Volume 50 Number 8, 2013
Pages xxvii — xxix
Over 12 mo following their initial evaluation,
Veterans screening positive on a traumatic brain injury
(TBI) clinical reminder had over 85 percent higher
total costs than Veterans who screened negative. Understanding
healthcare utilization and cost patterns following
TBI screening is important for policymakers as
they address the ongoing and future healthcare needs of
returning Operation Iraqi Freedom/Operation Enduring
Prosthetic vacuum pumps generate high levels of
vacuum pressure that are used to secure prosthetic
sockets onto the residual limbs of persons with amputation.
Despite the increasing use of vacuum pumps
in clinical practices, there are only a few guidelines
directing the prosthetist's and user's selection among
alternative vacuum pumps. These guidelines are primarily
limited to manufacturer specifications. This
report describes techniques developed to assess the
performance of prosthetic vacuum pumps and demonstrates
those techniques using a number of commercially
available electrical and mechanical pumps. The
findings may contribute to clinicians– judgments on
appropriate componentry for their patients– needs.
This article highlights the efficacy of a new impression
technique, the triple-layer impression technique
(TLIT), which plays a vital role in fabricating
a cosmetic silicone auricular prosthesis for unilateral
auricular defects. The TLIT reduces the distortion of
the ear in impressions. The models were more accurate
when compared with the conventional impression
technique described in the literature. Thus,
TLIT will help the maxillofacial prosthetist achieve
better orientation of unilateral ear prostheses.
Older adults who are receiving home-care physical
therapy services were studied to determine
whether how they think and how they walk are related.
We studied 10,953 people over the age of 65
to try to better understand if there was a relationship
between a clinician's ranking of how well someone's
brain was working and how well that person walked.
There appears to be a strong relationship between
people's ability to think clearly and how well they
can walk in their homes.
The use of accelerometers in patients with stroke
is novel, especially in the acute phase of stroke. The
use of accelerometers in acute stroke is warranted since
no cooperation of the patient is needed to collect data.
We investigated whether arm use, measured by accelerometers,
has a predictive value for the disability status
3 mo after stroke. It was demonstrated that age and the
amount of arm use could correctly predict (85%) the
modified Rankin Scale score after 3 mo of follow-up.
Lack of physical activity has serious health and
functional consequences for people after a stroke.
Therefore, interventions to improve activity after a
stroke and accurate methods to measure activity are
needed. This study examined how the length of the
interval over which activity data are sampled affects
the measurement of activity. The results showed that
the length of the sampling interval can result in either
overestimating or underestimating activity. Such
overestimation and underestimation is worse when
activity is low, which could affect the interpretation
of comparisons between groups of people with very
different activity amounts.
Presently, rehabilitation of weakness after stroke
exclusively involves work with physical and occupational
therapists. Scientific studies have shown that, if provided correctly and in adequate amount, this
rehabilitation can be effective but that strong limitations
exist to how much recovery can be achieved in
this way. Significant advances in neurorehabilitation
will depend on increasing the amount of neural tissue
that recovers from the stroke. This study suggests
that weakness after stroke is caused predominantly by
damage to neural connections deep within the brain
(white matter) and that neuroscientists should concentrate
on strategies to enhance white matter recovery.
Multiarticulated myoelectric prosthetic hands
move almost like human hands. But are these hands
more functional than traditional prosthetic hands?
The i-LIMB and i-LIMB Pulse hands were tested
over time in a case study. Functionality of the i-LIMB
improved after a year of use. The i-LIMB Pulse had
more grip strength and was less vulnerable than the
i-LIMB. The user valued the preset grip features of
the i-LIMB Pulse because it made complex control
quicker and easier. Conclusions from this study are
that the i-LIMB Pulse is more functional than the
i-LIMB and that training and experience are needed
to benefit from multiarticulated hands.
A wrist-driven flexor hinge orthosis (WDFHO) is
a device used to restore hand function in persons with
paralyzed hands. The device is inexpensive and
easy to use by persons with impaired hand function
caused by spinal cord injury. We analyzed the
effectiveness of a WDFHO in persons with spinal
cord injury. For this, we introduced mathematical equations to model operating principles and evaluated
the effectiveness of the WDFHO. Our results
confirmed that pinch force significantly improved
after using the WDFHO. In addition, we found that
the device requires better alignment for persons with
greater wrist strength.
According to the Department of Veteran Affairs,
approximately 26,000 veterans have been diagnosed
with multiple sclerosis (MS) and are included in the
VA MS data repository. MS is related to reductions
in physical abilities and loss of independence. Our
data suggest that lower relative body fat and greater
physical activity are related to higher levels of physical
function in women with MS. So, reducing fat and
increasing physical activity may be effective intervention
strategies for helping MS patients maintain
independence. A healthcare provider can prescribe
appropriate types of exercise for an MS patient.
Heel pressure ulcers are associated with significant
morbidity. There are sparse data regarding the basic etiology of heel ulcers and efficacy of prevention
aids such as heel padding devices. We explored
the effects of foot posture and different padding devices
on soft tissue deformations using magnetic resonance
imaging (MRI). We found that when the foot
is in external rotation, skin tissue deformations are
significantly greater than when the foot is upright.
Heel padding devices have a significant effect on reducing
internal soft tissue deformations. This study
shows that MRI is a powerful tool in assessing the biomechanical
performances of heel padding devices.
This study evaluates the effect of perceptive
training on the visual performance and the emotional
state of people with restriction in contrast sensitivity
(CS), such as those with retinitis pigmentosa (RP).
The outcomes showed significant progress, which
suggests that the program could be a helpful addition
to RP rehabilitation, improving performance and
autonomy in daily life tasks and emotional state. The
program could also be useful in the rehabilitation of
other people with deficits in CS, alleviating the repercussions
that these problems have for performing
daily activities and well-being.
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Last Reviewed or Updated Wednesday, December 11, 2013 9:43 AM