| 1. |
- Hermansson, Liselotte M N, 1954-, et al.
(författare)
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Intensive training camp for children with a myoelectric prosthetic hand
- 2013
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Ingår i: ISPO 2013 World Congress. - : International Society for Prosthetics and Orthotics.
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Konferensbidrag (refereegranskat)abstract
- Since 1978, the Limb Deficiency and Arm Prosthetic Centre (LDAPC) at Örebro University Hospital in Sweden offers a 5-day training camp for paediatric myoelectric prosthesis users1. The aim of the camp is to support the establishment of a regular prosthesis wearing pattern, increase capacity for control of the device, and establish prosthesis use in everyday tasks. Every year in August paediatric myoelectric hand users and their parents are invited to attend this intensive training. The camp consists of around 8 hours of scheduled training each day, both in everyday tasks and outdoor play activities. A structured programme with training of fine motor skills in the mornings and gross motor skills later in the days is prepared by the occupational therapists. The aim was to evaluate the effectiveness of this training procedure on children’s ability to operate the myoelectric hand.During 8-13 August, 2010, 11 children (aged 6-9, 6 boys) with unilateral below-elbow deficiency participated in the camp. The Assessment of Capacity for Myoelectric Control (ACMC)2 was used to evaluate the effectiveness of intensive training on ability to operate the hand. Every child performed an ACMC activity on the first and the last day of the camp (packing suitcase). Their performances were videotaped and scored by an ACMC rater that did not take part in training of the participants at the camp. An ability score for each child was calibrated by Winsteps program. The average ability scores changed from 2.45 logits to 5.04 logits. Most of the children (n=8) had a big change in the ACMC items that measure timing in grasping and releasing objects. The Conclusion is that the training camp is effective in improving the children’s ability to operate a myoelectric hand. The long-term effects on wearing time, skill and bimanual performance from intensive training camps need further studies.
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| 3. |
- Hermansson, Liselotte M. N., 1954-, et al.
(författare)
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Test-retest reliability and rater agreements of the Assessment of Capacity for Myoelectric Control version 2.0.
- 2014
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Ingår i: MEC'14. - Frederiction, New Brunswick, Cananda : University of New Brunswick, Fredericton, Canada.
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Konferensbidrag (refereegranskat)abstract
- Introduction: The Assessment of Capacity for Myoelectric Control (ACMC) is an observation-based tool that evaluates ability to control a myoelectric prosthetic hand [1]. Validity evidence led to ACMC version 2.0, but test - retest reliability and minimal detectable change (MDC) of ACMC have never been evaluated. For instruments that have an evaluative purpose, such as ACMC, the MDC is a useful clinical value to suggest whether a change is due to measurement error or true change. Investigation of rater agreements in this version was also needed because it has new definitions in certain rating categories and items.Methods: Upper limb prosthesis users (n=25, 13/12 male/female, 15/10 congenital/acquired; mean age 27.5, range 7-72, years) performed one standardized activity twice, 2–5 weeks apart. Activity performances were video-recorded and assessed by two ACMC raters. The item raw scores were converted to Rasch interval ability measures. Ordinal data were analyzed by weighted κ; interval data were analyzed by intraclass correlation coefficient (ICC) and Bland–Altman limit of agreement (LOA) method.Results: For test–retest reliability, ICC2,1 was 0.94. Average weighted κ was 0.76 and percentage agreement (PA) was 85%. In individual items, weighted κ agreements were fair to excellent (0.52・1.00) and PAs were ≥6・100%. MDC95 was ≤.55 logits (1 rater) and 0.69 logits (2 raters). All MDC95 values were ≤5% of the total ability logit range. In the Bland-Altman plot the upper and lower LOA were 0.86 and -0.88 respectively. All except one participant were within the 95% LOA. For inter-rater reliability, weighted κ agreements were fair to excellent in both sessions (0.44–1.00), and ICC2,1 was 0.95 (test) and 0.92 (retest). Intra-rater agreement (rater 1) was excellent (ICC3,1 0.98). The weighted κ values of the test session were all >0.80 and the PAs for each item were ≥6%.Conclusion: The results of the present study demonstrate different aspects of the reliability of ACMC 2.0. Based on these results, we can recommend ACMC as a tool to follow the progress of users in controlling their myoelectric prostheses. The MDC is clinically useful for ACMC raters as a guideline when following the client’s changes over time.
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| 4. |
- Jarl, Gustav, 1978-, et al.
(författare)
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Cross-cultural validity and differential item functioning of theOrthotics and Prosthetics Users’ Survey with Swedish and Americanusers of lower limb prosthesis
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objective: To investigate the cross-cultural validity of the Orthotics and Prosthetics Users’ Survey (OPUS), to investigate differential item functioning (DIF) in the OPUS related to sex, age, amputation level and amputated sides (unilateral or bilateral), and to determine the known-group validity of the OPUS.Design: Cross-sectional study design.Setting: 2 outpatient clinics in Sweden and 7 outpatient clinics in the United States.Participants: A total of 195 Swedish and 126 American adults using lower limb prosthesis.Interventions: Not applicable.Main Outcome Measure: 4 modules from the OPUS were used in this study, including the Lower extremity functional status (LEFS), Client satisfaction with device (CSD), Client satisfaction with services (CSS), and Health-related quality of life (HRQoL) modules. Items were scored on 4- or 5-level Likert scales, and a Rasch measure was calculated for each person and module.Results: The cross-cultural validity was satisfactory. Many items demonstrated DIF related to country and demographic characteristics, but the impact on mean person measures was negligible. The rating scales of the CSD and CSS needed adjustments, and the unidimensionality of the CSD and CSS was weak. The differences between the mean measures of known patient groups were statistically significant for age in the LEFS and for the level of amputation in the CSD.Conclusions: This study supports the validity of comparing OPUS measures between Sweden and USA and between patient groups with different demographic characteristics. The OPUS can, to some extent, discriminate between patient groups known to be different. The unidimensionality of the CSD and CSS modules is weaker than the other modules and these need further development and evaluation.
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| 5. |
- Jarl, Gustav M., 1978-, et al.
(författare)
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Cross-cultural validity and differential item functioning of the Orthotics and Prosthetics Users’ Survey with Swedish and American users of lower-limb prosthesis
- 2015
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier BV. - 0003-9993 .- 1532-821X. ; 96:9, s. 1615-1626
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate the cross-cultural validity of the Orthotics and Prosthetics Users’ Survey (OPUS), to evaluate differential item functioning (DIF) related to country, sex, age, amputation level, and amputated side (unilateral, bilateral), and to determine known-group validity of the OPUS.Design: Survey.Setting: Outpatient clinics.Participants: The sample (NZ321) consisted of Swedish (nZ195) and U.S. (nZ126) adults using lower-limb prostheses.Interventions: Not applicable.Main Outcome Measures: Four OPUS modules were used: lower extremity functional status, client satisfaction with device (CSD), client satisfaction with services (CSS), and health-related quality of life. Rasch analysis was used to calculate measures for persons and items.Results: The cross-cultural validity was satisfactory. Many items demonstrated DIF related to country and demographic characteristics, but the impact on mean person measures was negligible. The rating scales of CSD and CSS needed adjustments, and the unidimensionality of CSD and CSS was weak. The differences between the mean measures of known patient groups were statistically significant for 2 out of 6 comparisons.Conclusions: This study supports the validity of OPUS measure comparisons between Sweden and the United States and between subgroups with different demographic characteristics. Some of the country-related DIF may reflect the different health care financing systems. The findings demonstrate that the OPUS can discriminate between certain patient groups. The results also challenge some of our preconceptions about persons with bilateral amputation, indicating that we might know these persons less well than we think.
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| 6. |
- Johansson, Marika, et al.
(författare)
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Barn med Downs syndrom och fritidsaktivitet : ur ett föräldraperspektiv
- 2019
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Ingår i: Arbetsterapiforum 2019.
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Konferensbidrag (refereegranskat)abstract
- Bakgrund/Syfte: Barn med Downs syndrom utvecklas inte i samma takt som andra barn och är ibland socialt avskilda. Fritidsaktivitet leder både till delaktighet och utveckling. För att kunna delta i fritidsaktivitet behöver miljön i vissa fall anpassas så alla kan vara med och känna delaktighet. Det är vanligt att barn med Downs syndrom har tilläggsdiagnoser, bland annat autism. Föräldrar till barn med Downs syndrom har en viktig roll i sitt barns deltagande i fritidsaktivitet i många avseenden. Syfte: Syftet med studien är att kartlägga deltagandet i fysiska och kreativa fritidsaktiviteter hos barn med Downs syndrom - utifrån ett föräldraperspektiv.Metod/Tillvägagångssätt: Enkäter skickades ut till Svenska Downföreningen, Föreningen för barn, unga och vuxna med utvecklingsstörning (FUB) och en Facebook grupp; ”Barn med Downs syndrom som går/inskrivna i särskola/sär-gymnasium”. Datamaterialet analyserades med deskriptiv statistik och Mann-Whitney test genomfördes för att beräkna skillnader mellan grupper.Resultat/Preliminärt resultat: Undersökningen visade att barn med Down syndrom är aktiva i fritidsaktivitet, särskilt av fysisk karaktär. Barnen deltog mellan 1–2 gånger per vecka, i en eller flera aktiviteter. Majoriteten av föräldrarna såg en positiv utveckling hos sitt barn, socialt, fysiskt och kommunikativt. Det fanns flera anledningar till varför barnet deltog i fritidsaktivitet, bland annat att barnet själv valt att delta och att föräldrarna ville att de skulle utvecklas. Orsaker till att barnet inte deltog i fritidsaktivitet var brist på resurser eller brist på passande fritidsaktiviteter.Slutsats/Praktisk tillämpning: Barn med Downs syndrom med/utan tilläggsdiagnos har ett högt deltagande i fritidsaktiviteter. Deltagande i fritidsaktivitet är en viktig faktor i utvecklingen hos barn med Downs syndrom.
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| 7. |
- Lindner, Helen Y, 1967-, et al.
(författare)
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A Study Protocol for Persons With Neurological Diseases : Linking Rehabilitation Goals to the International Classification of Functioning, Disability and Health With a Focus on Assistive Technology for Cognition and Its Effects
- 2022
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Ingår i: Frontiers in rehabilitation sciences. - : Frontiers Media S.A.. - 2673-6861. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Persons with neurological diseases often have some degree of cognitive impairment. They are in need of assistive technology for cognition (ATC) to compensate for cognitive impairments that affect their daily functioning. Goal setting in relation to cognitive deficits using ATC are common in clinical practice, and therapists often set several rehabilitation goals together with a patient. However, these rehabilitation goals are usually phrased differently, which limit the comparison of ATC and rehabilitation goals. It is thus valuable to link the goals to some standardized terminologies, such as the International Classification of Functioning, Disability and Health (ICF). Furthermore, goal achievement is seldom used to evaluate long-term effects of ATC in persons with neurological diseases and limited attention has been paid to the factors that predict goal achievement in using the ATC as cognitive support in persons with neurological diseases. The aim of the project is 3-fold. Firstly, we will use the ICF to link rehabilitation goals regarding the use of ATC in adults with neurological diseases. Secondly, we will evaluate effects of the ATC using goal achievement over a 5-year period. Thirdly, we will explore the variables that predict goal achievement in relation to the effects of ATC.
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| 8. |
- Lindner, Helen Y, 1967-
(författare)
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An Inside Guide to Evaluate the Effect of an Assistive Device Using Clinic-Based Capacity Measurement and Patient-Reported Performance Measurement
- 2020
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Ingår i: SAGE Research Methods Cases. - 1 Oliver's Yard, 55 City Road, London EC1Y 1SP United Kingdom : Sage Publications. - 9781529740516
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Bokkapitel (refereegranskat)abstract
- This case study describes the use of a capacity measurement tool and a performance measurement tool to evaluate the effect of an assistive device, using upper limb prosthesis as an example of assistive device. The case describes the benefits of using the International Classification of Functioning, Disability and Health to understand “capacity” and “performance” and the importance of using correct measurement tools to measure these two concepts. A patient-reported questionnaire that collects data about daily performance in wide range of activities from real-life environment is a good option for measuring performance when assessment in real-life environment is not possible.However, behind the measurements, there were several considerations in how I can minimize errors in the measurements. This was done by providing pictures to explain patient-reported questions and by providing training before data collection. It was also beneficial to have an extended recruiting period to achieve a representative sample. This case study provides an insight into the practical details of how a clinical evaluation project was carried out through the eyes of a clinical researcher.
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| 9. |
- Lindner, Helen Y, 1967-, et al.
(författare)
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Cognitive load and compensatory movement in learning to use a multi-function hand
- 2019
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Ingår i: Prosthetics and Orthotics International. - : Sage Publications. - 0309-3646 .- 1746-1553. ; 43:1 suppl. 1, s. 52-52
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- BACKGROUND: Recent technology provides increased dexterity in multi-function hands with the potential to reduce compensatory body movements. However, it is challenging to learn how to operate a hand that has up to 36 grips. While the cognitive load required to use these hands is unknown, it is clear that if the cognitive load is too high, the user may stop using the multi-functional hand or may not take full advantage of its advanced features.AIM: The aim of this project was to compare cognitive load and compensatory movement in using a multi-function hand versus a conventional myo hand.METHOD: An experienced prosthesis user was assessed using his conventional myo hand and an unfamiliar iLimb Ultra hand, with two-site control and the same wrist for both prostheses. He was trained to use power grip, lateral grip and pinch grip and then completed the SHAP test while wearing the Tobii Pro 2 eye-tracking glasses. Pupil diameter (normal range: 2-4mm during normal light) was used to indicate the amount of cognitive load.[1] The number of eye fixations on the prosthesis indicate the need of visual feedback during operation. Dartfish motion capture was used to track the maximum angles for shoulder abduction and elbow flexion.RESULTS: Larger pupils were found in the use of Ilimb ultra (2.6-5.6mm) than in the use of conventional myo hand (2.4-3.5mm) during the SHAP abstract light tests. The pupils dilated most often during changing grips, e.g. switching to pinch grip for the tripod task (from 2.7 to 5.6mm). After training of using power grip and pinch grip repeatedly, the maximum pupil diameter decreased from 5.6 to 3.3mm. The number of eye fixations on the I-limb ultra (295 fixations) were also higher than on the conventional myo-hand (139 fixations). Smaller shoulder abduction and elbow flexion were observed in the use of I-limb ultra (16.6°, 36.1°) than in the use of conventional myo hand (57°, 52.7°).DISCUSSION AND CONCLUSION: Although it is cognitively demanding to learn to use a multi-function hand, it is possible to decrease this demand with adequate prosthetic training. Our results suggest that using a multi-function hand enables reduction of body compensatory movement, however at the cost of a higher cognitive load. Further research with more prosthesis users and other multi-function hands is needed to confirm the study findings.REFERENCES [1] van der Wel P, van Steenbergen H. Psychon Bull Rev 2018; 25(6):2005-15.ACKNOWLEDGEMENTS: This project was supported financially by Norrbacka-Eugenia Foundation, Promobilia Foundation and Örebro University.
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| 10. |
- Lindner, Helen Y, 1967-, et al.
(författare)
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Compensatory Movement in Upper Limb Prosthesis Users during Activity Performance
- 2019
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Ingår i: Prosthetics and Orthotics International. - : Sage Publications. - 0309-3646 .- 1746-1553. ; 43:1 suppl., s. 512-512
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- BACKGROUND: Low dexterity of conventional two-function (open, close) myoelectric hand prostheses with limited wrist movement often leads to compensatory shoulder and elbow movements, e.g. excess shoulder abduction and elbow flexion. Compensatory movements may lead to musculoskeletal pain [1] and it is thus important to identify prosthesis users with compensatory movements and to develop preventive treatments for musculoskeletal pain.AIM: The study aim was to measure and compare compensatory movements during activity performance among upper limb prosthesis users with different levels of myoelectric control.METHOD: Twenty-seven users of conventional myoelectric hand prosthesis performed the Assessment of Capacity for Myoelectric Control (ACMC) at the Örebro Limb Deficiency and Arm Prosthesis Centre. The performances were recorded and analyzed with Dartfish motion capture video analysis software. The software was used to track and measure the maximum angles for shoulder abduction and elbow flexion at the non-prosthetic and prosthetic sides during the activity performance. Two independent raters used Dartfish to analyze 10 videos and Intra-class Correlation Coefficient (ICC) was used to calculate inter-rater reliability. The ability to control a myoelectric prosthetic hand was assessed by the ACMC.RESULTS: The within-individual differences for shoulder abduction ranged from 2° to 52° and for elbow flexion from 1° to 66°. When compared between prosthetic and non-prosthetic side, larger differences in shoulder abduction and elbow flexion were found among the users with ACMC ≤ 0 than users with ACMC > 0 (Fig.1a). When comparing the within-individual side differences between prosthesis users with ACMC ≤0 and users with ACMC >0, a significant angle difference was found in the elbows (p=0.03) but not in the shoulders (p=0.34) (Fig.1b). Inter-rater reliability between the two independent raters was excellent (ICC 0.91).DISCUSSION AND CONCLUSION: Compensatory elbow movements during activity performance are higher in upper limb prosthesis users with low level of myoelectric control. Prevention for musculoskeletal pain should consist of both training for improved prosthetic control and improved prosthetic use in activity performance. Measurement of compensatory movements can help to identify amputees with frequent compensatory movements. Future studies are needed to investigate the effect of ability to control myoelectric prosthesis on musculoskeletal pain.REFERENCES [1] Jones LE, Davidson JH. Prosthet Orthot Int 1999; 23(1):55-8.ACKNOWLEDGEMENTS This study was supported financially by the Norrbacka-Eugenia Foundation.
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