Research Tag

Cycling in people with a lower limb amputation – Editor’s choice collection Olympic and Paralympic Games

• Poonsiri, J., Dekker, R., Dijkstra, P. U., Hijmans, J. M., & Geertzen, J. (2021). Cycling in people with a lower limb amputation. BMC sports science, medicine & rehabilitation, 13(1), 75.
• DOI: 10.1186/s13102-021-00302-3

Abstract

Background
To evaluate cycling participation and identify barriers and facilitators related to cycling participation in people with a lower limb amputation (LLA) in the Netherlands.

Methods
A questionnaire was sent to adults with a LLA between March and August 2019 to obtain information regarding prosthesis, individual’s characteristics, amputation, cycling barriers and facilitators, and prosthetic satisfaction. The questionnaires were distributed via 8 orthopedic workshops, post and were given directly. To find cycling predictors, variables associated with cycling (p < 0.1) were entered into a logistic regression analysis. Non-significant variables were removed manually.

Results
Participants (n = 207, 71% males) had a mean age of 62.0 ± 13.0 years. The most frequent level of amputation was transtibial (42%), and trauma was the most frequent cause of amputation (43%). After the LLA, 141 participants (68%) cycled for recreation (80%), physical fitness (74%), and transport (50%). In the past six months, cyclists cycled for recreation (79%) and transport (66%). Most cycled less than once a day. Recreational cyclists cycled alone (75%) for a median duration of 45 min or 14 km per ride. Cyclists with a transportation purpose usually cycled to go shopping (80%) or to visit friends (68%), with a median duration of 20 min or five kilometers per ride. Cyclists reported more facilitators (median (IQR) = 5 (3, 7) than non-cyclists 0 (0, 3). The majority of cyclists reported a positive attitude toward cycling (89%) and cycled because of health benefits (81%). A dynamic foot (odds ratio: 5.2, 95% CI 2.0, 13.3) and a higher number of facilitators (odds ratio: 1.3, 95% CI 1.2, 1.5) positively predicted cycling, whereas the presence of other underlying diseases (odds ratio: 0.4, 95% CI 0.2, 0.9) negatively predicted cycling (R2: 40.2%).

Conclusion
In the Netherlands, the majority of adults cycled after a LLA, mainly for recreational purposes. A dynamic foot, a higher number of facilitators, and no other underlying diseases increases the likelihood of cycling after a LLA. The results suggest that personal motivation and a higher mobility level could be the key to increasing cycling participation. Future research should determine the association between motivation, mobility levels, and cycling with a LLA.

Hashtags: #Research #Thailand #siriraj #sirirajhospital #sspo #prosthetics #SirirajHospital #ProstheticsSchool #Siriraj #Mahidol #Healthcare #Rehabilitation #InternationalCooperation #Education  #กายอุปกรณ์ #กายอุปกรณ์สิรินธร #โรงเรียนกายอุปกรณ์ #ศิริราช #มหิดล

Fitting transtibial and transfemoral prostheses in persons with a severe flexion contracture: problems and solutions – a systematic review

• Jutamanee Poonsiri, Pieter U. Dijkstra & Jan H. B. Geertzen (2021) Fitting transtibial and transfemoral prostheses in persons with a severe flexion contracture: problems and solutions – a systematic review, Disability and Rehabilitation, DOI: 10.1080/09638288.2021.1893393
• DOI: 10.1080/09638288.2021.1893393

Abstract
Purpose
In persons with a hip or knee flexion contracture ≥25°, fitting a prosthesis is said to be difficult. This systematic review aims to assess the evidence for fitting of a prosthesis in persons with a severe contracture (≥25°) after a lower limb amputation.

Method
PubMed, Embase, Scopus, CINAHL, and Orthotics & Prosthetics Virtual Library databases were searched from inception to December 2019, using database specific search terms related to amputation, prosthesis, and contracture. Reference lists of included studies were checked for relevant studies. Quality of the included studies was assessed using the critical appraisal checklist for case reports (Joanna Briggs Institute).

Results
In total, 13 case studies provided evidence for fitting of a prosthesis in more than 63 persons with a transtibial amputation and three with a transfemoral amputation, all of whom had a hip or knee flexion contracture ≥25°. Some studies found a reduction in contractures after prosthesis use.

Conclusions
Several techniques for fitting a prosthesis in case of a flexion contracture ≥25° were found. Contracture reduction occurred in some cases and was possibly related to prosthesis use. Fitting a transtibial or transfemoral prosthesis in persons with a lower limb amputation with a severe flexion contracture is possible.

Hashtags: #Research #Thailand #siriraj #sirirajhospital #sspo #prosthetics #SirirajHospital #ProstheticsSchool #Siriraj #Mahidol #Healthcare #Rehabilitation #InternationalCooperation #Education  #กายอุปกรณ์ #กายอุปกรณ์สิรินธร #โรงเรียนกายอุปกรณ์ #ศิริราช #มหิดล