Feasibility of Freedom of Information Requests for Amputee Epidemiology in the United Kingdom.

Introduction: While each of the 44 National Health Service commissioned artificial limb clinics in the United Kingdom record information about their own prosthetic limb users, these are not collated to give a national picture of amputee epidemiology. The requirement to respond to Freedom of Information (FoI) requests within 20 working days offers another way of extracting data from all centres, and this study describes a first attempt to use this method to update national epidemiological data.

Methods: Questions were sent to the FoI email addresses of all 44 centres, requesting numbers of adult unilateral below-knee amputees, adult unilateral above or through-knee amputees and child unilateral above or through-knee amputees (all of K2 level mobility), numbers of people consistently using a prosthesis with a single axis myoelectric hand, and access to an occupational therapist with skills to teach someone to use a myoelectric hand.

Getting up With Lateral Thinking.

Introduction: Falls in the community can have major impacts on patient lives. There can be long lasting physical and psychological consequences of a fall and subsequent long lie. The annual burden to ambulance services responding to falls at home is high.

Reassessing referral of touch following peripheral deafferentation: The role of contextual bias.

Some amputees have been famously reported to perceive facial touch as arising from their phantom hand. These referred sensations have since been replicated across multiple neurological disorders and were classically interpreted as a perceptual correlate of cortical plasticity. Common to all these and related studies is that participants might have been influenced in their self-reports by the experimental design or related contextual biases.

Case report: Post-traumatic Tourette syndrome resolving with treatment of jugular venous narrowing; reconciling organic brain dysfunction following whiplash trauma with the absence of direct brain injury.

We describe a man aged 33 years who developed multiple symptoms, personality change, and a severe tic disorder following a road traffic accident, which were undiminished for 3 years until jugular venous narrowing between the styloid process of the skull and the transverse process of the C1 vertebra was treated by surgical decompression. Immediately following surgery, his abnormal movements almost completely resolved, with no regression in 5 years of follow-up. Vigorously debated at the time was whether or not his condition represented a functional disorder.

Orthoses for neurological ankles.

Patients with weakness or abnormal posture of their lower leg may benefit greatly from appropriate orthoses. This paper describes the sorts of problems that can be helped in neurological practice and the range of devices commonly used, and also highlights some of the factors influencing selection. With greater understanding of their use, clinicians will feel more confident about referring patients for early orthotic assessment.

Talking with Your (Artificial) Hands: Communicative Hand Gestures as an Implicit Measure of Embodiment.

When people talk, they move their hands to enhance meaning. Using accelerometry, we measured whether people spontaneously use their artificial limbs (prostheses) to gesture, and whether this behavior relates to everyday prosthesis use and perceived embodiment. Perhaps surprisingly, one- and two-handed participants did not differ in the number of gestures they produced in gesture-facilitating tasks.

Isolated lower limb hypoplasia secondary to congenital varicella syndrome: a rare occurrence and management of its complications.

Isolated lower limb hypoplasia is a rare consequence of maternal congenital varicella syndrome (CVS). The hypoplastic limb is susceptible to multiple injuries, including fractures, especially if there is associated muscle weakness and lack of sensation. We describe a unique index case of a woman aged 26 years with a background of CVS who presented with a distal femur fracture following a fall onto her insensate, hypoplastic right leg.

Diagnosis, investigation and management of hereditary spastic paraplegias in the era of next-generation sequencing.

The hereditary spastic paraplegias (HSPs) are a group of genetic conditions in which spastic paralysis of the legs is the principal clinical feature. This is caused by a relatively selective distal axonal degeneration involving the longest axons of the corticospinal tracts. Consequently, these conditions provide an opportunity to identify genes, proteins and cellular pathways that are critical for axonal health.

A new orthosis for subluxed, flaccid shoulder after stroke facilitates gait symmetry: a preliminary study.

Objective: The aims of this study were: (i) to evaluate the immediate effects on subluxation and gait pattern of a new shoulder orthosis, developed for treatment of painful shoulder syndrome in subacute stroke patients; and (ii) to evaluate patients' and therapists' opinions about its fit and benefits after 4 weeks.

Methods: A total of 40 subacute in-rehabilitation stroke patients with non-functional arm and painful shoulder were included in the study. Of these, 12 subjects underwent shoulder radiography and gait analysis with and without the orthosis to determine the immediate effects of the orthosis.

Alteration in phantom pain and sensation with visceral movement.

Some lower limb amputees can present with alteration in phantom pain and sensation with visceral movement (micturition/defaecation). The authors specifically questioned 200 lower limb amputees from 2 amputee rehabilitation centers (150 recent lower limb amputees in the first center and 50 consecutive recent and established lower limb amputees in the second center) for such symptoms. Eight patients from the first center and 5 patients from the second center reported having the phenomenon.

A new electromechanical trainer for sensorimotor rehabilitation of paralysed fingers: a case series in chronic and acute stroke patients.

Background: The functional outcome after stroke is improved by more intensive or sustained therapy. When the affected hand has no functional movement, therapy is mainly passive movements. A novel device for repeating controlled passive movements of paralysed fingers has been developed, which will allow therapists to concentrate on more complicated tasks.

Treadmill training with partial body-weight support after total hip arthroplasty: a randomized controlled trial.

Objective: To compare treadmill training with partial body-weight support (TT-BWS) and conventional physical therapy (PT) in ambulatory patients with hip arthroplasty.

Design: Randomized controlled trial.

Setting: Rehabilitation center.