106 research outputs found
RESPONSE TO THE LETTER TO THE EDITOR REGARDING "HEALTH ECONOMIC EVALUATION OF MICROPROCESSOR AND NON-MICROPROCESSOR-CONTROLLED PROSTHETIC KNEES"
No full textWe responded to comments by Brüggenjürgen et al. (https://doi.org/10.33137/cpoj.v8i2.46339) regarding our study on cost-effectiveness of different prosthesis types (https://doi.org/10.33137/cpoj.v8i2.45823). We explained why small effect differences lead to high ICUR values and clarify our costing approach. We emphasized the need for future studies on prosthesis life-cycle, long-term outcomes, and improved quality-of-life measures for more accurate evaluations.
Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/46486/34608
How To Cite: Bosman C.E, van der Sluis C.K, Vrieling A.H, Geertzen J.H.B, Seves B.L, Groen H. Response to the letter to the editor regarding “Health economic evaluation of microprocessor and non-microprocessor-controlled prosthetic knees". Canadian Prosthetics & Orthotics Journal. 2025; Volume 8, Issue 2, No. 7. https://doi.org/10.33137/cpoj.v8i2.46486
Corresponding Author: Professor Henk Groen, Affiliation: Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.E-Mail: [email protected] ID: https://orcid.org/0000-0002-6629-318
Recovery of arm-hand function after stroke: developing neuromechanical biomarkers to optimize rehabilitation strategies.
Get PDFThe aim
of this thesis was to explore the neuromechanics of recovery of arm-hand
function after stroke. A literature review revealed six articles that measured
biomechanical and electromyographical outcome measures simultaneously, while
applying active and passive tasks and multiple movement velocities to separate
neural and non-neural contributors to movement disorders after stroke.
Therefore, a neuromechanic assessment protocol was developed. Parameters were
responsive to clinical status and had good to excellent test-retest
reliability. Selective muscle activation was assessed with high measurement
reliability and was significantly lower in chronic stroke patients compared to
healthy participants.
Longitudinally, neuromechanical parameters were combined with data on arm-hand
function at six months after stroke. Paresis and diminished modulation of
reflexes were associated with poor functional outcome. Changes in tissue
properties were represented by a shift in wrist rest angle towards flexion and
decline in passive range of motion. Increase in active range of motion and
steady rest angle contributed most to prediction of functional outcome.
The precision diagnostics provided by a neuromechanical assessment protocol
could support clinical decision making and should be used in prediction models
and as biomarkers in recovery of arm-hand function after stroke, for example by
improving the selection of time-window and patients.ZON/MW grant 89000001LUMC / Geneeskund
Learning to control opening and closing a myoelectric hand
Get PDFBouwsema H, van der Sluis CK, Bongers RM. Learning to control opening and closing a myoelectric hand. OBJECTIVE: To compare 3 different types of myoelectric signal training. DESIGN: A cohort analytic study. SETTING: University laboratory. PARTICIPANTS: Able-bodied right-handed participants (N=34) randomly assigned to 1 of 3 groups. INTERVENTIONS: Participants trained hand opening and closing on 3 consecutive days. One group trained with a virtual myoelectric hand presented on a computer screen, 1 group trained with an isolated prosthetic hand, and 1 group trained with a prosthetic simulator. One half of the participants trained with their dominant side, and the other half trained with their nondominant side. Before and after the training period, a test was administered to determine the improvement in skill. Participants were asked to open and close the hand on 3 different velocities at command. MAIN OUTCOME MEASURES: Peak velocity, mean velocity, and number of peaks in the myoelectric signal of hand opening and closing. RESULTS: No differences were found for the different types of training; all participants learned to control the myoelectric hand. However, differences in learning abilities were revealed. After learning, a subgroup of the participants could produce clearly distinct myoelectric signals, which resulted in the ability to open and close the hand at 3 different speeds, whereas others could not produce distinct myoelectric signals. CONCLUSIONS: Acquired control of a myoelectric hand is irrespective of the type of training. Prosthetic users may differ in learning capacity; this should be taken into account when choosing the appropriate type of control for each patient
Postoperative hand therapy in Dupuytren's disease
Get PDFBackground. Postoperative hand therapy in patients after surgery for Dupuytren's contracture is common medical practice to improve outcomes. Until now, patients are referred for postoperative hand rehabilitation on an empirical basis. Purpose. To evaluate whether referral criteria after surgery because of Dupuytren's disease were actually adhered to, and, to analyse differences in outcomes between patients who were referred according to the criteria (correctly referred) and those who were not referred but should have been (incorrectly not referred). Methods. Referral pattern was evaluated prospectively in 46 patients. Total active/ passive range of joint motion ( TAM/ TPM), sensibility, pinch force, Disability Arm Shoulder Hand questionnaire ( DASH) and Michigan Hand outcomes Questionnaire ( MHQ) were used as outcome measures preoperatively and 10 months postoperatively. Results. In total 21 patients were referred correctly and 17 patients were incorrectly not referred. Significant improvements on TAM/ TPM, DASH and MHQ were found at follow- up for the total group. No differences in outcomes were found between patients correctly referred and patients incorrectly not referred for postoperative hand therapy. Conclusion. Referral criteria were not adhered to. Given the lack of differences in outcomes between patients correctly referred and patients incorrectly not referred, postoperative hand therapy in Dupuytren's disease should be reconsidered
The value of the trauma mechanism in the triage of severely injured elderly
Get PDFBackground: The triage of trauma patients is currently based on the trauma mechanism. However, it is known that elderly patients can sustain severe injuries due to insignificant trauma mechanisms. As such, triage methods might be questionable. Objective: To evaluate whether current trauma triage criteria are appropriate in severely injured elderly patients. Methods: To analyze the effect of the trauma mechanism on triage and treatment, consecutive patients >= 55 years of age, with an injury severity score > 15, treated from 2002 to 2005 were divided into those who sustained a high-energy trauma (HET) versus a low energy trauma (LET). Pre-hospital and in-hospital data, injury characteristics, and data on mortality and disablement one year postinjury (sickness impact profile) were analyzed for HET and LET groups. Results: Age, sex and co-morbidity rate were similar in 84 HET patients and 107 LET patients. HET patients (mean ISS 28) received more sophisticated trauma care than LET patients (mean ISS 22), although mortality was similar (38 vs. 34%). Long-term disablement was also similar (median SIP scores 4 vs. 6). Severe head injuries and the Revised Trauma Score were related to mortality. Physical disablement was related to preexisting co-morbidities. No variables were related to psychosocial disablement. Conclusions: In elderly people a low energy trauma may lead to severe consequences. Not only the trauma mechanism, but also age, co-morbidity, and the likelihood of a brain injury should be leading in the triage and subsequent management of severely injured elderly
Comparison of EMG pattern separability in the affected and non-affected arm in individuals with amputation
No full textComparison of EMG pattern distinctness in the affected and non-affected arm in amputees
Authors: A.W. Franzke, M.B. Kristoffersen, A. Murgia, R.M. Bongers, C.K. van der Sluis
Presenter: Andreas W. Franzke
Affiliation: Univ. of Groningen, Univ. Medical Center Groningen, The Netherlands
E-mail: [email protected]
Abstract
In myocontrol of upper limb prostheses using machine learning techniques, a basic requirement is the user’s ability to generate sufficiently distinct surface electromyography (sEMG) signals for different movement intents, over a wide range of arm orientations.1 Experiments with regard to training this ability are often conducted on able bodied, but it is unclear to what extent findings in non-affected limbs are representative for the affected limb. In this study we investigated whether sEMG patterns are more distinct in the unaffected compared to the affected side, and whether distinctness is affected by arm posture. 11 individuals with transradial amputation performed seven bimanual movements in three different arm orientations (hanging down; on arm rest; reaching out in front). sEMG patterns were recorded simultaneously on both arms with 8 electrodes. Distinctness was assessed by estimating the distance between sEMG patterns in the sEMG feature space using a modified mahalanobis distance measure. The data analysis showed that distinctness was significantly higher in the unaffected arm (p = 0.027) and no effect for orientation of arm and no interaction effect between arm and orientation of arm (p = 0.21) was found. These findings suggest that sEMG pattern distinctness is negatively affected by the absence of a limb. Generating sEMG patterns of sufficient distinctness for proper myoelectric control might therefore be more challenging for an individual with amputation compared to an able-bodied individual, which could have implications for machine learning myocontrol studies conducted on able bodied populations.
Acknowledgement
This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No. 687795, project Acronym INPUT. The content of
this presentation does not reflect the official opinion of the European Union. Responsibility for the information and views expressed in therein lies entirely with the authors.
References
1. Resnik L, Huang H, Winslow A, et al. Evaluation of EMG pattern recognition for upper limb prosthesis control: a case study in comparison with direct myoelectric control. J Neuroeng Rehabil 2018; 15: 23.
Presented during TIPS/ISPO/BACPAR "Moving Beyond The Lab" on 20-23 March 2019 in Salford, Manchester.</p
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