ischial Containment and Subischial Sockets on Comfort, Function, Quality of Life, and Satisfaction With Device in Persons With Unilateral Transfemoral Amputation: A Randomized Crossover Trial.

Objective: To compare comfort and functional performance of the Northwestern University Flexible Subischial Vacuum (NU-FlexSIV) Socket with the ischial containment (IC) socket in persons with unilateral transfemoral amputation.

Design: Randomized crossover trial with two 7-week periods.

Setting: Private prosthetic clinics and university research laboratory.

Wireless sensors for continuous, multimodal measurements at the skin interface with lower limb prostheses.

Precise form-fitting of prosthetic sockets is important for the comfort and well-being of persons with limb amputations. Capabilities for continuous monitoring of pressure and temperature at the skin-prosthesis interface can be valuable in the fitting process and in monitoring for the development of dangerous regions of increased pressure and temperature as limb volume changes during daily activities. Conventional pressure transducers and temperature sensors cannot provide comfortable, irritation-free measurements because of their relatively rigid construction and requirements for wired interfaces to external data acquisition hardware.

Using mechanical testing to assess the effect of lower-limb prosthetic socket texturing on longitudinal suspension.

To function effectively, a lower limb prosthetic socket must remain securely coupled to the residual limb during walking, running and other activities of daily living; this coupling is referred to as suspension. When this coupling is insufficient longitudinal pistoning of the socket relative to the residual limb occurs. Increasing friction of the socket/liner interface may improve socket suspension and textured sockets may be fabricated relatively easily with 3D printing.

Identifying Instruments to Assess Care Quality for Individuals With Custom Ankle Foot Orthoses: A Scoping Review.

Objectives: We conducted 2 complementary scoping reviews to identify instruments that assess the experience and outcomes of custom ankle-foot orthosis (AFO) care in individuals with neurologic and traumatic conditions and to determine to what extent they might be psychometrically sound for AFO users. A stakeholder advisory committee considered to what extent the identified and psychometrically sound instruments might be feasible for use in developing quality measures for custom AFO users.

Data Sources: Both scoping reviews were conducted using PubMed, the Cumulative Index to Nursing and Allied Health Literature, Embase, and Cochrane Systematic Reviews.

Use of a myoelectric upper limb orthosis for rehabilitation of the upper limb in traumatic brain injury: A case report.

Background: Upper limb motor deficits following traumatic brain injury are prevalent and effective therapies are needed. The purpose of this case report was to illustrate response to a novel therapy using a myoelectric orthosis in a person with TBI. A 42-year-old female, 29.

Using mechanical testing to assess texturing of prosthetic sockets to improve suspension in the transverse plane and reduce rotation.

Creating a secure and comfortable linkage between the residual limb and prosthetic socket in persons with lower limb amputation is a critical factor for successful rehabilitation, including ambulation and other activities of daily living. Unwanted rotation within the socket can be a clinical problem for prosthesis users. One way of addressing issues experienced with transverse plane control of the socket may be through increased friction interface forces.