Rebuilding wounded veterans: Annual review of limb loss & prosthetics research


The Journal of Rehabilitation Research and Development (JRRD) has compiled a compendium of articles describing advances in limb loss and prosthetics research published in 2004. This research provides state-of-the-science knowledge, evidence-based rehabilitation practices, techniques, and devices that enable veterans and others with limb loss to improve their health outcomes, to participate in sports and leisure activities, and to perform the mundane activities of daily-living able-bodied people take for granted.

March/April 2004 (Volume 41, Number 2) Pg. 175 "Liner" classification system may revolutionize prosthetic limb fitting
Investigators developed a classifica-tion system to better match elastomeric liners (stretchy socks worn between residual limbs and prosthetic sockets) with the needs of patients with amputations. The newly-developed classification system will guide elastomeric liner prescription and fitting by providing information comparing the mechanical performance of different liner products.

May/June 2004 (Volume 41, Number 3B) Pg. 453 Smoking, foot care linked to self-efficacy in people with amputations
Investigators describe the extent to which veterans with a nontraumatic, unilateral lower-limb amputation engage in foot care and smoking, and if health beliefs and psychological well-being are related to those health behaviors. A belief in one's ability to engage in good foot care and that good foot care reduces the risk of future foot problems were significantly correlated with daily foot care practices. In addition, psychological well-being was significantly related to foot care and smoking status.

Pg. 481 Telerehabilitation for veterans with a lower-limb amputation or ulcer
Investigators analyze the acceptability of information available via a customized telerehabilitation system regarding patients with lower-limb ulcers or recent lower-limb amputa-tions. This study provides evidence that the telerehabilitation system has the potential to present sufficient information to experienced clinicians so they can make informed decisions regarding wound management.

Pg. 491 New prosthetic sockets system streamlines artificial limb production
Investigators discuss a simple method of fabricating a prosthetic socket using a pressure casting (PCast) technique. The simplicity and potentially rapid fabrication of the PCast system makes it a useful alternative in prosthetic socket production.

July/August 2004 (Volume 41, Number 4) Pg. 535 Shoe choice impacts soft tissue damage to residual limb of people with amputations
Investigators quantify the structural properties and energy dissipation capacity of prosthetic feet and footwear. They found energy dissipation capacity knowledge can aid in prosthetic foot and shoe selection to reduce the risk of residual limb soft tissue damage.

Pg. 547 Shoes worn during lower-limb prosthesis fitting limits shoe choice later
Investigators examine how shoe heel height affects the rollover characteristics of the biologic foot and ankle. The data reveal that the initial alignment of the prosthesis with a particular pair of shoes creates a heel height constraint for other shoes that might be used with the device without further manual adjustments of the alignment.

Pg. 555 Literature review reveals huge gaps in prosthetics research
Investigators report the results of a literature review on the effects of prosthetic components on human functioning with a lower-limb prosthesis. This literature review points out considerable gaps in knowledge concerning the effects of prosthetic components on human functioning with a lower-limb prosthesis.

Pg. 581 Greissinger Plus foot outperforms SACH foot for individuals with limb loss
Investigators evaluate the SACH and the Greissinger Plus prosthetic feet during gait in below-knee amputees during early rehabilitation. The Greissinger Plus foot significantly improved both spatial and temporal parameters, and provided increased interlimb symmetry for the range of motion in the hip and ankle, and for the stance phase period.

Pg. 591 Individuals who use gel liner socket with prosthesis more physically active
Investigators compare two socket liner/suspension systems for below-knee artificial legs on patient satisfac-tion, comfort, pain, and walking activity during normal daily life. This study provides information that may guide prosthetists in choosing the most appropriate socket system for patients.

September/October 2004 (Volume 41, Number 5)
Pg. 675 Novel knee prosthesis provides more stability and ease of movement than those currently available

Investigators compare the gait (walking) of individuals with lower-limb amputations using a prototype knee to prosthetic knees currently used. Volunteers had increased stability and ease of swing with the knee prototype.

Pg. 683 Most residual limb changes occur within minutes of removing prosthesis
Investigators determine how much a residual limb changes volume and shape after prosthesis removal. Results showed that changes in volume over a 35-minute interval after prosthesis removal were greater than those experienced over a two-week interval. Study results provide a base from which to investigate fluid movement responsible for the shape changes in residual limbs.

Pg. 695 Q-TFA reliably measures prosthetic use, health in persons with a lower-limb amputation
Investigators assess the validity and reliability of the Q-TFA (Questionnaire for Persons with a Trans-femoral Amputation), a new self-report outcome measure designed to reflect current prosthetic use, mobility, problems, and health in nonelderly persons with an above-the-knee amputation. Study results support adequate measurement properties of the Q-TFA on persons using an above-the-knee socket prosthesis.

November/December 2004 (Volume 41, Number 6A)
Pg. 757 Molecular study of osseointegration in rodents helps identify human candidates for new technique

Investigators analyze osseointegration at the molecular level to better understand the unique relationship of a titanium implant to living bone in a rodent femur model. This insight into bone biology will help define the patient selection criteria and enhance the success of the procedure.

Pg. 775 Monolimb provides same comfort and flexibility as high-end prosthetic limbs
Investigators study the effect of leg design on the flexibility and structural integrity of monolimbs and the stress distribution at the prosthetic socket-residual limb interface. The data revealed that stress is reduced at the socket-limb interface when a more flexible shank is used, providing a more comfortable fit.

Pg. 821 Prosthesis with suction suspension system better for amputee with active lifestyle
Investigators compare pressure applied to the residual limb with pin and suction suspension systems to identify causes of residual limb skin problems. They found that walking with the pin liner likely disrupts circulation within the residual limb, resulting in skin changes, the system may be inappropriate for an active amputee or those with circulatory complications.

About the Journal
JRRD has been a leading research journal in the field of rehabilitation medicine and technology for 40 years. JRRD, a peer-reviewed, scientifically indexed journal, publishes original research papers, review articles, as well as clinical and technical commentary from U.S. and international researchers on all rehabilitation research disciplines. JRRD's mission is to responsibly evaluate and disseminate scientific research findings impacting the rehabilitative healthcare community. For more information about JRRD, visit

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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