scholarly journals CLINICAL OUTCOME OF TRANSFEMORAL DIRECT SOCKET INTERFACE (PART 2)

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Joel Walker ◽  
W. Russ Marable ◽  
Christian Smith ◽  
Benedikt Þorri Sigurjónsson ◽  
Ingi Freyr Atlason ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Outcome ◽  
The United States ◽  
Activity Level ◽  
Residual Limb ◽  
Transtibial Amputation ◽  
Single Visit ◽  
Life Years ◽  
Socket Interface

BACKGROUND: Amputation at the transfemoral (TF) level reduces the rate of successful prosthetic fitting, functional outcome, and quality of life (QoL) compared with transtibial amputation. The TF socket interface is considered the most critical part of the prosthesis, but socket discomfort is still the most common user complaint.  Direct Socket for transfemoral prosthesis users is a novel interface fabrication process where the socket is shaped and laminated directly on the residual limb and delivered in a single visit. OBJECTIVE(S): The aim of this study was to investigate if prosthetic users' quality of life (QoL), comfort, and mobility with a Direct Socket TF interface were comparable to their experience with their previous prostheses. METHODOLOGY: The pre/post design prospective cohort study included 47 subjects. From this cohort, 36 subjects completed the 6-months follow-up (mean age 58 years, 27 males). Outcomes at baseline included EQ-5D-5L®, PLUS-M™, CLASS, ABC, AMPPRO, and TUG. At 6-weeks and 6-months, subjects repeated all measures. Seven Certified Prosthetist (CP) investigators performed observations and data collection at six different sites (from July 2018 to April 2020).  FINDINGS: Results showed significant improvement in all outcome measures for the 36 subjects that completed both 6-weeks and 6-months follow-ups. CLASS sub-scales showed significantly improved stability, suspension, comfort, and socket appearance. Improvement in K-Level and less use of assistive devices were observed with the AMPPRO instrument, indicating improved user mobility and performance. QoL was also increased, as measured in Quality-Adjusted-Life-Years (QALY) from the EQ-5D-5L. CONCLUSION: Evidence from the findings demonstrate that the Direct Socket TF system and procedure can be a good alternative to the traditional method of prosthetic interface delivery. Layman's Abstract After lower limb amputation, the goal for most people is to regain mobility and independence and return to normal daily activities. Typically, people with transfemoral amputation are less likely to receive a prosthesis or fully use a prosthesis as compared to people with transtibial amputation. Moreover, their quality of life is also lower. The Direct Socket TF method is a new way of fabricating a prosthetic socket for users with above-knee amputation, enabling fabrication directly onto the residual limb and delivery of the socket in a single visit. In this study, we wanted to understand how the effect of Direct Socket TF on prosthetic 'user's quality of life, health, mobility level, and balance would compare to their previous prosthesis. This new Direct Socket TF procedure was implemented in six different prosthetic clinics across the United States and used by 36 prosthetic users for six months. Our first article on this study describes increased user satisfaction with their new interface and the single visit service model. This second article on the same clinical investigation documents the significant improvement in outcomes compared to their original interface in terms of quality of life, confidence, mobility, comfort, stability, and activity level. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36065/27923 Direct Socket TF – Summary (YouTube): https://www.youtube.com/watch?v=-fvVFqjgxjo How To Cite: Walker J, Marable W.R, Smith C, Sigurjónsson B.Þ, Atlason I.F, Johannesson G.A. Clinical outcome of transfemoral direct socket interface (part 2). Canadian Prosthetics & Orthotics Journal. 2021;Volume 4, Issue 1, No.6. https://doi.org/10.33137/cpoj.v4i1.36065 Corresponding Author: Anton Johannesson, PhDTeamOlmed, Kistagången 12, 164 40 Kista, Stockholm, Sweden.E-mail:  [email protected]: https://orcid.org/0000-0001-8729-458X

Design, Characterization, and Evaluation of a Dynamic Soft Robotic Prosthetic Socket Interface

2019 ◽  
Author(s):  
Breanna Holmes ◽  
Wenlong Zhang
Keyword(s):  
Quality Of Life ◽  
Lower Limb ◽  
Activity Level ◽  
Future Research ◽  
Residual Limb ◽  
Embedded Sensing ◽  
Prosthetic Socket ◽  
Socket Interface ◽  
Prototype Design

Prosthetic sockets are static interfaces for dynamic residual limbs. As the user’s activity level increases, the volume of the residual limb can decrease by up to 11% and increase by as much as 7% after activity. Currently, volume fluctuation is addressed by adding/removing prosthetic socks to change the profile of the residual limb. However, this is impractical and time consuming. These painful/functional issues demand a prosthetic socket with an adjustable interface that can adapt to the user’s needs. This paper presents a prototype design for a dynamic soft robotic interface which addresses this need. The actuators are adjustable depending on the user’s activity level, and their structure provides targeted compression to the soft tissue which helps to limit movement of the bone relative to the socket. Testing of the prototype demonstrated promising potential for the design with further refinement. Work on embedded sensing and intelligent feedback control should be continued in future research in order to create a viable consumer product which can improve a lower limb amputee’s quality of life.

scholarly journals A study of clinical outcome and patient quality of life in timing of free flap cover in type IIIB open fractures

2019 ◽  
Vol 7 (1) ◽  
pp. 69
Author(s):  
Kamal Kumar Manakchand ◽  
Naveen Narayan ◽  
Shivannaiah Chethan
Keyword(s):  
Quality Of Life ◽  
Clinical Outcome ◽  
Free Flap ◽  
Open Fractures ◽  
Microvascular Reconstruction ◽  
Flap Necrosis ◽  
Type Iiib ◽  
Life Years ◽  
Flap Cover

Background: Open fractures of leg classified under type IIIB, those requiring free flap cover could be done as emergency procedure. The ideal timing has still remained controversial. Although it appears imperative to operate early and reduce length of hospital stay, costs, disability adjusted life years and put the patient back on his feet, our study was necessitated in the context of differing views regarding ideal timing of free flap.Methods: The prospective observational study was conducted for duration of 4 years between October 2015 to September 2019. Patients were taken up for free flap cover after optimization for the major surgery. Details of flap complications and the procedures for salvage were noted. At the end of one year following the injury, patient quality of life (PQOL) was tabulated for all patients.Results: Most common mode of injury was road traffic accidents. Early flaps were done in 28 and primary flaps in 22 patients. One patient had partial flap necrosis while 7 others had sub flap collections and partial flap necrosis. Duration of hospitalization was significantly lower in early flap cover group. PQOL measured with EQ-5D (EuroQol 5D) was significantly higher in the early flap covers.Conclusions: From our study we concluded that timing of free flap cover positively influenced clinical outcome of reduced hospitalization, although there was no relation of timing of free flap to flap or bone complications. The functional outcome measured by PQOL was significantly higher in patients who had microvascular reconstruction early.

Abstract 17655: Cost-effectiveness of Ivabradine as a Treatment for Systolic Chronic Heart Failure in the United States

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Anuraag R Kansal ◽  
Martin Cowie ◽  
Adrian Kielhorn ◽  
Stanimira Krotneva ◽  
Ali Taffazzoli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Effective Treatment ◽  
Cost Effective ◽  
The United States ◽  
Medicare Advantage ◽  
Risk Of Death ◽  
Life Years ◽  
Cost Effective Treatment

Introduction: To compare the long-term clinical, cost and quality of life outcome of ivabradine+ standard of care (SoC) versus SoC and assess the cost-effectiveness of ivabradine as a treatment to systolic chronic HF, a cost effectiveness model was developed from the perspective of US payers. Hypothesis: Ivabradine+SoC is a cost-effective treatment for systolic chronic HF compared to SoC in the US. Methods: A state-transition model was developed modeling the risk of death and HF-, non-HF CV-, and non-CV- related hospitalization and mortality over 10 years in a cohort of patients receiving ivabradine+SoC. As patients experienced more HF and non-HF CV hospitalizations in the model, they were subject to higher future risk of HF and non-HF CV hospitalization and lower quality of life. Hospitalization rates and costs by hospitalization type were taken from US claims data for patients in commercial and Medicare Advantage insurance plans. Mortality, utility inputs, and ivabradine treatment effect were derived from analyses of the pivotal randomized placebo-controlled SHIFT study. Both health and cost outcomes were discounted at 3% per year. One-way and multi-way sensitivity analyses were conducted. Results: In the commercially insured population based on a cost of $4,500 per year for ivabradine, the total costs over 10 years were $355,080 for a patient treated on ivabradine+SoC and $361,516 for a patient on SoC alone. The total lifetime drug cost of ivabradine ($27,201) was more than offset with cost-savings from reduction in hospitalization. Patients on ivabradine+SoC also had better health outcomes with an incremental improvement of 0.21 life-years and 0.24 quality-adjusted life years (QALYs) compared to SoC. Similar incremental health benefit was seen in the Medicare Advantage (0.20 QALYs) population, but the lower cost per hospitalization led to a modest increase in cost ($7,284). The incremental cost-effectiveness ratio was $36,944/QALY in the Medicare Advantage population. Conclusions: The results of this model indicate that ivabradine+SoC may be a less costly and more effective option compared to SoC in the commercial population and a cost-effective treatment option among Medicare Advantage patients.

Quality of Life, Physical Activity Level and Psychological Profile of Nigerians with Serious Mental Illness and Healthy Psychotropic Naive Subjects (Preprint)

2020 ◽  
Author(s):  
Christian Arinze Okonkwo ◽  
Peter Olarenwaju Ibikunle ◽  
Izuchukwu Nwafor ◽  
Andrew Orovwigho
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Activity Level ◽  
Psychological Profile ◽  
Cross Sectional Survey ◽  
Significant Difference ◽  
Apparently Healthy

BACKGROUND Quality of life (QoL), physical activity (PA) level and psychological profile (PF) of patients with serious mental illness have been neglected during patient’s management OBJECTIVE The purpose of this study was to determine the effect of selected psychotropic drugs on the QoL, PA level and PF of patients with serious mental illness METHODS A cross sectional survey involving one hundred and twenty-four subject [62 Serious Mental Illness (SMI) and 62 apparently healthy subjects as control] using purposive and consecutive sampling respectively .Questionnaires for each of the constructs were administered to the participants for data collation. Analysis of the data was done using non parametric inferential statistics of Mann-Whitney U independent test and Spearman’s rho correlation with alpha level set as 0.05. RESULTS Significant difference was recorded in the QoL (p<0.05) of patient with SMI and apparently healthy psychotropic naive participants. There was a significant correlation between the QoL (p<0.05) and PF of participants with SMI. Participants with SMI had significantly lower QoL than apparently healthy psychotropic naive subject. QoL of the healthy psychotropic naive group was better than those of the participants with SMI. Female participants with SMI had higher PA than their male counterparts CONCLUSIONS Psychological profiles of male participants with SMI were lower than male healthy psychotropic naive participants. Clinicians should take precaution to monitor the QoL, PA level and PF because the constructs are relevant in evaluation of treatment outcome.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

2018 ◽  
pp. 220-236
Author(s):  
Elliot Friedman ◽  
Beth LeBreton ◽  
Lindsay Fuzzell ◽  
Elizabeth Wehrpsann
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Outcomes ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Quality Of Life Research ◽  
Increased Risk ◽  
Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

scholarly journals Inquiry Based Stress Reduction (IBSR) Improves Overall Stuttering Experience among Adults Who Stutter: A Randomized Controlled Trial

2021 ◽  
Vol 10 (10) ◽  
pp. 2187
Author(s):  
Omrit Feldman ◽  
Eran Goldstien ◽  
Benjamin Rolnik ◽  
Ariel B. Ganz ◽  
Shahar Lev-Ari
Keyword(s):  
Quality Of Life ◽  
Stress Reduction ◽  
Satisfaction With Life ◽  
Psychological Flexibility ◽  
Well Being ◽  
The United States ◽  
Control Group ◽  
Randomized Controlled ◽  
Adults Who Stutter

Stuttering is a speech disorder that can cause disturbances in the timing and flow of speech. In addition to being a communication disorder, stuttering is often accompanied by a reduction in the quality of life and has impacts on social status, mental well-being, self-acceptance, and the chances of integration into the labor market. The Inquiry Based Stress Reduction (IBSR) program, developed in the United States by Byron Katie in 1986, is the clinical application of “The Work” method (Thework.com) and represents an emerging mindfulness and cognitive-reframing method. IBSR has been demonstrated to improve mental health and well-being in adults and may alleviate psychological and psychosocial symptoms of stuttering. The purpose of this trial was to examine the effect of a 12-week IBSR intervention on the overall stuttering experience and indicators of anxiety, psychological flexibility, and well-being among adults who stutter (AWS). This study was a randomized controlled clinical trial. Participants were randomized to IBSR (n = 28) and control (n = 28) groups. Validated questionnaires of overall stuttering experience (OASES-A), anxiety (STAI), psychological flexibility (PFQ), and satisfaction with life (SWLS) were completed before, after, and one month after the intervention. An intention-to-treat approach was implemented for analysis. Our results show that participants in the IBSR intervention group exhibited a greater improvement in their overall stuttering experience as compared to the control group, as well as in general information on stuttering awareness and perception, reactions to stuttering, communication in daily situations, and quality of life. In addition, we found a greater reduction in anxiety levels and an increase in satisfaction-with-life scores in the IBSR group. These results indicate that IBSR can improve the overall stuttering experience.

scholarly journals SAT0620-HPR INACTIVITY BEHAVIOR AND EXERCISE BARRIERS IN PATIENTS WITH BEHÇET’S DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1270.1-1270
Author(s):  
S. Baglan Yentur ◽  
D. C. Saraç ◽  
N. G. Tore ◽  
F. Sarİ ◽  
N. Atas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Behçet’S Disease ◽  
Physical Activity Level ◽  
Behcet’S Disease ◽  
Behçet's Disease ◽  
Activity Level ◽  
Behcet's Disease ◽  
Exercise Barriers

Background:Behçet’s Disease (BD) is a chronic, inflammatory, rheumatic disease that is characterized by mucocutaneous lesions and can be seen major organ involvement such as eyes, musculoskeletal system, gastrointestinal system and central nervous system. Impaired quality of life, aerobic capacity, respiratory function and life satisfaction, sleep disorders, depression, anxiety and fatigue are seen commonly in BD patients like the other rheumatic diseases. Considering that regular physical activity effects survival for patients and healthy people, it is important to determine the factors affecting physical activity level and exercise barriers.Objectives:The aim of this study is to investigate physical activity level and exercise barriers in patients with BD.Methods:45 patients were included in the study. Physical activity level, exercise barriers, fatigue, depression, pain, quality of life and aerobic capacity were evaluated with International Physical Activity Questionnaire (IPAQ), Exercise Barriers and Benefits Scale (EBBS), Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), Visual Analog Scale (VAS), Behçet’s Disease Quality of Life Questionnaire (BDQoL) and 6 minutes walk test, respectively. Spaerman’s Correlation Coefficient were used to investigate the relationships between exercise barriers and other parameters.Results:IPAQ demonstrated that 22 (48.8%) of the patients had low level physical activitiy. Additionally, physical activity levels significantly correlated with both exercise barriers (rho= -0.345) and exercise benefits (rho= 0.320) (p<0.05). BDQoL scores also correlated significantly with exercise barrier scores (rho= 0.338), (p<0.05). No significant relationships were observed for other parameters.Conclusion:Exercise and physical activity are of great importance because of its positive contribution to the musculoskeletal system for BD patients’ rehabilitation. Thinking of negative effects of physical inactivity, patients with Behçet disease should be encouraged to exercise. Also, reasons of physical inactivity should be investigated and treated.References:[1]Ilhan B, Can M, Alibaz-Oner F, Yilmaz-Oner S, Polat-Korkmaz O, Ozen G et al. Fatigue in patients with Behcet’s syndrome: relationship with quality of life, depression, anxiety, disability and disease activity. International journal of rheumatic diseases. 2018;21(12):2139-45.[2]Alder NM, Fisher M, Yazici Y. Behçet’s syndrome patients have high levels of functional disability, fatigue and pain as measured by a Multi-dimensional Health Assessment Questionnaire (MDHAQ). Clin Exp Rheumatol. 2008;26(Suppl 50):S110-3.Disclosure of Interests:None declared

A Review of Studies of the Association of Vision-Related Quality of Life with Measures of Visual Function and Structure in Patients with Glaucoma in the United States

2021 ◽  
Vol 28 (3) ◽  
pp. 265-276
Author(s):  
Naira Khachatryan ◽  
Maxwell Pistilli ◽  
Maureen G. Maguire ◽  
Angela Y. Chang ◽  
Marissa R. Samuels ◽  
...  
Keyword(s):  
Quality Of Life ◽  
United States ◽  
Visual Function ◽  
The United States ◽  
Related Quality
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