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Biomedical subjects

Z Susak

Publications and source records attributed to Z Susak.

33 records · Page 2Linked to original sources
PubMed1983

Effects of alignment variables on thigh axial torque during swing phase in AK amputee gait.

It is suggested that a major source of discomfort for above-knee amputees during the swing phase of walking, is the thigh axial torque (TAT) transferred at the stump--socket interface. The relation between TAT and variations in its six relevant alignment adjustments, has been investigated. A computerized routine has been established which indicates optimum choice of alignment setting, based on minimal TAT peaks. Feasibility for attenuating swing phase TAT has been demonstrated in three simulated patterns of amputee gait. As a conclusion, it is suggested that a useful clinical tool could be based on the presented alignment optimization procedure and may be expanded to include other factors associated with swing and stance phase comfort and performance.

Amputation, Surgical↗
PubMed1982

In-vivo elastic and damping response of the human leg to impact forces.

The transmission of impact forces in a straight leg from the foot to the level of the greater trochanter was investigated by a two-degree of freedom linear damped-spring model. Foot ground forces measured during a vertical jump and accelerations measured at the level of the greater trochanter were used as model input. The model elastic constant and damping coefficient were determined by solving the dynamic equations of the system. The model was used to predict peak acceleration values for a given input force. Satisfactory prediction of the magnitudes of the first two peaks of the acceleration (maximum difference of 3 percent) was achieved in the two subjects studied.

Adult↗
PubMed1982

Variation of time-distance parameters of the stride as related to clinical gait improvement in hemiplegics.

Gait improvement was evaluated in two different ways for 20 hemiplegics during an average follow-up period of 8 weeks in early rehabilitation. One way was by weekly measuring time-distance parameters of the stride on an electrical contact system walkway. The second was a clinical evaluation of gait improvement. The parameters studied were contact time, double contact time, stride length, velocity, time symmetry and distance symmetry. The variation of each of these parameters during the follow-up period was correlated with the variation in gait evaluated clinically. This correlation showed that both evaluations agreed, supporting the usage of time-distance parameters as a tool for an objective follow-up of walking ability of hemiplegics during rehabilitation.

Aged↗
PubMed1980

Arterial occlusive disease in amputee patients: assessment with the Doppler ultrasound flowmeter and correlation with rehabilitation.

The vascular status of 14 below-knee (BK) amputee patients and 12 above-knee (AK) amputee patients who had undergone amputation for arterial occlusive disease was assessed with the Doppler ultrasound technique. Ten healthy subjects were investigated as a control group. The ankle-arm pressure index in the sound leg and thigh-arm pressure index in the stump were classified in 4 grades. Rehabilitation was graded according to the amputee patients' ability to use their prostheses. The vascular condition of the BK amputees was generally better than that of the AK amputees. The vascular condition of the stump in both groups was better than that of the sound leg. A good correlation was found between prosthetic rehabilitation and the vascular condition of the sound leg, but not with that of the stump. It is suggested that amputation removes the most severely affected part of the lower extremity and the so-called sound leg thus becomes the restricting factor in rehabilitation.

Aged↗
PubMed1979

End-bearing characteristics of patellar-tendon-bearing prosthesis--a preliminary report.

The present work was aimed at investigating the degree of participation of the stump end in the weightbearing process in PTB prostheses. Despite the belief that the stump end is not capable of withstanding high loads, it was revealed that most patients can bear from 15 percent up to 45 percent and more of their weight on the stump end. The limited number of patients studied diminishes the statistical significance, but the results of this work do suggest that the weightbearing mechanism of a PTB prosthesis can be further improved by transferring more load through the stump end. It is suggested that a nondestructive technique for assessing the end-bearing efficiency of the prosthesis be developed. Also, the criteria for design of the socket end in order to produce the desired load-bearing features needs further investigation.

Adult↗
PubMed1978

The influence of the deep femoral artery on wound healing in amputees.

Seventeen patients with arterial occlusive disease, of whom 14 were diabetics, were studied by angiography after amputation of the lower extremity. In one patient the angiography was normal and the stump wound healed well. In two patients the angiographic findings indicated extremely severe impairment of blood supply and wound healing was considerably delayed. Of the remaining 14 patients: in five the superficial femoral artery alone was occluded and wound healing was normal and in nine patients, both the superficial and deep femoral arteries were occluded and wound healing was delayed. Wound healing of the stump after amputation of the lower extremity due to extensive arterial occlusive disease is decided by the patency of the deep femoral artery.

Aged↗
PubMed1978

Dynamic features of standing and their correlation with neurological disorders.

Standing posture is a result of complex activity of the human control system. Irregularities of postural control may be expected to result in deviations from normal standing. In the present study a ballistic monitoring technique was employed to establish criteria for assessment of postural disorders. Two "Kistler" force plate dynamometers were used to measure changes in the weight bearing components of each foot and displacement of the center of pressure of each foot. The patterns were analysed separately, and it was found that each of the monitored parameters demonstrated three modes of oscillation--termed Tremor, Ataxia and Sway. Statistical analysis conducted on three groups of subjects (normals, post-C.V.A. hemiplegics and brain injured) revealed significant intergroup differences in movement patterns. Good agreement was found between the interpretation of the ballistic features and the clinical diagnosis.

Ataxia↗
PubMedDate not supplied

The control of genu recurvatum by combining the Swedish knee-cage and an ankle-foot brace.

Genu recurvatum is a consequence of a poor control over the knee joint due to muscle weakness, impaired tonus and deficit in joint proprioception. Uncontrolled locking of the knee during ambulation causes recurrent microtrauma which leads to degenerative changes and instability. Known methods to control hyperextension of the knee during ambulation often fail. We have used the Swedish knee-cage attached to ankle-foot brace in an attempt to improve control over the knee in three patients. Gait analysis was performed to evaluate the effectiveness of this combined orthosis. Quality of gait improved, as demonstrated by a decrease in stance time asymmetry in the order of 45%; stride increased by 29% and speed of ambulation increased by 72%.

Braces↗
PubMedDate not supplied

Self-injury resulting in amputation among vascular patients: a retrospective epidemiological study.

In the course of 24 months, 164 nontraumatic vascular amputees were accepted for prosthetic rehabilitation; 120 (73%) were diabetic and 44 (27%) non-diabetic. Subjects were divided into two groups, the first consisting of 114 with spontaneous foot infection or gangrene and the second of 50, of whom 44 were diabetic and six had peripheral arterial disease on its own. Sixty-five per cent of all amputees had fewer than nine years of formal education and 46% were in the low-income bracket, but no significant relationship was found between mechanism of self-injury and level of education and income. All patients in the second group were able to detail ways in which they had injured their feet. The relationship between the mechanism of self-injury and the presence of diabetes mellitus was found to be highly significant. By instructing in better self-care it may be possible to prevent or at least postpone amputation in these patients.

Aged↗
PubMedDate not supplied

Anatomic sites of foot lesions resulting in amputation among diabetics and non-diabetics.

OBJECTIVE: To identify and quantify the anatomic sites of foot lesions resulting in amputation among patients suffering from peripheral arterial disease with and without diabetes mellitus. DESIGN: A retrospective study. SETTING: Department of Orthopaedic Rehabilitation. PATIENTS: A total of 212 recent lower limb amputees with diabetes mellitus (158) or peripheral arterial disease only (54) admitted for prosthetic rehabilitation. RESULTS: In 62.2% of all amputees the site of lesion that led to amputation was located in the digits. A lesion under the metatarsal heads was reported in 8.0%, along the mid-foot and heel in 8.5%, on the dorsum of the foot in 3.3%, around the ankle joint and lower leg in 5.7%. Finally, 12.3% reported multiple lesions or were unable to recall the exact anatomic location. CONCLUSIONS: Most foot lesions resulting in amputation are located around the digits. These high-risk sites, therefore, need the patient's and the health care team's special attention. The patient should be trained in self foot examination and meticulous daily care, whereas the role of the health care team is in foot evaluation and provision of protective foot wear.

Adult↗