| 1. |
- Pilch, Monika, et al.
(författare)
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Interplay Between Innovation and Intersubjectivity: Therapists Perceptions of Phantom Motor Execution Therapy and Its Effect on Phantom Limb Pain
- 2023
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Ingår i: Journal of Pain Research. - : Dove Medical Press. - 1178-7090. ; 16, s. 2747-2761
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Interpersonal processes, including therapeutic alliance, may modulate the impact of interventions on pain experience. However, the role of interpersonal context on the effects of technology-enhanced interventions remains underexplored. This study elicited therapists’ perspectives on how a novel rehabilitative process, involving Phantom Motor Execution (PME), may impact phantom limb pain. The mediating role of therapeutic alliance, and the way PME influenced its formation, was investigated. Methods: A qualitative descriptive design, using a framework method, was used to explore therapists’ (n=11) experiences of delivering PME treatment. Semi-structured online-based interviews were conducted. Results: A 3-way interaction between therapist, patient, and the PME device was an overarching construct tying four themes together. It formed the context for change in phantom limb experience. The perceived therapeutic effects (theme 1) extended beyond those initially hypothesised and highlighted the mediating role of the key actors and context (theme 2). The therapeutic relationship was perceived as a transformative journey (theme 3), creating an opportunity for communication, collaboration, and bonding. It was seen as a cause and a consequence of therapeutic effects. Future directions, including the role of expertise-informed adaptations and enabling aspects of customised solutions, were indicated (theme 4). Conclusion: This study pointed to intrapersonal, interpersonal, and contextual factors that should be considered in clinical implementation of novel rehabilitative tools. The results demonstrated that therapists have unique insights and a crucial role in facilitating PME treatment. The study highlighted the need to consider the biopsychosocial model of pain in designing, evaluating, and implementing technology-supported interventions.
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| 2. |
- Franzke, Andreas W., et al.
(författare)
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Testing the Use of Advanced Upper Limb Prostheses: Towards Quantifying the Movement Quality with Inertial-Magnetic Measurement Units
- 2023
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Ingår i: Prosthesis. - : MDPI AG. - 2673-1592. ; 5:1, s. 264-281
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Tidskriftsartikel (refereegranskat)abstract
- Background: A thorough assessment of upper limb prostheses could help facilitate their transfer from scientific developments into the daily lives of users. Ideally, routine clinical testing would include assessments of upper limb function using motion-capturing technology. This is particularly relevant for the state-of-the-art upper limb prostheses. Methods: We designed a test based on an activity of daily life (“tray-task”) which could be completed outside the laboratory, and developed a set of outcome measures aimed at characterizing the movement quality. For this purpose, kinematics of the thorax and the humerus were captured with an inertial–magnetic measurement unit (IMMU) motion-capture system. Six prosthesis users and ten able-bodied participants were recruited to test the feasibility of the proposed assessment procedure and to evaluate the outcome variables. Results: All participants completed the test either at home or in our lab. The prosthesis users needed more time to complete the task and showed a larger range of motion in the thoracic flexion and a smaller range of motion in the humeral elevation, compared to the able-bodied participants. Furthermore, the prosthesis users’ movements were less smooth and characterized by less stable coordination patterns between the humerus and thorax. Conclusion: A new test method and associated outcome variables have been proposed.
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| 4. |
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| 5. |
- Lendaro, Eva, 1989, et al.
(författare)
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Phantom motor execution as a treatment for phantom limb pain: Protocol of an international, double-blind, randomised controlled clinical trial
- 2018
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Ingår i: BMJ Open. - : BMJ. - 2044-6055 .- 2044-6055. ; 8:7
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Phantom limb pain (PLP) is a chronic condition that can greatly diminish quality of life. Control over the phantom limb and exercise of such control have been hypothesised to reverse maladaptive brain changes correlated to PLP. Preliminary investigations have shown that decoding motor volition using myoelectric pattern recognition, while providing real-time feedback via virtual and augmented reality (VR-AR), facilitates phantom motor execution (PME) and reduces PLP. Here we present the study protocol for an international (seven countries), multicentre (nine clinics), double-blind, randomised controlled clinical trial to assess the effectiveness of PME in alleviating PLP. Methods and analysis Sixty-seven subjects suffering from PLP in upper or lower limbs are randomly assigned to PME or phantom motor imagery (PMI) interventions. Subjects allocated to either treatment receive 15 interventions and are exposed to the same VR-AR environments using the same device. The only difference between interventions is whether phantom movements are actually performed (PME) or just imagined (PMI). Complete evaluations are conducted at baseline and at intervention completion, as well as 1, 3 and 6 months later using an intention-to-treat (ITT) approach. Changes in PLP measured using the Pain Rating Index between the first and last session are the primary measure of efficacy. Secondary outcomes include: Frequency, duration, quality of pain, intrusion of pain in activities of daily living and sleep, disability associated to pain, pain self-efficacy, frequency of depressed mood, presence of catastrophising thinking, health-related quality of life and clinically significant change as patient's own impression. Follow-up interviews are conducted up to 6 months after the treatment. Ethics and dissemination The study is performed in agreement with the Declaration of Helsinki and under approval by the governing ethical committees of each participating clinic. The results will be published according to the Consolidated Standards of Reporting Trials guidelines in a peer-reviewed journal.
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| 6. |
- Postema, Sietke, et al.
(författare)
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Body structures and physical complaints in upper limb reduction deficiency : a 24-year follow-up study
- 2012
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Ingår i: PLOS ONE. - San Francisco, USA : Public Library Science. - 1932-6203. ; 7:11
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe upper body structures associated with upper limb reduction deficiency and the development of these structures over time, to examine the presence of physical complaints in this population, and to compare body structures and complaints between groups based on prosthesis use.Design: Prospective cohort study with a follow-up period of 24 years, with matched able-bodied controls.Subjects: Twenty-eight patients with unilateral below-elbow reduction deficiency fitted with myoelectric prostheses, aged 8-18 years at inclusion.Method: Measurements of upper arm, trunk and spine were performed and study-specific questionnaires were answered at baseline and follow-up; the Brief Pain Inventory and the Quick Disability of Arm, Shoulder, and Hand questionnaires were answered at follow-up.Results: Both at baseline and follow-up, within-subjects differences in structures of the arm and trunk were shown in patients but not in controls. Spinal deviations, although small, were greater in patients compared to controls. Self-reported disability was higher in patients compared to controls. Differences in back pain and effect of prostheses use could not be shown.Conclusions: Patients with unilateral below-elbow reduction deficiency have consistent differences in upper body structures. Deviations of the spine, probably of functional origin, do not progress to clinically relevant scoliosis.
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| 7. |
- Postema, Sietke, et al.
(författare)
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Body structures and physical complaints in Upper Limb Reduction Deficiency : a 24 year follow up study
- 2013
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Ingår i: ISPO 2013 World Congress.
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Konferensbidrag (refereegranskat)abstract
- Introduction: In children with upper limb reduction deficiency (ULRD) scoliosis has been reported but the development of these spinal deviations over time is unclear. Furthermore, little is known about the development of other upper body structures and potential physical complaints in this population. Also, the influence of prosthesis use on the development of body structures or complaints is unknown.Aim: To describe upper body structures of persons with unilateral ULRD and the development of these structures over time, to examine the presence of physical complaints in this population, and to study the effect of prosthetic use on body structures and physical complaints.Method: A prospective cohort study with a follow-up period of 24 years was conducted. Twenty-eight persons (age 8-18 years at inclusion) with ULRD and 62 matched controls underwent measurements of upper-arm, trunk and spine and answered study-specific questionnaires at baseline and follow-up. In addition, at follow-up the Brief Pain Inventory and the Quick Disability of Arm, Shoulder and Hand questionnaires were answered.Results: Within-subject differences in structures of the arm and trunk were shown in patients but not in controls both at baseline and follow-up. Spinal deviations were greater in patients compared to controls. No structural scoliosis was found. Self-reported disability was higher in patients compared to controls. Differences in back pain and effects of prosthesis use could not be detected.Discussion: The structural within-person difference between body-halves may explain the findings of spinal deviations. The rates of physical complaints were remarkably low, compared to other studies. This might be due to differences between persons with ULRD and acquired upper limb amputations, level of deficiency, prosthetic use or age.Conclusions: Persons with ULRD have consistent differences in upper body structures over time. Deviations of the spine, probably of functional origin, do not proceed to clinically relevant scoliosis.
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| 8. |
- Postema, Sietke G., et al.
(författare)
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Musculoskeletal Complaints in Transverse Upper Limb Reduction Deficiency and Amputation in The Netherlands : Prevalence, Predictors, and Effect on Health
- 2016
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Ingår i: Archives of Physical Medicine and Rehabilitation. - Philadelphia, USA : Saunders Elsevier. - 0003-9993 .- 1532-821X. ; 97:7, s. 1137-1145
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Tidskriftsartikel (refereegranskat)abstract
- Objective: (1) To determine the prevalence of musculoskeletal complaints (MSCs) in individuals with upper limb absence in The Netherlands, (2) to assess the health status of individuals with upper limb absence in general and in relation to the presence of MSCs, and (3) to explore the predictors of development of MSCs and MSC-related disability in this population.Design: Cross-sectional study: national survey.Setting: Twelve rehabilitation centers and orthopedic workshops.Partiscipants: Individuals (n=263; mean age, 50.7±16.7y; 60% men) ≥18 years old, with transverse upper limb reduction deficiency (42%) or amputation (58%) at or proximal to the carpal level (response, 45%) and 108 individuals without upper limb reduction deficiency or amputation (n=108; mean age, 50.6±15.7y; 65% men) (N=371).Interventions: Not applicable.Main outcome measures: Point and year prevalence of MSCs, MSC-related disability (Pain Disability Index), and general health perception and mental health (RAND-36 subscales).Results: Point and year prevalence of MSCs were almost twice as high in individuals with upper limb absence (57% and 65%, respectively) compared with individuals without upper limb absence (27% and 34%, respectively) and were most often located in the nonaffected limb and upper back/neck. MSCs were associated with decreased general health perception and mental health and higher perceived upper extremity work demands. Prosthesis use was not related to presence of MSCs. Clinically relevant predictors of MSCs were middle age, being divorced/widowed, and lower mental health. Individuals with upper limb absence experienced more MSC-related disability than individuals without upper limb absence. Higher age, more pain, lower general and mental health, and not using a prosthesis were related to higher disability.Conclusions: Presence of MSCs is a frequent problem in individuals with upper limb absence and is associated with decreased general and mental health. Mental health and physical work demands should be taken into account when assessing such a patient. Clinicians should note that MSC-related disability increases with age.
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| 9. |
- Postema, Sietke, et al.
(författare)
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Upper limb absence : predictors of work participation and work productivity
- 2016
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Ingår i: Archives of Physical Medicine and Rehabilitation. - Philadelphia, USA : Elsevier. - 0003-9993 .- 1532-821X. ; 97:6, s. 892-899
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to analyze work participation, work productivity and contributing factors, as well as physical work demands, in individuals with an upper limb defect (ULD).Design: cross-sectional study: postal survey (response rate: 53%).Setting: patients of twelve rehabilitation centers and orthopedic workshops in the Netherlands.Participants: 207 individuals with unilateral transversal upper limb reduction deficiency (ULRD) or amputation (ULA), at or proximal to the carpal level, between the ages of 18 and 65 years, and a convenience sample of 90 controls (matched on age and gender).Interventions: not applicable.Main outcome measures: employment status, self-reported work productivity and self-reported upper extremity work demands.Results: 74% of individuals with ULRD and 57% of the individuals with ULA were employed. Males, using a prosthesis, with medium or higher level of education and good general health were most often employed. Work productivity was similar to the control group. Higher work productivity was related to predominantly mentally demanding type of work and less MSC related pain. Upper extremity work demands were higher in individuals with ULD with predominantly mentally demanding work, compared to controls with this type of work. Conclusions: the outcome of work participation of individuals with ULRD is comparable to the general population in the Netherlands. Individuals with ULA had lower rates of employment. Work productivity was not associated to one-handedness.
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