September 2018 O&P Almanac

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Lower-Limb Amputees With Comorbidities Shown To Benefit From Prosthetic Intervention Researchers at Hanger Inc. have concluded the second part of their Mobility Analysis of Amputees (MAAT II) study on lower-limb amputees. The study investigated the impact of those comorbidities comprising the Functional Comorbidities Index (FCI) and other notable comorbidities, and their influence on mobility among people living with lower limb loss. MAAT II findings demonstrated a person’s overall comorbid health has little impact on mobility with a lower-limb prosthesis, as patients with multiple comorbidities benefit from a prosthesis that provides meaningful mobility, according to the researchers. “The continued rise in lower-limb amputations is creating a need for improved means of identifying patients who will benefit from prosthetic rehabilitation and technology,” explained James

Campbell, PhD, CO, FAAOP, chief clinical officer, Hanger Clinic. “In the absence of strong research support to guide prosthetic rehabilitation, decision makers have been restricted in their options for identifying prosthetic candidates. Historically, comorbid health has been among the factors utilized, despite a lack of strong evidence to support this application, which necessitated further research.” Campbell, along with Shane R. Wurdeman, PhD, CP, FAAOP, and Phil M. Stevens, MEd, CPO, FAAOP, performed a retrospective review of outcomes data collected within multiple clinics, analyzing the data of nearly 600 adult lower-limb prosthesis users. The primary endpoint included within the analysis was the Prosthetic Limb Users Survey of Mobility (PLUS-M). The researchers found only four

factors to be significant predictors of mobility: age, history of stroke, presence of peripheral vascular disease (PVD), and anxiety/panic disorders. With compounding comorbid health conditions, mobility declines; however, after adjusting for age, history of stroke, PVD, and anxiety/panic disorders, there was no significant impact of comorbid health on mobility. The MAAT II study concluded the presence of comorbidities does not preclude meaningful mobility. The researchers advise clinicians to consider age, history of stroke, PVD, and anxiety/ panic disorders in formulating their plan of care to maximize patient mobility. The outcomes from the MAAT II study will be published in an upcoming print edition of American Journal of Physical Medicine and Rehabilitation, and are available via early release online.


Service Members Compete in Warrior Games More than 300 active-duty military service members and veterans took part in the 2018 Department of Defense Warrior Games, hosted this year by the Air Force Academy in Colorado. Representatives from all branches of the U.S. military, as well as competitors from the United Kingdom, Canada, and Australia, participated in the June event.



PHOTO: Scheck & Siress

Tim Russo, CPO, LPO, a Scheck & Siress practitioner, assists a competitor at a repair station during the 2018 Warrior Games.

Athletes competed over a nine-day period in June in 11 Paralympic-style sporting events, including track and field, sitting volleyball, wheelchair basketball, swimming, shooting, archery, powerlifting, and indoor rowing. Designed to introduce wounded, ill, and injured service members to adaptive sports, the Games featured several participants using prostheses or orthoses. Scheck & Siress participated in the event as a sponsor and provided a prosthetic and orthotic repair station, featuring a team of clinicians and a mobile lab equipped with machinery and computer-aided design technology. The repair team completed tasks such as overhauling prosthetic running legs, troubleshooting and repairing O&P equipment, resolving comfort and fit issues, and performing modifications and adaptations to optimize various sporting equipment. “After struggling to walk with paralysis in the back of my leg for over two years, I spoke with the people working at the Scheck & Siress stand at Warrior Games. They set me up with a small orthotic that compensates for the weakness in my calf and they had me walking normally in five minutes,” said Breton Carroll, a retired Canadian Army signals officer. Next year’s Warrior Games will take place in Tampa, Florida, June 21-30, and will be hosted by the U.S. Special Operations Command.