Biomechanical effects of an articulating prosthetic toe joint during stair navigation for individuals with unilateral, below-knee limb loss.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of competing interest The authors declare that they have no competing financial interests nor personal relationships that could have inappropriately influenced this work. 6. BMJ Open. 2023 Sep 11;13(9):e071662. doi: 10.1136/bmjopen-2023-071662. Women with limb loss: rationale, design and protocol for a national, exploratory needs assessment to evaluate the unique physical and psychosocial needs of women with limb loss. Disla R(1), Pruziner AL(2)(3)(4), Sidiropoulos AN(5), Ellis KM(4)(6), Bushnik T(7), Hyre MJ(8), Nelson LM(2)(3)(5), Klingbeil H(9), Maikos JT(5). Author information: (1)Physical Medicine and Rehabilitation, James J Peters Veterans Affairs Medical Center, New York, New York, USA Roxanne.Disla@va.gov. (2)National Veterans Sports Programs and Special Events, Department of Veterans Affairs, Washington, District of Columbia, USA. (3)Extremity Trauma and Amputation Center of Excellence, Bethesda, Maryland, USA. (4)Physical Medicine and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland, USA. (5)Prosthetics and Sensory Aids Service, Veterans Affairs New York Harbor Healthcare System, New York, New York, USA. (6)The Center for Rehabilitation Sciences Research, Uniformed Services University of Health Sciences, Bethesda, Maryland, USA. (7)Rusk Rehabilitation, New York University Langone Health, New York, New York, USA. (8)Narrows Institute for Biomedical Research and Education, Inc, New York, New York, USA. (9)Physical Medicine and Rehabilitation, James J Peters Veterans Affairs Medical Center, New York, New York, USA. INTRODUCTION: There is a growing population of women with limb loss, yet limited research is available to provide evidentiary support for clinical decision-making in this demographic. As such, there is a critical gap in knowledge of evidence-based healthcare practices aimed to maximise the physical and psychosocial needs of women with limb loss. The objective of this study is to develop a comprehensive, survey-based needs assessment to determine the unique impact of limb loss on women, including physical and psychosocial needs. METHODS AND ANALYSIS: A bank of existing limb loss-specific and non-limb loss-specific surveys were arranged around domains of general health, quality of life, prosthetic use and needs, psychosocial health and behaviours and body image. These surveys were supplemented with written items to ensure coverage of relevant domains. Written items were iteratively refined with a multidisciplinary expert panel. The interpretability of items and relevance to limb loss were then internally tested on a small group of rehabilitation, engineering and research professionals. A diverse sample of 12 individuals with various levels of limb loss piloted the instrument and participated in cognitive interviews. Items from existing surveys were evaluated for relevance and inclusion in the survey, but not solicited for content feedback. Pilot testing resulted in the removal of 13 items from an existing survey due to redundancy. Additionally, 13 written items were deleted, 42 written items were revised and 17 written items were added. The survey-based needs assessment has been crafted to comprehensively assess the wide spectrum of issues facing women with limb loss. The final version of the survey-based needs assessment included 15 subsections. ETHICS AND DISSEMINATION: This study was approved by the Veterans Affairs Central Institutional Review Board. The results will be disseminated through national and international conferences, as well as through manuscripts in leading peer-reviewed journals. TRIAL REGISTRATION NUMBER: No healthcare intervention on human participants was conducted. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. DOI: 10.1136/bmjopen-2023-071662 PMCID: PMC10496675