Conventional transcutaneous electrical nerve stimulation(cTENS),which uses a modulated square waveform as stimuli,has been generally used in testing and eliciting artificial tactile perception in forearm amputees.Howe...Conventional transcutaneous electrical nerve stimulation(cTENS),which uses a modulated square waveform as stimuli,has been generally used in testing and eliciting artificial tactile perception in forearm amputees.However,a novel neuromorphic TENS(nTENS)model based on neural signals has been largely ignored.In this study,we further explore the effect of nTENS patterns to elicit tactile perception in forearm amputees.Four forearm amputees were recruited to test discriminate tactile perception elicited by different TENS patterns with electroencephalography(EEG)recording at the following four stimulated sites:the index finger and the little finger on both phantom and real sides.Finally,we compared the results of cortical networks in six frequency bands at different stimulated sites between forearm amputees and able-bodied subjects.Behavioral results suggested that n TENS patterns required a lower electric charge at each stimulated site than cTENS patterns.And forearm amputees required a higher intensity in each TENS pattern than able-bodied subjects.Moreover,amputees showed a lower clustering coefficient(aCP),global efficiency(aEG),local efficiency(aEL),and a longer path length(aLP)than able-bodied subjects in all six frequency bands when stimulation was accessed.Specifically,the SMU pattern showed a higher functional network efficiency in real fingers than at phantom sites in theta,alpha,and high gamma bands.This study highlighted the characteristics of n TENS patterns in eliciting tactile perception among forearm amputees,which provided insights into evaluating the neural mechanism of tactile information processing in forearm amputees and building tactile perceptual systems for sensory rehabilitation.展开更多
The prevalence of limb amputation is increasing globally as a devastating experience that can physically and psychologically affect the lifestyle of a person. The residual limb pain and phantom limb pain are common di...The prevalence of limb amputation is increasing globally as a devastating experience that can physically and psychologically affect the lifestyle of a person. The residual limb pain and phantom limb pain are common disabling sequelae after amputation surgery. Assistive devices/technologies can be used to relieve pain in people with amputation. The existing assistive devices/technologies for pain management in people with amputation include electrical nerve block devices/technologies, TENS units, elastomeric pumps and catheters, residual limb covers, laser systems, myoelectric prostheses and virtual reality systems, etc. There is a great potential to design, fabricate, and manufacture some portable, wireless, smart, and thin devices/technologies to stimulate the spinal cord or peripheral nerves by electrical, thermal, mechanical, and pharmaceutical stimulus. Although some preliminary efforts have been done, more attention must be paid by researchers, clinicians, designers, engineers, and manufacturers to the post amputation pain and its treatment methods.展开更多
Shoulder disarticulation amputees account for a small portion of upper-limb amputees,thus little emphasis has been devoted to developing functional prosthesis for this cohort of amputees.In this study,shoulder girdle ...Shoulder disarticulation amputees account for a small portion of upper-limb amputees,thus little emphasis has been devoted to developing functional prosthesis for this cohort of amputees.In this study,shoulder girdle recognition was investigated with acquired data from electrophysiological(electromyography[EMG])and low frequency contraction(accelerometer[Acc])signals from both amputee and non-amputee participants.The contribution of this study is based around the contrast of the classification accuracy(CA)for different sensor configurations using a unique set of signal features.It was seen that the fusion of the EMG-Acc produced an enhancement in the CA in the range of 10%-20%,depending on which windowing parameters were considered.From this,it was seen that the best combination of a windowing scheme and classifier would likely be for the 350 ms and spectral regression discriminant analysis,with a fusion of the EMG-Acc information.The results have thus provided evidence that the two sensors can be combined and used in practice for prosthesis control.Taking a holistic view on the study,the authors conclude by providing a framework on how the shoulder motion recognition could be combined with neuromuscular reprogramming to contribute towards easing the cognitive burden of amputees during the prosthesis control process.展开更多
AIM: To present an inclusion criterion for patients who have suffered bilateral amputation in order to be treated with the supplementary resuscitation treatment which is hereby proposed by the author.METHODS: This wor...AIM: To present an inclusion criterion for patients who have suffered bilateral amputation in order to be treated with the supplementary resuscitation treatment which is hereby proposed by the author.METHODS: This work is based on a Retrospective Cohort model so that a certainly lethal risk to the control group is avoided.RESULTS: This paper presents a hypothesis on acupunctural PC-9 Zhong chong point, further supported by previous statistical work recorded for the K-1 Yong quan resuscitation point.CONCLUSION: Thanks to the application of the resuscitation maneuver herein proposed on the previously mentioned point, patients with bilateral amputation would have another alternative treatment available in case basic and advanced CPR should fail.展开更多
In this review intended for medical staff involved in patient rehabilitation,we provided an overview of the basic methods for managing amputation stumps.After the amputation surgery,it is imperative to optimize the re...In this review intended for medical staff involved in patient rehabilitation,we provided an overview of the basic methods for managing amputation stumps.After the amputation surgery,it is imperative to optimize the remaining physical abilities of the amputee through rehabilitation processes,including postoperative rehabilitation,desensitization,and continuous application of soft or rigid dressings for pain reduction and shaping of the stump.Depending on the situation,a prosthesis may be worn in the early stage of recovery or an immediate postoperative prosthesis may be applied to promote stump maturation.Subsequently,to maintain the range of motion of the stump and to prevent deformation,the remaining portion of the limb should be positioned to prevent contracture.Continuous exercises should also be performed to improve muscle strength to ensure that the amputee is able to perform activities of daily living,independently.Additionally,clean wound or edema management of the stump is necessary to prevent problems associated with wearing the prosthesis.Our review is expected to contribute to the establishment of basic protocols that will be useful for stump management from the time of completion of amputation surgery to the fitting of a prosthesis to optimize patient recovery.展开更多
Nursing plays an important part in the rehabilitation of residual limbs and the utilization of artificial limbs after the attack of the earthquake,which also prevent and reduce the damage severity,supplement and impro...Nursing plays an important part in the rehabilitation of residual limbs and the utilization of artificial limbs after the attack of the earthquake,which also prevent and reduce the damage severity,supplement and improve functional state,increase quality of life and strengthen the social life participating capacity of the amputees. According to the Guiding Principles for Adaptation and Utilization of Common Assistive Devices for Injury of the Wounded in Earthquake [1]compiled jointly by CDPF and Ministry of Health,to further promote the development of scientific work for rehabilitation of the wounded in the earthquake,improve the whole level and efficacy of medical remedy and rehabilitation,and maximally reduce the severity of disability,this study mainly interpreted the precautions to the post-amputation nursing for residual limbs of the wounded,hoping to provide reference for medical staff who will receive patients for amputation to implement rehabilitation therapy.展开更多
Despite recent controversy, it is not yet formally recognised how lower-limb prosthesis should be assessed for their performance. To assist in this process, experiments are undertaken to investigate the linearity, sti...Despite recent controversy, it is not yet formally recognised how lower-limb prosthesis should be assessed for their performance. To assist in this process, experiments are undertaken to investigate the linearity, stiffness and assessment of feet based energy return prosthesis technology typically used for elite level high speed running. Through initial investigations, it is concluded that static load testing would not be recommended to specify or regulate energy return prostheses for athletes with a lower-limb amputation. Furthermore, an assessment of energy return technology when loaded under dynamic conditions demonstrates changes in mechanical stiffness due to bending and effective blade length variation during motion. Such radical changes of boundary conditions due to loading suggest that any assessment of lower-limb prosthesis technology in the future should use methods that do not assume linear mechanical stiffness. The research into such effects warrants further investigation in the future.展开更多
Altered biomechanics due to amputation can contribute to substantial limitations,influencing sporting activities.Individuals with lower extremity amputations or congenital lower limb deficiency are encouraged to parti...Altered biomechanics due to amputation can contribute to substantial limitations,influencing sporting activities.Individuals with lower extremity amputations or congenital lower limb deficiency are encouraged to participate in para-sports.However,to compete in Paralympic sports,the candidate must have an impairment that results in lower extremity loss of function and meets or exceeds the sport's minimum impairment criteria(MIC).This review will focus on the MIC for competitive wheelchair tennis.Limb deficiency is known as one of the MIC used to regulate participation in competitive para-sports since it impacts gait,kinematics,and biomechanics of both the upper and lower body.Notwithstanding,it is questionable whether the MIC concerning limb deficiency is set at the correct level for determining eligibility for participating in Paralympic sports.This study aims to provide an overview of the evidence examining the impact of different partial foot amputation(PFA)levels on gait as a proxy for sporting performance.This scoping review will be based on a 6-step methodological framework and Preferred Reporting Items for Systematic Reviews and Meta-Analysis,extension for scoping reviews(PRISMA-ScR).Studies will be selected from PubMed,Embase,CINAHL,and SPORTDiscus.Two authors will screen the titles/abstracts independently.Selected studies will be scrutinised,and the same authors will extract data.Findings will be relevant to informing the evidence-based development of MIC for lower limb impairment after PFA and may be extrapolated to specific Paralympic sports,including wheelchair tennis.Results will be disseminated through scientific publications and conferences to audiences interested in Paralympic sports.展开更多
Intracapsular fractures of the proximal femur are one of the most common fractures of the lower limbs. Most cases require osteosynthesis with suitable implants, and intraoperative positioning of the patient on the fra...Intracapsular fractures of the proximal femur are one of the most common fractures of the lower limbs. Most cases require osteosynthesis with suitable implants, and intraoperative positioning of the patient on the fracture table is a prerequisite to facilitate fracture manipulation, traction, reduction and fluoroscopy assessment. However, positioning the limbs of bilateral above-knee amputees for internal fixation of related proximal femoral fractures is a difficult task, which requires customized inventory for effective limb positioning and fracture manipulation. This study reported a rare case following a crush injury of bilateral lower limb in a road traffic accident, and described some technical tips of acute femoral neck fractures in bilateral above-knee amputation. The patient was managed with immediate guillotine amputation and later secondary wound closure followed by internal fixation of the right-sided femoral neck fracture with multiple cancellous cannulated screws.展开更多
基金supported by the National Key R&D Program of China(Grant No.2018YFB1307301)。
文摘Conventional transcutaneous electrical nerve stimulation(cTENS),which uses a modulated square waveform as stimuli,has been generally used in testing and eliciting artificial tactile perception in forearm amputees.However,a novel neuromorphic TENS(nTENS)model based on neural signals has been largely ignored.In this study,we further explore the effect of nTENS patterns to elicit tactile perception in forearm amputees.Four forearm amputees were recruited to test discriminate tactile perception elicited by different TENS patterns with electroencephalography(EEG)recording at the following four stimulated sites:the index finger and the little finger on both phantom and real sides.Finally,we compared the results of cortical networks in six frequency bands at different stimulated sites between forearm amputees and able-bodied subjects.Behavioral results suggested that n TENS patterns required a lower electric charge at each stimulated site than cTENS patterns.And forearm amputees required a higher intensity in each TENS pattern than able-bodied subjects.Moreover,amputees showed a lower clustering coefficient(aCP),global efficiency(aEG),local efficiency(aEL),and a longer path length(aLP)than able-bodied subjects in all six frequency bands when stimulation was accessed.Specifically,the SMU pattern showed a higher functional network efficiency in real fingers than at phantom sites in theta,alpha,and high gamma bands.This study highlighted the characteristics of n TENS patterns in eliciting tactile perception among forearm amputees,which provided insights into evaluating the neural mechanism of tactile information processing in forearm amputees and building tactile perceptual systems for sensory rehabilitation.
基金supported by the Janbazan Medical and Engineering Research Center(JMERC).
文摘The prevalence of limb amputation is increasing globally as a devastating experience that can physically and psychologically affect the lifestyle of a person. The residual limb pain and phantom limb pain are common disabling sequelae after amputation surgery. Assistive devices/technologies can be used to relieve pain in people with amputation. The existing assistive devices/technologies for pain management in people with amputation include electrical nerve block devices/technologies, TENS units, elastomeric pumps and catheters, residual limb covers, laser systems, myoelectric prostheses and virtual reality systems, etc. There is a great potential to design, fabricate, and manufacture some portable, wireless, smart, and thin devices/technologies to stimulate the spinal cord or peripheral nerves by electrical, thermal, mechanical, and pharmaceutical stimulus. Although some preliminary efforts have been done, more attention must be paid by researchers, clinicians, designers, engineers, and manufacturers to the post amputation pain and its treatment methods.
文摘Shoulder disarticulation amputees account for a small portion of upper-limb amputees,thus little emphasis has been devoted to developing functional prosthesis for this cohort of amputees.In this study,shoulder girdle recognition was investigated with acquired data from electrophysiological(electromyography[EMG])and low frequency contraction(accelerometer[Acc])signals from both amputee and non-amputee participants.The contribution of this study is based around the contrast of the classification accuracy(CA)for different sensor configurations using a unique set of signal features.It was seen that the fusion of the EMG-Acc produced an enhancement in the CA in the range of 10%-20%,depending on which windowing parameters were considered.From this,it was seen that the best combination of a windowing scheme and classifier would likely be for the 350 ms and spectral regression discriminant analysis,with a fusion of the EMG-Acc information.The results have thus provided evidence that the two sensors can be combined and used in practice for prosthesis control.Taking a holistic view on the study,the authors conclude by providing a framework on how the shoulder motion recognition could be combined with neuromuscular reprogramming to contribute towards easing the cognitive burden of amputees during the prosthesis control process.
文摘AIM: To present an inclusion criterion for patients who have suffered bilateral amputation in order to be treated with the supplementary resuscitation treatment which is hereby proposed by the author.METHODS: This work is based on a Retrospective Cohort model so that a certainly lethal risk to the control group is avoided.RESULTS: This paper presents a hypothesis on acupunctural PC-9 Zhong chong point, further supported by previous statistical work recorded for the K-1 Yong quan resuscitation point.CONCLUSION: Thanks to the application of the resuscitation maneuver herein proposed on the previously mentioned point, patients with bilateral amputation would have another alternative treatment available in case basic and advanced CPR should fail.
基金Supported by the National Research Foundation of Korea Grant funded by the Korean government,No.NRF2021R1A2C1013073.
文摘In this review intended for medical staff involved in patient rehabilitation,we provided an overview of the basic methods for managing amputation stumps.After the amputation surgery,it is imperative to optimize the remaining physical abilities of the amputee through rehabilitation processes,including postoperative rehabilitation,desensitization,and continuous application of soft or rigid dressings for pain reduction and shaping of the stump.Depending on the situation,a prosthesis may be worn in the early stage of recovery or an immediate postoperative prosthesis may be applied to promote stump maturation.Subsequently,to maintain the range of motion of the stump and to prevent deformation,the remaining portion of the limb should be positioned to prevent contracture.Continuous exercises should also be performed to improve muscle strength to ensure that the amputee is able to perform activities of daily living,independently.Additionally,clean wound or edema management of the stump is necessary to prevent problems associated with wearing the prosthesis.Our review is expected to contribute to the establishment of basic protocols that will be useful for stump management from the time of completion of amputation surgery to the fitting of a prosthesis to optimize patient recovery.
文摘Nursing plays an important part in the rehabilitation of residual limbs and the utilization of artificial limbs after the attack of the earthquake,which also prevent and reduce the damage severity,supplement and improve functional state,increase quality of life and strengthen the social life participating capacity of the amputees. According to the Guiding Principles for Adaptation and Utilization of Common Assistive Devices for Injury of the Wounded in Earthquake [1]compiled jointly by CDPF and Ministry of Health,to further promote the development of scientific work for rehabilitation of the wounded in the earthquake,improve the whole level and efficacy of medical remedy and rehabilitation,and maximally reduce the severity of disability,this study mainly interpreted the precautions to the post-amputation nursing for residual limbs of the wounded,hoping to provide reference for medical staff who will receive patients for amputation to implement rehabilitation therapy.
文摘Despite recent controversy, it is not yet formally recognised how lower-limb prosthesis should be assessed for their performance. To assist in this process, experiments are undertaken to investigate the linearity, stiffness and assessment of feet based energy return prosthesis technology typically used for elite level high speed running. Through initial investigations, it is concluded that static load testing would not be recommended to specify or regulate energy return prostheses for athletes with a lower-limb amputation. Furthermore, an assessment of energy return technology when loaded under dynamic conditions demonstrates changes in mechanical stiffness due to bending and effective blade length variation during motion. Such radical changes of boundary conditions due to loading suggest that any assessment of lower-limb prosthesis technology in the future should use methods that do not assume linear mechanical stiffness. The research into such effects warrants further investigation in the future.
文摘Altered biomechanics due to amputation can contribute to substantial limitations,influencing sporting activities.Individuals with lower extremity amputations or congenital lower limb deficiency are encouraged to participate in para-sports.However,to compete in Paralympic sports,the candidate must have an impairment that results in lower extremity loss of function and meets or exceeds the sport's minimum impairment criteria(MIC).This review will focus on the MIC for competitive wheelchair tennis.Limb deficiency is known as one of the MIC used to regulate participation in competitive para-sports since it impacts gait,kinematics,and biomechanics of both the upper and lower body.Notwithstanding,it is questionable whether the MIC concerning limb deficiency is set at the correct level for determining eligibility for participating in Paralympic sports.This study aims to provide an overview of the evidence examining the impact of different partial foot amputation(PFA)levels on gait as a proxy for sporting performance.This scoping review will be based on a 6-step methodological framework and Preferred Reporting Items for Systematic Reviews and Meta-Analysis,extension for scoping reviews(PRISMA-ScR).Studies will be selected from PubMed,Embase,CINAHL,and SPORTDiscus.Two authors will screen the titles/abstracts independently.Selected studies will be scrutinised,and the same authors will extract data.Findings will be relevant to informing the evidence-based development of MIC for lower limb impairment after PFA and may be extrapolated to specific Paralympic sports,including wheelchair tennis.Results will be disseminated through scientific publications and conferences to audiences interested in Paralympic sports.
文摘Intracapsular fractures of the proximal femur are one of the most common fractures of the lower limbs. Most cases require osteosynthesis with suitable implants, and intraoperative positioning of the patient on the fracture table is a prerequisite to facilitate fracture manipulation, traction, reduction and fluoroscopy assessment. However, positioning the limbs of bilateral above-knee amputees for internal fixation of related proximal femoral fractures is a difficult task, which requires customized inventory for effective limb positioning and fracture manipulation. This study reported a rare case following a crush injury of bilateral lower limb in a road traffic accident, and described some technical tips of acute femoral neck fractures in bilateral above-knee amputation. The patient was managed with immediate guillotine amputation and later secondary wound closure followed by internal fixation of the right-sided femoral neck fracture with multiple cancellous cannulated screws.
