Utilization of orthoses and assistive devices among a national sample of lower limb orthosis users.

Introduction: Lower limb orthoses (LLOs) and assistive devices (ADs) can be used together or separately to improve mobility when performing daily activities. The goal of this study was to examine utilization of LLOs and ADs in a national sample of adult LLO users.

Methods: A survey was designed to ask participants whether they typically use their LLOs and/or ADs to perform 20 daily activities.

Functional and perceptive differences between conventional and advanced ankle foot orthoses in community ambulators post-limb trauma: the injuries managed with advanced bracing of the lower extremity (IM ABLE) study.

Introduction: Many military service members and civilians suffer from lower extremity trauma. Despite recent advancements in lower limb bracing technology, it remains unclear whether these newer advanced braces offer improved comfort and functionality compared to conventional options. The IDEO (Intrepid Dynamic Exoskeletal Orthosis), a type of "advanced" orthosis was developed to assist in maintaining high functional performance in patients who have experienced high-energy lower extremity trauma and underwent limb salvage surgeries.

Development and initial validation of the Orthotic Patient-Reported Outcomes-Mobility (OPRO-M): An item bank for evaluating mobility of people who use lower-limb orthoses.

Lower limb orthoses (LLOs) are externally-applied leg braces that are designed to improve or maintain mobility in people with a variety of health conditions that affect lower limb function. Clinicians and researchers are therefore often motivated to measure LLO users' mobility to select or assess the effectiveness of these devices. Patient-reported outcome measures (PROMs) can provide insights into important aspects of a LLO user's mobility for these purposes.

Activity and Participation, Bimanual Function, and Prosthesis Satisfaction are Strong Predictors of General Well-Being Among Upper Limb Prosthesis Users.

Objective: To determine the role of multiple factors on general well-being for upper limb prosthesis users.

Design: Retrospective cross-sectional observational design.

Setting: Prosthetic clinics across the United States.

Creating Adjusted Scores Targeting mobiLity Empowerment (CASTLE 1): determination of normative mobility scores after lower limb amputation for each year of adulthood.

Purpose: As United States healthcare transitions from traditional fee-for-service models to value-based care, there is increased need to demonstrate quality care through clinical outcomes. Therefore, the purpose of this study was to create equations to calculate an expected mobility score for lower limb prosthesis users specific to their age, etiology, and amputation level to provide benchmarks to qualify good outcomes.

Materials And Methods: A retrospective cross-sectional analysis of outcomes collected during clinical care was performed.

GGEM: Gender, Geography, and EMployment differences based on mobility levels among lower limb prosthesis users living in the United States.

Background: For individuals with a disability, an increase in functional mobility may improve their quality of life and well-being. Greater understanding is needed on how factors such as gender, geography, and employment may play a role in mobility levels among individuals with lower limb amputation.

Objectives: To assess the relationship between gender, geography, and employment status on mobility among lower limb prosthesis users.

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.

Transfemoral interface considerations: A clinical consensus practice guideline.

Background: Although there have been a number of studies exploring the impact and efficacy of transfemoral prosthetic components such as knee and foot mechanisms, the empirical evidence surrounding transfemoral prosthetic interface considerations is limited. This constitutes a substantial void for practicing clinicians seeking to apply best practices for patients who use transfemoral prostheses. Recent years have seen increased production and availability of clinical practice guidelines germane to prosthetic rehabilitation.

A catalog of validity indices for step counting wearable technologies during treadmill walking: the CADENCE-adults study.

Background: Standardized validation indices (i.e., accuracy, bias, and precision) provide a comprehensive comparison of step counting wearable technologies.

Racial Disparities in Health Care With Timing to Amputation Following Diabetic Foot Ulcer.

Objective: To examine variations in timing of lower-limb amputation (LLA) across race/ethnicity and sex among older adults with a diabetic foot ulcer (DFU). It was hypothesized Black/African Americans were more likely to have LLA post-DFU earlier compared with non-Hispanic/Whites, and more men would receive LLA earlier post-DFU compared with women.

Research Design And Methods: This was a retrospective cohort analysis of enrolled Medicare fee-for-service (FFS) beneficiaries with a diagnosis of DFU during the study period (2012-2017), allowing up to 5 years post-DFU.

Microprocessor feet improve prosthetic mobility and physical function relative to non-microprocessor feet.

The clinical benefits associated with the microprocessor regulation of prosthetic ankle position and resistance have largely been reported through manufacturer conducted research in controlled laboratory environments. Measures with greater ecological validity are needed. This study aimed to understand if there are differences in physical function and mobility outcomes as patients transitioned from a non-Microprocessor to Microprocessor Feet.

Assessment of Patient-Reported Physical Function in Persons With Upper Extremity Amputation: Comparison of Short Form Instruments.

Objective: The aim of the study was to compare psychometric properties of the Patient-Reported Outcomes Measurement Information System upper extremity measure (PROMIS UE) 7-item short form with 6- and 13-item versions for persons with upper limb amputation.

Design: The study used a telephone survey of 681 persons with upper limb amputation. Versions were scored two ways: PROMIS health measure scoring (PROMIS UE HMSS) and sample-specific calibration (PROMIS UE AMP).

Stability and Falls Evaluations in AMPutees (SAFE-AMP 2): Reduced functional mobility is associated with a history of injurious falls in lower limb prosthesis users.

Background: Injurious falls have a high cost and economic impact on an individual and the health system. Several studies have assessed performance-based functional mobility in lower limb prosthesis (LLP) users and fall risk including fall history. However, limited data exist regarding the relationship between functional mobility and a history of injurious falls in individuals who use a LLP.

Factors that influence time to prosthesis receipt after lower limb amputation: A Cox proportional hazard model regression.

Background: Early mobility, functional independence, and ambulation are associated benefits after lower limb amputation (LLA), whereas an increased risk of clinical complications is associated with no prosthesis.

Objective: To describe time to prosthesis receipt after amputation and to assess the impact of patient demographic and health factors on the rate of prosthesis receipt within 12 months post LLA.

Design: A retrospective cohort analysis using commercial administrative claims data.

Prosthetic management of unilateral transradial amputation and limb deficiency: Consensus clinical standards of care.

Introduction: Upper limb research is currently lacking detailed clinical guidance on the provision of unilateral transradial prostheses. Clinical practice guidelines are meant to serve as assistance for the decision-making process, and Delphi surveys have been used with increasing frequency within orthotics and prosthetics to create these guidelines for clinical practice.

Methods: A three round Delphi survey was used to gain consensus on clinical statements regarding unilateral transradial prostheses.