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  • 1.
    Anderson, Sarah
    et al.
    School of Allied Health, Human Services, and Sport, La Trobe University, Melbourne, Australia.
    Barnett, Cleveland T.
    School of Science and Technology, Nottingham Trent University, Nottingham, U.K..
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Celebrating 50 years of the International Society for Prosthetics and Orthotics: Past, present, and future2020In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 44, no 6, p. 365-367Article in journal (Other academic)
  • 2.
    Anderson, Sarah
    et al.
    School of Allied Health, Human Services, and Sport, La Trobe University, Melbourne, VIC, Australia.
    Barnett, Cleveland T.School of Science and Technology, Nottingham Trent University, Nottingham, UK.Rusaw, DavidJönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Editorial Special Issue: ISPO 50th Anniversary: Prosthetics and Orthotics International, Volume 44 Issue 6, December 20202020Collection (editor) (Other academic)
  • 3.
    Anderson, Sarah P.
    et al.
    School of Allied Health Human Services and Sport, La Trobe University, Australia.
    Barnett, Cleveland T.
    School of Science and Technology, Nottingham Trent University, UK.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Exploring the perspectives of prosthetic and orthotic users: Past and present experiences and insights for the future2022In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 44, no 18, p. 5284-5290Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this work was to qualitatively explore the personal perspectives of prosthetic and orthotic users, in the context of their past and present experiences and understand their insights for the future.

    Materials and Methods: A narrative exploration study design employing a phenomenological approach was used. Semi-structured interviews were conducted with three female and two male prosthetic and orthotic users from Australia and the United Kingdom. Interviews were analysed, coded and key themes and sub-themes identified. 

    Results: Three themes were identified. The Maximising Opportunity theme linked sub-themes of recreation and pushing boundaries.  The Health Care Network theme included sub-themes of communication, peer support and building a team. The final theme, Changes over time, included sub-themes of disability perception, advice and advancements over time. 

    Conclusion: Prosthetic and orthotic users identified there had been vast changes in disability perception, disability rights, and their role in the health care system, along with the variety of technology and materials available. Key findings were that prosthetic and orthotic users want to be listened to, considered central to the health care team, and had a deep understanding of their own health care needs.

  • 4. Barnett, C. T.
    et al.
    Vanicek, N.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    A longitudinal analysis of the relationships between postural control, falls efficacy and falling in unilateral transtibial prosthesis users2017Conference paper (Refereed)
  • 5.
    Barnett, Cleveland
    et al.
    Nottingham Trent University, Nottingham, United Kingdom.
    Miller, Bill
    University of British Columbia, Vancouver, Canada.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Anderson, Sarah
    La Trobe University, Melbourne, Australia.
    Dhariwal, Aditya
    The University of British Columbia, Vancouver, Canada.
    Balance and postural control of people with lower limb amputations: Perspectives from an interdisciplinary group of professionals2023In: ISPO 19th World Congress, 24-27 April 2023, Guadalajara, Mexico – Abstract book, Wolters Kluwer, 2023, Vol. 47 (Suppl.), no Suppl. 1, p. 39-39Conference paper (Refereed)
    Abstract [en]

    Balance, postural control and issues related to falling and the fear of falling are major problems for people with leg amputations. Structural changes after an amputation that affect balance and postural control include asymmetry of limb length. The inability to actively control posture via an intact foot and ankle complex on the affected side as well as altered sensory input may affect postural control. Such changes can be considered intrinsic factors as these are specific to the individual. Prosthetic restrictions that attempt to mitigate the above intrinsic limitations can be considered extrinsic factors. These intrinsic and extrinsic factors interact to determine an individual’s balance which is a key determinant of their likelihood of falling and/or fear of falling.

    The aim of this symposium is to bring together representatives from a variety of related fields relevant to lower limb amputation to provide a holistic view of the topic and future directions.

    As a basis for the symposium, the progress and current results of a scoping review to summarise the current state of research in balance and postural control will be presented. Based on this, we aim to explore future directions in both clinical care and research. The review will be summarised in two categories: intrinsic factors (person/patient-related) and extrinsic factors (prosthesis/environment).

    We will also provide additional viewpoints from a variety of perspectives, highlighting the interdisciplinary nature of this issue. These include practical aspects of physical therapy, balance and self-confidence and biomechanics, among others.

    Statement of the objective / learning objectivesThe aim of the symposium is to communicate the different approaches to research on this topic, in addition to the issues arising in clinical practice. Participants are be encouraged to join in the discussion. 

  • 6.
    Barnett, Cleveland T.
    et al.
    Nottingham Trent University, Nottingham, U.K. .
    Vanicek, Natalie
    University of Hull, Hull, U.K. .
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Do predictive relationships exist between postural control and falls efficacy in unilateral transtibial prosthesis users?2018In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 99, no 11, p. 2271-2278Article in journal (Refereed)
    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.

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  • 7.
    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)
  • 8.
    Bergman, Paula
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Department of Public Health and Healthcare, Region Jönköpings län, Jönköping, Sweden.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Bülow, Pia H.
    Jönköping University, School of Health and Welfare, HHJ, Department of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Department of Social Work, University of the Free State, Bloemfontein, South Africa.
    Skillmark, Mikael
    Jönköping University, School of Health and Welfare, HHJ, Department of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Jansson, Inger
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Effects of arts on prescription for persons with common mental disorders and/or musculoskeletal pain: A controlled study with 12 months follow-up2023In: Cogent Public Health, E-ISSN 2770-7571, Vol. 10, no 1, article id 2234631Article in journal (Refereed)
    Abstract [en]

    Aims: Involvement in arts has shown potential to promote mental health. Thus, arts may be able to complement conventional healthcare to address common mental disorders (CMD). The aim of this study was to evaluate the long-term effect of a 10-week Arts on Prescription program regarding CMD (stress, anxiety, depression), compared to conventional healthcare. The study also aimed to examine whether CMD differed between groups.

    Methods: A quasi-experimental prospective design with intervention and control group and 6- and 12-month follow-up was used to evaluate an Arts on Prescription program in Sweden, focusing on the effects on stress, anxiety, and depression. Participants were on sick leave due to CMD and/or musculoskeletal pain. Data was collected using questionnaires.

    Results: The study population consisted of 479 participants (n=247 intervention group, n=232 control group). The result indicates a greater effect size (ŋ) in the intervention group compared to the control group for reduction in stress, anxiety, and depression at follow-up after 12 months. The difference in depression was significant.

    Conclusions: The results indicate AoP could be an adjunct to conventional healthcare interventions to address CMD, especially depression.

  • 9.
    Burrola-Mendez, Yohali
    et al.
    School of Rehabilitation, Université de Montréal, Montréal, Canada; CHU Sainte-Justine Research Centre, Montréal, Canada.
    Kamalakannan, Sureshkumar
    Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom; Public Health Foundation of India, Institute of Public Health, Hyderabad, India.
    Rushton, Paula W
    School of Rehabilitation, Université de Montréal, Montréal, Canada; CHU Sainte-Justine Research Centre, Montréal, Canada.
    Bouziane, Selsabil-A
    School of Rehabilitation, Université de Montréal, Montréal, Canada.
    Giesbrecht, Ed
    Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Manitoba, Canada.
    Kirby, R. Lee
    Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada.
    Gowran, Rosemary J.
    School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Health Implementation Science and Technology, University of Limerick, Limerick, Ireland; Assisting Living and Learning (ALL) Institute Maynooth University, Maynooth, Ireland.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Tasiemski, Tomasz
    Department of Adapted Physical Activity, Poznan University of Physical Education, Poznan, Poland.
    Goldberg, Mary
    Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA.
    Tofani, Marco
    Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
    Pedersen, Jessica P.
    Department of Physical Medicine, Northwestern University, Evanston, IL, USA.
    Pearlman, Jon
    Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA.
    Wheelchair service provision education for healthcare professional students, healthcare personnel and educators across low- to high-resourced settings: a scoping review2023In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 18, no 1, p. 67-88Article, review/survey (Refereed)
    Abstract [en]

    PURPOSE: This review aimed to collate and summarize available research literature about wheelchair service provision education available to healthcare professional students, healthcare personnel and educators across low- to high-resourced settings.

    METHODS: The Joanna Briggs Institute methodological steps for scoping reviews were followed. Included studies were mainly sourced from Medline, Embase, CINAHL, Scopus, Academic Search Complete and ProQuest. Independent title, abstract and full-text screening with defined inclusion and exclusion criteria was performed. All screening and extraction were performed independently by two authors. A thematic approach was used to synthesize results. Data extracted from included studies were charted according to a template that we created. The study quality was also appraised.

    RESULTS: A total of 25 articles were included (11, 36% from high-income settings) with 12 (48%) observational studies and 13 (52%) experimental studies. The literature addressed three main topics: (1) assessing wheelchair service provision knowledge, (2) implementing training interventions using in-person, online and/or hybrid learning approaches and (3) describing current wheelchair service provision education globally. The most frequently reported training programs used were the Wheelchair Skills Program and the World Health Organization Wheelchair Service Training Package - Basic Level.

    CONCLUSION: Limited information has been published about the integration of wheelchair content into the curricula of professional rehabilitation programs. Efforts to build international partnerships, improve the quality and currency of training programs and build resources that can assist educators in the integration of wheelchair-related content into professional rehabilitation programs should be prioritized.Implications for RehabilitationThis is the first review that examined and synthesized the current state of wheelchair service provision education for rehabilitation students and personnel across low- to high-income countries.Findings from this review indicate that there is limited information about the integration of wheelchair-related content into professional rehabilitation programs.Efforts to build international partnerships, standardize wheelchair service provision content and evaluation and integrate training into professional rehabilitation programs worldwide should be prioritized.

  • 10.
    Cochrane, Helen
    et al.
    University of Pittsburgh, USA.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Mullen, Ashley
    Baylor College of Medicine, Houston, USA.
    Spaulding, Sue
    University of Washington, USA.
    Brinkman, John
    Northwestern University, Chicago, USA.
    Evidence-based practice in education for prosthetic orthotic occupations2023In: ISPO 19th World Congress, 24-27 April 2023, Guadalajara, Mexico – Abstract book, Wolters Kluwer, 2023, Vol. 47 (Suppl.), no Suppl. 1, p. 48-48Conference paper (Refereed)
    Abstract [en]

    This symposium aims to present the current state of evidence-based practice in education for prosthetic orthotic occupations. Presenters will share the current evidence, best practices and ongoing development of a research plan for prosthetic orthotic educators.

    The symposium will follow on from the Global Educators Meeting (GEM) in June 2022 the symposium will present the findings of the educator focus groups held during the GEM and discuss the educators survey.

    Presented by educators aimed at educators this symposium offers an opportunity to learn, contribute and discuss how to get the most out of educational time.

    The objective of this symposium are to help educators in prosthetic orthotic occupations;

    • become more aware of the current evidence, best practices and the work currently ongoing to advance the evidence base for teaching in the field.
    • cultivate collaborations among educator peers.
    • develop and diversify educational practices to stimulate an effective learning environment.

    Statement of the objective/learning objectivesThe objectives of this symposium are to help educators in prosthetic orthotic occupations;

    • become more aware of the current evidence, best practices and the evidence base
    • cultivate collaborations
    • develop and diversify educational practices
  • 11.
    Fors, Nils Olov
    et al.
    Kanda University of International Studies, Chiba, Japan.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Languaged education: Developing language-conscious pedagogy for an undergraduate English-taught program at a Swedish university2021Conference paper (Refereed)
  • 12.
    Heitzmann, Daniel Walter Werner
    et al.
    University Hospital Heidelberg.
    Barnett, Cleveland T.
    Nottingham Trent University.
    Berli, Martin
    University of Zürich, Switzerland.
    Johansson, Paola
    Jönköping University, The University Library.
    Miller, William
    University of British Columbia.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Scheepers, Lisan
    Össur hf, Reykjavik, Iceland.
    Dhariwal, Aditya
    University of British Columbia.
    Balance and postural control of people with a lower-limb amputation: a systematic review of the influence of intrinsic and extrinsic factors [protocol]2022Other (Other academic)
    Abstract [en]

    Review question: What are the research outcomes and methodologies that focus on issues specifically related to either (a) theindividual (intrinsic) and/or (b) factor surrounding the individual (extrinsic)?

    Aim - To identify the foci ofresearch addressing issues related to balance, fear of falling and falls in prosthesis users. 

  • 13.
    Hellstrand Tang, Ulla
    et al.
    Göteborgs universitet.
    Jarl, Gustav
    Örebro universitet.
    Eriksson, Marie
    TeamOlmed, Stockholm.
    Johannesson, Anton
    TeamOlmed, Stockholm.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Kliniska riktlinjer som innefattar ortopedtekniska lösningar i Sverige2022Conference paper (Other academic)
  • 14.
    Hellstrand Tang, Ulla
    et al.
    Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Jarl, Gustav
    Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Eriksson, Marie
    Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
    Johannesson, G. Anton
    Össur Clinics Scandinavia, Stockholm, Sweden.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Clinical guidelines recommending prosthetics and orthotics in Sweden: agreement between national and regional guidelines2023In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553Article in journal (Refereed)
    Abstract [en]

    Background and purpose: Despite the presence of both national and regional clinical practical guidelines (CPGs) in Sweden, no previous studies have investigated the quality of CPGs or the level of agreement between national and regional CPGs. This study aimed to examine the quality of national CPGs recommending prosthetics and orthotics (P&O), and; quantify agreement between national and regional CPGs in Sweden.

    Materials and Methods: National and regional CPGs were identified in public databases and by surveyed local Nurse Practitioners. Quality of the national guidelines was assessed by using AGREE II. Agreement between recommendations in the national and regional CPGs were quantified on a four-grade rating scale ("similar", "partially similar", "not similar/not present" and "different").

    Results: Of 18 national CPGs, three CPGs (CPGs of Diabetes, Musculoskeletal disorders and Stroke) had nine recommendations related to P&O. The Musculoskeletal disorders and Stroke CPGs had quality scores >60% in all domains and the Diabetes CPG had scores >60% in five out of six domains according to AGREE II. Seven regional CPGs for P&O treatment were identified. Three national recommendations (in Diabetes CPG) showed "similar" content for all regions and two national recommendations (in Diabetes CPG) showed "not similar" content for all regions. The remaining four national recommendations (in Diabetes, Musculoskeletal disorders and Stroke CPGs) had varying agreement with regional CPGs.

    Interpretation: There is a limited number of national recommendations for treatment within P&O. There was variation in the agreement of P&O-related recommendations in national and regional CPGs, which might lead to unequal care throughout the national healthcare system.

  • 15.
    Hill, Sophie
    et al.
    Oslo Metropolitan University.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Goihl, Tobias
    Helse Midt-Norge, Trondheim, Norway. & Trøndelag Ortopediske Verksted.
    Hjerman, Anne Katrine
    Drammen Ortopediskse Institutt, Drammen, Norway. .
    Reed Schwannborg, Linn
    Oslo Metropolitan University & Sophies Minde, Oslo, Norway.
    Bauger, Krister
    Oslo Metropolitan University.
    Developing National Curriculum Guidelines: An Appropriateness-Based Approach2019Conference paper (Refereed)
    Abstract [en]

    BACKGROUND

    In 2017, the Norwegian Ministry of Education and Research began work on a project to develop national curriculum guidelines for all health and social care education programmes at Bachelor level and above. The guidelines will consist of a statement of purpose, learning outcomes and guidance on the structure of the programme. Whilst curriculum guidance exists for many professions and disciplines, there is little written about its development.

    AIM

    To develop national guidelines for prosthetics and orthotics education using an appropriateness-based approach.

    METHOD

    A modified RAND/UCLA method was used to gather information and rank appropriateness of developed learning outcomes. Collaboration with stakeholders was important and information was gathered from various professional and user organisations. Programme outlines (if available in English) from ISPO category 1 accredited programmes, together with those from northern European countries were also gathered.

    RESULTS

    A total of 23 programmes were invited to provide their programme documents or were accessible online. 11 programme documents were obtained and - without programme level outcomes - were excluded (n=4). Information was obtained via email, online discussion and focus groups from various organisations. The data were collated and organised into different competency areas. From this data 126 learning outcomes were developed and organised into an online questionnaire. All participants who had attended the focus groups and development group members rated the appropriateness of the learning outcome and its competence area. A further focus group and development meeting was held where results were discussed, and the learning outcomes reduced to 51. After drafting of the remaining sections, the document was sent out for consultation. Feedback from the consultation was collated and the guidelines adjusted as necessary.

    DISCUSSION AND CONCLUSION

    In comparison to existing programme learning outcomes from the documents obtained, there is a considerable difference in the number of learning outcomes. There are country specific differences that need to be accounted for when developing national guidelines. However, the development of national curriculum guidelines using an appropriateness-based approach ensured both a national and international focus.

  • 16.
    Hill, Sophie
    et al.
    Oslo Metropolitan University, Oslo, Norway.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Goihl, Tobias
    Helse Midt-Norge, Trondheim, Norway.
    Hjerman, Anne Katrine
    Drammen Ortopediske Institutt, Drammen, Norway.
    Schwannborg, Linn Reed
    Oslo Metropolitan University, Oslo, Norway.
    Bauge, Krister
    Oslo Metropolitan University, Oslo, Norway.
    Development of national curriculum guidelines using a modified RAND/UCLA Appropriateness Method2020In: Quality in Higher Education, ISSN 1353-8322, E-ISSN 1470-1081, Vol. 26, no 3, p. 323-336Article in journal (Refereed)
    Abstract [en]

    In 2017, the Norwegian Ministry of Education and Research implemented a project to develop curriculum guidelines for all health and social care programmes. The modified RAND/UCLA appropriateness method used by the group developing guidelines for programmes in prosthetics and orthotics is described. The method resulted in 126 learning outcomes that were condensed into 48, encompassed within eight competency areas. This number is greater than the number of learning outcomes found in most existing syllabi but comparable to those found in similar work carried out internationally. The article suggests that the RAND/UCLA appropriateness method is a suitable method to deploy in the development of curriculum guidelines.

  • 17.
    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 1746-1553, Vol. 43, no 5, p. 556-563Article, 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.

  • 18.
    Jarl, Gustav
    et al.
    Örebro universitet.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Eriksson, Marie
    TeamOlmed, Stockholm.
    Hellstrand Tang, Ulla
    Göteborgs universitet.
    Johannesson, Anton
    TeamOlmed, Stockholm.
    Regionala variationer i egenavgifter2022Conference paper (Other academic)
  • 19.
    Jarl, Gustav
    et al.
    Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Johannesson, Anton
    International Organization for Standardization, Convenor ISO/TC 168, WG1; Össur Clinics Scandinavia, Stockholm, Sweden.
    Comment on van Netten, et al.: Definitions and criteria for diabetic foot disease2020In: Endocrinology, Diabetes & Metabolism, E-ISSN 2398-9238, Vol. 3, no 3, article id e00142Article in journal (Refereed)
    Abstract [en]

    Objective

    The International Working Group on the Diabetic Foot (IWGDF) recently published updated definitions for the diabetic foot field. However, the suggested definitions of lower limb amputations differ from the definitions of the International Organization of Standardization (ISO), which may create problems when implementing the definitions. This paper compares and discusses the amputation definitions of IWGDF and ISO.

    Results

    Despite many similarities, the IWGDF and ISO systems have some important differences. First, the IWGDF uses the term “minor amputation” which is value‐laden, arbitrary and has been defined in several different ways in the literature. Second, the IWGDF system lacks descriptions of amputations distal or through the ankle, which may increase the risk for misclassification. Third, hip disarticulations and transpelvic amputations are not included in the IWGDF system.

    Conclusion

    It is suggested that future updates of the IWGDF definitions should be aligned with those of ISO, to meet the goal of global consensus on terminology related to lower limb amputation.

  • 20.
    Jarl, Gustav
    et al.
    Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Terrill, Alexander J.
    School of Mechanical, Medical and Process Engineering, Queensland University of Technology (QUT), Brisbane, QLD, Australia; Centre for Biomedical Technologies, Queensland University of Technology (QUT), Brisbane, QLD, Australia; Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia.
    Barnett, Cleveland T.
    School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom.
    Woodruff, Maria A.
    School of Mechanical, Medical and Process Engineering, Queensland University of Technology (QUT), Brisbane, QLD, Australia; Centre for Biomedical Technologies, Queensland University of Technology (QUT), Brisbane, QLD, Australia.
    Lazzarini, Peter A.
    School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Australia.
    Personalized offloading treatments for healing plantar diabetic foot ulcers2023In: Journal of Diabetes Science and Technology, E-ISSN 1932-2968, Vol. 17, no 1, p. 99-106Article in journal (Refereed)
    Abstract [en]

    Background: Non-removable knee-high devices are the gold-standard offloading treatments to heal plantar diabetic footulcers (DFUs). These devices are underused in practice for a variety of reasons. Recommending these devices for all patients,regardless of their circumstances and preferences influencing their ability to tolerate the devices, does not seem a fruitfulapproach.

    Purpose: The aim of this article is to explore the potential implications of a more personalized approach to offloading DFUsand suggest avenues for future research and development.

    Methods: Non-removable knee-high devices effectively heal plantar DFUs by reducing plantar pressure and shear at theDFU, reducing weight-bearing activity and enforcing high adherence. We propose that future offloading devices shouldbe developed that aim to optimize these mechanisms according to each individual’s needs. We suggest three differentapproaches may be developed to achieve such personalized offloading treatment. First, we suggest modular devices, wheredifferent mechanical features (rocker-bottom sole, knee-high cast walls/struts, etc.) can be added or removed from thedevice to accommodate different patients’ needs and the evolving needs of the patient throughout the treatment period. Second, advanced manufacturing techniques and novel materials could be used to personalize the design of their devices,thereby improving common hindrances to their use, such as devices being heavy, bulky, and hot. Third, sensors could be usedto provide real-time feedback to patients and clinicians on plantar pressures, shear, weight-bearing activity, and adherence.

    Conclusions: By the use of these approaches, we could provide patients with personalized devices to optimize plantartissue stress, thereby improving clinical outcomes.

  • 21.
    Johansson, Robin
    et al.
    Jönköping University, School of Health and Welfare.
    Jensen, Louise
    Jönköping University, School of Health and Welfare. Southern Älvsborg Hospital, Borås, Sweden.
    Barnett, Cleveland T.
    School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Quantitative methods used to evaluate balance, postural control and the fear of falling in lower limb prosthesis users: A systematic review2023In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 47, no 6, p. 586-598Article, review/survey (Refereed)
    Abstract [en]

    Problems with balance, postural control and fear of falling are highly prevalent in lower limb prosthesis users, with much research conducted to understand these issues. The variety of tools used to assess these concepts presents a challenge when interpreting research outcomes. This systematic review aimed to provide a synthesis of quantifiable methods used in the evaluation of balance, postural control and fear of falling in lower limb prosthesis users with an amputation level at or proximal to the ankle joint. A systematic search was conducted in CINAHL, Medline, AMED, Cochrane, Ageline, Scopus, Web of Science, Proquest, PsychINFO, PsycArticles and PubPsych databases followed by additional manual searching via reference lists in the reviewed articles databases. Included articles utilized quantitative measure of balance or postural control as one of the dependent variables, lower limb prosthesis users as a sample group, were published in a peer-reviewed journal in English. Relevant assessment questions were created by the investigators to rate the assessment methods used in the individual studies. Descriptive and summary statistics are utilized to synthesize the results. The search yielded (n=187) articles assessing balance or postural control (n=5487 persons in total) and (n=66) articles assessing fear of falling or balance confidence (n=7325 persons in total). A large number of studies did not present if the chosen methods were valid and reliable for the lower limb prosthesis users. Among study limitations, small sample size was common.

  • 22.
    Kamalakannan, Sureshkumar
    et al.
    Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom; Public Health Foundation of India, Institute of Public Health, Hyderabad, India.
    Rushton, Paula W.
    School of Rehabilitation, Université de Montréal, Montréal, Canada; CHU Sainte-Justine Research Centre, Montréal, Canada.
    Giesbrecht, Ed
    Department of Occupational Therapy, University of Manitoba, Winnipeg, Canada.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Bouziane, Selsabil-A.
    School of Rehabilitation, Université de Montréal, Montréal, Canada.
    Nadeau, Melodie
    Department of Biology, University of Concordia, Montréal, Canada.
    McKee, Jennifer
    School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
    Gowran, Rosemary J.
    School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Health Implementation Science and Technology, University of Limerick, Limerick, Ireland.
    Kirby, R. Lee
    Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada.
    Pedersen, Jessica P.
    Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
    Tasiemski, Tomasz
    Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań,Poland.
    Burrola-Mendez, Yohali
    Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, USA; Consejo Nacional de Ciencia y Tecnología (CONACyT), Ciudad de México, México.
    Tofanin, Marco
    Consejo Nacional de Ciencia y Tecnología (CONACyT), Ciudad de México, México; Neurorehabilitation Unit, Department of Neurosciences and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy.
    Goldberg, Mary
    International Society of Wheelchair Professionals, Pittsburgh, PA, USA; Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, PA, USA.
    Pearlman, Jon
    Department of Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, USA.
    Wheelchair service provision education for healthcare professional students, healthcare personnel and educators across low- to high-resourced settings: a scoping review protocol2023In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 18, no 3, p. 343-349Article, review/survey (Refereed)
    Abstract [en]

    Purpose

    Appropriate wheelchair provision is necessary for addressing participation barriers experienced by individuals with mobility impairments. Health care professionals involved in the wheelchair service provision process require a specific set of skills and knowledge to enable wheelchair use that meets individual posture, mobility and daily living requirements. However, inconsistencies exist in academic programmes globally about providing comprehensive education and training programmes. The planned scoping review aims to review and synthesize the global literature on wheelchair service provision education for healthcare professional students, healthcare personnel and educators offered by universities, organizations and industries.

    Methods

    This scoping review will be guided by the Joanna Briggs Institute (JBI) methodological framework. Comprehensive literature searches will be conducted on various global electronic databases on health to seek out how wheelchair service provision education is organized, integrated, implemented and evaluated. Two independent reviewers will perform eligibility decisions and key data extractions. Data from selected studies will be extracted and analysed using conventional content analysis. Information related to wheelchair service provision education including curriculum development, content, teaching methods, evaluation and models of integration will be synthesized.

    Implications and dissemination

    The planned scoping review will be the first to examine all aspects of wheelchair service provision education across professionals, settings and countries. We anticipate that results will inform the content of a Wheelchair Educators’ Package, and if appropriate, a follow-up systematic review. An article reporting the results of the scoping review will be submitted for publication to a scientific journal.

    Implications for Rehabilitation

    • A comprehensive examination of wheelchair service provision education could help develop strategies to address the unmet need for wheelchair services globally.
    • Findings for this review will facilitate the planning and development of an evidence-based education package that could bridge the existing knowledge gaps related to safe and effective wheelchair service provision among health professionals involved.
    • This review will also inform the potential barriers and enablers for effective integration and implementation of wheelchair service provision education worldwide.
  • 23.
    Möller, Saffran
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Hagberg, Kerstin
    Advanced Reconstruction of Extremities, Sahlgrenska University Hospital.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Can Microprocessor-Controlled Prosthetic Knees Reduce Attentional Demand during Single and Dual-task Walking?2019Conference paper (Refereed)
    Abstract [en]

    BACKGROUND

    Walking with a lower-limb prosthesis while performing a secondary task (dual-tasking) has been suggested to increase demand on attentional resources, negatively affecting balance and gait performance.[1, 2] Brain imaging research has suggested that microprocessor-controlled prosthetic knees (MPKs) reduce attentional demands during single-task walking.[3] To date the effects of MPK on brain activity during dual-task walking has not been investigated.

    AIM

    To evaluate effects of single- and dual-task walking on cortical brain activity in individuals using a non-MPK or MPK and controls and compare differences between the 3 groups.

    METHOD

    A cross-sectional study was performed involving twenty-nine individuals with a transfemoral amputation or knee disarticulation who were provided with either a non-MPK or an MPK, and 16 controls. Functional near-infrared spectroscopy was used to evaluate cortical brain activity (oxygenated haemoglobin (oxyHb) concentration level changes) while participants walked on a stable level surface and simultanously performed 2 dual-task activities; 1) walking while sorting through keys; and, 2) walking in sequence around randomly number cones. Temporospatial variables was recorded for each activity.

    RESULTS

    Increased brain activity (oxyHb concentration level changes) were observed when a secondary task was added in the MPK-group (p=.000) and in the control group (p=.007). No significant differences were observed between single- and dual-task walking in the non-MPK group (p>.05). Significantly increased brain activity (oxyHb concentrations level changes) was observed during single-task walking in the non-MPK group when compared to the MPK-group and controls. Significantly different results in temporospatial parameters were also observed.

    DISCUSSION AND CONCLUSION

    Results suggest that dual-task walking increases cognitive demand in individuals fitted with MPKs and controls. The lack of difference with the non-MPK group may suggests that their maximum capacity was already reached during single-task walking.

    REFERENCES

    [1] Morgan, Prosthet Orthot Int 2016. [2] Nagamatsu, Psychol Aging 2011. [3] Möller, Prosthet Orthot Int 2018.

    ACKNOWLEDGEMENTS

    Thanks to Jette Schack, Evin Güler, Vera Kooiman, Lamija Pasalic, Promobilia Foundation, ALF/LUA Research Grants, Össur and Team Olmed.

  • 24.
    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.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Hagberg, Kerstin
    Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Cortical brain activity in transfemoral or knee-disarticulation prosthesis users performing single and dual-task walking activities2020In: Journal of Rehabilitation and Assistive Technologies Engineering, E-ISSN 2055-6683, Vol. 7, article id 2055668320964109Article in journal (Refereed)
    Abstract [en]

    Introduction: Walking with a prosthesis while performing secondary tasks increases demand on cognitive resources, compromising balance and gait. This study investigated effects of a secondary task on patterns of brain activity and temporospatial gait parameters in individuals using a prosthesis with or without a microprocessor-controlled prosthetic knee(MPK) and controls.Methods: A cross-sectional study with repeated measures was performed. Twenty-nine individuals with amputations and 16 controls were recruited. Functional near-infrared spectroscopy was used to evaluate changes in oxygenated and de-oxygenated haemoglobin in the prefrontal cortex and temporospatial variables during single-and dual-task walking.Results: Differences in brain activity were observed within the MPK-group and controls without changes in temporospatial parameters. The Trail-Walking test was associated with highest levels of brain activity in both groups. No differences were observed between single- and dual-task walking in the non-MPK-group (p > 0.05). The Non-MPK and the MPK-group recorded higher levels of brain activity than controls during single-task walking and poorer results on temporospatial variables compared to controls.Conclusions: For the MPK-group and controls, introduction of a secondary task led to an increase in brain activity. This was not seen in the Non-MPK-group. Significant differences in brain activity were observed in the absence of changes in temporospatial parameters.

  • 25.
    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.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Hagberg, Kerstin
    Department of Prosthetics and Orthotics, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Differences in mobility for individuals using a non-microprocessor-controlled versus a microprocessor-controlled prosthetic kneeManuscript (preprint) (Other academic)
  • 26.
    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.

  • 27.
    Nylander, Elisabeth
    et al.
    Jönköping University, The University Library.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Hjort, Margareta
    Jönköping University, The University Library.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Development and validation of a sensitive MEDLINE search strategy to identify literature relevant to limb prostheses2021In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 45, no 3, p. 289-294Article in journal (Refereed)
    Abstract [en]

    Background: Researchers and clinicians may find it challenging to identify relevant articles about limb prostheses in online databases. Searches may be improved by using standardized strategies, also known as filters or hedges.

    Objectives: To develop and validate a highly sensitive MEDLINE (EBSCOHost) search strategy for limb prostheses.

    Study Design: Search strategy development/validation.

    Methods: A gold standard (GS) list of peer-reviewed articles on the topic of limb prostheses was created using a relative recall method. This involved identifying and including relevant systematic reviews/meta-analyses and then adding articles that were included in the analysis section of these reviews. Possible terms for the search strategy were identified through brainstorming and exploration of medical subject headings in MEDLINE (MeSH) and standards from the International Organization for Standardization (ISO). Concepts were grouped using relevant Boolean operators (e.g. AND and OR) and database record search fields (i.e. MeSH terms, title, and abstract). Part of the GS was used to refine the search strategy and reduce the number of records retrieved in total. The remaining GS set was used to validate and calculate sensitivity of the search strategy. Performance of the search strategy was compared against searches using only relevant MeSH terms.

    Results: After screening, the final GS totaled 853 records. The developed search strategy was highly sensitive (99.80%) and performed with higher relative recall than searches with relevant MeSH terms.

    Conclusions: This study provides a highly sensitive search strategy that can be used by clinicians and researchers when searching for relevant literature on limb prostheses in MEDLINE (EBSCOHost).

  • 28.
    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.

  • 29.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Gjøvaag, T.
    Starholmen, I.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Effects of knee orthosis design on proprioception and balance2017Conference paper (Refereed)
  • 30.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Gjøvaag, Terje
    Oslo Metropolitan University, Norway.
    Starholm, Inger Marie
    Oslo Metropolitan University, Norway.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Effects of knee orthoses on kinesthetic awareness and balance in healthy individuals2019In: Journal of Rehabilitation and Assistive Technologies Engineering, ISSN 2055-6683, Vol. 6Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 31.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Möller, Saffran
    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.
    Transitioning to a microprocessor-controlled prosthetic knee – Executive functioning during single and dual-task gait2020In: Prosthetics and Orthotics International, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 44, no 1, p. 27-35Article in journal (Refereed)
    Abstract [en]

    Background

    Walking with a prosthesis requires substantial concentration on behalf of the user and places increased demands on executive functions. Little is known of the effects that prosthetic knee joint prescription may have on executive functioning.

    Objectives

    Evaluate executive functioning in trans-femoral prosthesis users during single and dual-task walking, before and after they transition to a Microprocessor-controlled prosthetic knee unit.

    Study Design

    Multiple case-study design.

    Methods

    Single and dual task gait was evaluated while recording cortical brain activity. Testing occasion 1 occurred prior to participants receiving their microprocessor-controlled prosthetic knee, while testing occasion 2 was conducted a minimum of 8 months after they had been fitted with an microprocessor-controlled prosthetic knee.

    Results

    During single-task level walking and walking while performing a dual-task key finding test, executive functions, measured as the relative haemodynamic response in the frontal cortex, reduced for most, but not all participants after transitioning to an Microprocessor-controlled prosthetic knee. There did not appear to be any difference when participants performed a trail walk test.

    Conclusions

    Results suggest Microprocessor-controlled prosthetic knee prosthetic knees may have a positive effect on executive functioning for some individuals who have undergone a lower-limb amputation. A larger, longitudinal study with careful control of extraneous variables (e.g. age, training) is needed to confirm results and determine causality.

    Clinical relevance

    This article provides some evidence to suggest that prosthetic prescription may influence executive functioning and that microprocessor-controlled prosthetic knee mechanisms may reduce cognitive effort when walking.

  • 32.
    Ramstrand, Nerrolyn
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Thuesen, Anna Helena
    Nielsen, Dennis Brandborg
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Effects of an unstable shoe construction on balance in women aged over 50 years.2010In: Clinical Biomechanics, ISSN 0268-0033, E-ISSN 1879-1271, Vol. 25, no 5, p. 455-460Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Shoes with an unstable sole construction are commonly used as a therapeutic tool by physiotherapists and are widely available from shoe and sporting goods retailers. The aim of this study was to investigate the effects of using an unstable shoe (Masai Barefoot Technology) on standing balance, reactive balance and stability limits. METHODS: Thirty-one subjects agreed to participate in the study and underwent balance tests on three different occasions. After test occasion one (baseline) 20 subjects received Masai Barefoot Technology shoes and were requested to wear them as much as possible for the remaining eight weeks of the study. Three specific balance tests were administered on each test occasion using a Pro Balance Master (NeuroCom International Inc., Oregon, USA). Tests included; a modified sensory organization test, reactive balance test and limits of stability test. FINDINGS: Subjects in the intervention group significantly improved their performance on elements of all three tests however results on these variables were not demonstrated to be significantly better than the control group. No significant differences were observed across testing occasions in the control group. INTERPRETATION: Results from the present study suggest that, for this group of individuals, use of unstable footwear may improve certain aspects of balance.

  • 33.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Adaptations from the prosthetic and intact limb during standing on a sway referenced support surface for transtibial prosthesis users2019In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 14, no 7, p. 682-691Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate the bilateral postural adaptations as a result of standing on an increasingly unstable sway-referenced support surface with both the intact and prosthetic limb for transtibial prosthesis users (TPUs).

    Method: TPUs (n = 14) and matched controls (n = 14) stood quietly in multiple foot placement conditions (intact foot, prosthetic foot and both feet) on a sway-referenced support surface which matched surface rotation to the movement of the centre of pressure (CoP). Force and motion data were collected and used to analyse CoP mean position, displacement integral and force components under intact and prosthetic limbs.

    Results: Significant differences were found between prosthesis users and controls in CoP mean position in anteroposterior (1.5 (95% CI, 1.2–1.8) cm) and mediolateral directions (3.1 (95% CI, 0.5–5.7) cm. CoP displacement integrals were significantly different greater for prosthesis user group in the anteroposterior direction. Force components differences were found in all planes (anteroposterior: 0.6 (95% CI, 0.4–0.8 N); mediolateral: 0.1 (95% CI, 0.0–0.2 N & 0.3 (95% CI, 0.2–0.4) N, inferosuperior: 2.2 (95% CI, 1.4–3.0) N).

    Conclusions: TPUs have bilateral static and dynamic postural adaptations when standing on a sway-referenced support surface that is different to controls, and between prosthetic and intact sides. Results further support evidence highlighting importance of the intact limb in maintenance of postural control in prosthesis users. Differences indicate clinical treatment should be directed towards improving outcomes on the intact side.

    Implications for rehabilitation:

    • Prosthesis users have bilateral adaptations when standing on a sway referenced support surface

    • These adaptations are different to controls, and between prosthetic and intact sides.

    • The intact limb is the major contributor to maintenance of postural control in prosthesis users.

    • Clinical treatment should account for this when interventions are designed.

  • 34.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    An Iterative Feedback Procedure for Course Evaluation and Structure2018Conference paper (Refereed)
  • 35.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Biomechanical Models of Standing in Prosthetic Users2018Conference paper (Other academic)
  • 36.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Instrumented motion analysis and trans-tibial prosthetics: a systematic review2009Conference paper (Other academic)
  • 37.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Instrumented motion analysis of trans-tibial prosthesis users: a systematic review of data capture and analysis techniques2010In: 13th ISPO World Congress: Abstracts, 2010, p. 969-970Conference paper (Refereed)
  • 38.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Limb prostheses and postural control: evaluation, interaction and functional consequence2015Conference paper (Other academic)
  • 39.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Observational gait analysis: The prosthetic challenges2004Conference paper (Other academic)
  • 40.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Sagittal plane position of the functional joint centre of prosthetic foot-ankle mechanisms2010In: 13th ISPO World Congress: Abstracts, 2010, p. 1257-1258Conference paper (Refereed)
  • 41.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    The effects of liner thickness and suspension technique on knee joint proprioception in trans-tibial amputees2007Conference paper (Refereed)
  • 42.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    The prosthesis and weight-bearing contributions on EMG response latency subsequent to rapid platform perturbation in transtibial prosthesis users2013Conference paper (Refereed)
  • 43.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    The use of vibratory feedback to improve postural stability of individuals with transtibial amputation2013Conference paper (Refereed)
  • 44.
    Rusaw, David
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    The validity of forceplate data as a measure of rapid and targeted volitional movements of the center of mass in transtibial prosthesis users2017In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 12, no 7, p. 686-693Article in journal (Refereed)
    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.

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  • 45.
    Rusaw, David
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Alinder, Rasmus
    Jönköping University, School of Health and Welfare.
    Edholm, Sigurd
    Jönköping University, School of Health and Welfare.
    Hallstedt, Karin L. L.
    Jönköping University, School of Health and Welfare.
    Runesson, Jessica
    Jönköping University, School of Health and Welfare.
    Barnett, Cleveland T.
    School of Science and Technology, Nottingham Trent University, Nottingham, U.K..
    Development of a theoretical model for upright postural control in lower limb prosthesis users2021In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 8263Article in journal (Refereed)
    Abstract [en]

    Methods used to assess quiet standing in unilateral prosthesis users often assume validity of an inverted pendulum model despite this being shown as invalid in some instances. The aim of the current study was to evaluate the validity of a proposed unilaterally-constrained pin-controller model in explaining postural control in unilateral prosthesis users. Prosthesis users were contrasted against the theoretical model as were able-bodied controls that stood on a platform which unilaterally constrained movement of the CoP. All participants completed bouts of quiet standing with eyes open, eyes closed and with feedback on inter-limb weight bearing asymmetry. Correlation coefficients were used to infer inverted pendulum behavior in both the anteroposterior and mediolateral directions and were derived from both kinematic (body attached markers) and kinetic (centre of pressure) experimental data. Larger, negative correlation coefficients reflected better model adherence, whilst low or no correlation reflected poorer model adherence. Inverted pendulum behavior derived from kinematic data, indicated coefficients of high magnitude in both mediolateral (all cases range 0.71–0.78) and anteroposterior (0.88–0.91) directions, irrespective of groups. Inverted pendulum behavior derived from kinetic data in the anteroposterior direction indicated validity of the model with large negative coefficients associated with the unconstrained/intact limbs (prosthesis users: − 0.45 to − 0.65, control group: − 0.43 to − 0.72), small coefficients in constrained/prosthetic limbs (prosthesis users: − 0.02 to 0.07, control group: 0.13–0.26) and large negative coefficients in combined conditions (prosthesis users: − 0.36 to − 0.56, control group: − 0.71 to − 0.82). For the mediolateral direction, coefficients were negligible for individual limbs (0.03–0.17) and moderate to large negative correlations, irrespective of group (− 0.31 to − 0.73). Data suggested both prosthesis users’ and able-bodied individuals’ postural control conforms well to that predicted by a unilaterally-constrained pin-controller model, which has implications for the fundamental control of posture in transtibial prosthesis users.

  • 46.
    Rusaw, David
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Alinder, Rasmus
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Edholm, Sigurd
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Hallstedt, Karin L. L.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Runesson, Jessika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Barnett, Cleveland T.
    School of Science & Technology, Nottingham Trent University, UK.
    Towards a new biomechanical model to explain upright postural control in unilateral transtibial prosthesis users2021Conference paper (Refereed)
    Download full text (pdf)
    Abstract
  • 47.
    Rusaw, David
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Barnett, Cleveland T.
    Nottingham Trent University, School of Science and Technology, Clifton, Nottingham, United Kingdom.
    Lövgren Hallberg, Christina
    Jönköping University, School of Health and Welfare.
    Nilsson, Madeleine
    Jönköping University, School of Health and Welfare.
    Test-retest reliability of the Falls Efficacy Scale International for lower limb prosthesis users2023Conference paper (Refereed)
    Abstract [en]

    Introduction and Objective

    Falling and the fear of falling are major issues for people with lower limb amputation. A number of tools have been developed to assess the fear of falling, these include The Falls Efficacy Scale – International (FES-I). As with any tool, it is important that the validity and reliability of the tool is established for specific target populations. The reliability of the FES-I has been established for multiple patients group. A previous study had established good relative reliability in a small sam- ple of lower limb prosthesis users (ICC = 0.87, 95% CI: 0.70-0.94) (Nugent et al. 2022). However, the current project aimed to evaluate the test-retest reliability and concurrent validity of the FES-I for lower limb prosthesis users with a larger sample. The current abstract outlines the assessment of test-retest reliability of the FES-I.

    Materials and Methods

    Forty lower limb prosthesis users with varying levels of amputation from Sweden (n=27) and England (n=13) completed an online questionnaire, which included the FES-I, on two separate oc- casions, separated by two weeks. Given the data distribution, Spearman’s rank correlation analysis was used to evaluate the test re-test reliability of the FES-I responses between these two occasions.

    Results

    A strong, positive, statistically significant correlation between the two occasions was indicated (rs (25)=0,902, p=< .001). This suggested that there was excellent test re-test reliability for the FES-I in a group of lower limb prosthesis users.

    Conclusions

    The FES-I shows excellent test-retest reliability (rs>.8) for lower limb prosthesis users, and re- searchers interested in utilizing this instrument can be confident in the reliability in this specific group. This is useful information, particularly for those involved in longitudinal assessment of falls efficacy.

  • 48.
    Rusaw, David
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Department of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Goldberg, Mary
    University of Pittsburgh, USA.
    Burrola-Mendez, Yohali
    Université de Montréal, Canada.
    The Wheelchair Educators' Package (WEP): A tool to integrate wheelchair-related content into prosthetics and orthotics curricula2023In: ISPO 19th World Congress, 24-27 April 2023, Guadalajara, Mexico – Abstract book, Wolters Kluwer, 2023, Vol. 47 (Suppl.), no Suppl. 1, p. 76-76Conference paper (Refereed)
    Abstract [en]

    Only 5-15% of the 75 million people worldwide that require a wheelchair to fulfill their human rights have access (WHO, 2018). This lack of access increases inequity and limits the ability for countries to meet their obligations under the United Nations Convention on the Rights of Persons with Disabilities.

    Although lack of access to an appropriate wheelchair is a multifaceted issue, recent evidence highlights limited wheelchair service delivery education in professional rehabilitation programs worldwide. Indeed, only 50% of Prosthetics & Orthotics educational programs. This situation perpetuates a rehabilitation workforce that often lacks the competencies required for comprehensive wheelchair service delivery.

    The WEP was developed as an online, ‘living’ resource to guide educators in the integration of wheelchair content into university health care professional programs and regional training center curricula. Developed by a team of wheelchair provision experts from across professions and settings, the WEP is intended to be applicable worldwide.

    Given the established growing global need for access to appropriate wheelchairs and the expressed focus on educational strategies to increase these competencies in the global prosthetic and orthotics (P&O) community (ISPO Education Standards for Prosthetic/Orthotic Occupations), this course will focus on providing participants with a walk-through of the WEP and with practical examples on how to use it provided by instructors. Additionally, participants will be provided with a supported real-time exploration of the WEP and discussions covering integration within multiple contexts.

    Statement of the objective / learning objectives

    • describe the Wheelchair Educators’ Package (WEP) purpose and content;
    • identify how the WEP can enhance wheelchair education provided within P&O programs;
    • understand how the WEP may be adapted to improve utility within multiple contexts.
  • 49.
    Rusaw, David
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Hagberg, Kerstin
    University of Gothenburg.
    Nolan, Lee
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics. Karolinska Institutet and GIH, Stockholm.
    Bilateral electromyogram response latency following platform perturbation in unilateral transtibial prosthesis users: Influence of weight distribution and limb position2013In: Journal of rehabilitation research and development, ISSN 0748-7711, E-ISSN 1938-1352, Vol. 50, no 4, p. 531-544Article in journal (Refereed)
    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.

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    Bilateral electromyogram response latency following platform perturbation in unilateral transtibial prosthesis users: Influence of weight distribution and limb position
  • 50.
    Rusaw, David
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Hagberg, Kerstin
    Institute for Clinical Sciences, Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Nolan, Lee
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Can vibratory feedback be used to improve postural stability in persons with transtibial limb loss?2012In: Journal of rehabilitation research and development, ISSN 0748-7711, E-ISSN 1938-1352, Vol. 49, no 8, p. 1239-1254Article in journal (Refereed)
    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.

    Download full text (pdf)
    Can vibratory feedback be used to improve postural stability in persons with transtibial limb loss?
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