18 research outputs found
User accommodation to an active microprocessor-controlled knee in individuals with unilateral transfemoral amputation: a 5-week non-randomized trial
No full textAbstract Background Evaluation studies on active microprocessor-controlled knees (AMPK) in individuals with unilateral transfemoral amputation (TFA) are lacking in the literature. Furthermore, research on user accommodation to AMPK remains to be investigated. Hence, this study aims to conduct a comparison between an AMPK and individual’s current prosthesis and assess the accommodation to using an AMPK during daily activities over a 5-week period on functional performance tests. Methods Participants with TFA completed a protocol comprising L-test, slope walking, level walking (2MWT) and dual-task level walking (dual-2MWT) once a week with their current prosthesis and the AMPK. The outcomes of interest were the distance covered during the 2MWT and dual-2MWT, time required to perform the L-test, accuracy of the serial subtractions during the dual-2MWT, heart rate (HR), rating of perceived exertion, fatigue, comfort and perceived workload. Generalised least-squared models were built to investigate differences in prosthetic conditions over time. Pearson correlations were calculated to determine associations between the performance and subjective outcomes. The level of significance was set at 0.05. Results Seven participants (age = 53 years ± 14 years) completed the study. Over time, the AMPK participants took longer to complete the L-test than their current prosthesis (p < 0.001). They reported higher fatigue (p = 0.033), lower comfort (p = 0.010), and higher perceived exertion with the AMPK (p = 0.048). Slope walking showed no significant walking speed or HR differences except higher HR with the AMPK in session 3 (p = 0.032). Dual-task level walking demonstrated lower walking speed with the AMPK (p = 0.035) and more responses to serial subtractions in sessions two (p = 0.043) and four (p = 0.023). No other differences between conditions were found on one of the functional tests. Weak associations (|r|= 0–0.5) were observed between performance and subjective measures. Conclusion Using the AMPK highlights initial challenges in task completion times and subjective comfort and fatigue levels. Our findings indicate that five one-hour sessions are insufficient for achieving user accommodation, and underscore the need for further research with a larger sample, continued prosthetic use and user accommodation to enhance prosthetic functioning and user experiences. Trial registration: NCT05407545
Test-retest, intra- and inter-rater reliability of the reactive balance test in patients with chronic ankle instability
No full textIntroduction: The Reactive Balance Test (RBT) could be a valuable addition to research on chronic ankle instability (CAI) and clinical practice, but before it can be used in clinical practice it needs to be reliable. It has already been proven reliable in healthy recreational athletes, but not yet in patients with CAI who have shown persistent deficits in dynamic balance. The study aimed to determine the test-retest, intra-, and inter-rater reliability of the RBT in patients with CAI, and the test-retest and inter-rater reliability of the newly developed RBT score sheet. Methods: We used a repeated-measures, single-group design to administer the RBT to CAI patients on three occasions, scored by multiple raters. We included 27 participants with CAI. The study used multiple reliability measures, including Pearson r, intra-class correlations (ICC), standard error of measurement (SEM), standard error of prediction (SEP), minimal detectable change (MDC), and Bland–Altman plots, to evaluate the reliability of the RBT’s outcome measures (visuomotor response time and accuracy). It also assessed the test-retest and inter-rater reliability of the RBT score sheet using the same measures. Results: The ICC measures for test-retest reliability were similar for accuracy (0.609) and VMRT (0.594). Intra-rater reliability had high correlations and ICCs for accuracy (r = 0.816, ICC = 0.815) and VMRT (r = 0.802, ICC = 0.800). Inter-rater reliability had a higher ICC for VMRT (0.868) than for accuracy (0.690). Conclusion: Test-retest reliability was moderate, intra-rater reliability was good, and inter-rater reliability showed moderate reliability for accuracy and good reliability for VMRT. Additionally, the RBT shows robust SEM and mean difference measures. The score sheet method also demonstrated moderate test-retest reliability, while inter-rater reliability was good to excellent. This suggests that the RBT can be a valuable tool in assessing and monitoring balance in patients with CAI
Test-retest, intra- and inter-rater reliability of the reactive balance test in patients with chronic ankle instability
No full textIntroduction: The Reactive Balance Test (RBT) could be a valuable addition to research on chronic ankle instability (CAI) and clinical practice, but before it can be used in clinical practice it needs to be reliable. It has already been proven reliable in healthy recreational athletes, but not yet in patients with CAI who have shown persistent deficits in dynamic balance. The study aimed to determine the test-retest, intra-, and inter-rater reliability of the RBT in patients with CAI, and the test-retest and inter-rater reliability of the newly developed RBT score sheet. Methods: We used a repeated-measures, single-group design to administer the RBT to CAI patients on three occasions, scored by multiple raters. We included 27 participants with CAI. The study used multiple reliability measures, including Pearson r, intra-class correlations (ICC), standard error of measurement (SEM), standard error of prediction (SEP), minimal detectable change (MDC), and Bland–Altman plots, to evaluate the reliability of the RBT’s outcome measures (visuomotor response time and accuracy). It also assessed the test-retest and inter-rater reliability of the RBT score sheet using the same measures. Results: The ICC measures for test-retest reliability were similar for accuracy (0.609) and VMRT (0.594). Intra-rater reliability had high correlations and ICCs for accuracy (r = 0.816, ICC = 0.815) and VMRT (r = 0.802, ICC = 0.800). Inter-rater reliability had a higher ICC for VMRT (0.868) than for accuracy (0.690). Conclusion: Test-retest reliability was moderate, intra-rater reliability was good, and inter-rater reliability showed moderate reliability for accuracy and good reliability for VMRT. Additionally, the RBT shows robust SEM and mean difference measures. The score sheet method also demonstrated moderate test-retest reliability, while inter-rater reliability was good to excellent. This suggests that the RBT can be a valuable tool in assessing and monitoring balance in patients with CAI
Targeting visual-sensory and cognitive impairments following lateral ankle sprains: a practical framework for functional assessment across the return-to-sport continuum. Part 2: from theory to practice: recommendations for optimizing return to sport after lateral ankle sprains using cognitive and visual-sensory assessments
No full textLateral ankle sprain (LAS) is the most common traumatic injury in sports, characterized by a high recurrence rate, with chronic ankle instability (CAI) developing in ∼40% of cases. Both altered sensory reweighting and cognitive impairments have been identified as potential contributors to the elevated risk of (re)injury. The first part of this work aimed to clarify cognitive constructs relevant to post-injury rehabilitation, alongside the concept of sensory reweighting that may be observed in patients following LAS. It also introduced the Ankle-GO™, the first validated score providing clinicians with an objective criterion to support return-to-sport (RTS) decision-making. However, this promising tool does not account for visual and cognitive constraints encountered during functional tasks. Therefore, the second part of this work aims to translate emerging theories and growing evidence into practical applications, illustrating concrete examples of RTS assessments in patients with LAS and CAI. This perspective's article proposes a “β(rain)” extension of the Ankle-GO™ integrating dual-tasks paradigms and visual constraints to better approximate sport-specific conditions. Each functional test (Single leg stance, modified Star Excursion Balance Test, Side Hop Test and Figure-of-8 test) is paired with either a dual-tasks targeting key cognitive domains or a visual constraint. An adapted scoring method is outlined, together with a guide for interpreting results during the late rehabilitation phase, tailored to patients' specific deficits
Targeting visual-sensory and cognitive impairments following lateral ankle sprains: a practical framework for functional assessment across the return-to-sport continuum—Part 1. Sensory reweighting and cognitive impairments: what are we really talking about and why clinicians should consider central alterations in return to sport criteria
No full textInternational audienceLateral ankle sprain (LAS) is the most common traumatic injury, with a high recurrence rate and chronic ankle instability (CAI) developing in ∼40% of cases. LAS leads to patho-mechanical, sensory-perceptual and motor-behavioral deficits. Poor management of the return-to-sport (RTS) is now considered a major cause of re-injury and development of CAI, particularly due to the lack of validated tests and the failure of existing ones to account for those central deficits. The first part of this topic aimed to clarify concepts of cognitive constructs and sensory reweighting and their association with CAI. We also aimed to identify objective RTS criteria and discuss their limits regarding their ability to encompass central impairments. Motor-cognitive deficits have been identified using computerized cognitive tasks and dual-task paradigms. More specifically, deficits in visual memory, processing speed or inhibitory control and attentional resource allocation have demonstrated reduced performance in CAI populations. In addition, altered sensory reweighting process towards visual input has also been observed. While objective criteria are crucial to prevent re-injury, current evaluations remain largely subjective and central impairments are unaccounted for in conventional RTS testing. The Ankle-GO TM score was recently developed to guide clinicians in decision making process. To date, it is the first validated score that could help to identify patients who will RTS at the same level, those at risk of recurrence and those who are more likely to become copers. Unfortunately, it does not target cognitive or sensory reweighting alterations, that are both relevant in sport to manage gameplay demands
Targeting visual-sensory and cognitive impairments following lateral ankle sprains: a practical framework for functional assessment across the return-to-sport continuum. Part 2: from theory to practice: recommendations for optimizing return to sport after lateral ankle sprains using cognitive and visual-sensory assessments
No full textInternational audienceLateral ankle sprain (LAS) is the most common traumatic injury in sports, characterized by a high recurrence rate, with chronic ankle instability (CAI) developing in ∼40% of cases. Both altered sensory reweighting and cognitive impairments have been identified as potential contributors to the elevated risk of (re)injury. The first part of this work aimed to clarify cognitive constructs relevant to post-injury rehabilitation, alongside the concept of sensory reweighting that may be observed in patients following LAS. It also introduced the Ankle-GO™, the first validated score providing clinicians with an objective criterion to support return-to-sport (RTS) decision-making. However, this promising tool does not account for visual and cognitive constraints encountered during functional tasks. Therefore, the second part of this work aims to translate emerging theories and growing evidence into practical applications, illustrating concrete examples of RTS assessments in patients with LAS and CAI. This perspective's article proposes a “β(rain)” extension of the Ankle-GO™ integrating dual-tasks paradigms and visual constraints to better approximate sport-specific conditions. Each functional test (Single leg stance, modified Star Excursion Balance Test, Side Hop Test and Figure-of-8 test) is paired with either a dual-tasks targeting key cognitive domains or a visual constraint. An adapted scoring method is outlined, together with a guide for interpreting results during the late rehabilitation phase, tailored to patients' specific deficits
Test-retest, intra- and inter-rater reliability of the reactive balance test in patients with chronic ankle instability
No full textIntroductionThe Reactive Balance Test (RBT) could be a valuable addition to research on chronic ankle instability (CAI) and clinical practice, but before it can be used in clinical practice it needs to be reliable. It has already been proven reliable in healthy recreational athletes, but not yet in patients with CAI who have shown persistent deficits in dynamic balance. The study aimed to determine the test-retest, intra-, and inter-rater reliability of the RBT in patients with CAI, and the test-retest and inter-rater reliability of the newly developed RBT score sheet.MethodsWe used a repeated-measures, single-group design to administer the RBT to CAI patients on three occasions, scored by multiple raters. We included 27 participants with CAI. The study used multiple reliability measures, including Pearson r, intra-class correlations (ICC), standard error of measurement (SEM), standard error of prediction (SEP), minimal detectable change (MDC), and Bland–Altman plots, to evaluate the reliability of the RBT’s outcome measures (visuomotor response time and accuracy). It also assessed the test-retest and inter-rater reliability of the RBT score sheet using the same measures.ResultsThe ICC measures for test-retest reliability were similar for accuracy (0.609) and VMRT (0.594). Intra-rater reliability had high correlations and ICCs for accuracy (r = 0.816, ICC = 0.815) and VMRT (r = 0.802, ICC = 0.800). Inter-rater reliability had a higher ICC for VMRT (0.868) than for accuracy (0.690).ConclusionTest-retest reliability was moderate, intra-rater reliability was good, and inter-rater reliability showed moderate reliability for accuracy and good reliability for VMRT. Additionally, the RBT shows robust SEM and mean difference measures. The score sheet method also demonstrated moderate test-retest reliability, while inter-rater reliability was good to excellent. This suggests that the RBT can be a valuable tool in assessing and monitoring balance in patients with CAI
377 Test-retest, intra- and inter-rater reliability of the reactive balance test: a neurocognitive functional test to evaluate adaptability within injury risk profiling
No full textTherapeutic benefits of lower limb prostheses: a systematic review
No full textAbstract Background Enhancing the quality of life of people with a lower limb amputation is critical in prosthetic development and rehabilitation. Yet, no overview is available concerning the impact of passive, quasi-passive and active ankle–foot prostheses on quality of life. Objective To systematically review the therapeutic benefits of performing daily activities with passive, quasi-passive and active ankle–foot prostheses in people with a lower limb amputation. Methods We searched the Pubmed, Web of Science, Scopus and Pedro databases, and backward citations until November 3, 2021. Only English-written randomised controlled trials, cross-sectional, cross-over and cohort studies were included when the population comprised individuals with a unilateral transfemoral or transtibial amputation, wearing passive, quasi-passive or active ankle–foot prostheses. The intervention and outcome measures had to include any aspect of quality of life assessed while performing daily activities. We synthesised the participants’ characteristics, type of prosthesis, intervention, outcome and main results, and conducted risk of bias assessment using the Cochrane risk of bias tool. This study is registered on PROSPERO, number CRD42021290189. Results We identified 4281 records and included 34 studies in total. Results indicate that quasi-passive and active prostheses are favoured over passive prostheses based on biomechanical, physiological, performance and subjective measures in the short-term. All studies had a moderate or high risk of bias. Conclusion Compared to passive ankle–foot prostheses, quasi-passive and active prostheses significantly enhance the quality of life. Future research should investigate the long-term therapeutic benefits of prosthetics devices
