LAS VEGAS — Four finalists of the award-winning Thranhardt Lecture Series presented their “best of the show” studies at the 2017 American Orthotic & Prosthetic Association World Congress.
“This lecture series is made possible by a gift J.E. Hanger in memory of Howard R. Thranhardt, who lives in our memory as one of the great leaders of the orthotic and prosthetic profession,” Thomas V. DiBello, CO, LO, FAAOP, director of scientific affairs for Hanger Clinic, said during his introduction of the presentations. A panel of experts will select two winners, who will be announced during the general session on the last day of the congress. Each winning presenter will receive $500.
Among the four Thranhardt presenters is Michael Wininger, PhD, of the University of Hartford in Connecticut, who introduced the concept of the “homologue,” or a lifelike prosthetic that “looks like me” from the perspective of the patient. His study examined whether 32 individuals with intact limbs would select an image of their own hand vs. another “reasonable” hand when asked to identify the hand they found to be the most aesthetically pleasing. According to Wininger, the study found moderate preference for homologues, with no significant difference found between genders or when results were stratified by social anxiety score.
“We found that for some people, the homologue is important. For others, it is not so important; but they do have narrow interests in what they want to see as their most aesthetically pleasing hand,” he said.
Andrea Giovanni Cutti, PhD, a finalist from the INAIL Prostheses Centre in Vigorso di Budrio in Italy, presented a study on whether there are typical values for temporal gait symmetry and loading of lower knee amputees and whether such patients tend to overload their sound side. The researchers followed 63 patients in a single, specialized prosthetic and rehabilitation clinic.
According to Giovanni, perfect symmetry was rarely achieved, but patients with the C-leg and ESAR feet should expect better symmetry and fewer related comorbidities. Symmetry often depends on the level of amputation and components, he added.
Thranhardt finalist Michael C. Ryan, PhD, director of research and development at Kiwi Orthotic Services, presented a multi-clinic study of 6,658 patients. The study tested the efficacy of foot orthoses and used evidence-based medicine. Researchers analyzed electronic records from 10 pedorthic clinics in the greater Vancouver area from January 2016 to August 2017. They recorded 3,990 follow-up outcomes.
“About 12% rated themselves has completely recovered with no pain and another 32% said they are much improved, so I would combine these and say about 44% that would rate themselves as clinical successes for custom foot orthoses,” Ryan said. “Another 37% rated themselves as having some improvement, with 15% reporting no change and about 3% saying they were worse.”
Finalist Shenan Hoppe-Ludwig, CPO, of the Max Näder Lab for Rehabilitation Technologies and Research at the Shirley Ryan AbilityLab, presented a study that evaluated the potential for a microprocessor-controlled orthosis to improve functional mobility in patients with lower extremity impairments compared to stance-control orthoses and conventional knee ankle foot orthoses. Researchers analyzed data from 18 patients, with a mean of 28.44 years of predicate brace use. According to Hoppe-Ludwig, technology continues to enhance the performance of orthotics and assistive devices.
“C-brace may improve users’ experience by increasing activity, community mobility via reduction in falls, increased walking speed, endurance and balance, and easing difficulty in stairs, ramps and uneven surfaces,” she said. “These results demonstrate greater safety over stance-control orthoses and conventional knee ankle foot orthoses.” – by Jason Laday
Cutti AG, et al. Reference values for temporal gait and loading symmetry of lower-limb amputees can help in refocusing rehabilitation targets.
Hoppe-Ludwig S, et al. The micro-processor controlled orthosis: What is the impact to the user versus the stance control orthosis and conventional knee ankle foot orthosis?
Ryan MC, et al. Do foot orthoses work?
Wininger M, et al. Introducing the prosthetic homologue for embodiment.
All presented at: American Orthotic & Prosthetic Association World Congress; Sept. 6-9, 2017; Las Vegas.
Disclosures: Hoppe-Ludwig reports that her research was funded by Ottobock and the Shirley Ryan AbilityLab. Ryan reports employment with Kiwi Orthotic Services. Cutti and Wininger report no relevant financial disclosures.