12 research outputs found
Analysis of biomechanical effectiveness of valgus-inducing knee brace for osteoarthritis of knee
No full textThe biomechanical effectiveness of a valgus-inducing knee brace was investigated for 16 patients with knee osteoarthritis (mean +/- standard deviation age 56 +/- 10 yr, height 172 +/- 9 cm, mass 83 +/- 7 kg, body mass index 27.6 +/- 74.5 kg/m(2)). At the time of investigation, all subjects had been wearing the brace for at least 4 weeks. In addition to conducting standard gait analysis, we calculated the valgus moment generated by the brace by using a novel system that measured the actual deformation of the brace during stance phase and determined the reaction force created by the brace on the leg. The mean maximum value of the orthotic valgus moment was 0.053 Nm/kg, which represents approximately 10% of the external genu varus moment without the brace. This finding may explain the pain relief reported by patients using such braces in clinical studies. Use of the tested brace also decreased the magnitude of gait asymmetry between the braced and contralateral legs during walking (horizontal ground reaction force, external knee flexion moment), presumably because the subjects' need to walk abnormally to shield the knee from pain was reduced
Ingeborg Drewitz in the Field of Literature and Politics
No full textDer aus einer Berliner Tagung im November 2003 hervorgegangene Band „Von der Unzerstörbarkeit des Menschen“ versammelt zahlreiche interessante Beiträge zu Leben und Werk der Autorin Ingeborg Drewitz. Der erste Teil des Bandes ist unter dem Titel „Vita activa“ vor allem dem vielfältigen politischen Engagement der Autorin gewidmet, während „Themen und Schreibweisen“ ihres literarischen Werks in einem sehr umfangreichen zweiten Teil behandelt werden. Insgesamt zeichnen die Texte in dem Band ein sehr differenziertes Bild von Ingeborg Drewitz als engagierter Schriftstellerin und von ihrem Werk.The volume “On Human Indestructibility” (“Von der Unzerstörbarkeit des Menschen“), which is based on a conference held in Berlin in November 2003, contains numerous interesting contributions on the life and work of the author Ingeborg Drewitz. The first part of the volume, which is entitled “Vita activa,” is dedicated to the author’s numerous political engagements, while the expansive second section, “Themes and Syntax,” approaches her literary work. In total, the texts in the volume draw a differentiated image of the politically engaged author Ingeborg Drewitz and of her work
EXPERTS' PERCEIVED PATIENT BURDEN AND OUTCOMES OF KNEE-ANKLE-FOOT-ORTHOSES (KAFOs) VS. MICROPROCESSOR-STANCE-AND-SWING-PHASE-CONTROLLED-KNEE-ANKLE-FOOT ORTHOSES (MP-SSCOs)
No full textBACKGROUND: Patients with neuromuscular knee-instability assisted with orthotic devices experience problems including pain, falls, mobility issues and limited engagement in daily activities.
OBJECTIVES: The aim of this study was to analyse current real-life burden, needs and orthotic device outcomes in patients in need for advanced orthotic knee-ankle-foot-orthoses (KAFOs).
METHODOLOGY: An observer-based semi-structured telephone interview with orthotic care experts in Germany was applied. Interviews were transcribed and content-analysed. Quantitative questions were analysed descriptively.
FINDINGS: Clinical experts from eight centres which delivered an average of 49.9 KAFOs per year and 13.3 microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot orthoses (MP-SSCOs) since product availability participated. Reported underlying conditions comprised incomplete paraplegia (18%), peripheral nerve lesions (20%), poliomyelitis (41%), post-traumatic lesions (8%) and other disorders (13%). The leading observed patient burdens were “restriction of mobility” (n=6), followed by “emotional strain” (n=5) and “impaired gait pattern” (n=4). Corresponding results for potential patient benefits were seen in “improved quality-of-life” (n=8) as well as “improved gait pattern” (n=8) followed by “high reliability of the orthosis” (n=7). In total, experts reported falls occurring in 71.5% of patients at a combined annual frequency of 7.0 fall events per year when using KAFOs or stance control orthoses (SCOs). In contrast, falls were observed in only 7.2 % of MP-SSCO users.
CONCLUSION: Advanced orthotic technology might contribute to better quality of life of patients, improved gait pattern and perceived reliability of orthosis. In terms of safety a substantial decrease in frequency of falls was observed when comparing KAFO and MP-SSCO users.
Layman's Abstract
Patients who are not able to control the muscles of their legs may need to wear a brace to improve their ability to walk. However, some users are reporting problems including pain, falls, mobility issues and limited engagement in daily activities. The aim of this study was to analyse current real-life burden, needs and experiences of patients who need to wear a brace for their knee, ankle and foot (KAFO). Therefor, experts were interviewed via telephone with a structured set of questions. Eight experts provided observations for patients who suffered from several diseases affecting leg muscle control. The leading patient burdens were identified as “restriction of mobility”, followed by “emotional strain” and “impaired way of walking”. Potential patient benefits were seen in “improved quality-of-life” as well as “improved way of walking” followed by a “high trust in the brace”. Experts reported a higher number of falls per year when using KAFO without the active control of a microprocessor. On a long-term basis, experts observed consequences of KAFO use as disorders of the back, reduced amount of muscles as well as swelling in areas not covered by the brace, scrub marks and degenerative impact on joints. Braces with active control of a microprocessor might result in better quality of life of patients, improved normal way of walking and perceived trust in the brace.
Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/37795/29114
How To Cite: Brüggenjürgen B., Braatz F., Greitemann B., Drewitz H., Ruetz A., Schäfer M., et al. Experts’ perceived patient burden and outcomes of knee-ankle-foot-orthoses (KAFOs) vs. microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot orthoses (MP-SSCOs). Canadian Prosthetics & Orthotics Journal. 2022; Volume 5, Issue 1, No.7.https://doi.org/10.33137/cpoj.v5i1.37795Corresponding Author: Prof. Dr. med. Bernd Brüggenjürgen,
Head Institute Health Services Research and Technical Orthopedics, Orthopedic Department - Medical School Hannover (MHH) at DIAKOVERE Annastift Hospital, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany.
E-Mail:[email protected]
ORCID ID:https://orcid.org/0000-0002-8866-080
The post-war division of Berlin and its social effects, as illustrated by the translations of three short stories by Ingeborg Drewitz
No full textThis thesis examines three short stories by Ingeborg Drewitz, translated from German to English for this specific purpose. All three stories deal with a major concern of Drewitz, namely the effects the separation between East and West Germany had on the population. The introduction comments on the importance of the stories, their relevance to the chosen topic, and the author's writing techniques. A brief account of the historical events leading up to the establishment of the Berlin Wall will provide the necessary background information to set the stories into context. A further section is dedicated to Ingeborg Drewitz herself, including a look at her childhood, her literary accomplishments and awards. The central portion of the thesis is the presentation of the English translations of the stories, each followed by a brief analysis. The concluding comparison of these stories focuses on their contribution to the overall theme.Bibliography: leaves 129-132
The effect of orthoses on biomechanical gait parameters in medial knee compartment osteoarthritis: Comparison of KO and AFO principles
No full textThe Contribution of Women Authors to the Discovery of People of the Female Sex in German-Speaking Literature Since 1945
No full textThe paper proceeds from the assumption that women write differently from men; that, as Virginia Woolf asserted, if one were to place two texts side by side, one by a woman and one by a man, one would be able to ascertain the sex of the author. This paper attempts to shed some light on the reasons why this should be so: is it a result of innate differences in personality, or in socialization, or both? It also examines in some detail (and this is its main burden) the different subjects that women in the Federal Republic of Germany after 1945 choose to write about and the different ways in which they treat these subjects. Extensive quotations from a number of important women writers are given in order to convey a sense of the texture of this writing to an English-speaking audience
The influence of sole wedges on frontal plane knee kinetics, in isolation and in combination with representative rigid and semi-rigid ankle–foot-orthoses
No full textEffectiveness of ankle-foot orthoses for patients with weakness of the plantarflexors and dorsiflexors: biomechanical comparison of different orthotic concepts
No full textIntroduction Weakness of plantarflexor and dorsiflexor muscles is a complex individual condition and can result in pathological gait, such as crouch gait or knee hyperextension. Affected patients can be supported with ankle-foot orthoses (AFOs) to improve gait and safety.Objective This study aims to compare three orthotic ankle joint designs in AFOs for patients with muscle weakness in the plantarflexors and/or dorsiflexors: a conventional hinged ankle joint with rigid stops (CAJ), a jointless orthosis (JLO), and a reactive-dynamic ankle joint with adjustable spring modules (RDA).Study Design Seven patients with plantarflexor and/or dorsiflexor muscle weakness tested three orthosis configurations in randomized order during a single session.Methods Biomechanical gait analysis was performed during standing and walking on level ground and up and down 10° slopes. The main outcomes were ground reaction forces, joint angles, moments, and power at the ankle, knee, and hip joints. Mean values of outcome measures for patients and values of an able-bodied control group were compared with nonparametric analyses of variance and pairwise post hoc tests.Results Throughout all motion tasks, statistically significant differences (P Conclusions For this patient group, RDA enabled the most physiological gait, with outcomes measure values closest to those of the able-bodied control group, and the best perception of support for an active lifestyle and physically demanding activities. In less physically demanding situations, such as short walking distances and even surfaces, JLO also showed sufficient support for physiological gait and may be an adequate orthosis for patients living with supportive infrastructure or a more sedentary lifestyle. CAJ restricted physiological movements, showed the highest deviations from the values of the able-bodied controls in most activities, and provides the least comfort for patients in the tested situations.Clinical Relevance Statement Determining the best possible orthotic care and support for different patient groups is essential to enable independence, safety, and comfort during activities of daily living based on individual requirements
EXPERTS’ PERCEIVED PATIENT BURDEN AND OUTCOMES OF KNEE-ANKLE-FOOT-ORTHOSES (KAFOs) VS. MICROPROCESSOR-STANCE-AND-SWING-PHASE-CONTROLLED-KNEE-ANKLE-FOOT ORTHOSES (MP-SSCOs)
No full textBACKGROUND: Patients with neuromuscular knee-instability assisted with orthotic devices experience problems including pain, falls, mobility issues and limited engagement in daily activities.
OBJECTIVES: The aim of this study was to analyse current real-life burden, needs and orthotic device outcomes in patients in need for advanced orthotic knee-ankle-foot-orthoses (KAFOs).
METHODOLOGY: An observer-based semi-structured telephone interview with orthotic care experts in Germany was applied. Interviews were transcribed and content-analysed. Quantitative questions were analysed descriptively.
FINDINGS: Clinical experts from eight centres which delivered an average of 49.9 KAFOs per year and 13.3 microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot orthoses (MP-SSCOs) since product availability participated. Reported underlying conditions comprised incomplete paraplegia (18%), peripheral nerve lesions (20%), poliomyelitis (41%), post-traumatic lesions (8%) and other disorders (13%). The leading observed patient burdens were “restriction of mobility” (n=6), followed by “emotional strain” (n=5) and “impaired gait pattern” (n=4). Corresponding results for potential patient benefits were seen in “improved quality-of-life” (n=8) as well as “improved gait pattern” (n=8) followed by “high reliability of the orthosis” (n=7). In total, experts reported falls occurring in 71.5% of patients at a combined annual frequency of 7.0 fall events per year when using KAFOs or stance control orthoses (SCOs). In contrast, falls were observed in only 7.2 % of MP-SSCO users.
CONCLUSION: Advanced orthotic technology might contribute to better quality of life of patients, improved gait pattern and perceived reliability of orthosis. In terms of safety a substantial decrease in frequency of falls was observed when comparing KAFO and MP-SSCO users.
Layman\u27s Abstract
Patients who are not able to control the muscles of their legs may need to wear a brace to improve their ability to walk. However, some users are reporting problems including pain, falls, mobility issues and limited engagement in daily activities. The aim of this study was to analyse current real-life burden, needs and experiences of patients who need to wear a brace for their knee, ankle and foot (KAFO). Therefor, experts were interviewed via telephone with a structured set of questions. Eight experts provided observations for patients who suffered from several diseases affecting leg muscle control. The leading patient burdens were identified as “restriction of mobility”, followed by “emotional strain” and “impaired way of walking”. Potential patient benefits were seen in “improved quality-of-life” as well as “improved way of walking” followed by a “high trust in the brace”. Experts reported a higher number of falls per year when using KAFO without the active control of a microprocessor. On a long-term basis, experts observed consequences of KAFO use as disorders of the back, reduced amount of muscles as well as swelling in areas not covered by the brace, scrub marks and degenerative impact on joints. Braces with active control of a microprocessor might result in better quality of life of patients, improved normal way of walking and perceived trust in the brace.
Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/37795/29114
How To Cite: Brüggenjürgen B., Braatz F., Greitemann B., Drewitz H., Ruetz A., Schäfer M., et al. Experts’ perceived patient burden and outcomes of knee-ankle-foot-orthoses (KAFOs) vs. microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot orthoses (MP-SSCOs). Canadian Prosthetics & Orthotics Journal. 2022; Volume 5, Issue 1, No.7.https://doi.org/10.33137/cpoj.v5i1.37795
Corresponding Author: Prof. Dr. med. Bernd Brüggenjürgen,Head Institute Health Services Research and Technical Orthopedics, Orthopedic Department - Medical School Hannover (MHH) at DIAKOVERE Annastift Hospital, Anna-von-Borries-Str. 1-7, 30625 Hannover, Germany.
E-Mail:[email protected] ORCID ID:https://orcid.org/0000-0002-8866-080
Extended pancreas donor program - the EXPAND study rationale and study protocol
No full textBACKGROUND:
Simultaneous pancreas kidney transplantation (SPK), pancreas transplantation alone (PTA) or pancreas transplantation after kidney (PAK) are the only curative treatment options for patients with type 1 (juvenile) diabetes mellitus with or without impaired renal function. Unfortunately, transplant waiting lists for this indication are increasing because the current organ acceptability criteria are restrictive; morbidity and mortality significantly increase with time on the waitlist. Currently, only pancreas organs from donors younger than 50 years of age and with a body mass index (BMI) less than 30 are allocated for transplantation in the Eurotransplant (ET) area. To address this issue we designed a study to increase the available donor pool for these patients.
METHODS/DESIGN:
This study is a prospective, multicenter (20 German centers), single blinded, non-randomized, two armed trial comparing outcome after SPK, PTA or PAK between organs with the currently allowed donor criteria versus selected organs from donors with extended criteria. Extended donor criteria are defined as organs procured from donors with a BMI of 30 to 34 or a donor age between 50 and 60 years. Immunosuppression is generally standardized using induction therapy with Myfortic, tacrolimus and low dose steroids. In principle, all patients on the waitlist for primary SPK, PTA or PAK are eligible for the clinical trial when they consent to possibly receiving an extended donor criteria organ. Patients receiving an organ meeting the current standard criteria for pancreas allocation (control arm) are compared to those receiving extended criteria organ (study arm); patients are blinded for a follow-up period of one year. The combined primary endpoint is survival of the pancreas allograft and pancreas allograft function after three months, as an early relevant outcome parameter for pancreas transplantation.
DISCUSSION:
The EXPAND Study has been initiated to investigate the hypothesis that locally allocated extended criteria organs can be transplanted with similar results compared to the currently allowed standard ET organ allocation. If our study shows a favorable comparison to standard organ allocation criteria, the morbidity and mortality for patients waiting for transplantation could be reduced in the future.
TRIAL REGISTRATION:
Trial registered at: NCT0138400
