Traumatic amputations remain one of the most frequent and disturbing wounds of armed conflict.In this scenario,most amputees develop residual and phantom limb pain,impacting their quality of life.There are several ele...Traumatic amputations remain one of the most frequent and disturbing wounds of armed conflict.In this scenario,most amputees develop residual and phantom limb pain,impacting their quality of life.There are several elective surgical procedures available for both conditions,such as neuroma excision followed by nerve reconstruction,nerve relocation,e.g.,surgically implanting a transected nerve into a muscle,nerve transfers in cases of associated paralysis,and most recently,regenerative peripheral nerve interface surgery.Whenever possible in the post-conflict phase,a coordinated effort between traveling humanitarian surgeons specializing in reconstructive microsurgery and local healthcare providers is essential for successfully treating phantom and chronic residual limb pain in post-conflict amputees.While providing a detailed logistical framework for global humanitarian missions is beyond the scope of this article,we provide a brief perspective on a topic of utmost importance for reconstructive surgeons worldwide:the high-quality care and treatment of refugees and those whose lives have been impacted by conflict,disaster,or displacement.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
目的系统评价非创伤性下肢截肢患者生活的真实体验和感受。方法计算机检索PubMed、Cochrane Library、Embase、Web of Science、CINAHL、PsycINFO、中国知网、万方数据库、维普数据库、中国生物医学文献数据库关于非创伤性下肢截肢患者...目的系统评价非创伤性下肢截肢患者生活的真实体验和感受。方法计算机检索PubMed、Cochrane Library、Embase、Web of Science、CINAHL、PsycINFO、中国知网、万方数据库、维普数据库、中国生物医学文献数据库关于非创伤性下肢截肢患者生活体验的质性研究,检索时限为建库至2022年8月。采用澳大利亚乔安娜布里格斯研究所循证卫生保健中心质性研究质量评价标准进行文献质量评价,采用汇集性整合方法对结果进行归纳和整合。结果共纳入11项研究,提炼出43个结果,综合为3个整合结果。整合结果1:面临多重压力与挑战,打破生活常态。整合结果2:存在多维度未满足需求。整合结果3:采取不同的策略应对截肢事件。结论护理人员应识别和关注患者的负性心理,联合患者可获得的支持,减少患者未满足的需求,减轻向家庭过渡的压力,以促进患者重新融入并恢复正常社会生活。展开更多
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
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
本研究通过Meta分析探讨运动处方是否可以显著提升截肢者生活质量和运动表现。在PubMed、Web of Science、Scopus和OVID等数据库中进行文献检索,并对数据进行合并分析发现,截肢者实施为其定制的运动处方后,生活质量明显提升,信心增强,...本研究通过Meta分析探讨运动处方是否可以显著提升截肢者生活质量和运动表现。在PubMed、Web of Science、Scopus和OVID等数据库中进行文献检索,并对数据进行合并分析发现,截肢者实施为其定制的运动处方后,生活质量明显提升,信心增强,疼痛程度降低,最大摄氧量、无氧阈值均显著提升,双侧腿部及髋、膝关节肌力显著增强,灵活性以及柔韧性均有所改善,2分钟步行距离有效增加。因此,量身定制的运动处方可显著提升截肢者生活质量并改善其运动表现。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
文摘Traumatic amputations remain one of the most frequent and disturbing wounds of armed conflict.In this scenario,most amputees develop residual and phantom limb pain,impacting their quality of life.There are several elective surgical procedures available for both conditions,such as neuroma excision followed by nerve reconstruction,nerve relocation,e.g.,surgically implanting a transected nerve into a muscle,nerve transfers in cases of associated paralysis,and most recently,regenerative peripheral nerve interface surgery.Whenever possible in the post-conflict phase,a coordinated effort between traveling humanitarian surgeons specializing in reconstructive microsurgery and local healthcare providers is essential for successfully treating phantom and chronic residual limb pain in post-conflict amputees.While providing a detailed logistical framework for global humanitarian missions is beyond the scope of this article,we provide a brief perspective on a topic of utmost importance for reconstructive surgeons worldwide:the high-quality care and treatment of refugees and those whose lives have been impacted by conflict,disaster,or displacement.
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.
文摘目的系统评价非创伤性下肢截肢患者生活的真实体验和感受。方法计算机检索PubMed、Cochrane Library、Embase、Web of Science、CINAHL、PsycINFO、中国知网、万方数据库、维普数据库、中国生物医学文献数据库关于非创伤性下肢截肢患者生活体验的质性研究,检索时限为建库至2022年8月。采用澳大利亚乔安娜布里格斯研究所循证卫生保健中心质性研究质量评价标准进行文献质量评价,采用汇集性整合方法对结果进行归纳和整合。结果共纳入11项研究,提炼出43个结果,综合为3个整合结果。整合结果1:面临多重压力与挑战,打破生活常态。整合结果2:存在多维度未满足需求。整合结果3:采取不同的策略应对截肢事件。结论护理人员应识别和关注患者的负性心理,联合患者可获得的支持,减少患者未满足的需求,减轻向家庭过渡的压力,以促进患者重新融入并恢复正常社会生活。
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.
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.
文摘本研究通过Meta分析探讨运动处方是否可以显著提升截肢者生活质量和运动表现。在PubMed、Web of Science、Scopus和OVID等数据库中进行文献检索,并对数据进行合并分析发现,截肢者实施为其定制的运动处方后,生活质量明显提升,信心增强,疼痛程度降低,最大摄氧量、无氧阈值均显著提升,双侧腿部及髋、膝关节肌力显著增强,灵活性以及柔韧性均有所改善,2分钟步行距离有效增加。因此,量身定制的运动处方可显著提升截肢者生活质量并改善其运动表现。
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.
