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  • 1. Barnett, C. T.
    et al.
    Vanicek, N.
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    A longitudinal analysis of the relationships between postural control, falls efficacy and falling in unilateral transtibial prosthesis users2017Konferensbidrag (Refereegranskat)
  • 2.
    Barnett, Cleveland T.
    et al.
    Nottingham Trent University, Nottingham, U.K. .
    Vanicek, Natalie
    University of Hull, Hull, U.K. .
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Do predictive relationships exist between postural control and falls efficacy in unilateral transtibial prosthesis users?2018Ingår i: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821XArtikel i tidskrift (Refereegranskat)
    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.

    Publikationen är tillgänglig i fulltext från 2019-06-18 00:00
  • 3.
    Barnett, Cleveland T.
    et al.
    Nottingham Trent University, Nottingham, UK.
    Vanicek, Natalie
    University of Hull, Hull, UK.
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Does postural control predict falling and the fear of falling in lower limb amputees?2015Ingår i: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 39, nr 1 (suppl.), artikel-id 313Artikel i tidskrift (Refereegranskat)
  • 4. Brorsson, Annelie
    et al.
    Willy, R. W.
    Tranberg, Roy
    Gothenburg University, Institute of Clinical Sciences, Section for Anesthesiology, Biomaterials and Orthopaedics, Department of Orthopaedics.
    Grävare Silbernagel, Karin
    Heel-Rise Height Deficit 1 Year After Achilles Tendon Rupture Relates to Changes in Ankle Biomechanics 6 Years After Injury2017Ingår i: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 45, nr 13, s. 3060-3068Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: It is unknown whether the height of a heel-rise performed in the single-leg standing heel-rise test 1 year after an Achilles tendon rupture (ATR) correlates with ankle biomechanics during walking, jogging, and jumping in the long-term.

    Purpose: To explore the differences in ankle biomechanics, tendon length, calf muscle recovery, and patient-reported outcomes at a mean of 6 years after ATR between 2 groups that, at 1-year follow-up, had less than 15% versus greater than 30% differences in heel-rise height.

    Methods: Seventeen patients with less than 15% (<15% group) and 17 patients with greater than 30% (>30% group) side-toside difference in heel-rise height at 1 year after ATR were evaluated at a mean (SD) 6.1 (2.0) years after their ATR. Ankle kinematics and kinetics were sampled via standard motion capture procedures during walking, jogging, and jumping. Patient-reported outcome was evaluated with Achilles tendon Total Rupture Score (ATRS), Physical Activity Scale (PAS), and Foot and Ankle Outcome Score (FAOS). Tendon length was evaluated by ultrasonography. The Limb Symmetry Index (LSI = [Injured Side divided by Healthy Side x 3 100) was calculated for side differences.

    Results: The.30% group had significantly more deficits in ankle kinetics during all activities compared with patients in the <15% group at a mean of 6 years after ATR (LSI, 70%-149% and 84%-106%, respectively; P =.010-.024). The.30% group, compared with the <5% group, also had significantly lower values in heel-rise height (LSI, 72% and 95%, respectively; P<. 001) and heel-rise work (LSI, 58% and 91%, respectively; P<. 001) and significantly larger side-to-side difference in tendon length (114% and 106%, respectively; P =.012). Achilles tendon length correlated with ankle kinematic variables (r = 0.38-0.44; P =.015-.027) whereas heel-rise work correlated with kinetic variables (r = 20.57 to 0.56; P =.001-.047). LSI tendon length correlated negatively with LSI heel-rise height (r = 20.41; P =.018). No differences were found between groups in patient-reported outcome (P =.143-.852).

    Conclusion: Height obtained during the single-leg standing heel-rise test performed 1 year after ATR related to the long-term ability to regain normal ankle biomechanics. Minimizing tendon elongation and regaining heel-rise height may be important for the long-term recovery of ankle biomechanics, particularly during more demanding activities such as jumping.

  • 5. Eek, M. N.
    et al.
    Zügner, Roland
    Stefansdottir, I.
    Tranberg, Roy
    Gothenburg University, Institute of Clinical Sciences, Section for Anesthesiology, Biomaterials and Orthopaedics, Department of Orthopaedics.
    Kinematic gait pattern in children with cerebral palsy and leg length discrepancy: Effects of an extra sole2017Ingår i: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 55, s. 150-156Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The gait pattern in children with cerebral palsy (CP) often differs from normal, with slow velocity, problem with foot clearance and increased stress on joints. Several factors, such as muscle tone, impaired motor control, muscle contractures, skeletal deformities and leg length discrepancy affect gait. Leg length discrepancy can be treated surgically or with elevation of the shoe on the short leg. The purpose of this study was to examine whether compensating for leg length discrepancy, with elevation of the sole, leads to a change in movement pattern during walking in children with spastic CP. Results: Ten children with spastic CP, able to walk without aids, and 10 typically developing (TD) children aged between seven and 14 years were assessed with 3D gait analysis: 1) barefoot, 2) with shoes and 3) with an extra sole beneath the shoe for the shorter leg. All children with CP had a leg length discrepancy of more than or equal to 1.0 cm. In the barefoot condition, the velocity was slower and the stride length was shorter, in children with CP compared with TD. The stride length and gait velocity increased in children with CP with shoes and shoe + sole and the stance time became more symmetrical. Among children with CP, there was more flexion in the longer leg relative to the short leg during barefoot walking. Differences in the kinematic pattern between the long and the short leg decreased with the extra sole. 

  • 6.
    Flodin, Ulf
    et al.
    Occupational and Environmental Medicine, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Rolander, Bo
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. SALVE (Socialt arbete, Livssammanhang, Välfärd). Futurum, Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.
    Löfgren, H.
    Neuro-Orthopedic Center, Ryhov Hospital, Jönköping, Sweden.
    Krapi, B.
    Occupational and Environmental Medicine, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Nyqvist, F.
    Occupational and Environmental Medicine, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Wåhlin, C.
    Occupational and Environmental Medicine, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Risk factors for neck pain among forklift truck operators: a retrospective cohort study2018Ingår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 19, nr 44, s. 1-10Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: No previous research has been performed into neck pain among forklift operators. This is a common complaint among these workers, who number around 150,000 in Sweden and six million in Europe. The aim of the study was to examine long-term exposure to unnatural neck positions among forklift operators as a risk factor for neck pain.

    METHODS: A retrospective cohort study was conducted of all eligible employees at a high-level warehouse. Forklift operators and office workers answered an 18-page questionnaire comprising questions about joint pain, work tasks, work postures and year of start for all items. By using person years in the exposed and less-exposed groups before start of neck pain we were able to calculate Incident Rate ratios for various exposures.

    RESULTS: Forty nine percent of the forklift operators reported having experienced neck pain compared to 30 % of office workers. Being a forklift operator was associated with an increased risk of neck pain (OR = 5.1, 95% CI 1.4-18.2). Holding the head in an unnatural position resulted in significantly increased risks for neck pain, irrespective of type of position. The risks for neck pain remained after taking other ergonomic exposures and psychosocial aspects into consideration.

    CONCLUSIONS: This is the first published study showing that forklift operators have an increased risk of neck pain. The results are therefore of significance for improving work schedules, the adjustment of work tasks for these workers and the design of the vehicles.

  • 7. Hellstrand Tang, Ulla
    et al.
    Siegenthler, Jacqueline
    Hagberg, Kerstin
    Karlsson, Jon
    Tranberg, Roy
    Gothenburg University, Institute of Clinical Sciences, Section for Anesthesiology, Biomaterials and Orthopaedics.
    Foot anthropometrics in individuals with diabetes compared with the general Swedish population: Implications for shoe design2017Ingår i: Foot and Ankle Online Journal, ISSN 1941-6806, Vol. 10, nr 3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The literature offers sparse information about foot anthropometrics in patients with diabetes related to foot length, foot width and toe height, although these measurements are important in shoe fitting. A poorly fitted shoe is one of many contributory factors in the development of diabetic foot ulcers. The purpose of this study was to describe the foot anthropometrics in groups of patients with diabetes, in groups representing the general population and to explore whether foot anthropometrics differ between patients with diabetes and the general population.

    Method: Foot anthropometrics (foot length, foot width and maximum toe height) was measured in 164 patients with diabetes, with and without neuropathy (n = 102 and n = 62 respectively). The general population was represented by 855 participants from two sources.

    Results: Foot length, foot width and toe height varied (220-305 mm; 82-132 mm and 15-45 mm respectively) in the diabetic group and in the group representing the general population (194-306 mm; 74-121 mm and 17-31 mm respectively). Age, gender and BMI influence the foot anthropometrics, however, when adjusting for theses variables the index foot length/width was lower (2.58) in patients with diabetes without neuropathy vs. controls (2.63), p = 0.018. Moreover, patients with diabetes with neuropathy had wider feet (98.6 mm) compared with the controls (97.0 mm), p = 0.047.

    Conclusions: The individual variations of foot length, foot width and maximum toe height were large. The impact of gender on foot anthropometrics was confirmed and the impact of age and BMI were shown. Patients with diabetes seemed to have a wider forefoot width and a lower foot length to foot width ratio compared to the controls.

  • 8. Hellstrand Tang, Ulla
    et al.
    Tranberg, Roy
    Gothenburg University, Institute of Clinical Sciences, Section for Anesthesiology, Biomaterials and Orthopaedics, Department of Orthopaedics.
    Zügner, Roland
    Karlsson, Jon
    Lisovskaja, Vera
    Siegenthaler, Jacueline
    Hagberg, Kerstin
    The D-Foot, for prosthetists and orthotists, a new eHealth tool useful in useful in risk classification and foot assessment in diabetes2017Ingår i: Foot and Ankle Online Journal, ISSN 1941-6806, Vol. 10, nr 2Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The prevention and care of foot problems in diabetes begins with a risk classification. Today, the prosthetists and orthotists (CPO) and other health care professionals assess the risk of developing foot ulcers more or less subjectively. The objective of the study was to describe the construction of an eHealth tool, the D-Foot, which generates a risk classification. The reliability of the D-Foot was tested.

    Methods: The D-Foot includes 22 clinical assessments and four self-reported questions. The content validity was assured by expert group consensus and the reliability was assessed through an empirical test-retest study. Inter- and intra-rater reliability was calculated using patients referred to four departments of prosthetics and orthotics (DPO).

    Results: The agreement for the risk classification generated using the D-Foot was 0.82 (pooled kappa 0.31, varying from 0.16 to 1.00 at single DPOs). The inter-rater agreement was > 0.80 regarding the assessments of amputation, Charcot deformity, foot ulcer, gait deviation, hallux valgus/hallux varus and risk grade. The inter- and intra-rater agreements for the discrete measurements were > 0.59 and > 0.72 respectively. For continuous measurements, the inter- and intra-rater correlation varied (0.33-0.98 and 0.25-0.99 respectively).

    Conclusion: The D-Foot gave a reliable risk foot classification. However, there was a variation in the inter- and intra-rater reliability of the assessments included and refinements are needed for variables with low agreement. Based on the results, the D-Foot will be revised before it is implemented in clinical practice.

  • 9. Hellstrand Tang, Ulla
    et al.
    Zügner, Roland
    Lisovskaja, Vera
    Karlsson, Jon
    Hagberg, Kerstin
    Tranberg, Roy
    Gothenburg University, Institute of Clinical Sciences, Section for Anesthesiology, Biomaterials and Orthopaedics, Department of Orthopaedics.
    Comparison of plantar pressure in three types of insole given to patients with diabetes at risk of developing foot ulcers – A two-year, randomized trial2014Ingår i: Journal of Clinical & Translational Endocrinology, ISSN 2214-6237, Vol. 1, nr 4, s. 121-132Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Special insoles and shoes designed to prevent foot ulcerscaused by repetitive high pressures are recommended for patients with diabetes who have any of the following risk factors: neuropathy; peripheral vascular disease; foot deformities; previous ulcers; amputation; and skin pathologies. However, there is a need for increased knowledge regarding: a) differences in the peak pressure (PP) and pressure time integral (PTI) for different types of insoles; and b) the properties of the pressure distribution for insoles used over a period of several months. We present the results of a randomized trial to compare the plantar pressures of three commonly used insoles.

    Objectives

    The primary objective was to compare the PP and PTI between three types of insoles. The secondary objective was to explore the long-term pattern of peak plantar pressure distribution and variations in specific regions of interest (ROI). The tertiary objective was to investigate the impacts of insole adjustments, how much the insoles were used, and the levels of patient satisfaction.

    Methods

    In a 2-year trial, 114 patients with type 1 (N = 31) or type 2 (N = 83) diabetes (62 men and 52 women; mean age, 57.7 ± 15.4 years; duration of diabetes, 12.3 ± 11.2 years; neuropathy, 38%), were randomized to be supplied with one of three different insoles. The ethylene vinyl acetate (EVA) insoles were used in outdoor walking shoes. The 35 EVA group (N = 39) received soft custom-made insoles composed of EVA of 35 shore A hardness, the 55 EVA group (N = 37) received custom-made insoles composed of EVA of 55 shore hardness, and the control group (N = 38) received prefabricated insoles composed of a hard core with a top layer of soft 12 shore hardness microfiber. Using F-Scan®, the in-shoe plantar pressures were measured at seven ROI (hallux, metatarsal head 1, metatarsal head 2, metatarsal head 4, metatarsal head 5, lateral aspect of the mid-foot, heel) on five occasions during the study period. The plantar-pressure variables used were PP (main outcome) and PTI. The plantar patterns of load were explored, satisfaction and usage of the insoles were rated by the participants, and insole adjustments were recorded.

    Results

    A mixed model analysis estimated lower PP values in the heel regions for the 35 EVA and 55 EVA insoles (171 ± 13 and 161 ± 13 kPa, respectively) than for the prefabricated insoles (234 ± 10 kPa) (p < 0.001). Also for some of the other six ROI indications of difference in PP or PTI could be observed. The redistribution of peak plantar pressure for all of the insoles, was stable at the mid-foot, while the proportion of load on the distal area changed during the study period According to the self-reported answers (scale, 0–100), the average usage of the insoles was rated as 79 and satisfaction was rated as 85 (N = 75). Thirty-two percent of the subjects had not received foot care. Fourteen adjustments to insoles were made during the study period, and 86 pairs of insoles were exchanged due to wear, with 49% being exchanged in the 35 EVA group.

    Conclusions

    Custom-made insoles used in combination with stable walking shoes gave lower pressures at the heel region. The variation makes it difficult to detect a systematic difference in plantar pressure for the 6 ROI, if such a difference indeed exists. The levels of satisfaction and usage for all the insoles tested were high. The insoles maintained their pressure redistribution properties over long periods, and few adjustments were needed.

  • 10. Hellstrand Tang, Ulla
    et al.
    Zügner, Roland
    Lisovskaja, Vera
    Karlsson, Jon
    Hagberg, Kerstin
    Tranberg, Roy
    Gothenburg University, Institute of Clinical Sciences, Section for Anesthesiology, Biomaterials and Orthopaedics, Department of Orthopaedics.
    Foot deformities, function in the lower extremities, and plantar pressure in patients with diabetes at high risk to develop foot ulcers2015Ingår i: Diabetic Foot & Ankle, ISSN 2000-625X, Vol. 6, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Foot deformities, neuropathy, and dysfunction in the lower extremities are known risk factors that increase plantar peak pressure (PP) and, as a result, the risk of developing foot ulcers in patients with diabetes. However, knowledge about the prevalence of these factors is still limited. The aim of the present study was to describe the prevalence of risk factors observed in patients with diabetes without foot ulcers and to explore possible connections between the risk factors and high plantar pressure. 

    Patients and methods: Patients diagnosed with type 1 (n = 27) or type 2 (n = 47) diabetes (mean age 60.0 +/- 15.0 years) were included in this cross-sectional study. Assessments included the registration of foot deformities; test of gross function at the hip, knee, and ankle joints; a stratification of the risk of developing foot ulcers according to the Swedish National Diabetes Register; a walking test; and self-reported questionnaires including the SF-36 health survey. In-shoe PP was measured in seven regions of interests on the sole of the foot using F-Scan (R). An exploratory analysis of the association of risk factors with PP was performed. 

    Results: Neuropathy was present in 28 (38%), and 39 (53%) had callosities in the heel region. Low forefoot arch was present in 57 (77%). Gait-related parameters, such as the ability to walk on the forefoot or heel, were normal in all patients. Eighty percent had normal function at the hip and ankle joints. Gait velocity was 1.2 +/- 0.2 m/s. All patients were stratified to risk group 3. Hallux valgus and hallux rigidus were associated with an increase in the PP in the medial forefoot. A higher body mass index (BMI) was found to increase the PP at metatarsal heads 4 and 5. Pes planus was associated with a decrease in PP at metatarsal head 1. Neuropathy did not have a high association with PP. 

    Conclusions: This study identified several potential risk factors for the onset of diabetic foot ulcers (DFU). Hallux valgus and hallux rigidus appeared to increase the PP under the medial forefoot and a high BMI appeared to increase the PP under the lateral forefoot. There is a need to construct a simple, valid, and reliable assessment routine to detect potential risk factors for the onset of DFU.

  • 11.
    Jardenius, Daniel
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Johansson, Emil
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Fotens plantara tryck med hellånga variserande och valgiserande inläggskilar2008Självständigt arbete på grundnivå (högskoleexamen), 10 poäng / 15 hpStudentuppsats
    Abstract [en]

    Abstract

    Introduction

    Wedged shoe insoles are used as a treatment for different problems in order to change the ground reaction force. They can secondary cause different loading patterns under the foot compared to normal. No previous study has, to the author’s knowledge, clinically evaluated the plantar foot pressure with different full-length wedges in normal persons.

    Purpose

    The purpose was to evaluate the plantar pressure with different degrees of full-length wedges in normal persons.

    Method

    Twenty persons with normal feet have participated in this single blind study. Wedges were produced clinically in four different shapes, 3° valgus, 0° flat, 3° varus och 6° varus. The test persons were told to walk with the wedges in their comfortable pace in a randomized order. The plantar pressure was measured in the medial and lateral heel as well as in the first and fifth metatarsal head.

    Results

    The results show significant increased mean pressure for varus wedges compared to flat as well as valgus wedges, in the area of the medial heel and first metatarsal joint. Also, valgus wedges show significant increased mean pressure compared to flat condition in area of the medial heel. There is no correlation between wedge height and mean pressure for any of the wedge conditions.

    Conclusion

    Treatment with wedges leads secondary to increased mean pressure for varus wedges compared to flat as well as valgus wedges, in medial heel and first metatarsal joint. Furthermore, valgus wedges show increased mean pressure compared to flat condition in medial heel. Patients sensitive to high plantar pressures in these areas should be treated with caution.  Further studies are recommended.

     

  • 12.
    Jarl, Gustav
    et al.
    Örebro University, Sweden.
    Ramstrand, Nerrolyn
    Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    A model to facilitate implementation of the International Classification of Functioning, Disability and Health into prosthetics and orthotics2017Ingår i: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The International Classification of Functioning, Disability and Health is a classification of human functioning and disability and is based on a biopsychosocial model of health. As such, International Classification of Functioning, Disability and Health seems suitable as a basis for constructing models defining the clinical P&O process. The aim was to use International Classification of Functioning, Disability and Health to facilitate development of such a model. Proposed model: A model, the Prosthetic and Orthotic Process (POP) model, is proposed. The Prosthetic and Orthotic Process model is based on the concepts of the International Classification of Functioning, Disability and Health and comprises four steps in a cycle: (1) Assessment, including the medical history and physical examination of the patient. (2) Goals, specified on four levels including those related to participation, activity, body functions and structures and technical requirements of the device. (3) Intervention, in which the appropriate course of action is determined based on the specified goal and evidence-based practice. (4) Evaluation of outcomes, where the outcomes are assessed and compared to the corresponding goals. After the evaluation of goal fulfilment, the first cycle in the process is complete, and a broad evaluation is now made including overriding questions about the patient's satisfaction with the outcomes and the process. This evaluation will determine if the process should be ended or if another cycle in the process should be initiated.

    CONCLUSION: The Prosthetic and Orthotic Process model can provide a common understanding of the P&O process. Concepts of International Classification of Functioning, Disability and Health have been incorporated into the model to facilitate communication with other rehabilitation professionals and encourage a holistic and patient-centred approach in clinical practice. Clinical relevance The Prosthetic and Orthotic Process model can support the implementation of International Classification of Functioning, Disability and Health in P&O practice, thereby providing a common understanding of the P&O process and a common language to facilitate communication with other rehabilitation professionals.

  • 13. Jarl, Gustav
    et al.
    Tranberg, Roy
    Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    An innovative sealed shoe to off-load and heal diabetic forefoot ulcers - a feasibility study2017Ingår i: Diabetic Foot & Ankle, ISSN 2000-625X, Vol. 8, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Non-removable knee-high devices are the gold standard to treat diabetic foot ulcers located on the plantar forefoot, but they immobilize the ankle, which restricts daily life activities and has negative effects on joint functioning.Objective: To investigate the feasibility of sealing a therapeutic shoe to off-load and heal diabetic forefoot ulcers.

    Design: A case series of seven men with type 2 diabetes and a metatarsal head ulcer were prescribed therapeutic shoes and custom-made insoles. The shoe was sealed with a plastic band. Off-loading was assessed with the F-scan pressure measurement system. Adherence to wearing the shoe was assessed with a temperature sensor and by documenting the status of the seal.

    Results: The off-loading was effective and all ulcers healed. Median time to healing was 56 days (range 8-160). Complications were secondary ulcer (n = 1) and plantar hematoma (n = 1). Five of seven participants did not disturb the seal.

    Conclusions: Sealing a therapeutic shoe is a feasible way to off-load and heal forefoot ulcers. A controlled trial is needed to compare the effectiveness and safety of a sealed shoe to other non-removable devices.

  • 14.
    Kerai, Kavita
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Roser, Louise
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Measuring function and mobility among clients with diabetes in Samoa2016Självständigt arbete på grundnivå (kandidatexamen), 10 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Syftet med studien var att samla in grundata och att hitta ett lämpligt fysiskt test och ett självadministrativt formulär. Den insamlade grunddatan användes för att hitta ett rutinmässigt mätinstrument för undersökning av fothälsa, funktion och mobilitet hos klienter som lider av diabetes i landet Samoa. I undersökningen deltog 21 personer som lider av diabetes. Deltagarna fick besvara ett så kallat ”Foot Function Index formulär” (FFI) och utföra de två fysiska testerna ”Bergs Balance Scale” (BBS) och ”Time Up and Go” (TUG). Resultaten från de fysiska testerna påvisade såväl en stor balansrubbning som mobilitetsbegränsningar hos majoriteten av deltagarna. Ett generellt högt BMI-värde och stor vikt uppmättes hos båda könen. Personer med högst BMI-värde presterade kortast tid under TUG-testet. Den statistiska analysen påvisade en stark korrelation mellan de två fysiska testen, vilket indikerar att endast ett av testerna kan användas som mätinstrument i framtida undersökningar av funktion och mobilitet på Samoa. Sammanställningen av de självadministrativa formulären påvisade en generellt god fothälsa med begränsad smärta, oförmåga och aktivitetsbegränsning hos deltagarna i studien. 

  • 15.
    Larsen, Louise B.
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Tranberg, Roy
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, PO Sahlgrenska University Hospital, Gothenburg, Sweden.
    Ramstrand, Nerrolyn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Effects of thigh holster use on kinematics and kinetics of active duty police officers2016Ingår i: Clinical Biomechanics, ISSN 0268-0033, E-ISSN 1879-1271, Vol. 37, s. 77-82Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Body armour, duty belts and belt mounted holsters are standard equipment used by the Swedish police and have been shown to affect performance of police specific tasks, to decrease mobility and to potentially influence back pain. This study aimed to investigate the effects on gait kinematics and kinetics associated with use of an alternate load carriage system incorporating a thigh holster.

    Methods: Kinematic, kinetic and temporospatial data were collected using three dimensional gait analysis. Walking tests were conducted with nineteen active duty police officers under three different load carriage conditions: a) body armour and duty belt, b) load bearing vest, body armour and thigh holster and c) no equipment (control).

    Findings: No significant differences between testing conditions were found for temporospatial parameters. Range of trunk rotation was reduced for both load carriage conditions compared to the control condition (p < 0.017). Range of hip rotation was more similar to the control condition when wearing thigh holster rather than the belt mounted hip holster (p < 0.017). Moments and powers for both left and right ankles were significantly greater for both of the load carriage conditions compared to the control condition (p < 0.017).

    Interpretation: This study confirms that occupational loads carried by police have a significant effect on gait kinematics and kinetics. Although small differences were observed between the two load carriage conditions investigated in this study, results do not overwhelmingly support selection of one design over the other.

  • 16.
    Li, Yumeng
    et al.
    Department of Kinesiology, California State University, Chico, USA .
    Simpson, Kathy J.
    Department of Kinesiology, University of Georgia, Athens, USA .
    Nolan, Lee
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Miller, Marilyn
    Millsboro, USA .
    Johnson, Benjamin
    epartment of Kinesiology and Health Promotion, University of Kentucky, Lexington, USA.
    Lower extremity kinematics of curve sprinting displayed by runners using a transtibial prosthesis2018Ingår i: Journal of Sports Sciences, ISSN 0264-0414, E-ISSN 1466-447X, Vol. 36, nr 3, s. 293-302Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of the study was to determine if the kinematics exhibited by skilled runners wearing a unilateral, transtibial prosthesis during the curve section of a 200-m sprint race were influenced by interaction of limb-type (prosthetic limb (PROS-L) vs. nonprosthetic limb (NONPROS-L)) and curve-side (inside and outside limb relative to the centre of the curve). Step kinematics, toe clearance and knee and hip flexion/extension, hip ab/adduction for one stride of each limb were generated from video of 13 males running the curve during an international 200 m transtibial-classified competition. Using planned comparisons (P < 0.05), limb-type and curve-side interactions showed shortest support time and lowest hip abduction displacement by outside-NONPROS-L; shortest step length and longest time to peak knee flexion by the inside-PROS-L. For limb-type, greater maximum knee flexion angle and lower hip extension angles and displacement during support and toe clearance of PROS-Ls occurred. For curve-side, higher hip abduction angles during non-support were displayed by inside-limbs. Therefore, practitioners should consider that, for curve running, these kinematics are affected mostly by PROS-L limitations, with no clear advantage of having the PROS-L on either side of the curve. 

  • 17. Lundgren, Lina
    et al.
    Zügner, Roland
    Tranberg, Roy
    Gothenburg University, Gothenburg, Sweden.
    Brorsson, Sofia
    Osvalder, Anna-Lisa
    Effect of stance width on kinematics of laboratory landings with fixed feet on a kiteboard2017Konferensbidrag (Refereegranskat)
  • 18. Lundgren, Lina
    et al.
    Zügner, Roland
    Tranberg, Roy
    Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden.
    Osvalder, Anna-Lisa
    Brorsson, Sofia
    Normalizing stance width2012Ingår i: Proceedings of the XIXth Congress of the International Society of Electrophysiology & Kinesiology / [ed] Kylie Tucker, Bianca Butler & Paul Hodges, Brisbane: NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health , 2012, s. 221-221Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    INTRODUCTION: In previous studies, stance widths are most often determined as a percentage of shoulder width, where 70% of shoulder width is considered a narrow stance width and 140% of shoulder width is considered a wide stance width. A few studies have also normalized stance width to the width of the hips (distance between trochanters). However, there are also a possibility to normalize stance width in relation to the length of the lower extremities, since this variable might not change as much in dynamic situations and may correlate higher to the angle of the lower extremity in a frontal plane. 

    AIM: This study aims to compare measurements of stance width when normalized to shoulder width, hip width and leg length for three different stance widths with feet attached to a board. 

    METHOD: Motion capture (Qualisys, 16 Oqus-cameras) was used to measure 7 active male kitesurfers with their feet attached to a kiteboard (136 cm). They were 20-28 years old, in average 180 cm (SD=7 cm) and 78 kg (SD=7 kg). The subjects were standing with three different stance widths, using the same external rotation (20° bilaterally). Markers were attached to shoulders (acromion processes), knee joint lines, hips (trochanter major), heels (mid-posterior of calcaneus) and ankles (lateral and medial malleoli). Stance width was measured as the distance between the two medial ankle markers and normalized towards the distances between (1) the shoulder markers, (2) the hip markers and knee marker plus knee marker and lateral ankle marker and (3) the right and left hip marker. Furthermore, the angle of an extended lower extremity towards a vertical line in the frontal plane was measured. All measurements were done twice, and SPSS 20 was used for data analysis of correlation (Pearson’s r). 

    RESULTS: The measured stance widths between ankles were 39.9 cm, 43.6 cm, and 48 cm (SD=1.2-1.4) for all subjects. The correlations (r) between the angle of the leg towards a vertical line and normalized stance width for the three normalization variables were: (1) 0.79, (2) 0.96 and (3) 0.93. All of the correlations were significant at a level of p&gt;0.01. 

    CONCLUSION: The results show that the variables hip or leg length would be preferred to use when normalizing stance width for young male athletes, standing in wide stance widths. Further studies using a greater number of subjects, more stance widths and a more heterogeneous group are suggested for the future.

  • 19.
    Mlakar, Maja
    et al.
    University Rehabilitation Institute, Ljubljana, Slovenia.
    Ramstrand, Nerrolyn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Burger, Helena
    University Rehabilitation Institute, Ljubljana, Slovenia.
    Vidmar, Gaj
    University Rehabilitation Institute, Ljubljana, Slovenia.
    Effect of custom-made and prefabricated orthoses on grip strength in persons with carpal tunnel syndrome2014Ingår i: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 38, nr 3, s. 193-198Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Based on the literature, patients with carpal tunnel syndrome are suggested to wear a custom-made wrist orthosis immobilizing the wrist in a neutral position. Many prefabricated orthoses are available on the market, but the majority of those do not assure neutral wrist position. Objectives: We hypothesized that the use of orthosis affects grip strength in persons with carpal tunnel syndrome in a way that supports preference for custom-made orthoses with neutral wrist position over prefabricated orthoses. Study design: Experimental. Methods: Comparisons of grip strength for three types of grips (cylindrical, lateral, and pinch) were made across orthosis types (custom-made, prefabricated with wrist in 20 degrees of flexion, and none) on the affected side immediately after fitting, as well as between affected side without orthosis and nonaffected side. Results: Orthosis type did not significantly affect grip strength (p = 0.661). Cylindrical grip was by far the strongest, followed by lateral and pinch grips (p < 0.050). The grips of the affected side were weaker than those of the nonaffected side (p = 0.002). Conclusions: In persons with carpal tunnel syndrome, neither prefabricated orthoses with 20 degrees wrist extension nor custom-made wrist orthoses with neutral wrist position influenced grip strength of the affected hand. Compared to the nonaffected side, the grips of the affected side were weaker. Clinical relevance The findings from this study can be used to guide application of orthoses to patients with carpal tunnel syndrome.

  • 20.
    Möller, Saffran
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. 0000-0002-5360-7776.
    Hagberg, Kerstin
    Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Samuelsson, Kersti
    Department of Rehabilitation Medicine and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Ramstrand, Nerrolyn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Perceived self-efficacy and specific self-reported outcomes in persons with lower-limb amputation using a non-microprocessor-controlled versus a microprocessor-controlled prosthetic knee2017Ingår i: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, s. 1-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To measure self-efficacy in a group of individuals who have undergone a lower-limb amputation and investigate the relationship between self-efficacy and prosthetic-specific outcomes including prosthetic use, mobility, amputation-related problems and global health. A second purpose was to examine if differences exist in outcomes based upon the type of prosthetic knee unit being used.

    Method: Cross-sectional study using the General Self-Efficacy (GSE) Scale and the Questionnaire for Persons with a Transfemoral Amputation (Q-TFA). Forty-two individuals participated in the study. Twenty-three used a non-microprocessor-controlled prosthetic knee joint (non-MPK) and 19 used a microprocessor-controlled prosthetic knee joint (MPK).

    Results: The study sample had quite high GSE scores (32/40). GSE scores were significantly correlated to the Q-TFA prosthetic use, mobility and problem scores. High GSE scores were related to higher levels of prosthetic use, mobility, global scores and negatively related to problem score. No significant difference was observed between individuals using a non-MPK versus MPK joints. Conclusions: Individuals with high self-efficacy used their prosthesis to a higher degree and high self-efficacy was related to higher level of mobility, global scores and fewer problems related to the amputation in individuals who have undergone a lower-limb amputation and were using a non-MPK or MPK knee. Implications for rehabilitationPerceived self-efficacy has has been shown to be related to quality of life, prosthetic mobility and capability as well as social activities in daily life. Prosthetic rehabilitation is primary focusing on physical improvement rather than psychological interventions. More attention should be directed towards the relationship between self-efficacy and prosthetic related outcomes during prosthetic rehabilitation after a lower-limb amputation. 

  • 21.
    Nolan, Lee
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Patritti, Benjamin L.
    Repatriat Gen Hosp, Dept Rehabil & Aged Care, Adelaide, SA, Australia.
    Simpson, Kathy J.
    Univ Georgia, Dept Kinesiol, Athens, GA 30602 USA.
    Effect of take-off from prosthetic versus intact limb on transtibial amputee long jump technique2012Ingår i: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 36, nr 3, s. 297-305Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Increasing numbers of long jumpers with lower limb amputations choose to take off from their prosthetic limb. It is not yet known what difference in technique, if any, this requires, or which is more advantageous. Objectives: To investigate kinematic differences in long jump technique in athletes with a unilateral transtibial ampution (TT) who take off from their prosthetic limb versus those who take off from their intact limb. Study Design: Naturalistic, field-based, observational; independent group, nonparametric comparison. Methods: Two-dimensional sagittal plane kinematic analysis was performed on all athletes competing in the men's Paralympic TT long jump finals. Five athletes took off from their prosthetic limb (TOprosth) and five from their intact limb (TOintact). Results: No differences were seen between the two groups in terms of jump distance, approach speed or vertical velocity at touch down. While in contact with the take-off board, the two groups gained a similar amount of vertical velocity. However, the TOprosth group appeared to conserve horizontal velocity by using the prosthesis as a 'springboard', minimizing the large hip and knee range of motion displayed by the TOintact group and athletes in previous studies. Conclusions: While differences in technique were observed, no difference was found for jump distance.

  • 22.
    Ramstrand, Nerrolyn
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Andersson, Christina Björk
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Effects of an unstable shoe construction on standing balance in children with developmental disabilities: a pilot study2008Ingår i: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 32, nr 4, s. 422-433Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aimed to investigate if prolonged use of shoes incorporating an unstable sole construction could facilitate improvements of balance in a sample of developmentally disabled children. Ten children (six male and four female) aged between 10 and 17 years participated in the study. Children were fitted with shoes incorporating an unstable sole (Masai Barefoot Technology) and instructed to wear them for a minimum of two hours per day for eight weeks. A within subjects repeated measures design was used. Children were tested prior to receiving the shoes, four weeks after receiving the shoes and eight weeks after receiving the shoes. A force plate capable of rotating about a single axis (NeuroCom International Inc, Oregon) was used to test static balance, reactive balance and directional control. Static balance was not found to be influenced by prolonged use of the footwear; however, significant improvements were noted in children's reactive balance both with the shoes and barefoot. Results suggest that reactive balance can be improved by prolonged and regular use of shoes incorporating an unstable sole construction.

  • 23.
    Ramstrand, Nerrolyn
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Brodtkorb, T.-H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Considerations for developing an evidenced-based practice in orthotics and prosthetics2008Ingår i: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 32, nr 1, s. 93-102Artikel i tidskrift (Refereegranskat)
  • 24.
    Ramstrand, Nerrolyn
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Gjøvaag, T.
    Starholmen, I.
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Effects of knee orthosis design on proprioception and balance2017Konferensbidrag (Refereegranskat)
  • 25.
    Ramstrand, Nerrolyn
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Jacobs, Norman
    ISPO Consensus Conference on Appropriate Lower Limb Orthotics for Developing Countries: Conclusions and Recommendations2007Ingår i: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 31, nr 2, s. 214-216Artikel i tidskrift (Övrigt vetenskapligt)
  • 26.
    Rexhaj, Behar
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Danielsson, Theresia
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Patients with Lower Limb Amputation in Vietnam: A quantitative study on Patients’ Satisfaction with their given Prosthetic Device and Service2017Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Syfte: Syftet med denna studie är att evaluera patienters nöjdhet med deras utgivna protes och service på nedre extremitetsamputerade i Danang, Vietnam och att implementera jämförelser mellan subgrupperna kön, bostadsområde, amputations- orsak och nivå. Metod: En cross-sectional studiedesign blev utförd genom användning av Quebec User Evaluation of Satisfaction with assistive Technology (QUEST) 2.0 enkäten för att mäta patienters nöjdhet. Femtio patienter blev rekryterade genom International Committee of the Red Cross (ICRC) och datainsamlingen blev utförd i patienternas egna hushåll med en tolk. Den insamlade datan blev statistiskt analyserad med lämpliga tester genom användning av Statistical Package for the Social Sciences (SPSS). Resultat: Patienterna var ganska nöjda med deras utgivna proteser (medelvärde 4,16 SD ± 0,561) och mer eller mindre nöjda med deras utgivna service (medelvärde 2,83 SD ± 1,213). Signifikanta skillnader hittades mellan kön gällande patienters nöjdhet med deras utgivna protes. Det fanns inga signifikanta skillnader mellan de resterande subgrupperna; bostadsområde, amputationsorsak och amputationsnivå. Slutsats: Den här studien demonstrerar att patienterna i Danang verkar vara ganska nöjda med deras utgivna proteser, fastän de rapporterade problem med protesens hållbarhet. Dessutom var patienterna mer eller mindre nöjda med deras utgivna service. Fynden i denna studie påvisar också att kvinnorna var mindre nöjda gällande protesen jämfört med männen. Dessa slutsatser skall dock tas med aktsamhet, eftersom reliabiliteten och validiteten blev lägre än önskat och det var svårt att generalisera resultaten till populationen.

  • 27.
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Adaptations from the prosthetic and intact limb during standing on a sway referenced support surface for transtibial prosthesis users2018Ingår i: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115Artikel i tidskrift (Refereegranskat)
  • 28.
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Biomechanical Models of Standing in Prosthetic Users2018Konferensbidrag (Övrigt vetenskapligt)
  • 29.
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Instrumented motion analysis and trans-tibial prosthetics: a systematic review2009Konferensbidrag (Övrigt vetenskapligt)
  • 30.
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Instrumented motion analysis of trans-tibial prosthesis users: a systematic review of data capture and analysis techniques2010Ingår i: 13th ISPO World Congress: Abstracts, 2010, s. 969-970Konferensbidrag (Refereegranskat)
  • 31.
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Limb prostheses and postural control: evaluation, interaction and functional consequence2015Konferensbidrag (Övrigt vetenskapligt)
  • 32.
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Observational gait analysis: The prosthetic challenges2004Konferensbidrag (Övrigt vetenskapligt)
  • 33.
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Sagittal plane position of the functional joint centre of prosthetic foot-ankle mechanisms2010Ingår i: 13th ISPO World Congress: Abstracts, 2010, s. 1257-1258Konferensbidrag (Refereegranskat)
  • 34.
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    The effects of liner thickness and suspension technique on knee joint proprioception in trans-tibial amputees2007Konferensbidrag (Refereegranskat)
  • 35.
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    The prosthesis and weight-bearing contributions on EMG response latency subsequent to rapid platform perturbation in transtibial prosthesis users2013Konferensbidrag (Refereegranskat)
  • 36.
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    The use of vibratory feedback to improve postural stability of individuals with transtibial amputation2013Konferensbidrag (Refereegranskat)
  • 37.
    Rusaw, David
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    The validity of forceplate data as a measure of rapid and targeted volitional movements of the center of mass in transtibial prosthesis users2017Ingår i: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 12, nr 7, s. 686-693Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To validate outcome variables from the Limits of Stability protocol that are derived from the center of pressure with those same variables derived from the center of mass during rapid, volitional responses in transtibial prosthesis users.

    Method: Prosthesis users (n=21) and matched controls (n=21) executed movements while force and motion data were collected.  Correlation coefficients were used to investigate relationships between center of pressure and center of mass for: x/y coordinates positions, Limits of Stability outcome variables and muscular reaction times. 

    Results: Significant differences were seen in correlation between x/y coordinate positions toward the intact limb (mean effect size of differences: r = 0.38).  Limits of Stability variables were positively correlated (reaction time and maximum excursion range rs: 0.585 – 0.846; directional control and mean velocity range rs: 0.307 – 0.472).  Muscular reaction times correlated weakly with those from center of pressure (mean rs prosthesis users – 0.186 and controls –  0.101). 

    Conclusions: Forceplate measures are valid in describing rapid, volitional movements in unilateral transtibial prosthesis users.  Limits of Stability outcomes extracted from center of pressure and center of mass are highly correlated but can be sensitive to direction.  Muscular reaction time correlates very little with reaction times extracted from the other variables.

  • 38.
    Rusaw, David
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Hagberg, Kerstin
    University of Gothenburg.
    Nolan, Lee
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Ramstrand, Nerrolyn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform. Karolinska Institutet and GIH, Stockholm.
    Bilateral electromyogram response latency following platform perturbation in unilateral transtibial prosthesis users: Influence of weight distribution and limb position2013Ingår i: Journal of rehabilitation research and development, ISSN 0748-7711, E-ISSN 1938-1352, Vol. 50, nr 4, s. 531-544Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Appropriate muscular response following an external perturbation is essential inpreventing falls. Transtibial prosthesis users lack a foot-ankle complex and associatedsensorimotor structures on the side with a prosthesis. Its effect on rapid responses ofthe lower-extremity to external surface perturbations is unknown. The aim of thepresent study was to compare electromyographic (EMG) response latencies of otherwisehealthy unilateral transtibial prosthesis users (n=23, mean age 48 years [standarddeviation 14]) and a matched control group (n=23, mean age 48 years [standard deviation13]) following sudden support surface rotations in the pitch plane (toes-up and toesdown).Perturbations were elicited in various weight-bearing and limb-perturbedconditions. The results indicated that transtibial prosthesis users have delayed responsesof multiple muscles of the lower-extremity following perturbation, both in the intact limband the residual limb. Weight-bearing had no influence on the response latency in theresidual limb, but did on the intact limb. Which limb received the perturbation wasfound to influence the muscular response, with the intact limb showing a significantlydelayed response when the perturbation was received only on the side with a prosthesis.These delayed responses may represent an increased risk of falling for individuals thatuse a transtibial prosthesis.

  • 39.
    Rusaw, David
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Hagberg, Kerstin
    Institute for Clinical Sciences, Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Nolan, Lee
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Ramstrand, Nerrolyn
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Can vibratory feedback be used to improve postural stability in persons with transtibial limb loss?2012Ingår i: Journal of rehabilitation research and development, ISSN 0748-7711, E-ISSN 1938-1352, Vol. 49, nr 8, s. 1239-1254Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The use of vibration as a feedback modality to convey motion of the body has been shown to improve measures of postural stability in some groups of patients. Because individuals using transtibial prostheses lack sensation distal to the amputation, vibratory feedback could possibly be used to improve their postural stability. The current investigation provided transtibial prosthesis users (n = 24, mean age 48 yr) with vibratory feedback proportional to the signal received from force transducers located under the prosthetic foot. Postural stability was evaluated by measuring center of pressure (CoP) movement, limits of stability, and rhythmic weight shift while participants stood on a force platform capable of rotations in the pitch plane (toes up/toes down). The results showed that the vibratory feedback increased the mediolateral displacement amplitude of CoP in standing balance and reduced the response time to rapid voluntary movements of the center of gravity. The results suggest that the use of vibratory feedback in an experimental setting leads to improvements in fast open-loop mechanisms of postural control in transtibial prosthesis users.

  • 40.
    Rusaw, David
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Hellstrand Tang, Ulla
    Nordén, Erika
    Johannesson, Anton
    Jarl, Gustav
    Clinical guidelines for orthotic treatment of osteoarthritis of the knee: a review with a nordic perspective2018Konferensbidrag (Övrigt vetenskapligt)
  • 41.
    Rusaw, David
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform. Institute for Clinical Sciences, Department of Orthopaedics, University of Gothenburg, Sweden.
    Ramstrand, Nerrolyn
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Motion-analysis studies of transtibial prosthesis users: a systematic review2011Ingår i: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 35, nr 1, s. 8-19Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Three-dimensional motion analysis has been used since the beginning of the 1980s to evaluate many aspects of physical function of transtibial amputees. Despite its common use for clinical research, there is large variability in methods of capturing three-dimensional data, description of these methods, reporting of joint kinematics and interpretation of research findings.

    Objectives: The aim of the following review is to critically examine the specific methodologies used by researchers when collecting three-dimensional kinematic data on transtibial amputees and to provide an overview of the methods used.

    Study design: Systematic review.

    Methods: A systematic review of the literature between January 1984 and June 2009 was conducted. A total of 68 papers were identified for review based on the following criteria: experimental research design, collection of three-dimensional kinematic data of lower-extremity joints, and inclusion of transtibial amputees as experimental subjects.

    Results: A number of methodological shortcomings were identified in the papers reviewed.

    Conclusions: The authors recommend that future studies more appropriately address the product name and number of prosthetic components used; how the position of reflective markers on the prosthesis is defined; presentation of data from both sound and affected sides; and definition of the neutral position of the ankle when reporting kinematic data. Where possible, the authors recommend use of a control group.

  • 42.
    Rusaw, David
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Rudholmer, E.
    Barnett, C. T.
    A limits of stability protocol utilizing measures of the center of mass and center of pressure in transtibial prosthesis users: learning effects and reliability2017Konferensbidrag (Refereegranskat)
  • 43.
    Rusaw, David
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Rudholmer, Elin
    Högskolan i Jönköping, Hälsohögskolan.
    Barnett, Cleveland T.
    School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom.
    Development of a limits of stability protocol for use in transtibial prosthesis users: Learning effects and reliability of outcome variables2017Ingår i: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 58, s. 539-545Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aims of this study were to empirically quantify reliability and learning effects of a Limits of Stability protocol for transtibial prosthesis users. Outcome variables from center of pressure and center of mass were tested on: 1) multiple test repetitions within a single test occasion; and 2) between multiple test occasions. Trantibial prosthesis users (n=7) and matched controls (n=7) executed five trials of the Limits of Stability protocol on two occasions per day, on two consecutive days. Inter-trial learning effects and reliability of outcomes extracted via center of mass and center of pressure were evaluated utilizing standard biomechanics laboratory equipment. Reliability was good to excellent except the reaction time variable which was poor (Pooled 95%CI of ICC=0.248-0.484). An inter-trial learning effect was present in directional control for prosthesis users when the first trial was included in analysis (center of mass: 95%CI of r=0.065-0.239; center of pressure: 95%CI of r=0.076-0.249). The use of standard biomechanics lab equipment can produce reliable results for the Limits of Stability protocol. Researchers should be aware of low reliability of reaction time variable in the protocol assessed and should execute at least one practice trial prior to that which is used in subsequent analysis.

  • 44. Sant’Anna, Anita
    et al.
    Wickström, Nicholas
    Eklund, Helene
    Tranberg, Roy
    Gothenburg University, Institute of Clinical Sciences, Section for Anesthesiology, Biomaterials and Orthopaedics, Department of Orthopaedics.
    A wearable gait analysis system using inertial sensors Part II: Evaluation in a clinical setting2012Ingår i: Proceedings of the International Conference on Bio-inspired Systems and Signal Processing - Volume 1: BIOSIGNALS, (BIOSTEC 2012) / [ed] S. Van Huffel, C. Correia, A. Fred & H. Gamboa, SciTePress, 2012, s. 5-14Konferensbidrag (Refereegranskat)
    Abstract [en]

    The gold standard for gait analysis, in-lab 3D motion capture, is not routinely used for clinical assessment due to limitations in availability, cost and required training. Inexpensive alternatives to quantitative gait analysis are needed to increase the its adoption. Inertial sensors such as accelerometers and gyroscopes are promising tools for the development of wearable gait analysis (WGA) systems. The present study evaluates the use of a WGA system on hip-arthroplasty patients in a real clinical setting. The system provides information about gait symmetry and normality. Results show that the normality measurements are well correlated with various quantitative and qualitative measures of recovery and health status.

  • 45. Sant'Anna, Anita
    et al.
    Wickström, Nicholas
    Eklund, Helene
    Zügner, Roland
    Tranberg, Roy
    Sahlgrenska Academy, Department of Orthopedics, Gothenburg University, Göteborg, Sweden, .
    Assessment of Gait Symmetry and Gait Normality Using Inertial Sensors In-Lab and In-Situ Evaluation2013Ingår i: Biomedical Engineering Systems and Technologies: 5th International Joint Conference, BIOSTEC 2012, Vilamoura, Portugal, February 1-4, 2012, Revised Selected Papers / [ed] J. Gabriel et al., Heidelberg: Springer, 2013, Vol. s. 239-254, s. 239-254Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    Quantitative gait analysis is a powerful tool for the assessment of a number of physical and cognitive conditions. Unfortunately, the costs involved in providing in-lab 3D kinematic analysis to all patients is prohibitive. Inertial sensors such as accelerometers and gyroscopes may complement in-lab analysis by providing cheaper gait analysis systems that can be deployed anywhere. The present study investigates the use of inertial sensors to quantify gait symmetry and gait normality. The system was evaluated in-lab, against 3D kinematic measurements; and also in-situ, against clinical assessments of hip-replacement patients. Results show that the system not only correlates well with kinematic measurements but it also corroborates various quantitative and qualitative measures of recovery and health status of hip-replacement patients.

  • 46. Sant'Anna, Anita
    et al.
    Wickström, Nicholas
    Zügner, Roland
    Tranberg, Roy
    Department of Orthopedics, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
    A wearable gait analysis system using inertial sensors Part I: Evaluation of measures of gait symmetry and normality against 3D kinematic data2012Ingår i: BIOSIGNALS 2012 - Proceedings of the International Conference on Bio-Inspired Systems and Signal Processing, SciTePress, 2012, s. 180-188Konferensbidrag (Refereegranskat)
    Abstract [en]

    Gait analysis (GA) is an important tool in the assessment of several physical and cognitive conditions. The lack of simple and economically viable quantitative GA systems has hindered the routine clinical use of GA in many areas. As a result, patients may be receiving sub-optimal treatment. The present study introduces and evaluates measures of gait symmetry and gait normality calculated from inertial sensor data. These indices support the creation of mobile, cheap and easy to use quantitative GA systems. The proposed method was compared to measures of symmetry and normality derived from 3D kinematic data. Results show that the proposed method is well correlated to the kinematic analysis in both symmetry (r=0.84, p<0.0001) and normality (r=0.81, p<0.0001). In addition, the proposed indices can be used to classify normal from abnormal gait.

  • 47.
    Sidenvall, Josef
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Gustavsson, Matilda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Påverkar skon styvheten i ankel-fotortoser?: En funktionell analys2018Självständigt arbete på grundnivå (högskoleexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Varierande styvhet mot dorsal-/plantarflektion i en ankel-fotortos (AFO)kan påverka kinematik och kinetik kring ankel och knä hos personer med cerebral pares eller post-stroke. Kunskap om huruvida skon påverkar styvheten i ett AFO-sko-benkomplex är begränsad. En tidigare studie har undersökt ämnet men använde bänktester för att adressera frågan. Syfte: Syftet var att, med funktionell analys, undersöka huruvida skor påverkar styvheten i ett AFO-sko-benkomplex, i sagittalplanet. Studiedesign: Överkorsningsstudie. Metod: Gånganalys genomfördes på fem friska individer. Deltagarna fick gå med tre olika AFO-skokombinationer. Data om ankelvinklar och ankelmoment extraherades för att beräkna styvheten för respektive AFO-skokombination. Styvheten för de olika kombinationerna jämfördes under fyra intervall. Resultat: Det fanns en skillnad i styvhet med olika skor. Styvheterna varierade mellan 0,0314–0,1652 Nm/° under de olika intervallen. Vilken AFO-skokombination som hade störst styvhet varierade beroende på vart i gångfasen de befann sig. Största skillnaden som uppmättes mellan två skor var 49,6%. Konklusion: Styvheten hos ett ben-AFO-sko-komplex kan variera beroende på vilken sko som används hos friska individer. Endast mindre skillnader kunde o mellan de olika AFO-skoalternativen varvid den kliniska relevansen av resultatet kan ifrågasättas.

  • 48.
    Tennstedt, Frida
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Mastoraki Karlsson, Linnea
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Barns intryck av omgivningen på en ortopedteknisk avdelning: -      En kvalitativ studie om hur barn uppfattar miljön och mötet på en ortopedteknisk avdelning2016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: För att uppnå en god barnanpassad vård inom ortopedteknik krävs information om hur barn uppfattar mötet på en ortopedteknisk avdelning. Genom att ta del av barns tankar, åsikter och förslag kan verksamheter i framtiden lättare argumentera för exempelvis hur lokaler bör inredas och hur man bör bemöta barn.

     

    Syfte: Syftet med denna studie är att undersöka hur barn upplever mötet på en ortopedteknisk avdelning i avseendet vårdmiljö och möte med ortopedingenjören.

     

    Metod: En kvalitativ metod där deltagarna får rita och berätta kallad “Draw and tell” och åtta intervjuer med barn mellan 6 till 12 år om deras upplevelse efter besöket hos en ortopedingenjör genomfördes. Intervjuerna transkripterades och en innehållsanalys genomfördes.

     

    Resultat: Vissa gemensamma faktorer hittades i intervjuerna så som att det ansågs att det samtalades för mycket utan att engagera barnet samt att aktiviteter som fanns sågs som bra då det kunde bli lite väntan under besöket. Det fanns flera förslag på andra aktiviteter som önskades under väntan och speglade barnens egna intressen så som datorspel och böcker.

     

    Slutsats: Denna studie visar att det som ortopedingenjören är viktigt att engagera barnen vid mötena samt att aktiviteter finns till hands under långa väntetider.

     

    Nyckelord: Barns upplevelser, ortopedteknik, ortopedingenjör, bemötande, miljö

  • 49.
    Wijk, Ulrika
    et al.
    Skånes universitetssjukhus.
    Dahlström, Örjan
    Linköpings universitet.
    Björk, Mathilda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    The concurrent validity of the Amharic version of Screening of Activity Limitation and Safety Awareness (SALSA) in persons affected by leprosy2013Ingår i: Leprosy Review, ISSN 0305-7518, E-ISSN 2162-8807, Vol. 84, nr 1, s. 13-22Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Leprosy is endemic in many countries and results in activity limitations. There is a need for assessment tools to guide professionals in their evaluation and choice of intervention in order to improve conditions for leprosy-affected people. The purpose of our study was to evaluate the concurrent validity of the Amharic version of Screening of Activity Limitation and Safety Awareness (SALSA-am) scale with Amharic version of Disability of the Arm, Shoulder and Hand (DASH-am) questionnaire.

    Design: Thirty-eight individuals with nerve damage due to leprosy completed the SALSA-am and DASH-am questionnaires. Spearman's rank correlation was used to determine relationships between SALSA and DASH scores. Specificity, sensitivity and accuracy were calculated.

    Results: There was a good correlation 0.87 (P < 0.001) between SALSA-am and DASH-am scores. Sensitivity, specificity and accuracy were calculated with acceptable results.

    Conclusions: SALSA-am is considered a useful questionnaire for determining activity limitations in persons affected by leprosy, and showed good correlation with DASH-am. The concurrent validity was considered good.

  • 50. Willy, R. W.
    et al.
    Brorsson, Annelie
    Powell, H. C.
    Willson, J. D.
    Tranberg, Roy
    Gothenburg University, Gothenburg, Sweden.
    Grävare Silbernagel, Karin
    Elevated Knee Joint Kinetics and Reduced Ankle Kinetics Are Present During Jogging and Hopping After Achilles Tendon Ruptures2017Ingår i: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 45, nr 5, s. 1124-1133Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Deficits in plantarflexor function are common after an Achilles tendon rupture. These deficits may result in an altered distribution of joint loads during lower extremity tasks. Hypothesis: We hypothesized that, regardless of treatment, the Achilles tendon-ruptured limb would exhibit deficits in ankle kinematics and joint power while exhibiting elevated knee joint power and patellofemoral joint loads during walking, jogging, and hopping. We further hypothesized that this loading pattern would be most evident during jogging and hopping. Methods: Thirty-four participants (17 participants treated surgically, 17 treated nonsurgically) were tested at a mean 6.1 +/- 2.0 years after an Achilles tendon rupture. Lower extremity kinematics and kinetics were assessed while participants completed walking, jogging, and single-legged hopping trials. Patellofemoral joint stress was calculated via a musculoskeletal model. Data were analyzed via mixed-model repeated analyses of variance (alpha = .05) and the limb symmetry index (LSI). Results: No differences (P >= .05) were found between the surgical and nonsurgical groups. In both groups, large side-to-side deficits in the plantarflexion angle at toeoff (LSI: 53.5%-73.9%) were noted during walking, jogging, and hopping in the involved limb. Side-to-side deficits in the angular velocity were only present during jogging (LSI: 93.5%) and hopping (LSI: 92.5%). This pattern was accompanied by large deficits in eccentric (LSI: 80.8%-94.7%) and concentric (LSI: 82.2%-84.7%) ankle joint powers in the involved limb during all tasks. Interestingly, only jogging and hopping demonstrated greater knee joint loads when compared with the uninvolved limb. Concentric knee power was greater during jogging (LSI: 117.2%) and hopping (LSI: 115.9%) compared with the uninvolved limb. Similarly, peak patellofemoral joint stress was greater in the involved limb during jogging (LSI: 107.5%) and hopping (LSI: 107.1%), while only hopping had a greater loading rate of patellofemoral joint stress (LSI: 110.9%). Conclusion: Considerable side-to-side deficits in plantarflexor function were observed during walking, jogging, and hopping in patients after an Achilles tendon rupture. As a possible compensation, increased knee joint loads were present but only during jogging and hopping. Clinical Relevance: These data suggest that after an Achilles tendon rupture, patients may be susceptible to greater mechanical loading of the knee during sporting tasks, regardless of surgical or nonsurgical treatment.

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