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  • 1.
    Areskoug Josefsson, Kristina
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Thidell, Fredrik
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Rolander, Bo
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Prosthetic and orthotic students’ attitudes toward addressing sexual health in their future profession2018In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 6, p. 612-619Article in journal (Refereed)
    Abstract [en]

    Background:

    Prosthetists and orthotists have a responsibility to direct treatment toward enabling their clients to perform desired activities and to facilitate participation of their clients in all areas of life. This may include provision of assistive technologies to help clients meet goals related to participation in sexual activities. To help prosthetic and orthotic students develop competencies in dealing with the sexual health of their future clients, it is necessary to generate knowledge of their own perceived competence and capacity.

    Objectives:

    To explore prosthetic and orthotic students’ attitudes and competence toward working with sexual health and to evaluate reliability and validity of the Students’ Attitudes Towards Addressing Sexual Health questionnaire.

    Study design:

    Cross-sectional study.

    Methods:

    Students enrolled in all three years of an undergraduate prosthetic and orthotic program were requested to complete the Students’ Attitudes Towards Addressing Sexual Health questionnaire (n = 65). Reliability and validity were evaluated using the content validity index and Cronbach’s alpha.

    Results:

    Students felt unprepared to talk about sexual health with future clients and thought that they would be embarrassed if they raised the issue. No differences were identified between students enrolled in each of the three years of the program and few differences were observed between male and female students. The content validity index values were low but improved as the students’ level of education increased. Internal consistency of the questionnaire was acceptable (α = 0.86).

    Conclusion:

    Prosthetic and orthotic students are unprepared to address sexual health issues with their future clients. There is a need to provide students with training related to sexual health issues.

    Clinical relevance:

    This study indicates the need for additional education of prosthetic and orthotic students in issues related to sexual health and how to address sexual health issues with clients. Results can be used to develop training programs for students and will serve to improve the sexual health of individuals who receive prosthetic and orthotic services.

  • 2.
    Barnett, Cleveland T.
    et al.
    Nottingham Trent University, Nottingham, UK.
    Vanicek, Natalie
    University of Hull, Hull, UK.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Does postural control predict falling and the fear of falling in lower limb amputees?2015In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 39, no 1 (suppl.), article id 313Article in journal (Refereed)
  • 3.
    Dillon, Michael P.
    et al.
    Department of Physiotherapy, Podiatry, and Prosthetics and Orthotics, La Trobe University, Melbourne, Australia.
    Fatone, Stefania
    Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Hafner, Brian J.
    Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
    Prosthetics and Orthotics International welcomes qualitative research submissions2019In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 43, no 4, p. 366-368Article in journal (Other academic)
  • 4.
    Glemne, Maria
    et al.
    Ortopedteknik, Southern Älvsborg Hospital, Borås, Sweden.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Crafoord, Jessica
    Ortopedteknik, Southern Älvsborg Hospital, Borås, Sweden.
    Nygren, Linus
    Ortopedteknik, Southern Älvsborg Hospital, Borås, Sweden.
    Preoperative characteristics and functional outcomes of lower limb amputees treated at Southern Älvsborg Hospital, Sweden2013In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 37, no 4, p. 298-304Article in journal (Refereed)
    Abstract [en]

    Background:Within the prosthetics profession, there is a lack of evidence to support many clinical practices. It is therefore important that clinicians systematically document and evaluate their daily practices.Objectives:To record preoperative characteristics and functional outcomes for patients with a lower limb amputation and to investigate variations between prosthetic users and non-prosthetic users.Study Design:Prospective cohort study.Methods:A total of 23 patients (mean age = 80 years, standard deviation = 7.3) who underwent a major lower limb amputation were assessed within 2 weeks of admission and 6 months post-operatively. Locomotor Capabilities Index-5, the Timed-Up-and-Go Test and prosthetic use were used to evaluate functional outcomes.Results:A total of 13 participants (57%) received a prosthesis within 6 months of amputation. Mean time to prosthetic fitting was 48 days (range = 28-97). No statistically significant difference was found between prosthetic users and non-prosthetic users regarding age, time to rehabilitation and Locomotor Capabilities Index-5 (p > 0.05). Locomotor Capabilities Index-5 basic was significantly lower at 6 months than prior to amputation (p = 0.039).Conclusion:The functional outcome at 6 months indicates a sizable restriction in mobility among lower limb amputees. No variation in preoperative characteristics between prosthetic users and non-prosthetic users could be confirmed in this study.Clinical relevanceThis study highlights the need for prosthetists to better incorporate research findings into their daily practice and presents an example of how to implement a procedure for assessment and documentation of patients' functional outcomes in a clinical setting. Results confirm difficulties in identifying amputees who will become prosthetic users based on preoperative characteristics.

  • 5.
    Jarl, Gustav
    et al.
    Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Hellstrand Tang, Ulla
    Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Nordén, Erika
    Ottobock, Medical Care Sweden, Stockholm, Sweden.
    Johannesson, Anton
    Össur Clinics Scandinavia, Stockholm, Sweden.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Nordic clinical guidelines for orthotic treatment of osteoarthritis of the knee: A systematic review using the AGREE II instrument2019In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553Article, review/survey (Refereed)
    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.

  • 6.
    Jarl, Gustav
    et al.
    Örebro University, Sweden.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    A model to facilitate implementation of the International Classification of Functioning, Disability and Health into prosthetics and orthotics2018In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 5, p. 468-475Article in journal (Refereed)
    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.

  • 7.
    Ma, Christina Zong-Hao
    et al.
    The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Wong, Duo W.-C.
    The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Wan, Anson H.-P.
    The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Lee, Winson C.-C.
    Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW, Australia.
    Effects of orthopedic insoles on static balance of older adults wearing thick socks2018In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 3, p. 357-362Article in journal (Refereed)
    Abstract [en]

    Background: The wearing of socks and insoles may affect the ability of the foot to detect tactile input influencing postural balance.

    Objectives: The aim of this study was to investigate whether (1) thick socks adversely affected the elderly postural balance and (2) orthopedic insoles could improve the elderly postural balance while wearing thick socks.

    Study design: Repeated-measures study design. Methods: In total, 14 healthy older adults were recruited. A monofilament test was conducted to evaluate foot plantar sensation with and without thick socks. Subjects then performed the Romberg tests under three conditions: (1) barefoot, (2) with socks only, and (3) with both socks and insoles. Postural balance was assessed by measuring the center of pressure movement during standing in each experimental condition.

    Results: Thick socks significantly decreased the monofilament score (p < 0.001), suggesting reduction in ability to detect external forces. All center of pressure parameters increased significantly while wearing thick socks (p < 0.017), implying reduction of postural stability. They then decreased significantly with the additional use of insoles (p < 0.017).

    Conclusion: Previous studies have documented the changes in plantar pressure distribution with the use of orthopedic insoles. This study further suggests that such changes in contact mechanics could produce some balance-improving effects, which appears not to have been reported earlier.

    Clinical relevance: Wearing thick socks reduces plantar pressure sensitivity and increases postural sway which may increase risk of falls. Orthopedic insoles and footwear with similar design could potentially be a cost-effective method in maintaining postural balance when wearing thick socks. 

  • 8.
    Mlakar, Maja
    et al.
    University Rehabilitation Institute, Ljubljana, Slovenia.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    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 syndrome2014In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 38, no 3, p. 193-198Article in journal (Refereed)
    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.

  • 9.
    Möller, Saffran
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Hagberg, Kerstin
    Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, Sweden.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Reduced cortical brain activity with the use of microprocessor-controlled prosthetic knees during walking2019In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 43, no 3, p. 257-265Article in journal (Refereed)
    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.

  • 10.
    Nolan, Lee
    et al.
    Jönköping University, School of Health Science, HHJ. Prosthetics and Orthotics.
    Lees, A
    The functional demands on the intact limb during walking for active trans-femoral and trans-tibial amputees.2000In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 24, no 2, p. 117-125Article in journal (Other academic)
  • 11.
    Nolan, Lee
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. Prosthetics and Orthotics.
    Patritti, Benjamin
    The take-off phase in transtibial amputee high jump2008In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 32, no 2, p. 160-171Article in journal (Refereed)
  • 12.
    Nolan, Lee
    et al.
    Jönköping University, School of Health Science, HHJ. Prosthetics and Orthotics.
    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 technique2012In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 36, no 3, p. 297-305Article in journal (Refereed)
    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.

  • 13.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    A comparison of foot placement strategies of transtibial amputees and able-bodies subjects during stair ambulation2009In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 33, no 4, p. 348-355Article in journal (Refereed)
    Abstract [en]

    Ambulation on stairs presents a significant challenge for lower extremity amputees and increases the risk of falling and sustaining a serious injury. This study aimed to compare foot placement and foot clearance during stair ambulation in a group of transtibial amputees and a group of able-bodied subjects Three-dimensional motion analysis was used to determine foot positioning and to calculate temporospatial parameters during stair ascent and descent of 10 transtibial amputees (mean age = 56) and a control group consisting of 10 healthy able-bodied individuals (mean age = 26 7) No significant difference was observed in foot positioning and foot clearance between the amputee and control groups Temporospatial data revealed a number of significant differences between the groups, particularly during stair ascent Amputees were observed to walk with a slower velocity and cadence (p < 0 01), to increase the time spent in stance phase and double support (p < 0 01) and to increase their step width during both stair ascent and descent (p < 0.01) Results suggest that foot placement and clearance are not factors that would contribute to a stumble or fall on stairs in established amputees but that balance related issues, such as relative motion of the centre of mass, require further investigation.

  • 14.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Translating research into prosthetic and orthotic practice2013In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 37, no 2, p. 108-112Article in journal (Refereed)
    Abstract [en]

    Background: Evidence-based practice is commonly accepted as a means of improving patient outcomes; however, there is little understanding of the processes required to successfully implement it into prosthetic and orthotic practice.

    Objectives: To discuss factors affecting adoption of evidence-based practice and present a theoretical framework for its implementation into prosthetic and orthotic practice.

    Discussion: Numerous factors that affect adoption of evidence-based practice are discussed, ranging from individual factors to those that can be attributed to administrative and environmental issues. Specific factors are likely to be context specific and are influenced by the manner in which evidence-based practice is introduced into the working environment. It is argued that successful implementation of evidence-based practice requires consideration of numerous interrelated factors. A formal translating research into practice model is presented as a means of developing a strategic plan that considers all relevant factors and maximizes acceptance of evidence-based practice into prosthetics and orthotics clinical practice.

    Conclusions: The use of a theoretical model for implementation of evidence-based practice is likely to improve its adoption by prosthetic and orthotic clinicians.

  • 15.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Andersson, Christina Björk
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Effects of an unstable shoe construction on standing balance in children with developmental disabilities: a pilot study2008In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 32, no 4, p. 422-433Article in journal (Refereed)
    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.

  • 16.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Brodtkorb, T.-H.
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Considerations for developing an evidenced-based practice in orthotics and prosthetics2008In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 32, no 1, p. 93-102Article in journal (Refereed)
  • 17.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Jacobs, Norman
    ISPO Consensus Conference on Appropriate Lower Limb Orthotics for Developing Countries: Conclusions and Recommendations2007In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 31, no 2, p. 214-216Article in journal (Other academic)
  • 18.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. Prosthetics and Orthotics.
    Nilsson, Kjell-Åke
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation.
    Validation of a patient activity monitor to quantify ambulatory activity in an amputee population2007In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 31, no 2, p. 157-166Article in journal (Refereed)
    Abstract [en]

    The ability to objectively measure an amputee's walking activity over prolonged periods can provide clinicins with a useful means of evaluating their patients' outcomes. The present study aimed to validate the temporospatial data output from a commercially available ambulatory activity monitor (PAM, Össur) fitted to trans-tibial and trans-femoral amputees, against data that was simultansously captured from a three dimensional motion analysis system (Qualisys Medical AB, Gothenburg, Sweden). Results indicate that the PAM monitor provides accurate measures of temporospatial aspects of amputee gait for walking speeds above 0.75m/s.

  • 19.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Ramstrand, Simon
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Competency standards for newly graduated prosthetist/orthotists in Sweden2018In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 42, no 4, p. 387-393Article in journal (Refereed)
    Abstract [en]

    Background:

    There are currently no national competency standards upon which to develop educational objectives for prosthetist/orthotists in Sweden. While standards have been developed in other countries, they cannot be applied without confirming their relevance in a Swedish context.

    Objectives:

    To describe and obtain consensus on core competencies required for newly graduated prosthetist/orthotists in Sweden.

    Study design:

    Modified Delphi process.

    Methods:

    A modified Delphi technique was carried out. Focus groups were initially used to identify core competency domains. Two consecutive questionnaires, containing a list of potential competency items, were sent to a group of stakeholders with ties to the prosthetic and orthotic profession. Stakeholders were requested to rate their level of agreement with each competency item and provide written comments. Finally, two focus groups were conducted to obtain feedback on the draft competency standards.

    Results:

    Forty-four competency items, listed under five key domains of practice, were identified as essential for newly graduated prosthetist/orthotists in Sweden.

    Conclusions:

    Many similarities exist in core competency descriptions for prosthetist/orthotists in Sweden when compared to other countries. Regional differences do however exist, and it is important to confirm the relevance of core competency items at a national level before they are applied.

    Clinical relevance

    Competency standards developed in this study can be used to guide development of learning objectives within an undergraduate prosthetic and orthotic program, provide a framework for workforce development, assist professional organizations in understanding the needs of their members, and prepare for international accreditation.

  • 20.
    Rusaw, David
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics. Institute for Clinical Sciences, Department of Orthopaedics, University of Gothenburg, Sweden.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Motion-analysis studies of transtibial prosthesis users: a systematic review2011In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 35, no 1, p. 8-19Article in journal (Refereed)
    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.

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