Biomedical subjects

Helena Burger

Publications and source records attributed to Helena Burger.

6 recordsLinked to original sources

PubMed2005

Synthesis of standing-up trajectories using dynamic optimization.

Dynamic optimization as a tool to compute standing-up trajectories was investigated. Sit-to-stand manoeuvres in five intact persons and five trans-femoral amputees were measured. Movements and ground reaction forces acting on the body were recorded. A five-segment 3D dynamic model of standing-up was developed. In each particular subject, the optimization criterion which yielded trajectories that best resemble the measured standing-up movement was determined. Since the intact persons used considerably different criteria in choosing the standing-up trajectories than the amputees, the optimal trajectories were computed by minimizing cost functionals (CF) with distinctive structures for each group of individuals. In intact persons, a unique cost functional was found which yielded realistic standing-up manoeuvres. In amputees, subject-specific sets of parameters indicating slightly different preferences in optimizing the effort of particular muscle groups were used.

Adult↗

PubMed2005

Transition from sitting to standing after trans-femoral amputation.

Standing up is an important and common daily activity. It is essential for independence and a prerequisite for walking. Many elderly and many subjects with impairments have problems with transition from sitting to standing. The aim of the present study was to determine whether there was any difference between the characteristics of standing up in trans-femoral amputees and healthy subjects. Five young trans-femoral amputees and five healthy subjects were included in the study. They were asked to stand up. The body motion was recorded using an Optotrak contactless optical system. The force and moment vectors exerted on the seat were recorded by a JR3 six-axis robot wrist sensor. The force under the feet was recorded by two AMTI force plates. The trans-femoral amputees were found to stand up more slowly than the healthy subjects. The angles of the hip, knee, and ankle joints on the amputated side were different from the angles on the healthy side or in the healthy subjects. There was also a great difference in loading between the healthy and the prosthetic foot. It can be concluded that there are differences in standing up between the trans-femoral amputees and the healthy subjects. These differences may indicate a reason for problems many elderly trans-femoral amputees face when standing up.

Adult↗

PubMed2004

Prosthetic device provision to landmine survivors in Bosnia and Herzegovina: outcomes in 3 ethnic groups.

OBJECTIVE: To determine differences in prosthetic provision, use, and effectiveness among unilateral lower-extremity amputees from 3 ethnic groups in Bosnia and Herzegovina. DESIGN: Case series with a consecutive sample of patients seen in field clinics. SETTING: Multiple field clinics in Bosnia and Herzegovina from October 1998 to May 2002. PARTICIPANTS: A total of 671 patients were examined, and information about their prosthetic history was recorded from observation or verbal responses. The majority of the amputations resulted from injuries inflicted by landmines. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Self-reported walking distance per day, prosthesis functionality (functional or nonfunctional as assessed by a physician and a prothetist), prosthesis status (broken or nonbroken as assessed by a physician and a prothetist), and employment status. RESULTS: Ethnic groups differed significantly in types of prostheses provided, functional status of the prostheses, and use of the prostheses for community ambulation. CONCLUSION: Prosthetic devices and delivery of rehabilitation services for unilateral lower-extremity amputees differed between ethnic groups. Despite these differences, functional prosthetic devices increased mobility. Persons in all 3 ethnic groups with functional prostheses were more mobile than persons with nonfunctional prostheses. The employment rate was higher for people with functional prostheses.

Adult↗

PubMed2004

Influence of foot pain on walking ability of diabetic patients.

OBJECTIVE: To assess foot pain and its correlation with walking ability in diabetic patients. SUBJECTS: Two groups of type 2 diabetic patients (30 with symptomatic neuropathy and 30 without symptomatic neuropathy) and 30 healthy volunteers were studied. METHODS: Pain was assessed by the pain sub-scale of the Foot Function Index. Internal consistency for the pain sub-scale was tested. Walking ability was assessed by the 6-minute walking test. RESULTS: The pain was worse in diabetic patients, the pain sub-scale scores differed between the groups (p < 0.05). High internal consistency was found for the pain sub-scale of the Foot Function Index. Results of the 6-minute walking test differed among the 3 groups: healthy volunteers performed best, and diabetic patients with symptomatic neuropathy worst (p < 0.001). Foot pain correlated moderately with the result of walking test (r = -0.449, p < 0.001). CONCLUSION: The pain sub-scale of the Foot Function Index is suitable for the assessment of pain in diabetic patients. Patients with severe foot pain have more difficulties when walking long distances than patients with less severe or without any pain.

Aged↗

PubMed2004

Assessing and adjusting for cross-cultural validity of impairment and activity limitation scales through differential item functioning within the framework of the Rasch model: the PRO-ESOR project.

INTRODUCTION: In Europe it is common for outcome measures to be translated for use in other languages. This adaptation may be complicated by culturally specific approaches to certain tasks; for example, bathing. In this context the issue of cross-cultural validity becomes paramount. OBJECTIVE: To facilitate the pooling of data in international studies, a project set out to evaluate the cross-cultural validity of impairment and activity limitation measures used in rehabilitation from the perspective of the Rasch measurement model. METHODS: Cross-cultural validity is assessed through an analysis of Differential Item Functioning (DIF) within the context of additive conjoint measurement expressed through the Rasch model. Data from patients undergoing rehabilitation for stroke was provided from 62 centers across Europe. Two commonly used outcome measures, the Mini-Mental State Examination (MMSE) and the Functional Independence Measure (FIM) motor scale are used to illustrate the approach. RESULTS: Pooled data from 3 countries for the MMSE were shown to fit the Rasch model with only 1 item displaying DIF by country. In contrast, many items from the FIM expressed DIF and misfit to the model. Consequently they were allowed to be unique across countries, so resolving the lack of fit to the model. CONCLUSIONS: Where data are to be pooled for international studies, analysis of DIF by culture is essential. Where DIF is observed, adjustments can be made to allow for cultural differences in outcome measurement.

Activities of Daily Living↗

PubMedDate not supplied

Comparison of clinical test and questionnaires for the evaluation of upper limb prosthetic use in children.

PURPOSE: The aim of the present study was to find out if there was a correlation between an observational clinical test and a questionnaire for the evaluation of upper limb prosthetic use in children and to determine which one was better and easier to use in clinical practice. METHOD: Twenty children who were patients of the children's prosthetic clinic at the Rehabilitation Institute in Ljubljana, Slovenia, and had a functional prosthesis were included in the study. The age appropriate subtest of the University of New Brunswick Test of Prosthetic Function (the UNB test) was assessed by an occupational therapist. Parents completed either the Child Amputee Prosthetics Project-Functional Status Inventory for Preschool children (CAPP-FSIP) or the Child Amputee Prosthetics Project-Functional Status Inventory (CAPP-FSI), depending on which was appropriate for the child's age. Information was limited to the upper extremity items. RESULTS: We found a significant correlation between UNB spontaneity and skill score (r = 0.956, p = 0.000) and also between the parental CAPP score and UNB test (UNB spontaneity--CAPP activities r = 0.634, p = 0.003; UNB spontaneity--CAPP prosthetic use r = 0.542, p = 0.014, UNB skill--CAPP activities r = 0.559, p = 0.010, UNB skill--CAPP prosthetic use r = 0.597, p = 0.005). CONCLUSIONS: We concluded that both instruments can be used for assessing upper limb prosthetic use in children but neither is an optimal choice.

Activities of Daily Living↗