Introduction

The objective of this study was to evaluate the effects of prescribing a traditional foam cosmetic cover versus a more recently developed 3D printed cosmetic cover on the satisfaction and psychosocial wellbeing of prosthesis users.

Methods

Transtibial and transfemoral prosthesis users were randomly assigned into two groups. One group was fitted with a foam cosmesis with a nylon stocking while the other received a 3D printed cosmetic cover. Cosmeses were worn for 12 weeks before being switched to the alternate design. Outcomes related to satisfaction and psychosocial wellbeing (ABIS-R, TAPES, QUEST) were collected on 3 occasions. Linear mixed effects models assessed for differences between the cosmetic covers.

Results

10 participants completed all outcome measures on 3 occasions. Significant differences in favour of the 3D printed cosmesis were observed for TAPES general psychosocial adjustment (p = .03), TAPES aesthetic satisfaction (p = .04) and ABIS-R (p = .025). Adjustment to physical limitations were higher for the foam cover (p = .008). No differences were observed in QUEST scores. Covariates; age, time since amputation, extroversion, did not have any significant effects.

Conclusion

Results suggest that cosmetic cover design can significantly affect prosthesis users' psychosocial wellbeing and satisfaction with aesthetic appearance. Variance between participants is high indicating diverse preferences.

Introduction: Traditionally, orthosis manufacturing is time and labor-intensive. Digitalization of some of the fabrication process is already ubiquitous, yet extension across device types could reduce the burden of manual labor and advance automation to help unblock access to assistive technologies globally. It seems, however, that appropriately strong evidence is holding this back. This review looks to thoroughly examine the current state of evidence to make this clear.

Objectives: To identify gaps in the literature that create barriers to decision-making on either appropriate uptake by clinical teams or setting research directions, by identifying what forms of evidence the current research literature provides to the orthotics community.

Study design: Scoping literature review.

Methods: A comprehensive search was completed in the following databases: AMED, MEDLINE, EMBASE, Global Health Archive, CINAHL Plus, Cochrane Library, Web of Science, ACM, IEEE, and Engineering Village, resulting in 3487 articles to be screened. Results: After screening, 121 lower limb orthosis, 104 upper limb orthosis, and 30 spinal orthosis articles were included in this review. For some areas such as CAD/CAM-produced insoles and spinal orthoses, the evidence base is strong. For most additive manufacture articles, long-term, larger-scale studies as well as research into training requirements are lacking.

Conclusion: The advantages of digital fabrication technology that could streamline orthotic device production in many cases are still blocked by a lack of strong formal evidence, ie large longitudinal studies with a range of evaluation measures. Increased collaboration between clinicians, patient/service users, academia, and industry could be a route to addressing these gaps and creating a better pathway to market for new technologies.

BACKGROUND: Traditionally, the manufacture of prostheses is time-consuming and labor-intensive. One possible route to improving access and quality of these devices is the digitalizing of the fabrication process, which may reduce the burden of manual labor and bring the potential for automation that could help unblock access to assistive technologies globally.

OBJECTIVES: To identify where there are gaps in the literature that are creating barriers to decision-making on either appropriate uptake by clinical teams or on the needed next steps in research that mean these technologies can continue on a pathway to maturity.

STUDY DESIGN: Scoping literature review.

METHODS: A comprehensive search was completed in the following databases: Allied and Complementary Medicine Database, MEDLINE, Embase, Global Health Archive, CINAHL Plus, Cochrane Library, Web of Science, Association for Computing Machinery, Institute of Electrical and Electronics Engineers, and Engineering Village, resulting in 3487 articles to be screened.

RESULTS: After screening, 130 lower limb prosthetic articles and 117 upper limb prosthetic articles were included in this review. Multiple limitations in the literature were identified, particularly a lack of long-term, larger-scale studies; research into the training requirements for these technologies and the necessary rectification processes; and a high range of variance of production workflows and materials which makes drawing conclusions difficult.

CONCLUSIONS: These limitations create a barrier to adequate evidence-based decision-making for clinicians, technology developers, and wider policymakers. Increased collaboration between academia, industry, and clinical teams across more of the pathway to market for new technologies could be a route to addressing these gaps.

OBJECTIVE: To explore cognitive load in people with transfemoral amputations fitted with socket or bone-anchored prostheses by describing activity in the left and right dorsolateral prefrontal cortices during single- and dual-task walking.

DESIGN: Cross-sectional pilot study.

PATIENTS: 8 socket prosthesis users and 8 bone-anchored prosthesis users. All were fitted with microprocessor-controlled prosthetic knees.

METHODS: Participants answered self-report questionnaires and performed gait tests during 1 single-task walking condition and 2 dual-task walking conditions. While walking, activity in the dorsolateral prefrontal cortex was measured using functional near-infrared spectroscopy. Cognitive load was investigated for each participant by exploring the relative concentration of oxygenated haemoglobin in the left and right dorsolateral prefrontal cortex. Symmetry of brain activity was investigated by calculating a laterality index.

RESULTS: Self-report measures and basic gait variables did not show differences between the groups. No obvious between-group differences were observed in the relative concentration of oxygenated haemoglobin for any walking condition. There was a tendency towards more right-side brain activity for participants using a socket prosthesis during dual-task conditions.

CONCLUSIONS: This pilot study did not identify substantial differences in cognitive load or lateralization between socket prosthesis users and bone-anchored prosthesis users.

Introduction: This study aimed to quantify the relationship between prosthetic users' emotional response to prosthesis aesthetics and specific product properties.

Methods: Words representing prosthesis users' emotional response (Kansei) to different aesthetic designs of prostheses were identified via interviews and mood boards. A group of experts consolidated the words into thematic groups, each represented by a single, high-level 'Kansei' word. 53 lower limb prosthesis users completed a questionnaire, rating their perception of 13 aesthetic designs using the 'Kansei' words. Quantification Theory Type 1 was applied to explore the relationship between words and product properties. Sub-analyses assessed for differences based on sex, age and level of extroversion.

Results: 5 high-level Kansei words were identified ('Natural', 'Technological', 'Cool', 'Unique' and 'Functional'). The Kansei word 'Natural' had a strong association with realistic looking prostheses while the words 'Technological', 'Cool' and 'Unique' were strongly associated with expressive designs which incorporate hard, colourful covers. The word 'Functional' was not a reliable predictor of product properties. No major differences were observed within sub-grouped categories.

Conclusion: Kansei words identified in this study can be used to help guide clients in their aesthetic design choices and to assist designers in achieving the desired response from their products.

PURPOSE: To evaluate client satisfaction with prosthetic and orthotic services in Sweden, determine if satisfaction differs between clients using different devices and identify factors which influence client satisfaction.

MATERIALS AND METHODS: A cross-sectional design was used to survey 7318 clients. The survey included items related to demographics, quality of life, device comfort, device use, the extent to which clients' needs were met and satisfaction with services. Ethics approval was provided by the Swedish Ethical Review Authority.

RESULTS: A total of 2925 surveys were returned reflecting a response rate of 41%. Mean OPUS-CSS point score was 61.9(SD 16.8) with differences observed between device categories (p < 0.001). Factors that were identified as most positively influencing client satisfaction were, being a limb prosthesis user and being under 65 years. When analysing scores for individual OPUS items breast prosthesis users scored higher than users of other devices. Clients were most satisfied with the level of respect they were shown by staff (mean = 2.72/3) and less satisfied with coordination of services with other therapists/doctors(mean = 1.88/3).

CONCLUSIONS: Prosthetic and orthotic users are reasonably satisfied with the services they receive. Attention should be directed towards understanding why prosthetic users are more satisfied than orthotic users and why clients under 65 years report higher satisfaction scores.

Over the past decade there has been an increase in scientific publications addressing intercultural competence (IC) of students. The sheer volume of publications available makes it difficult to determine the extent, breadth, and nature of research within the area. The aim of this scoping review was to describe the state of peer reviewed research related to IC, including academic disciplines addressing the issue, regions of the world conducting research, types of interventions used to foster IC and how outcomes are being evaluated. Six databases were searched, resulting in 15,128 articles. A total of 464 met the inclusion criteria. A trend was observed towards studying IC in interdisciplinary student populations as well as a post-COVID-19 trend towards more online interventions. Most research was conducted in North America (n = 198; 42.7%) within the discipline of education (n = 87; 18.8%). The most common intervention was pedagogical approaches delivered at the students’ home institution (n = 161; 34.7%). Results highlight a gap in research from the Global South and a lack of consensus regarding appropriate tools for evaluating IC. Continued work is required to determine the effects of specific interventions and to support educators in identifying appropriate tool(s) for measuring outcomes.

BACKGROUND: Mobility is a major goal of prosthetic and orthotic rehabilitation, and use of outcome measures to evaluate mobility is necessary for good clinical practice. To support the use of outcome measures worldwide, work is needed to translate relevant instruments and adapt them for use in multiple cultures.

OBJECTIVES: The objective of this research was to use a standardized method to translate the Locomotor Capabilities Index-5 (LCI-5) into Khmer, the national language in Cambodia, and to evaluate its cultural integrity by assessing it with a group of prosthesis and orthosis users.

STUDY DESIGN: Instrument translation and cultural validation.

METHODS: Two forward translations of the LCI-5 were produced and then reconciled into a single document. The Khmer version was back translated into English, and a group of experts reviewed the back translation. Two rounds of cognitive interviews were conducted with lower-limb prosthetic and orthotic users who provided feedback.

RESULTS: During the reconciliation process, minor changes were made to 6 of the 14 items. Changes were most often made to better reflect the conceptual meaning of the original English version. Cognitive interviews resulted in the addition of a new response alternative.

CONCLUSIONS: Use of a standardized method to translate the LCI-5 resulted in a linguistically and culturally valid Khmer version of the instrument. Following appropriate psychometric testing, this instrument will facilitate measurement of mobility in prosthetic and orthotic clinical practice in Cambodia as well as support national and multinational research.

INTRODUCTION: A lack of understanding of personal experiences related to limb amputation and prosthetic use limits the extent to which clinicians involved in rehabilitation can support and advise their clients in a person-centered consultation. The objective of this qualitative study was to explore the personal experience of daily life as a lower limb prosthesis user.

METHODS: Fifteen lower limb prosthesis users participated in individual semistructured interviews. Transcripts were analyzed using a phenomenographic approach.

RESULTS: The extent to which prosthesis users were able to adjust to their impairment and move on with their life was influenced by social interactions with other prosthesis users, access to relevant information about prosthetic solutions that may benefit them, and finding a balance between desired activities and their physical and/or cognitive capacity.

CONCLUSIONS: After a period of existential adjustment, prosthesis users described themselves as living active, fulfilling lives. This was facilitated to a large extent by social interactions with other prosthesis users and access to information they perceived as relevant. Social media plays a particularly important role in establishing connections with other prosthesis users and is perceived as a useful source of information.

Exercise is often cited as a major factor contributing to improved cognitive functioning. As a result, the relationship between exercise and cognition has received much attention in scholarly literature. Systematic reviews and meta-analyses present varying and sometimes conflicting results about the extent to which exercise can influence cognition. The aim of this umbrella review was to summarize the effects of physical exercise on cognitive functions (global cognition, executive function, memory, attention, or processing speed) in healthy adults & GE; 55 years of age.Methods An umbrella review of systematic reviews with meta-analyses investigating the effect of exercise on cognition was performed. Databases (CINAHL, Cochrane Library, MEDLINE, PsycInfo, Scopus, and Web of Science) were searched from inception until June 2023 for reviews of randomized or non-randomised controlled trials. Full-text articles meeting the inclusion criteria were reviewed and methodological quality assessed. Overlap within included reviews was assessed using the corrected covered area method (CCA). A random effects model was used to calculate overall pooled effect size with sub-analyses for specific cognitive domains, exercise type and timing of exercise.Results Database searches identified 9227 reviews. A total of 20 met the inclusion criteria. They were based on 332 original primary studies. Overall quality of the reviews was considered moderate with most meeting 8 or more of the 16 AMSTAR 2 categories. Overall pooled effects indicated that exercise in general has a small positive effect on cognition (d = 0.22; SE = 0.04; p < 0.01). Mind-body exercise had the greatest effect with a pooled effect size of (d = 0.48; SE = 0.06; p < 0.001). Exercise had a moderate positive effect on global cognition (d = 0.43; SE = 0,11; p < 0,001) and a small positive effect on executive function, memory, attention, and processing speed. Chronic exercise was more effective than acute exercise. Variation across studies due to heterogeneity was considered very high.Conclusions Mind-body exercise has moderate positive effects on the cognitive function of people aged 55 or older. To promote healthy aging, mind-body exercise should be used over a prolonged period to complement other types of exercise. Results of this review should be used to inform the development of guidelines to promote healthy aging.