Adrianus Buis

Provision of prosthetic and orthotic services in low-income countries: a review of the literature.

Background: Disability is inextricably linked to poverty. A total of 80% of the disabled population lives in low-income countries. The demand for prosthetic and orthotic services in these countries is increasing, and a variety of methods to provide services are currently used. Objectives: To assess current models of provision to facilitate sustainable, evidence-based prosthetic and orthotic services. Study Design: Literature review. Methods: A literature search was performed through Medline (Ovid), PubMed, ISI Web of Knowledge, EMBASE and RECAL Legacy using combinations of subject heading and text word searching strategies. Full-text publications were critically appraised and ranked according to the Scottish Intercollegiate Guidelines Network guidelines. Results: Three areas were deemed pertinent to the research question. Studies were grouped into one or more of these categories based on the issues addressed: instigators, types of service provision, demographics and region-specific issues. It was found that many complex factors influence prosthetic and orthotic services in low-income countries. Demographic and regional idiosyncrasies require prosthetic and orthotic services to be tailored to address the specific needs of individual countries. Conclusions: The lack of and quality of available research made efficacy of methods used to provide services in low-income countries difficult to determine. Clinical relevance This review aims to highlight areas of best practice in prosthetic and orthotic services in low-income countries and to show where further research is required in order to develop evidence-based prosthetic and orthotic services.

Nitinol for Prosthetic and Orthotic Applications

As global populations age, conditions such as stroke and diabetes require individuals to use rehabilitation technology for many years to come due to chronic musculoskeletal, sensory, and other physical impairments. One in four males currently aged 45 will experience a stroke within 40xa0years and will often require access to prolonged rehabilitation. In addition, worldwide, one individual loses a limb every 30xa0s due to the complications of diabetes. As a result, innovative ideas are required to devise more effective prosthetic and orthotic devices to enhance quality of life. While Nitinol has already found much favor within the biomedical industry, one area, which has not yet exploited its unique properties, is in the field of physical rehabilitation, ranging from prosthetic and orthotic devices to assistive technology such as wheelchairs. Improved intervention capabilities based on materials such as Nitinol have the potential to vastly improve patients’ quality of life and in the case of orthoses, may even reduce the severity of the condition over time. It is hoped that this study will spark discussion and interest for the materials community in a field which has yet to be fully exploited.

Cadence, energy expenditure, and gait symmetry during music-prompted and self-regulated walking in adults with unilateral transtibial amputation.

BACKGROUNDnWalking cadence has shown promise for estimating walking intensity in healthy adults. Auditory cues have been shown to improve gait symmetry in populations with movement disorders. We investigated the walking cadence-energy expenditure relationship in unilateral transtibial amputees (TTAs), and the potential of music cues for regulating walking cadence and improving gait symmetry.nnnMETHODSnSeventeen unilateral TTAs performed 2 5-min treadmill walking trials, followed by 2 5-min overground walking trials (self-regulated brisk intensity, and while attempting to match a moderate-tempo digital music cue).nnnRESULTSnWalking cadence significantly (P < .001) and accurately (R(2) = .55, SEE = 0.50 METs) predicted energy expenditure, and a cadence of 86 steps·min(-1) was equivalent to a 3-MET intensity. Although most participants were able to match cadence to prescribed music tempo, gait symmetry was not improved during the music-guided condition, compared with the self-regulated condition.nnnCONCLUSIONSnThis is the first study to investigate the utility of walking cadence for monitoring and regulating walking intensity in adults with lower limb prosthesis. Cadence has similar or superior accuracy as an indicator of walking intensity in this population, compared with the general population, and adults with a unilateral TTA are capable of walking at moderate intensity and above for meaningful bouts of time.

How photonic networking can help data centres

In light of rapidly increasing demand for ultra-high speed data transmission, data centres are under pressure to provide ever increasing data transmission through their networks and at the same time improve the quality of data handling in terms of reduced latency, increased scalability and improved channel speed for users. However as data rates increase, present electronic switching technology using current data centre architecture is becoming increasingly difficult to scale despite improved data management. In this paper electronic scalability issues will be discussed and alternative optical solutions will be reviewed including a novel and highly scalable optical interconnect.