OBJECTIVE: To validate a novel device termed the equinometer, which is designed to accurately measure ankle dorsiflexion. DESIGN: Test retest reliability analysis using serial measurements of dorsiflexion endpoint in a group of normal individuals. SETTING: Motion analysis laboratory. PARTICIPANTS: Ten healthy individuals. PRIMARY OUTCOME MEASURE: The mean and standard deviation of the absolute difference in dorsiflexion endpoint for the group. RESULTS: The mean absolute change in dorsiflexion endpoint for the group was 0.45 degrees with a standard deviation of 0.43 degrees. CONCLUSIONS: With the use of the device described, the mean change in dorsiflexion endpoint was well within acceptable clinical limits. The reliability of measurements obtained with the equinometer exceeds that which has been published with other techniques and devices.

Adult↗

PubMedDate not supplied

Postoperative patient-controlled analgesia in children.

Patient-controlled analgesia (PCA) has been found to be an effective method of pain management for adults. Children are now being considered for self-administration of analgesia. With careful patient selection and preparation, nurses and children find patient-controlled analgesia to be an effective way to maintain comfort in the postoperative period.

Analgesia, Patient-Controlled↗

PubMedDate not supplied

A reassessment of center-of-mass dynamics as a determinate of the metabolic inefficiency of above-knee amputee ambulation.

Above-knee (AK) amputation substantially increases the metabolic cost of ambulation. Although the biomechanical mechanisms contributing to the increase have not been well studied, it has been assumed that altered center-of-mass (COM) kinematics and increased mechanical work account for the adverse effect on oxygen consumption. To understand better the relationship between mechanical work and the metabolic cost, 8 normal subjects and 8 traumatic AK amputees were studied during overground ambulation. Using segmental energy and inverse dynamics analyses, trunk COM excursion, the mechanical work associated with movement of the COM, and the work done by the major lower limb sagittal plane muscle groups were determined. Oxygen consumption was measured using the Douglas bag technique. The metabolic cost was 27% higher in amputees compared with normal subjects (P > 0.01), but no significant differences were noted in the excursion of or the work done on the trunk COM. The muscle work needed to complete a stride was significantly greater in normal subjects compared with amputees. These results indicate that the role of abnormal kinematics and their effect on the mechanical work of walking are complex and incompletely understood, but may be overemphasized as a cause of the increased metabolic cost. Alternative mechanisms for the metabolic inefficiency must be considered.

Adult↗

PubMedDate not supplied

Individualized doll therapy with children experiencing limb loss.

Caring for the child and family experiencing a limb loss can be one of the most challenging opportunities for the health care worker. A family-centered approach provides a caring and compassionate way for the child and family to view the complicated medical world. One method that bridges communication between the health care team, patient, family, and community is doll therapy. Individualized doll therapy can help the child understand the amputation, physical limits, prosthetic care, and body image.

Amputation, Traumatic↗