This study suggests that targeting management toward the prevention of these adverse outcomes may improve parental satisfaction with anesthesia care of their children.
Individuals with transfemoral amputation experience relative motion between their residual limb and prosthetic socket, which can cause inefficient dynamic load transmission and secondary comorbidities that limit mobility. Accurately measuring the relative position and orientation of the residual limb relative to the prosthetic socket during dynamic activities can provide great insight into the complex mechanics of the socket/limb interface. Five participants with transfemoral amputation were recruited for this study. All participants had a well-fitting, ischial containment socket and were also fit with a compression/release stabilization socket. Participants underwent an 8-wk, randomized crossover trial to compare differences between socket types. Dynamic stereo x-ray was used to quantify three-dimensional residual bone kinematics relative to the prosthetic socket during treadmill walking at self-selected speed. Comfort, satisfaction, and utility were also assessed. There were no significant differences in relative femur kinematics between socket types in the three rotational degrees of freedom, as well as anterior-posterior and medial-lateral translation (p > 0.05). The ischial containment socket demonstrated significantly less proximal-distal translation (pistoning) of the femur compared to the compression/release stabilization socket during the gait cycle (p < 0.05), suggesting that the compression/release stabilization socket provided less control of the residual femur during distal translation. No significant differences in comfort and utility were found between socket types (p > 0.05). The quantitative, dynamic analytical tools used in the study were sensitive to distinguish differences in three-dimensional residual femur motion between two socket types, which can serve as a platform for future comparative effectiveness studies of socket technology.
Introduction/PurposeThis study aimed to investigate the effects of isovolumetric training with and without blood flow restriction (BFR) on muscle hypertrophy, power, strength, and aerobic capacity.MethodsTwenty participants (30.2 ± 7.7 yr, 69.6 ± 15.0 kg, 166.8 ± 7.3 cm) were randomized to a control (n = 11) or BFR group (n = 9). Testing sessions included measurement of bilateral thigh circumference, cross-sectional area of the vastus lateralis and biceps femoris via ultrasound imaging, determination of maximum oxygen consumption (V̇O2max) and power output via rowing, and estimated one-repetition maximum (1-RM) deadlift. Participants trained twice weekly for 4 wk. The BFR group (applied to thighs bilaterally at 80% occlusion) rowed at 40% maximum power output and lifted 30% 1-RM for 1 × 20 reps and 3 × 10 reps. The control group rowed at 80% power and lifted 60% 1-RM for 1 × 10 reps and 3 × 5 reps.ResultsAnalyses indicated a main effect over time (P = 0.001) for power (P = 0.001), cross-sectional area of vastus lateralis and biceps femoris bilaterally (P = 0.001 for both), and V̇O2max (P = 0.003), indicating that both groups improved over time. Results also indicated that the control group had higher ratings of perceived exertion than the BFR group during training (P = 0.04).ConclusionsThe two types of training did not produce different results, except the BFR group had a higher output in maximum power. BFR training can be a feasible option for individuals unable to train at 60%–80% of maximum allowing for progressive rehabilitation with lower intensity.
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