Moisture Mitigation Using Perforated Liner and Socket System For Individuals with Trans-Femoral Amputation
Presenter: Surya C. Gnyawali, MPhil, PhD
Perspiration and sweat build-up remain a major challenge that reduces the quality of life for people with amputations. Current prosthetic gel liners are primarily made of occlusive materials and sockets are usually closed structures. These liner-socket systems retain heat resulting in sweating of the residual limb. The sweat build-up in the skin-liner interface may result in the liner sliding off on the skin thereby affecting prosthesis suspension. Inappropriate suspension can cause shear forces, which can lead to skin breakdown compromising residual limb health, and may cause a physical accident by prosthesis failure in their daily activity. Because of sweat accumulation between, there is a likelihood of colonization of bacterial and limb infection.
To address these issues, Gnyawali will describe development of a vented suspension solution wherein relative humidity and temperature data were collected from vented and non-vented liner-socket systems. The objective was to evaluate the reduction in relative humidity during increased perspiration conditions and evaluate the perceived stability, suspension, and comfort from both vented and non-vented solutions.
The increased perspiration condition was achieved by allowing the patient to walk on a treadmill in a humid environment and collect data before and after the activity. The data was processed in terms of relative percent humidity as a function of time and of the humidity-time curve. The perceived sweat, comfort, stability, and socket fit response was evaluated from the patient’s perspective. The presentation will discuss how the vented liner and socket solution significantly reduced humidity in the skin-liner interface that was perceived by users.
The Coffee Task: An Assessment of Multi-Grip Upper Limb Prosthetic Performance
Presenters: Deanna Gates, PhD, and Alicia Davis, MPA, CPO, FAAOP
First introduced 15 years ago, there are now multiple commercially available multigrip prostheses. There are also several different control approaches to enable the person to change their grip. Unfortunately, there are currently no standardized outcome measures that quantify the ability to change grips. In this session, the presenters will describe the development of a functional assessment called the Coffee Task (CT). The CT is a bilateral activity of daily living, during which individuals simulate brewing a cup of coffee in a pod-style coffee maker using three functional grasps (fist, pinch, and point) and five grasp transitions.
There are two versions of the task. In the segmented CT, participants are given up to five attempts to complete all parts of the task. During the continuous CT, individuals complete the task as fast as possible, with a maximum of 2.5 minutes. The outcomes are number of errors and completion time, respectively.
For the research and findings being described in the presentation, 11 people without limb loss completed both versions of the CT and the Box and Block Test before and after training. They completed the task first with their intact limbs (continuous only), and then with a prosthetic emulator on their right limb. Two independent raters assessed the CT outcomes using video recordings.
Potentially Inappropriate Medication Use Among Adults with Lower-Limb Loss: A Beers Criteria-Based Study
Presenters: Samantha Jeanne Stauffer, CPO, MSOP, and Jaclyn Megan Sions, PT, DPT, PhD
As we age, the body undergoes significant changes—some of which affect its ability to metabolize medications, meaning we may need to keep a closer eye on the medications our older patients use. This has led to the development of the American Geriatrics Society Beers Criteria list, which identifies potentially inappropriate medications for older adults, will be discussed in this presentation. These medications, whose risks outweigh benefits, or which have safer alternatives, contribute to increased risk of hospitalization and drug-induced problems (e.g., falls) among older adults.
Evidence suggests medications may not be properly managed after lower-limb amputation. Lower-limb amputation removes a significant portion of body mass and alters physiologic responses, which may contribute to the risks of potentially inappropriate medications. The research findings presented in this session reveal 50 percent of older adults with lower-limb loss take at least one potentially inappropriate medication, and nearly 25 percent take multiple potentially inappropriate medications.
This session will provide an overview of potentially inappropriate medications for older adults, and particularly among those following lower-limb loss. The presenters will discuss why use of these medications is concerning, and what may necessitate alerting the prescribing medical provider.
The Design and Manufacture of Custom Footwear
Presenter: Séamus Kennedy, BEng(Mech), CPed, FAAOP(A)
Custom molded shoes are an essential tool when working with hard-to-fit feet such as patients with severe edema or partial foot amputations. This presentation will look at the process of designing and fabricating molded shoes from start to finish. Attendees can expect to learn best practices for serving this challenging group including casting and dispensing tips.
Rocker Sole Theory, Indications and Applications
Presenter: Séamus Kennedy, BEng(Mech), CPed, FAAOP(A)
Rocker soles are a great way to augment limited joint motion, relieve foot pain, and restore smooth gait characteristics. There are many types of rocker sole depending on the specific objective, as Kennedy will describe. Learn about the benefits and concerns of different rocker designs, and when each is best used.
Heel Pain: Not Just Plantar Fasciitis
Presenter: Séamus Kennedy, BEng(Mech), CPed, FAAOP(A)
Heel pain is one of the most common reasons people seek podiatric care and it can be very debilitating. There are several different diagnoses that can contribute to the condition—plantar fasciitis is only one cause of this complaint. This session will review plantar fasciitis and several other pathologies and discuss orthotic and pedorthic treatment options for heel pain. Kennedy will help clinicians learn to recognize and treat this common complaint.