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Publications (10 of 31) Show all publications
Ramstrand, N., Gjøvaag, T., Starholm, I. M. & Rusaw, D. (2019). Effects of knee orthoses on kinesthetic awareness and balance in healthy individuals.
Open this publication in new window or tab >>Effects of knee orthoses on kinesthetic awareness and balance in healthy individuals
2019 (English)In: Article in journal (Refereed) Accepted
Abstract [en]

Introduction: Conflicting evidence exists regarding the effects of knee orthoses on proprioception. One belief is that pressure applied by orthoses heightens kinesthetic awareness and that this affects balance. This study aimed to investigate effects of two different orthosis designs on kinesthetic awareness and balance in healthy individuals.

Methods: Twenty individuals (13 women) participated in this case series study. Each were tested wearing 1/no orthosis, 2/soft elastic orthosis and 3/non-elastic jointed orthosis. Pressure under orthoses was recorded. Kinesthetic awareness was investigated by testing Joint Position Sense (JPS) and Threshold to Detection of Passive Motion (TDPM). Balance was tested using a Modified Sensory Organization Test (mSOT).

Results: Non-elastic jointed orthoses applied the greatest pressure to the knee. With non-elastic jointed orthoses, TDPM was significantly poorer for pooled results (p= 0.02) and when the start position of the knee was 70 degrees (mean threshold = 0.6 º, 0.6 º, 0.7º for no-orthosis, elastic and jointed-orthoses; p= 0.03). No major differences were observed in JPS or balance and correlation between proprioception and balance was poor.

Conclusions: There may be a limit to the amount of pressure that should be applied to the knee joint by an orthosis. Exceeding this limit may compromise kinesthetic awareness.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Orthotics, joint position sense, detection of passive motion, proprioception, knee brace
National Category
Orthopaedics
Identifiers
urn:nbn:se:hj:diva-43599 (URN);HHJCHILDIS,HHJADULTIS (Local ID);HHJCHILDIS,HHJADULTIS (Archive number);HHJCHILDIS,HHJADULTIS (OAI)
Available from: 2019-05-07 Created: 2019-05-07 Last updated: 2019-05-07
Jarl, G., Hellstrand Tang, U., Nordén, E., Johannesson, A. & Rusaw, D. (2019). Nordic clinical guidelines for orthotic treatment of osteoarthritis of the knee: A systematic review using the AGREE II instrument. Prosthetics and orthotics international
Open this publication in new window or tab >>Nordic clinical guidelines for orthotic treatment of osteoarthritis of the knee: A systematic review using the AGREE II instrument
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2019 (English)In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553Article, review/survey (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: High-quality clinical practice guidelines are necessary for effective use of resources both at an individual patient- and national-level. Nordic clinical practice guidelines recommendations for orthotic treatment of knee osteoarthritis vary and little is known about their quality.

OBJECTIVES: The aim of the study was to critically evaluate the quality of clinical practice guidelines in orthotic management of knee osteoarthritis in the Nordic countries.

STUDY DESIGN: Systematic review.

METHODS: Four national clinical practice guidelines for treatment of knee osteoarthritis were assessed for methodological rigour and transparency by four independent assessors using the AGREE II instrument. Summary domain scores and inter-rater agreement (Kendall's W) were calculated.

RESULTS: Domain scores indicate that many guidelines have not sufficiently addressed stakeholder involvement (average score: 55%), applicability (20%) and editorial independence (33%) in the development process. Inter-rater agreement for assessors indicated 'good' agreement for clinical practice guidelines from Finland, Norway and Sweden (W = 0.653, p < 0.001; W = 0.512, p = 0.003 and W = 0.532, p = 0.002, respectively) and 'strong' agreement for the clinical practice guideline from Denmark (W = 0.800, p < 0.001).

CONCLUSION: Quality of clinical practice guidelines for orthotic treatment of knee osteoarthritis in the Nordic region is variable. Future guideline development should focus on improving methodology by involving relevant stakeholders (e.g. certified prosthetist/orthotists (CPOs)), specifying conflicts of interest and providing guidance for implementation.

CLINICAL RELEVANCE: The current review suggests that, for the Nordic region, there are areas of improvement which can be addressed, which ensure clinical practice guidelines are developed under stringent conditions and based on sound methods. These improvements would ensure knee osteoarthritis patients are receiving orthotic interventions based on appropriate guidance from published guidelines.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Orthotic device; braces; orthosis; practice guidelines
National Category
Orthopaedics
Identifiers
urn:nbn:se:hj:diva-43774 (URN)10.1177/0309364619857854 (DOI)31256710 (PubMedID)2-s2.0-85068589958 (Scopus ID)
Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-08-14
Möller, S., Rusaw, D., Hagberg, K. & Ramstrand, N. (2019). Reduced cortical brain activity with the use of microprocessor-controlled prosthetic knees during walking. Prosthetics and orthotics international, 43(3), 257-265
Open this publication in new window or tab >>Reduced cortical brain activity with the use of microprocessor-controlled prosthetic knees during walking
2019 (English)In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 43, no 3, p. 257-265Article in journal (Refereed) Published
Abstract [en]

Background: Individuals using a lower-limb prosthesis indicate that they need to concentrate on every step they take. Despite self-reports of increased cognitive demand, there is limited understanding of the link between cognitive processes and walking when using a lower-limb prosthesis.

Objective: The objective was to assess cortical brain activity during level walking in individuals using different prosthetic knee components and compare them to healthy controls. It was hypothesized that the least activity would be observed in the healthy control group, followed by individuals using a microprocessor-controlled prosthetic knee and finally individuals using a non-microprocessor-controlled prosthetic knee.

Study Design: Cross-sectional study.

Methods:: An optical brain imaging system was used to measure relative changes in concentration of oxygenated and de-oxygenated haemoglobin in the frontal and motor cortices during level walking. The number of steps and time to walk 10 m was also recorded. The 6-min walk test was assessed as a measure of functional capacity.

Results: Individuals with a transfemoral or knee-disarticulation amputation, using non-microprocessor-controlled prosthetic knee ( n = 14) or microprocessor-controlled prosthetic knee ( n = 15) joints and healthy controls ( n = 16) participated in the study. A significant increase was observed in cortical brain activity of individuals walking with a non-microprocessor-controlled prosthetic knee when compared to healthy controls ( p < 0.05) and individuals walking with an microprocessor-controlled prosthetic knee joint ( p < 0.05).

Conclusion: Individuals walking with a non-microprocessor-controlled prosthetic knee demonstrated an increase in cortical brain activity compared to healthy individuals. Use of a microprocessor-controlled prosthetic knee was associated with less cortical brain activity than use of a non-microprocessor-controlled prosthetic knee.

Clinical Relevance: Increased understanding of cognitive processes underlying walking when using different types of prosthetic knees can help to optimize selection of prosthetic components and provide an opportunity to enhance functioning with a prosthesis.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Attention, artificial limb, brain, gait, neuroimaging
National Category
Orthopaedics
Identifiers
urn:nbn:se:hj:diva-42040 (URN)10.1177/0309364618805260 (DOI)000473489500003 ()30375285 (PubMedID)2-s2.0-85059453859 (Scopus ID)
Available from: 2018-11-15 Created: 2018-11-15 Last updated: 2019-08-08Bibliographically approved
Rusaw, D. (2018). Adaptations from the prosthetic and intact limb during standing on a sway referenced support surface for transtibial prosthesis users. Disability and Rehabilitation: Assistive Technology
Open this publication in new window or tab >>Adaptations from the prosthetic and intact limb during standing on a sway referenced support surface for transtibial prosthesis users
2018 (English)In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115Article in journal (Refereed) Epub ahead of print
Place, publisher, year, edition, pages
Taylor & Francis, 2018
National Category
Orthopaedics
Identifiers
urn:nbn:se:hj:diva-41126 (URN)10.1080/17483107.2018.1498925 (DOI)XYZ ()2-s2.0-85057569055 (Scopus ID)
Available from: 2018-08-13 Created: 2018-08-13 Last updated: 2019-02-06
Rusaw, D. (2018). An Iterative Feedback Procedure for Course Evaluation and Structure. In: : . Paper presented at ISPO Global Educators Meeting 2018, Göttingen, Germany, 18-20 September 2018.
Open this publication in new window or tab >>An Iterative Feedback Procedure for Course Evaluation and Structure
2018 (English)Conference paper, Oral presentation only (Refereed)
National Category
Educational Sciences
Identifiers
urn:nbn:se:hj:diva-41671 (URN)
Conference
ISPO Global Educators Meeting 2018, Göttingen, Germany, 18-20 September 2018
Available from: 2018-10-01 Created: 2018-10-01 Last updated: 2018-10-02Bibliographically approved
Rusaw, D. (2018). Biomechanical Models of Standing in Prosthetic Users. In: : . Paper presented at 11. Nordiske Bandagist Kongres, 6-8 September, 2018, Copenhagen, Denmark.
Open this publication in new window or tab >>Biomechanical Models of Standing in Prosthetic Users
2018 (English)Conference paper, Oral presentation only (Other academic)
National Category
Orthopaedics
Identifiers
urn:nbn:se:hj:diva-41672 (URN)
Conference
11. Nordiske Bandagist Kongres, 6-8 September, 2018, Copenhagen, Denmark
Available from: 2018-10-01 Created: 2018-10-01 Last updated: 2018-10-02Bibliographically approved
Rusaw, D., Hellstrand Tang, U., Nordén, E., Johannesson, A. & Jarl, G. (2018). Clinical guidelines for orthotic treatment of osteoarthritis of the knee: a review with a nordic perspective. In: : . Paper presented at 11. Nordiske Bandagist Kongres, 6-8 September, 2018, Copenhagen, Denmark.
Open this publication in new window or tab >>Clinical guidelines for orthotic treatment of osteoarthritis of the knee: a review with a nordic perspective
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2018 (English)Conference paper, Oral presentation only (Other academic)
National Category
Orthopaedics
Identifiers
urn:nbn:se:hj:diva-41674 (URN)
Conference
11. Nordiske Bandagist Kongres, 6-8 September, 2018, Copenhagen, Denmark
Available from: 2018-10-01 Created: 2018-10-01 Last updated: 2018-10-02Bibliographically approved
Barnett, C. T., Vanicek, N. & Rusaw, D. (2018). Do predictive relationships exist between postural control and falls efficacy in unilateral transtibial prosthesis users?. Archives of Physical Medicine and Rehabilitation, 99(11), 2271-2278
Open this publication in new window or tab >>Do predictive relationships exist between postural control and falls efficacy in unilateral transtibial prosthesis users?
2018 (English)In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 99, no 11, p. 2271-2278Article in journal (Refereed) Published
Abstract [en]

Objective

To assess whether variables from a postural control test relate to and predict falls efficacy in prosthesis users.

Design

Twelve-month within and between subjects repeated measures design. Participants performed the Limits of Stability (LOS) test protocol at study baseline and at 6-month follow-up. Participants also completed the Falls Efficacy Scale-International (FES-I) questionnaire, reflecting the fear of falling, and reported the number of falls monthly between study baseline and 6-month follow-up, and additionally at 9- and 12-month follow-ups.

Setting

University biomechanics laboratories.

Participants

A group of active unilateral transtibial prosthesis users of primarily traumatic etiology (PROS) (n=12) with at least one year of prosthetic experience and age and gender matched control participants (CON) (n=12).

Interventions

Not applicable.

Main Outcome Measure(s)

Postural control variables derived from centre of pressure data obtained during the LOS test, which was performed on and reported by the Neurocom Pro Balance Master, namely; reaction time (RT), movement velocity (MVL), endpoint (EPE) and maximum (MXE) excursion and directional control (DCL). Number of falls and total FES-I scores.

Results

During the study period, the PROS group had higher FES-I scores (U = 33.5, p =0.02), but experienced a similar number of falls, compared to the CON group. Increased FES-I score were associated with decreased EPE (R=-0.73, p=0.02), MXE (R=-0.83, p<0.01) and MVL (R=-0.7, p=0.03) in the PROS group, and DCL (R=-0.82, p<0.01) in the CON group, all in the backwards direction.

Conclusions

Study baseline measures of postural control, in the backwards direction only, are related to and potentially predictive of subsequent 6-month FES-I scores in relatively mobile and experienced prosthesis users.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Balance; Efficacy; Falling; Falls; Limits of stability; Postural control; Prosthesis; Transtibial; Unilateral
National Category
Orthopaedics
Identifiers
urn:nbn:se:hj:diva-39411 (URN)10.1016/j.apmr.2018.05.016 (DOI)000451362700019 ()29920230 (PubMedID)2-s2.0-85050855562 (Scopus ID)PP HHJ 2018 embargo 12;HHJADULTIS (Local ID)PP HHJ 2018 embargo 12;HHJADULTIS (Archive number)PP HHJ 2018 embargo 12;HHJADULTIS (OAI)
Available from: 2018-05-14 Created: 2018-05-14 Last updated: 2019-06-18Bibliographically approved
Rusaw, D., Rudholmer, E. & Barnett, C. T. (2017). A limits of stability protocol utilizing measures of the center of mass and center of pressure in transtibial prosthesis users: learning effects and reliability. In: : . Paper presented at ISPO 16th World Congress 2017, Cape Town, South Africa, 8-11 May 2017.
Open this publication in new window or tab >>A limits of stability protocol utilizing measures of the center of mass and center of pressure in transtibial prosthesis users: learning effects and reliability
2017 (English)Conference paper, Oral presentation only (Refereed)
National Category
Orthopaedics
Identifiers
urn:nbn:se:hj:diva-35241 (URN)
Conference
ISPO 16th World Congress 2017, Cape Town, South Africa, 8-11 May 2017
Available from: 2017-03-21 Created: 2017-03-21 Last updated: 2018-01-13Bibliographically approved
Barnett, C. T., Vanicek, N. & Rusaw, D. (2017). A longitudinal analysis of the relationships between postural control, falls efficacy and falling in unilateral transtibial prosthesis users. In: : . Paper presented at ISPO 16th World Congress 2017, Cape Town, South Africa, 8-11 May 2017.
Open this publication in new window or tab >>A longitudinal analysis of the relationships between postural control, falls efficacy and falling in unilateral transtibial prosthesis users
2017 (English)Conference paper, Oral presentation only (Refereed)
National Category
Orthopaedics
Identifiers
urn:nbn:se:hj:diva-35240 (URN)
Conference
ISPO 16th World Congress 2017, Cape Town, South Africa, 8-11 May 2017
Available from: 2017-03-21 Created: 2017-03-21 Last updated: 2018-01-13Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0220-6278

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