CANADIAN PROSTHETICS & ORTHOTICS JOURNAL

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ISSN / EISSN : 2561-987X / 2561-987X
Current Publisher: University of Toronto Libraries - UOTL (10.33137)
Total articles ≅ 72
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, Mostafa Allami, Justin R. Murphy, Phillip Page,
CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, Volume 4; doi:10.33137/cpoj.v4i1.35070

Abstract:
BACKGROUND: Interventions to resolve thermal discomfort as a common complaint in amputees are usually chosen based on the residual limb skin temperature while wearing prosthesis; whereas, less attention has been paid to residual limb skin temperature while outside of the prosthesis. The objective of this study was to explore the localized and regional skin temperature over the transtibial residual limb (TRL) while outside of the prosthesis. METHODOLOGY: Eight unilateral transtibial adults with traumatic amputation were enrolled in this cross-sectional study. Participants sat to remove their prostheses and rested for 30 minutes. Twelve sites were marked circumferentially in four columns (anterolateral, anteromedial, posteromedial, and posterolateral) and longitudinally in three rows (proximal, middle, and distal) over the residual limb and used for attachment of analog thermistors. Skin temperature was recorded and compared for 11 minutes. Furthermore, the relationship of skin temperature with participants’ demographic and clinical characteristics was explored. FINDINGS: The whole temperature of the TRL was 27.73 (SD=0.83)°C. There was a significant difference in skin temperature between anterior and posterior columns. Likewise, the distal row was significantly different from the proximal and middle rows. The mean temperature at the middle and distal zones of the anteromedial column had the highest and lowest skin temperatures (29.8 and 26.3°C, p0.05) with participants’ demographic and clinical characteristics. CONCLUSIONS: An unequal distribution of temperature over the TRL was found with significantly higher and lower temperatures at its anterior column and distal row, respectively. This temperature pattern should be considered for thermoregulation strategies. Further investigation of the residual limb temperature with and without prosthesis, while considering muscles thickness and blood perfusion rate is warranted. Layman's Abstract The socket is a plastic hard-shell interface between the residual limb, the remaining part of the amputated limb, and a prosthesis. Heat buildup inside the prosthetic socket and perspiration of the residual limb are major discomforts in amputees when wearing a prosthesis. The majority of prior research measured residual limb skin temperature while the prosthesis was worn. However, less attention has been paid to skin temperature without prostheses. Skin temperature of eight adults with one-sided traumatic below-knee amputation was measured. Participants sat and removed their prostheses. Twelve anatomical sites were marked circumferentially in four columns and longitudinally in three rows over the residual limb and used for temperature recording using temperature sensors. The whole temperature of the residual limb was 27.73 (SD=0.83)°C. Skin temperature was higher at anterior columns compared to posterior columns. Similarly, the distal row of the residual limb had the lowest temperature compared to its middle and proximal rows. From a localized standpoint, the middle part at the anterior medial surface of the residual limb had the highest temperature, whereas the distal part at the anterior-medial surface had the lowest skin temperature. There was no noticeable relationship between the average of the residual limb skin temperature and participants’ demographic and clinical characteristics. Some strategies need to be developed to regulate and control heat dissipation over the residual limb's surface when amputees do not wear prostheses. Further temperature recording research by considering muscle thickness and arterial blood flow rate of the residual limb with and without prosthesis is suggested. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/35070/27313 How To Cite: Ghoseiri K, Allami M, Murphy J.R, Page P, Button D.C. Investigation of localized skin temperature distribution across the transtibial residual limb. Canadian Prosthetics & Orthotics Journal. 2021;Volume 4, Issue 1, No.2. https://doi.org/10.33137/cpoj.v4i1.35070 Corresponding Author: Duane C Button, PhDSchool of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada.E-mail: [email protected]: https://orcid.org/0000-0001-6402-8545
CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, Volume 4; doi:10.33137/cpoj.v4i1.35132

Abstract:
BACKGROUND: Balance impairment is a contributing factor to falls. Falls are a leading cause of injury and death in older adults. An ankle-foot orthosis (AFO) is a device that can be prescribed as an intervention to help individuals with compromised balance to ambulate safely. OBJECTIVE: The purpose of this review was to investigate the role ankle-foot orthoses have in affecting balance in community-dwelling older adults. METHODOLOGY: A scoping review was conducted searching MEDLINE, CINAHL, EMBASE, and REHABDATA databases to obtain the appropriate literature to meet the following criteria: 1) quantitative research design; 2) studies with participants over age 65; 3) studies with participants with drop-foot or sensory deficits in the lower extremity; 4) the treatment intervention was unilateral or bilateral AFOs; 5) the outcome measure was balance or stability. The retrieved articles were assessed based on the internal validity, external validity, objectivity, and reliability of the study design and the interpretation of results. FINDINGS: 11 articles were identified that met the inclusion criteria. Four major themes emerged in the analysis about the impact that ankle-foot orthoses have on balance in older adults: (1) AFOs improved lateral stability, (2) AFOs improved balance under static conditions, (3) AFOs provided a reduction in postural sway and (4) AFOs increased walking speed in community-dwelling older adults. CONCLUSIONS: The evidence from the findings of the review indicate that ankle-foot orthoses have a generally positive affect on balance in older adults. Clinicians can consider the ankle-foot orthosis an effective intervention that can improve balance in some older adult patient populations. Layman's Abstract Falls are a serious cause of injury and death in older adults over age 65. Poor balance can lead to an increased number of falls in the older population. The use of a brace, called an ankle-foot orthosis, can be prescribed to community living older adults to augment their balance. Ankle-foot orthoses can improve the stability and positioning of the ankle joint and foot to aid in balance during walking and standing, however ankle-foot orthoses have also been found to restrict natural movements and interrupt sensory feedback from the lower leg and foot. The purpose of this article was to investigate how the balance of older adults living in the community is impacted by wearing ankle-foot orthoses. Through conducting a database search to obtain appropriate literature on the topic, four trends were identified for how ankle-foot orthoses impact the balance of older adult wearers. Based on the findings of this review, ankle-foot orthoses were found to improve stability and standing balance, decrease bodily sway, and increase the walking speed of older adult wearers. These findings suggest that ankle-foot orthoses have a largely positive impact on the balance of older adults and can be considered to help improve balance in certain patient populations. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/35132/27291 How To Cite: Laidler J.L. The impact of ankle-foot orthoses on balance in older adults: A scoping review. Canadian Prosthetics & Orthotics Journal. 2021;Volume 4, Issue 1, No.1. https://doi.org/10.33137/cpoj.v4i1.35132 Corresponding Author: Jenna LaidlerAging and Health Program, School of Rehabilitation Therapy,Queen’s University, Kingston, Canada.E-mail: [email protected]
, Michelle G. Marquez, Matthew Kowgier
CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, Volume 3; doi:10.33137/cpoj.v3i2.34471

Abstract:
BACKGROUND: Lower extremity amputation due to complications from peripheral vascular disease and/or diabetes are common and these patients often have multiple comorbidities. Patients with end-stage renal disease receiving hemodialysis (ESRD/HD) are a particularly vulnerable group at risk for amputation. After lower extremity amputation (LEA) surgery, many patients undergo post-operative inpatient rehabilitation to improve their pre-prosthetic functional independence. Given the increased complexity of dysvascular patients living with ESRD/HD compared to those without ESRD/HD, the association of HD with pre-prosthetic inpatient functional outcomes warrants further study. OBJECTIVE: The objective of this study was to compare the pre-prosthetic functional outcomes and Length of Stay (LOS) among patients with recent dysvascular LEA with and without ESRD/HD. METHODOLOGY: A retrospective cohort design was used to analyze a group of 167 patients with unilateral, dysvascular limb loss who were admitted to inpatient rehabilitation with 24 of these patients in the ESRD/HD group. Age, gender, amputation level, amputation side, length of stay (LOS), time since surgery, Functional Independence Measure (FIM) scores (admission and discharge), and Charlson Comorbidity Index (CCI) were collected. FINDINGS: There was no difference between patients with dysvascular amputation with and without ESRD/HD in the association of functional outcomes or LOS in this cohort and rehabilitation model. The CCI score was higher in the ESRD/HD group. Multivariate analysis indicated an inverse relationship with age and FIM scores, where increased age was associated with lower Total and Motor FIM at admission and discharge. There were no associations with FIM change. Age was positively associated with LOS. Being female was inversely associated to motor FIM scores at admission and discharge CONCLUSION: Among patients with recent dysvascular LEA, ESRD/HD is not associated with different functional outcomes or LOS in the pre-prosthetic inpatient rehabilitation setting. This suggests that despite added comorbidity that patients with ESRD/HD may still benefit from inpatient rehabilitation to optimize pre-prosthetic function. Layman's Abstract Lower extremity limb loss caused by blood vessel disease and/or diabetes is common. Patients who need amputation often have additional medical conditions that may impact their recovery after surgery. One such condition, is diabetes-related poor kidney function requiring hemodialysis. Patients who attend hemodialysis are particularly vulnerable to limb amputation. After amputation surgery many individuals undergo inpatient rehabilitation to improve self-care and mobility prior to discharge from hospital and before being considered for a prosthesis. In patients who are admitted to rehabilitation hospitals after amputation we understand very little about how the demands of hemodialysis may impact their rehabilitation and how long they stay in a rehabilitation hospital. The objective of this study was to compare patients with amputation due to blood vessel disease and/or diabetes with patients who also require hemodialysis. We studied their functional outcomes and inpatient rehabilitation length of stay in hospital. 167 patients with unilateral, limb loss who were admitted to an inpatient rehabilitation hospital were included in the analysis with 24 of these patients attending hemodialysis. Age, sex, amputation level, amputation side, length of stay, time since surgery, Functional Independence Measure scores (measure of a patient’s function) and Charlson Comorbidity Index (measure of multiple medical conditions) were collected. We concluded that in patients with recent limb amputation, hemodialysis was not related to different functional outcomes or time in hospital in the inpatient rehabilitation setting. This suggests that despite receiving hemodialysis, patients with recent limb loss may still benefit from inpatient rehabilitation before being considered for a prosthesis. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/34471/26580 How To Cite: Journeay W.S., Marquez M.G., Kowgier M. Hemodialysis is not associated with pre-prosthetic inpatient rehabilitation outcomes after dysvascular lower extremity amputation: a retrospective cohort study. Canadian Prosthetics & Orthotics Journal. 2020; Volume 3, Issue 2, No.2. https://doi.org/10.33137/cpoj.v3i2.34471 Corresponding Author: Dr. W. Shane Journeay, PhD, MD, MPH, FRCPC, BC-Occ MedProvidence Healthcare – Unity Health Toronto, 3276 St Clair Avenue East, Toronto ON M1L 1W1E-mail: [email protected]: https://orcid.org/0000-0001-6075-3176
, , Alison Stenson, Zoe Savage, David Moser, Saeed Zahedi
CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, Volume 3; doi:10.33137/cpoj.v3i2.34610

Abstract:
BACKGROUND: Excessive sweating of the residual limb has a substantial effect on the daily activities of people with lower limb amputation. Prosthetic liners offer protection and comfort to sensitive areas but often exacerbate perspiration. They act as insulators, trapping sweat on the skin’s surface to the detriment of skin health. Recently, liners with perforations have been developed, allowing the moisture to escape. The goal of this study was to assess the impact of such liners. METHODS: A sample group of 13 patients with unilateral transtibial amputation, who wore a perforated liner (PL) as part of their current prescription, was compared to 20 control patients who wore non-perforated liners (NPL). During their routine appointments, they completed a survey of scientifically validated outcome measures relating to their limb health, pain and the impact on daily life over a 12-month period. RESULTS: Patients using the PL had healthier residual limbs, reporting higher scores on questions relating to limb health, experiencing fewer skin issues (p
Hamid Bateni
CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, Volume 3; doi:10.33137/cpoj.v3i2.33804

Abstract:
BACKGROUND: Falls can be detrimental to overall health and quality of life for lower extremity amputees. Most previous studies of postural steadiness focus on quantification of time series variables extracted from postural sway signals. While it has been suggested that frequency domain variables can provide more valuable information, few current studies have evaluated postural sway in amputees using frequency domain variables. OBJECTIVE: To determine time and frequency domain variables of postural sway among lower extremity amputees vs. healthy young and older adult controls. METHODOLOGY: Participants were assigned to 3 groups: lower extremity amputation (n=6), healthy young adults (n=10), and healthy older adults (n=10). Standing barefoot on a force platform, each individual completed 3 trials of each of 3 standing conditions: eyes open, eyes closed, and standing on a foam balance pad. Time and frequency domain variables of postural sway were computed and analyzed. RESULTS: Comparison of older adults, younger adults, and amputees on the three conditions of standing eyes open, eyes closed, and on foam revealed significant differences between groups. Mean mediolateral (ML) sway distance from the center of pressure (COP), total excursions and sway velocity was significantly higher for amputees and older adults when compared to young adults (p
, Wei Hou, Laura Goyarts, James Galassi, Eric Lamberg
CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, Volume 3; doi:10.33137/cpoj.v3i2.34609

Abstract:
BACKGROUND: Individuals with transtibial amputation (TTA) typically walk with an asymmetrical gait pattern, which may predispose them to secondary complications and increase risk of fall. Gait asymmetry may be influenced by prosthesis mass. OBJECTIVE: To explore the effects of prosthesis mass on temporal and limb loading asymmetry in people with TTA following seven days of acclimation and community use. METHODS: Eight individuals with transtibial amputation participated. A counterbalanced repeated measures study, involving three sessions (each one week apart) was conducted, during which three load conditions were examined: no load, light load and heavy load. The light load and heavy load conditions were achieved by adding 30% and 50% of the mass difference between legs, at a proximal location on the prosthesis. Kinematic and ground reaction force data was captured while walking one week after the added mass. Symmetry indices between the prosthetic and intact side were computed for temporal (Stance and Swing time) and limb loading measures (vertical ground reaction force Peak and Impulse). FINDINGS: Following seven days of acclimation, no significant differences were observed between the three mass conditions (no load, light load and heavy load) for temporal (Stance time: p=0.61; Swing time: p=0.13) and limb loading asymmetry (vertical ground reaction force Peak: p=0.95; vertical ground reaction force Impulse: p=0.55). CONCLUSION: Prosthesis mass increase at a proximal location did not increase temporal and limb loading asymmetry during walking in individuals with TTA. Hence, mass increase subsequent to replacing proximally located prosthesis components may not increase gait asymmetry, thereby allowing more flexibility to the clinician for component selection. Layman's Abstract People with a below the knee amputation typically have an asymmetrical walking style, i.e., they spend more time and put more body weight on their non-amputated leg. This may result in development of knee or hip osteoarthritis of the non-amputated leg, over time. Further, an asymmetrical walking style may also predispose people to a greater number of falls. It is believed that the weight of a prosthesis may influence the walking asymmetry. It is, however, unclear if changing the weight of a prothesis during routine clinical visits (for example, switching or replacing prosthesis parts) would increase walking asymmetry. To explore this, eight individuals with a below the knee amputation had two different weights added to the top half of their prosthesis. After the addition of the weight, participants went home to use the device in their communities for seven days. Subsequently, they returned to the lab to record their walking. We observed that walking with the heavier prosthesis, using either load, did not increase the amount of time spent and body weight applied by our participants on their non-amputated side. Hence, adding mass to the top half of a prosthesis may not increase walking asymmetry. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/34609/26769 How To Cite: Seth M, Hou W, Goyarts L.R, Galassi J.P, Lamberg E.M. Effect of transtibial prosthesis mass on gait asymmetries. Canadian Prosthetics & Orthotics Journal. 2020;Volume 3, Issue 2, No.5. https://doi.org/10.33137/cpoj.v3i2.34609 Corresponding Author: Mayank Seth, PhDDelaware Limb Loss Studies Lab, University of Delaware, Newark, USA.E-mail: [email protected]: https://orcid.org/0000-0003-3526-7058
W. Russ Marable, Christian Smith, Benedikt Þorri Sigurjónsson, Ingi Freyr Atlason, G. Anton Johannesson
CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, Volume 3; doi:10.33137/cpoj.v3i2.34672

Abstract:
BACKGROUND: Direct Socket for transfemoral (DS-TF) prosthetic user is a novel method of fabricating a laminated interface on to the residual limb but requires different training, production method and service model than what most prosthetists are familiar with. This method and model may improve patient satisfaction by enabling interface fabrication and delivery in one visit. OBJECTIVES: Document patient satisfaction regarding DS-TF interface versus the prosthetic users’ previous socket in terms of interface function and the clinic service model. METHODOLOGY: In this longitudinal study (from July 2018 to April 2020), the DS-TF was implemented in six prosthetic clinics across the United States. Certified prosthetists (CP) and assistants were trained using a standard protocol. 47 prosthetic users participated, both those in need of a new socket and those without need. Two modules from the Orthotics and Prosthetics Users’ Survey (OPUS), involving questions related to satisfaction with the Device and Services, was used to evaluate each DS-TF user outcome vs. baseline. The only part of the prosthesis that was replaced was the interface, except in 2 cases. FINDINGS: Each DS-TF interface was fabricated, fit and delivered in a single clinic visit. At 6-months follow-up, 38 users reported an average of 29.8% increase in satisfaction with their new interface compared with original, and a 14.8% increase in satisfaction with the services they received from the clinic in providing of the new prosthesis vs. their original prosthesis. The main outcome increases were between baseline (initial fitting) and 6-week follow-up and remained consistent after 6 months. This improvement was consistent irrespective if the user needed a new socket for clinical reasons or not. CONCLUSION: This study shows that after a standardized training and implementation, the DS-TF fabrication process including a new interface improves the user’s satisfaction with their prosthetic device and services. Layman's Abstract The connection between an amputee’s remaining limb and their prosthesis is called the interface and is the most critical part in a prosthetic system for the user satisfaction, comfort and mobility. Interfaces commonly consist of two parts; a flexible “liner” rolled onto the limb, which then goes into a hard socket custom-made by the prosthetist. The assembled interface then provides a secure connection between the users remaining limb and the prosthesis. Historically the prosthetist’s fabrication and fitting procedure required many hours of time and multiple visits to the prosthetic clinic before the interface was delivered to the user. Direct Socket for above knee prosthetic users is a new method of fabricating laminated sockets directly on the residual limb that enables fabrication and delivery in a single visit. However, Direct Socket require different training and methods than what most prosthetists are familiar with. This new procedure was implemented in six different prosthetic clinics across the United States. Seven CP’s were trained, each in their clinic and the method was tested on 38 users for a period of 6 months. The users filled in questionnaires about their experience and satisfaction using their existing socket, as well as their satisfaction of using their new socket. Overall, the Direct Socket prosthetic users reported after the 6-months follow-up significantly greater (29.8%) satisfaction with their new socket compared to their previous socket. They also reported 14.8% increase in satisfaction with the services they obtained from the clinic when receiving the new socket, compared to their satisfaction with receiving their original socket. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/34672/26933 How To Cite: Marable W.R, Smith C, Sigurjónsson B.Þ, Atlason I.F, Johannesson G.A. Transfemoral socket fabrication method using direct casting: outcomes regarding patient satisfaction with device and services. Canadian Prosthetics & Orthotics Journal. 2020;Volume 3, Issue 2, No.6. https://doi.org/10.33137/cpoj.v3i2.34672 Corresponding Author: G. Anton Johannesson, PhDTeamOlmed, Kistagången 12, 164 40 Kista, Stockholm, Sweden.E-mail: [email protected]: https://orcid.org/0000-0001-8729-458X
, Barbara Silver-Thorn,
CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, Volume 3; doi:10.33137/cpoj.v3i2.34481

Abstract:
BACKGROUND: A number of individuals with unilateral transfemoral amputation (TFA) run in a prosthesis with an unlocked prosthetic knee, while others choose to run with a locked prosthetic knee to increase stability. Research regarding running with an unlocked knee (UK) versus a locked knee (LK), with respect to energy efficiency, is limited and might be enhanced by characterization of the impact of knee condition on kinematics. OBJECTIVE: To investigate the effect of an UK versus LK on hip kinematics, energy efficiency, and running speed. METHODOLOGY: Five male novice runners with unilateral TFA completed one three-minute self-selected running speed (SSRS) trial and three peak speed trials per knee condition. Hip kinematics, energy efficiency, and running speed were compared between conditions. FINDINGS: Four of the five subjects exhibited a fast walk, rather than a consistent run. Hip flexion increased for all subjects and hip abduction decreased for four subjects during swing phase for the UK condition. Hip kinematic asymmetry was reduced for the UK condition in the sagittal plane for four individuals; hip kinematic asymmetry was also reduced in the frontal plane for the UK condition for three of these individuals. Mean energy efficiency was better for the UK condition (UK: 0.282 mLO2/kg/m, LK: 0.328 mLO2/kg/m). Peak running speed did not differ significantly between knee conditions (UK: 1.47 m/s, LK:1.32 m/s). CONCLUSIONS: For novice recreational runners with unilateral transfemoral amputation, the UK condition resulted in improved energy efficiency and enhanced kinematic symmetry, despite comparable peak speed relative to the LK condition. Therefore the UK condition may be advantageous for mid-range distance running. Layman's Abstract Runners with above-knee amputation may run with a prosthetic leg. Some runners prefer to run with their prosthetic knee unlocked, able to flex and extend, while others prefer to run with the prosthetic knee locked. The purpose of this study was to determine the effects of unlocked and locked knee conditions on hip motion, energy efficiency, and running speed during attempted running. Five male novice runners with an amputation above the knee attempted running for three-minutes at a comfortable speed, followed by three fast walks/sprints with the prosthetic knee unlocked and then locked. Most of the novice runners exhibited more symmetric hip motion while fast walking/running with an unlocked prosthetic knee. All our subjects were more energy efficient or exerted less energy with the unlocked prosthetic knee. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/34481/26590 How To Cite: Blakeley N., Silver-Thorn B., Cross J.A. Investigation of the effects of prosthetic knee condition for individuals with transfemoral amputation during attempted running. Canadian Prosthetics & Orthotics Journal. 2020; Volume 3, Issue 2, No.3. https://doi.org/10.33137/cpoj.v3i2.34481 Corresponding Author:Natalie Blakeley, Department of Biomedical Engineering, Marquette University, Milwaukee, USA. E-mail: [email protected]: https://orcid.org/0000-0002-2066-4096
Michelle G. Marquez, Matthew Kowgier,
CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, Volume 3; doi:10.33137/cpoj.v3i1.33916

Abstract:
BACKGROUND: Dysvascular amputations arising from peripheral vascular disease and/or diabetes are common. Patients who undergo amputation often have additional comorbidities that may impact their recovery after surgery. Many individuals undergo post-operative inpatient rehabilitation to improve their non-prosthetic functional independence. Thus far, our characterization of comorbidity in this population and how it is associated with non-prosthetic inpatient functional recovery remains relatively unexplored. OBJECTIVE: The objective of this study was to describe comorbidities, using the Charlson Comorbidity Index (CCI), and to examine associations between comorbidity and functional outcomes in a cohort of patients with dysvascular limb loss undergoing non-prosthetic inpatient rehabilitation. METHODOLOGY: A retrospective cohort design was used to analyze a group of 143 patients with unilateral, dysvascular limb loss who were admitted to inpatient rehabilitation. Age, sex, amputation level, amputation side, length of stay (LOS), time since surgery, Functional Independence Measure (FIM) scores (Total and Motor at admission and discharge), and CCI scores were collected. FINDINGS: The data showed that neither total or specific comorbidities were associated with functional outcomes or LOS in this cohort and rehabilitation model. Multivariate analysis demonstrated an inverse relationship with age and FIM scores, where increased age was associated with lower Total and Motor FIM at admission and discharge. Comorbidities were not associated with functional outcomes. Dementia was negatively associated with FIM scores, however this requires more study given the low number of patients with dementia in this cohort. CONCLUSION: These data suggest that regardless of burden of comorbidity or specific comorbidities that patients with dysvascular limb loss may derive similar functional benefit from post-operative non-prosthetic inpatient rehabilitation. Layman’s Lower extremity limb loss arising from peripheral vascular disease and/or diabetes is common. Patients who require amputation often have multiple medical conditions that may impact their recovery after surgery. Moreover, many individuals undergo inpatient rehabilitation after surgery to improve self-care and mobility before discharge from hospital. We understand very little about how multiple medical conditions in patients with recent limb loss who are admitted to rehabilitation hospitals are impacted. Specifically, whether individuals with multiple medical conditions have negative functional consequences and do they stay in a rehabilitation hospital for a longer period of time. The objective of this study was to describe the types of medical conditions that patients with recent limb loss have and to examine the relationship between these conditions with functional outcomes and length of stay in hospital while undergoing inpatient rehabilitation. 143 patients with unilateral, dysvascular limb loss who were admitted to an inpatient rehabilitation hospital were included in the analysis. Age, gender, amputation level, amputation side, length of stay, time since surgery, Functional Independence Measure scores (measure of a patient’s function) and Charlson Comorbidity Index (measure of multiple medical conditions) scores were collected. This study suggests that regardless of the burden of multiple medical conditions or specific medical problems, that patients with recent limb loss may derive similar benefit after surgery at an inpatient rehabilitation hospital prior to consideration for a prosthesis. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/33916/26327 How To Cite: Marquez M.G., Kowgier M., Journeay W.S. Comorbidity and non-prosthetic inpatient rehabilitation outcomes after dysvascular lower extremity amputation. Canadian Prosthetics & Orthotics Journal. 2020;Volume3, Issue1, No.1. https://doi.org/ 10.33137/cpoj.v3i1.33916 Corresponding Author: Dr. W. Shane Journeay, PhD, MD, MPH, FRCPC, BC-Occ MedProvidence Healthcare – Unity Health Toronto, 3276 St Clair Avenue East, Toronto ON M1L 1W1E-mail: [email protected]: https://orcid.org/0000-0001-6075-3176
Ihsan Balkaya, Eric Altschuler
CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, Volume 3; doi:10.33137/cpoj.v3i1.34528

Abstract:
This professional opinion describes the use of an off the shelf knee orthotic to correct the gait and functional mobility of a patient with hemisensory loss including proprioception following a stroke and provides supporting video. Interestingly, this case corrects a human analogue of a functional deficit found experimentally in monkeys in the 19th century by Mott and Sherrington. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/34528/26530 Video 1 Link: https://online-publication.com/wp/wp-content/uploads/2020/07/VIDEO-1-CPOJ.mov Video 2 Link: https://online-publication.com/wp/wp-content/uploads/2020/07/VIDEO-2-CPOJ.mov How To Cite: Balkaya I, Altschuler E.L. Correcting sherrington’s gait dysfunction with an off the shelf knee orthotic. Canadian Prosthetics & Orthotics Journal. 2020;Volume3, Issue1, No.4. https://doi.org/10.33137/cpoj.v3i1.34528 Corresponding Author: Eric L Altschuler, MD, PhDMetropolitan Hospital,1901 First Avenue, New York, NY, 10029, USA.E-Mail: [email protected]: (212) 423-6448Fax: (212) 423-6326ORCID: https://orcid.org/0000-0002-3575-6954
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