Saudi Cultural Missions Theses & Dissertations
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Item Restricted Effect of Light and Heavy Touch on Transtibial Amputees’ Postural Control and Weight-Bearing Asymmetry(University of Illinois Chicago, 2024) Tobaigy, Moaz; Sawers, AndrewThe objective of this thesis was to determine the effect of augmented sensory feedback and mechanical support on traumatic unilateral transtibial prosthesis users’ postural stability, neuromuscular control, and weight-bearing asymmetry during quiet stance. Our central hypothesis was that postural instability in traumatic unilateral transtibial prosthesis users is a sensory problem. To test this hypothesis 12 traumatic unilateral transtibial prosthesis users and 12 unimpaired age- and sex-matched adults were recruited, enrolled, and completed the study protocol. Participants postural stability, neuromuscular control, and weight-bearing asymmetry were assessed during quiet stance under three conditions: baseline no touch, light touch, which provides sensory feedback, and heavy touch, which provides mechanical support. Postural stability, neuromuscular control, and weight-bearing asymmetry were characterized by center of pressure mean velocity, total integrated area across select lower limb muscles, and a weight-bearing asymmetry index, respectively. In the first study of this thesis unilateral transtibial prosthesis users were found to have greater medial-lateral but not anterior-postural postural instability than age- and sex-matched adults. Importantly, this medial-lateral instability was only resolved relative to age- and sex-matched adults with mechanical support from heavy touch. In the second study we found that neither light touch (i.e., sensory) nor heavy touch (i.e., mechanical support) shifted traumatic unilateral transtibial prosthesis users’ neuromuscular control of postural stability towards proximal muscles during quiet stance. In contrast, we found that mechanical support from heavy touch significantly reduced the total muscle activity used by traumatic unilateral transtibial prosthesis users during quiet stance. In the third study of this thesis we found that despite improvements in postural stability via heavy touch, there was no accompanying reduction in weight-bearing asymmetry, suggesting that weight-bearing asymmetry is not used as a compensation to maintain stability The results of this thesis suggest that contrary to our central hypothesis postural instability in unilateral transtibial prosthesis users may be attributable to mechanical rather than sensory deficits.17 0Item Restricted Skin Complications in Lower Limb Amputees Due to Prolonged Prosthesis Use: A Narrative Review(Saudi Digital Library, 2023-07-27) Amer, Almatrafi; Worsley, PeteBackground: Several types of skin problems can occur due to prolonged use of prosthesis in lower limb amputees due to continuous contact between the device and skin, generation of warmth, increased sweating, and opportunistic microorganisms. These skin problems can lead to discontinuing prosthesis use and poor functional outcomes. Objectives: This study aimed to identify the various skin complications that can occur in lower limb amputees due to prolonged prosthesis use and their prevalence. Study design: This study is a systematic literature review. Methods: Three databases were searched using the relevant search terms and applying the inclusion and exclusion criteria to identify studies suitable for this review. Studies were finalised by scanning the titles and abstracts for relevance, and the quality of the studies was established using the CASP critical appraisal tool. Results: Fifteen studies were identified, and the information obtained from these studies was divided into four categories: incidence and prevalence of skin problems in lower limb amputees, types of skin problems, determinants of skin problems, and unconventional prosthetic devices. Conclusion: Skin problems in 60% of lower limb prosthesis users include pressure ulcers, hyperhidrosis, lesions, infections, sores, irritation, redness, and calluses. The material and fit of the prosthetic device are important determinants of skin problems, followed by the level of physical activity and environmental temperature and humidity. Newer technologies, such as osseointegration, are associated with comparatively fewer and less severe skin problems, and these technologies should be further explored in future studies.9 0