Advances in prosthetic, orthopedic, and audiologic diagnostic tools
The current issue of the Journal of Rehabilitation Research and Development (JRRD), a publication of Rehabilitation Research and Development Service, Department of Veterans Affairs, includes eight manuscripts that discuss recent advances in diagnostic tools in several fields of rehabilitation medicine, including prosthetics, orthopedics, and audiology. Also in this issue is an important article on the risk of injury to persons with mobility impairments involved in a front-end motor vehicle accident. Below are abstracts of studies featured in Volume 40, Issue 2, of the journal. Full-text manuscripts are available, free of charge, on-line at www.vard.org.
MANUSCRIPTS FEATURED IN VOL. 40, NO. 2
Wheelchair design increases risk of injury in front-end collision, pg. 125 Study used computer simulations to investigate the effect of wheelchair seating design on occupant response and injury risk in front-end collisions. Many people with mobility impairment travel in motor vehicles seated in their wheelchairs. In these cases, the wheelchair serves as a car seat, offering stability and protection to the occupant in a motor vehicle crash. Study data indicated that wheelchair-seating design influenced the risk of submarining or the tendency of the occupant’s pelvis to slip under their lap belt in a front-end crash. Findings will inform wheelchair and seating manufacturers to key design issues in developing transit wheelchairs.
Instrumented glove improves measurement of hand movement pg. 179
Investigators tested the feasibility of using a computerized glove, the Humanglove, to measure fingers’ range of motion (ROM). Data suggest that the Humanglove adequately measures fingers’ ROM. The glove also allows for recording hand movements when performing dynamic functional tasks. Potentially, this technology can help develop more objective methodologies for hand-function assessment and, consequently, improve planning of rehabilitative treatments. The Humanglove is also suitable as an aid for motor or vocally impaired subjects to control devices remotely or translate sign language into text or synthetic speech.
Globe system precision enhances shoulder rehabilitation, pg. 147
Study illustrates the “globe system,” an improved method to describe shoulder positions for physical exams and studies of everyday tasks. In contrast to the commonly used way to describe shoulder positions in terms of degrees of arm elevation, the globe system is a standardized method with direct visualization of the parameters by globe graphs. Angles are visualized as a position on a “globe” around the shoulder joint. Data indicate the globe system provides the most precise description of shoulder positions applicable to clinical practice. A standardized system of description will better define shoulder motions to aid in the evaluation of orthopedic interventions related to the shoulder or to document arm function.
Shock-absorbing prosthesis promotes active lifestyle for persons with amputations, pg. 109
Study investigates the effect of shock absorbing pylons (SAPs) on the gait of persons who walk with below- knee prostheses. SAPs are designed to decrease prosthetic stiffness and provide shock absorption during walking, running, and other high-impact activities in persons with leg amputations. Study data indicated SAPs reduce the magnitude of force that occurred when walking, which was more evident at higher speeds. Questionnaire results revealed that SAPs were generally more comfortable when walking. SAPs may provide significant benefit for transtibial amputees who are active and who routinely walk at moderate to fast speeds.
Novel treatment strategy for knee osteoarthritis rehabilitation, pg. 95
Study explores a strategy to strengthen the muscles around the knees for people with “wear and tear” arthritis of the knees (osteoarthritis), since pain tends to decrease as strength increases. Investigators introduced volunteers to the IsopadTM, a machine that provides the user with continuous and immediate feedback in lights and sounds to make strength training enjoyable. Within the Isopad is a novel force sensor, which is accurate and reliable. Although volunteers who used the Isopad successfully had reduced symptoms, a larger study is needed to test the efficacy of the Isopad as a rehabilitation strategy.
Expanded tinnitus retraining therapy forms aid in uniformly prescribing audiological care, pg. 157
Article presents expanded Tinnitus Retraining Therapy (TRT) forms and provides explanations for each question. TRT is an increasingly popular method for treating patients with severe tinnitus (ringing in the ears). TRT is highly structured, including the use of verbal interview forms to assess patients for treatment and treatment outcomes. Current interview forms are, however, difficult to administer in a standardized manner because of their abbreviated wording. Standardization of TRT training is important because clinical services are inconsistent across VA medical centers. Although the interview forms presented are specific to TRT, they will be useful to audiologists who evaluate any method of tinnitus rehabilitation.
Failure analysis of composite femoral components for hip arthroplasty, pg. 131
Study evaluates fatigue strength of composite hip stem with computer simulations. A numerical methodology was developed to analyze whether a composite hip could withstand the stress placed on it through everyday activities. Methodology was suitable for locating the critical region within the composite femoral component, providing three-dimensional ply-level stress distributions, and predicting damage initiation and propagation efficiently and accurately. The methodology can be used as a design tool for laminated composite implant components to improve their performance and decrease the occurrence of fatigue failure.
Newly developed digitizer advances prosthetics research, pg. 191
Article describes the development of a highly accurate mechanical digitizer for use in prosthetics research. Employing precision controllers, the instrument has far less errors than current commercial digitizers used for socket and cast shape assessment. The new digitizer has application in prosthetics research for the assessment of differences in shapes of sockets and differences in shapes of residuum casts (taken at two different points in time, for example), assessment of socket fabrication systems, and enhancement of prosthetic computer models.
JRRD is a peer-reviewed, scientifically indexed publication covering all rehabilitation research disciplines: neurology, orthopedics, engineering, audiology, ophthalmology and optometry, outcomes, restorative, prosthetics, geriatrics, psychiatrics, and community reintegration. Formerly the Bulletin of Prosthetics Research, JRRD debuted in 1983 to include cross-disciplinary findings in rehabilitation. JRRD accepts original research papers, review articles, as well as clinical and technical commentary from U.S. and international researchers who investigate disability rehabilitation.