Factors related to indoor prosthetic use in individuals with unilateral lower limb amputation.

BACKGROUND: The rate of indoor prosthetic use in people with lower limb amputation (LLA) is lower than that of outdoor use. Very few studies of indoor prosthetic use have been conducted, and no studies have focused on the perspective of instrumental activities of daily living (IADLs). OBJECTIVES: To assess the indoor prosthetic use of individuals with unilateral LLA from the perspective of IADLs. STUDY DESIGN: Cross-sectional study. METHODS: A total of 162 people with LLA participated in this study. Based on the information obtained from a questionnaire and medical records, the relationships between each outcome and indoor prosthetic use were assessed by univariate analysis and multivariate logistic regression analysis. RESULTS: Of the 110 respondents (72.8%), 6 participants did not use the prosthesis or used it for cosmesis. With respect to the prosthetic users (n = 104), 74 (71.2%) used their prosthesis indoors and outdoors and 30 (28.8%) used it only outdoors, but none used it indoors only. On univariate analysis, five items were identified: household size, amputation level, domestic chores and outdoor activities of the Frenchay Activities Index, and difficulty donning/doffing the prosthesis. Small household, transtibial amputation, and a high score on the domestic chores of the Frenchay Activities Index (cutoff value 9.0 points) were independently associated with indoor prosthetic use. CONCLUSIONS: Training of motions that are desirable to use the prosthesis and participation in domestic chores frequently based on IADLs before hospitalization may increase the frequency of prosthesis use in people with transfemoral amputation who use their prosthesis outdoors.

The relationship between balance ability and walking ability using the Berg Balance Scale in people with transfemoral amputation.

BACKGROUND: Few reports have examined the relationship between balance ability and walking ability in people with transfemoral amputation using the Berg Balance Scale. OBJECTIVES: To assess the construct validity (known groups discrimination, convergent validity, and floor/ceiling effects) of Berg Balance Scale for people with transfemoral amputation. STUDY DESIGN: Cross-sectional study. METHODS: Thirty people with transfemoral amputation participated (age: 54 ± 19 years; range: 18-78 years). Outcome measures (Berg Balance Scale, Timed Up & Go test, Six-Minute Walk Test, and use of ambulatory aids) were compared between the groups requiring and not requiring ambulatory aids by the Mann-Whitney U test, Student's t-test or Welch's t-test. Correlations were assessed using Spearman's rank correlation coefficients and age-corrected Spearman's partial rank correlation coefficients. RESULTS: The group using ambulatory aids had a significantly lower Berg Balance Scale score (41 ± 5 vs 52 ± 3). Berg Balance Scale score was correlated with Timed Up & Go test, use of aids, and Six-Minute Walk Test using Spearman's rank correlation coefficients (r =-0.85, p < 0.0001; r =-0.82, p < 0.0001; r = 0.81, p < 0.0001) and age-corrected partial rank correlation coefficients (r =-0.66, p < 0.0001; r =-0.56, p = 0.0017; r = 0.57, p = 0.0012). No ceiling effect of Berg Balance Scale was observed. CONCLUSIONS: Balance ability in people with transfemoral amputation could be evaluated using Berg Balance Scale and is correlated with walking ability. CLINICAL RELEVANCE: In clinical practice, using Berg Balance Scale for people with transfemoral amputation may adequately enable us to discriminate different groups based on walking ability from the perspective of balance ability. When walking ability is evaluated as low, the improvement of walking ability may be evaluated by Berg Balance Scale improvement during rehabilitation.

Perception of leaning backward while standing and patellar movement.

[Purpose] The purpose of this study was to investigate the relationship between the patellar movement and the standing backward leaning perceptibility. [Subjects and Methods] Fourteen volunteers who were confirmed presence of upward patellar movement during backward leaning from the quiet standing posture participated in this study. The quiet standing position, the standing backward leaning position at patellar movement onset and standing position perceptibility were measured. The position of the center of pressure in the anteroposterior direction in standing is represented as the percentage distance from the hindmost point of the heel in relation to the foot length (%FL). [Results] The mean value of the center of pressure on anteroposterior direction positions in quiet standing was 43.2%FL. The patellar movement onset position was 35.1%FL. The individual mean value of standard deviations for the onset position was 2.5%FL. The absolute error at the onset position is specifically and significantly small. [Conclusion] For the subjects whose patellas move during backward leaning in this study, the standing position near the onset position was perceived accurately, probably by the substantial change in sensory information associated with the onset of patellar movement while backward leaning.

Periodical measurement of urine volume in the bladder during sleep: Temporary volume reduction suggestive of absorption.

OBJECTIVES: To clarify the variance of urine volume in the urinary bladder during sleep. METHODS: Overnight measurements of urinary bladder capacity during sleep were carried out using transabdominal real-time 3-D ultrasound or an automatic capacity recorder, Yuririn, in 24 volunteers of various ages. RESULTS: Two types of patterns were observed in the increasing curve of capacity; namely, gradual elevation pattern when overnight urine production was less than functional bladder capacity and steep-flat pattern when it was more than functional bladder capacity. During steep-flat pattern, bladder capacity reached levels of the functional bladder capacity quickly, then maintained steadily at that level until morning without awakening. Temporary volume reduction, which might be suggestive of water absorption from urine in the bladder, occurred occasionally, when the volumes of urine reached functional bladder capacity. CONCLUSIONS: A considerable amount of urine in the bladder diminishes without micturition during sleep to maintain a good level of sleep. This is the first report suggesting the possibility of water absorption from urine within the human urinary bladder in a fully physiological situation.

Launch device using endlessly single-mode PCF for ultra-wideband WDM transmission in graded-index multi-mode fiber.

We demonstrated ultra-wideband wavelength division multiplexing (WDM) transmission from 850 to 1550 nm in graded-index multi-mode fiber (GI-MMF) using endlessly single-mode photonic crystal fiber (ESM-PCF) as a launch device. Effective single-mode guidance is obtained in multi-mode fiber at all wavelengths by splicing cm-order length ESM-PCF to the transmission fiber. We achieved 3 × 10 Gbit/s WDM transmission in a 1 km-long 50-µm-core GI-MMF. We also realized penalty free 10 Gbit/s data transmission at a wavelength of 850 nm by optimizing the PCF structure. This method has the potential to achieve greater total transmission capacity for MMF systems by the addition of more wavelength channels.