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Thursday evening culminated in poster presentations, a showcase of innovative research shaping the future of O&P. Amidst the discussion of 96 thought-provoking posters, attendees engaged in live voting to honor three standout contributors.

 

First place: Abby Citterman, Antonio Barron, and Kelbi Magnuson (Northwestern University)

Second place: Amanda Kemp (Northwestern University)

Third place: Megan Grunst, Kate Grylicki, and Pauline Porucznik (Northwestern University)

 

Citterman, Barron, and Magnuson presented their capstone research on identifying if clinical assessments of upper limb prosthesis users sufficiently capture all dimensions of human hand function. Guided by mentors Renato de las Reyes and Dr. Matthews, the team aimed to address the challenges faced by individuals with upper-limb differences and the need for valid and reliable outcome measures to assess prosthesis functionality.

 

Their scoping review categorized key hand functions into four domains and identified 12 specific functions of the hand. After searching databases and applying inclusion criteria, they analyzed 24 articles and identified 38 unique outcome measures. The Jebsen-Taylor Hand Function Test emerged as the most popular measure, followed by the Activity Measure for Upper Limb Amputees (AM-ULA) and the Disabilities of the Arm, Shoulder, and Hand (DASH) survey.

 

However, only one outcome measure, the Pediatric Outcomes Data Collection Instrument, evaluated all four identified domains of hand function. The team noted that most outcome measures capture a median of four key functions, with grasping and dexterity being the most represented, while functions like gesturing and communication are less frequently assessed.

 

The presentation emphasized the need for a comprehensive set of outcome measures to capture all dimensions of hand function effectively. They advocated for careful selection and combination of measures based on patient needs and available psychometric evidence. This approach can guide decision-making in both clinical and research settings, ensuring optimal assessment of upper limb prosthesis users' functionality and enhancing understanding of the congruency between anatomical and functional outcomes.

 

The primary objective of Kemper's study was to compare muscle forces between transradial myelogenous prosthesis users and able-bodied individuals during goal-oriented task completion. To achieve this, she assembled a cohort of six able-bodied participants and five individuals with unilateral transradial limb deficiency. The inclusion criteria ensured that both groups, besides the amputation for prosthesis users, had no neurological or other musculoskeletal pathology. Additionally, the prosthesis users had to employ self-suspending myolateral prostheses.

 

Participants were fitted with a marker set covering their upper limbs, and they were tasked with completing five goal-oriented tasks: cutting vegetables, turning a cage, pouring from a cup, lifting and transferring a tray, and lifting and transferring a weighted object. Motion capture data from these tasks facilitated the creation of a custom bimanual model in OpenSim, a simulation software aiding in tracking joint angles and muscle forces.

 

Amanda and her team focused on analyzing muscle forces at the biceps, deltoid, and triceps, aiming to identify peak forces during task completion. Contrary to expectations, muscle forces, particularly at the biceps, were often found to be lower in prosthesis users.

 

The study's findings point towards significant variability in the movement patterns of prosthesis users, a nuance not easily captured in mean and maximum muscle force graphs. This variability challenges preconceived notions and emphasizes the need for more understanding of the impact of compensatory motions on musculoskeletal health.

 

Grunst, Grylicki, and Porucznik presented their third-place poster for their capstone project titled "The Effects of Prosthesis Design Features on Osteoarthritis Risk in the Sound Limb.” They expressed gratitude to their mentors, Wendy Beattie and Matthew Major. The project aimed to investigate specific prosthesis design features' impact on risk factors for osteoarthritis (OA) in individuals with unilateral lower limb amputation.

 

After conducting a literature review using PubMed, Embase, and CINAHL, they narrowed down 250 articles to 25 that met their criteria. They focused on original research involving adult participants with major unilateral amputations and outcomes related to biomechanical risk factors for OA.

 

Key findings included:

 

• Powered prosthetic feet may reduce OA risk factors.

• Powered prosthetic knees may benefit individuals during tasks without prosthetic assistance.

• Microprocessor knees might be more effective in reducing OA risk than non-microprocessor knees.

• Increased ankle push-off in ESAR feet correlates with decreased contralateral external knee adduction moment and subsequent medial knee OA risk.

 

The team identified areas for future research, including considering participants' etiology, functional level, sex, and age due to insufficient data in these areas. They acknowledged limitations such as excluding potentially relevant articles published after their search and not originally including osseointegration terms in their search criteria. Additionally, there is a lack of longitudinal studies linking prosthesis changes to OA development and limited data on socket alignment, suspension, and weight's impact on OA outcomes.

 

As we reflect on these outstanding contributions, it becomes evident that the future of O&P is in capable hands, driven by innovative research that challenges assumptions, broadens understanding, and opens new avenues for advancement. The collaborative efforts of these researchers underscore the importance of continuous exploration and adaptation in the ever-evolving landscape of orthotics and prosthetics.