Which percentile is required for IIM Raipur

Prosthetics

Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Congress: ORTHOPAEDIE + REHA-TECHNIK 2012

Tuesday 2012/05/15 - Friday 2012/05/18

Session [4680]

Opening ceremony

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Congress: ORTHOPAEDIE + REHA-TECHNIK 2012

Tuesday 2012/05/15 - Friday 2012/05/18

Keynote Speech [4308-1029]

Prosthetics and orthotics under scrutiny of the care providers

Keynote Author

Lotz, Klaus-Jürgen (Gießen DE)

ORS GmbH

Abstract

The current situation of the orthopedic technical subject as well as the future direction in the

The supply system of the FRG is highlighted and the challenges presented and the necessary ones

Mechanisms of action shown.

Introduction

It shows how the supply situation has changed in recent years in the course of the legal requirements

has developed a strongly changed supply landscape. It is made clear that the resources in

are consumed in the wrong direction and this is actually the purpose of optimal patient care

the opposite: system maintenance versus need for supply.

It is highlighted what the consequences and what the benefit for society can be.

The question is also raised as to whether modern technical orthopedics will still be affordable in the future

and how the supply structures are adapted to medical and technical progress

have to. In addition, the need for more communication among the am

The people involved in the supply process gave a lecture and showed which design options

must be used in today's times.

In addition, the current status of the supply structure in the cash register landscape is analyzed and

the need for change is shown taking into account the legislation available

legal instruments provided.

Methods

The second part explains how the specialist representation should be set up in the next few years

which measures have to be taken and have already been taken to ensure that they are adequate and professional

Specialized drafts and concepts for working with the legislature and the payers too

shape.

Examples are used to explain how many challenges the subject will face in the next few years

and how necessary it is to work with those involved in care. Furthermore, the

Tasks and opportunities in the health market are presented and the constantly growing diversity is highlighted

the supply options and the further development of products and services Exemplary

listed.

Results

The change in the age pyramid and the associated need for

Structural change under the sign of affordability is one of the greatest challenges

the field of expertise. The professional orientation of the association is just as important here as the pronounced one

interdisciplinary cooperation of all those involved in the supply process.

In Germany we have a globally recognized high reputation in the supply of technical

Orthopedics, both in the field of professional training and further education as well as in the technical field

Further development. In addition, we are fortunate enough to be market leaders in the orthopedic industry

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

To know partners at our side who are ready to take on the challenge of the subject and

to translate shared responsibility into action.

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Congress: ORTHOPAEDIE + REHA-TECHNIK 2012

Tuesday 2012/05/15 - Friday 2012/05/18

Symposium [4196]

Influence of biomechanics on the design of modern sockets for

the lower extremity

Session chair

Gawron, Olaf (Heidelberg DE)

Pohlig Orthopädie-Technik, Heidelberg branch - lower extremity prosthetics

Session chair

Stinus, Hartmut (Bovenden DE) | Dr.

Orthopedic group practice Northeim

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Symposium: Influence of biomechanics on the design of modern sockets for the lower extremity

Tuesday 2012/05/15 15:00 - 16:15 | Topic: Prosthetics | Subtopic / Track: Lower Limb Prosthetics

Congress Lecture [4197-999]

The differences in anatomy and biomechanics from the knee

disarticulation to the short transfemoral amputation

Author

Blumentritt, Siegmar (Duderstadt DE) | Prof. Dr.

Otto Bock HealthCare GmbH - Research

Abstract

The stump performance is essential for the achievable participation of above-knee amputees. The

The length of the residual limb influences the residual limb performance. The article shows which effects

the length of the stump depends on the gait pattern of the transfemoral amputee and the selection of the joint.

Introduction

For the indication-based prescription of a knee joint, it is indisputably important which motor joint

The amputees have performance potential and what rehabilitation goal they are striving for. The

Stump performance has for regaining a high mobility of the amputee with a

The prosthesis is very important. The stump acts as a motor drive for the locomotion of the

For amputees and at the same time, the residual limb moment acts on the stability of the prosthesis in support phases of the

Movement a.

In general, it can be assumed that the shorter the stump, the more difficult it is

the residual limb bedding, fewer and fewer muscles are able to develop the strength of the residual limb and thus to

Prosthesis control contribute and ultimately the power transmission potential is reduced due to the

shortening lever arm. The article deals with anatomical and biomechanical aspects.

Methods

In the gait laboratory, three groups of patients were examined while walking on a level surface,

who mostly wore the C-Leg prosthetic knee joint. The first group consists of 10 one-sided

Above-thigh amputees who have short stumps. The subjects of the second group with 8 one-sided

Above-thigh amputees have stumps of medium or long length. Two knee disarticulates form the third

Group.

The prostheses were assembled in the LASAR assembly. With the LASAR Posture build-up measuring device

(Otto Bock HealthCare, D) the statics were adjusted. After the dynamic try-on, the

Measure the prosthesis structure and the statics of the contralateral leg with the LASAR Posture.

The movement was recorded with the 6 camera VICON System 460 (Vicon Motion Systems, Oxford, UK)

detected. The ground reaction forces were measured with 2 force plates (Kistler Instrumente AG, Winterthur, CH)

measured.

The kinematic and kinetic measured variables are converted into joint angles and external moments

calculated.

Results

Lower extremity statics

The foot and knee positions of the prosthesis in relation to the load line are the same for all groups. The

The distance between the greater trochanter and the load line is less in the short stump group than in the group with

long and medium stumps. The prostheses of the short stump group are thus built up somewhat more securely.

Time-distance parameters

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

In all three self-selected speed ranges, the amputees walk with short stumps

slower than the amputees with the longer stumps. The difference is about 13 percent.

The amputees with short stumps walk with shorter steps on the prosthesis side. They are against it

Stride lengths of the leg obtained are about the same.

The stance phase duration of the prosthetic leg does not depend on the length of the residual limb. The stance phase duration

On the non-amputated side, the short stump group of amputees is longer, the

The swing phase portion of the gait cycle is correspondingly shorter.

kinematics

The knee angle curve is not different when walking at ground level. The patients with short stumps

walk with a thigh that is about 5 degrees more stretched.

kinetics

The hip moments on the prosthesis side are around 50% in the first part of the stance phase for short stumps

reduced to comparison group. These patients also develop during the initiation of the swing phase

lower hip moments.

Higher hip moments are observed on the contralateral side for almost the entire gait cycle

the short stump group measured.

Conclusion

The motor skills of the amputee with a short stump are compared to that of the amputee with one

medium-length or long stump changed significantly. The stump performance, assessed with the

Hip moment when walking flat is reduced by about 50 percent in these amputees.

Because of the reduced stump performance, the amputees move around when taking on the load

at the beginning of the one-legged stance phase with low stance phase security and thus with a

increased potential risk of falling. The necessary stance phase security can only be achieved with the

Selection of a suitable knee joint that offers sufficient security is encountered

Stance phase security does not depend on the stump performance.

The stump performance of the knee disarticulate is also that of the above-knee amputee

clearly superior to a long stump. The residual limb is endurable, the hip biomechanics close to

physiological.

References

[1] Blumentritt S, Bellmann M, Schmalz T: Knee disarticulation: anatomy and biomechanics. Med Orth Tech

(6,2009);129:21-30

[2] Blumentritt S, Braun J, Bellmann M, Schmalz T: For the indication of the C-Leg knee joint system

in the prosthetic fitting of amputees with short transfemoral stumps. Med Orth Tech

(5,2009);129:61-74

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Symposium: Influence of biomechanics on the design of modern sockets for the lower extremity

Tuesday 2012/05/15 15:00 - 16:15 | Topic: Prosthetics | Subtopic / Track: Lower Limb Prosthetics

Congress Lecture [4198-1237]

The importance of muscle stabilization and its relation to

biomechanics in trans-femoral amputation

Author

Gottschalk, Frank (Dallas US) | Prof. Dr.

Southwestern Medical School - Dpt. of Orthopedics

Abstract

Maintenance of the mechanical axis of the leg and femoral shaft axis in trans-femoral amputations is vital

to allow for adequate socket fitting and enhancing patient function. The normal mechanical axis is 3 ° from

vertical and the femoral shaft axis is 9 ° from vertical.

Introduction

Contributing to the maintenance of the 2 axes is adductor magnus which is one of 2 crucial muscles

in a trans-femoral stump that provides soft tissue stabilization and continued muscle function. Myodesis

(anchorage of muscle directly to bone) of Adductor magnus and the Quadriceps musculature provides the

necessary soft tissue stabilization that holds the femur in its correct alignment. The muscle stabilization

provides the prosthetist with firm soft tissue and a stable residual femur in near normal alignment with

which to fit the socket, and for the patient, an opportunity to maintain function at their individual level. A.

myocutaneous flap is created using a medial flap which is sutured laterally over the end of the femur. The

Adductor magnus muscle is detached at the adductor tubercle and the muscle belly is not transected.

Viability is maintained by the obturator artery which remains patent in vascular disease. The quadriceps

muscle is sutured over the underlying adductor magnus and is anchored to the bone.

Methods

Radiographic studies of amputees with 2 types of sockets were done. Biomechanical studies of the

Adductor magnus muscle were undertaken. Operative myodesis of adductor magnus at the time of

amputation contributes to the maintenance of mechanical and femoral shaft axes.

Results

Adductor myodesis maintains femoral axis alignment and reduces the severity for femoral shaft abduction.

Conclusion

Muscle preservation myodesis allows for satisfactory prosthetic fitting to improve function.

References

1. Atlas of Amputations and Limb Deficiencies. Third edition. American Academy of Orthopedic Surgeons,

2004

2nd Symposium on Amputations Clin Orthop April 1999 Number 361; pp2 - 115.

3. Controversies in lower-extremity amputation J Bone Joint Surg 89A May 2007; 1118-27

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Symposium: Influence of biomechanics on the design of modern sockets for the lower extremity

Tuesday 2012/05/15 15:00 - 16:15 | Topic: Prosthetics | Subtopic / Track: Lower Limb Prosthetics

Congress Lecture [4199-1258]

Modern socket design in above knee prosthetics. What is allowed?

Author

Alley, Randall (Thousand Oaks US) | CP, LP

biodesigns, inc.

Abstract

Traditional prosthetic socket designs do not provide adequate control of the underlying bone of the

amputated limb. This is because their inherent encapsulation method cannot impart sufficient compression

to the overlying tissue to prevent unwanted skeletal motion within the interface.

A new model incorporating skeletal capture technology that utilizes an alternating series of compression

and release zones preloads strategic areas of soft tissue overlying the bone such that intrinsic motion or

motion within the interface is minimized.

A more responsive (energy conserving) and stable interface is the result.

Introduction

Newton’s First law essentially states that an object at rest will remain at rest unless acted upon by sufficient

force to create a change in state. In prosthetic applications, the low damping force of the surrounding soft

tissue overlying the bone of the amputated limb allows excess skeletal motion to occur within the interface

(intrinsic motion). This intrinsic motion occurs prior to any "change in state" of the prosthesis, otherwise

regarded as functional or prosthetic motion. Because the amputated bone is attached at its proximal joint,

It acts as a damped and driven pendulum as it swings in an arc within the interface until an appropriate

counterforce is exerted, typically by sufficient compression of the tissues lying between the moving bone

and the socket wall.

In this paper we illustrate why a different approach based on an alternating soft tissue compression and

release model offers a way to more efficiently capture and utilize skeletal motion in order to optimize

functional motion. Since more of the wearer's skeletal motion is being transferred to the prosthetic interface,

Less energy is expended during ambulation and positioning of the prosthesis. In addition, by mitigating

detrimental intrinsic motion, greater stability, load carrying ability and a greater range of motion are

possible.

Methods

Subjects: 5 males and 3 females of various ages heights, weights, amputation levels and lengths were

analyzed.

Apparatus: surveys, questionnaires; gait analysis, range of motion video analysis and energy expenditure

where appropriate was studied

Procedures: Study subjects were evaluated according to their amputation level such that desired

characteristics of lower limb and upper limb prosthetic function were delineated (eg distance walked in a

given time, HR, etc. for lower limb and range of motion under load for upper limb subjects)

Data Analysis: Distance over a given time interval was measured for traditional and high-fidelity sockets

on same components, heart rate was used to determine energy expenditure as well as gait analysis to

ascertain differences in stride length and gait speed in lower limb subjects while video analysis was used to

ascertain range of motion and positional capability along with interface rotation and translation in response

to applied external loads in upper limb subjects.

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Results

In lower limb subjects, greater distance in a given time was achieved with the High-Fidelity interface, and

energy expenditure was reduced relative to increases in gait velocity. In all upper limb subjects, range

of motion under load and positional capability were increased while interface rotation and translation in

response to applied external loads were decreased.

Conclusion

By releasing tissue out of the field of compression we gain greater preloading and hence increased density

of tissue over the underlying bone resulting in less lost motion and greater energy efficiency.

References

Newton, I. Philosophiae Naturalis Principia Mathematica. London: 1687

Alley, RD et al, Prosthetic Sockets Stabilized by Alternating Areas of Compression and Release

JRRD vol 48 no.6 2011 pgs 679-696

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Symposium: Influence of biomechanics on the design of modern sockets for the lower extremity

Tuesday 2012/05/15 15:00 - 16:15 | Topic: Prosthetics | Subtopic / Track: Lower Limb Prosthetics

Congress Lecture [4200-1256]

Functional prosthetic socket design as the key to a successfull

application of modern prosthetic systems in lower limb

prosthetics

Author

Gawron, Olaf (Heidelberg DE)

Pohlig Orthopädie-Technik, Heidelberg branch - lower extremity prosthetics

Coauthors

Schäfer M, builder T, Rehg M

Abstract

Despite technically highly demanding further developments of industrially manufactured prosthetic components

represents the prosthesis socket as an orthopedic, individual craft product in the

Overall view of a prosthesis is still the most important component.

Introduction

It acts as a link between people and technology and has essential tasks in the process

To fulfill prosthesis control, force absorption and transmission. Sophisticated, modern

Only then can microprocessor technology of passively or actively functioning foot and knee systems

can be used effectively if the user has continuous and stable control of these components

succeed.

Methods

A well-functioning shaft reflects the interplay of several important factors. An exact

Fit, correctly selected socket materials according to the stump properties and a

correct biomechanical structure are the essential characteristics for this. In principle, everyone should

Patient have a well-fitting prosthesis socket. Using innovative techniques, the

Components, especially active users, more and more functions are available.

New functions not only have a positive effect on use, but can also be new or

cause increased forces between the stump and socket. On top of that, technically

more complex components often have a greater dead weight than simpler constructions. Both

Factors cause the shear and loading forces on the stump to increase. So that the

If the buttocks are able to absorb these forces evenly, an optimal one is required

Stem adjustment.

Results

Ensuring the correct stem volume, maintaining the clear width dimensions in the

The shaft entry level, the soft tissue compression between the residual limb and the shaft and the determination of the

adequate shaft length are just a few important parameters.

The following article will explain the necessities of modern socket systems using different socket

Represent design variants. The aim must always be to construct a shaft,

in which there are as few residual limb movements as possible in the socket and as few movements as possible

of the bony structures within the soft tissues. If this succeeds, the user has one possible

good control of the prosthesis and can achieve the maximum possible according to the supply situation

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Absorb force on the stump. This means that the prosthesis wearer

can use the advantages of modern leg prosthesis systems as effectively as possible.

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Congress: ORTHOPAEDIE + REHA-TECHNIK 2012

Tuesday 2012/05/15 - Friday 2012/05/18

Symposium [4191]

P&O considerations in the treatment of patients with severe burns

Session chair

Brückner, Lutz (Leipzig DE) | Priv.-Doz. Dr. med. habil.

Session chair

Martig, Ralph (Freiburg DE)

Medical supply store Franz Schaub KG

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Symposium: P&O considerations in the treatment of patients with severe burns

Tuesday 2012/05/15 15:00 - 16:15 | Subtopic / Track: Compression Therapy

Congress Lecture [4192]

Acute treatment of burn injuries

Author

Steen, Michael (Hall DE) | PD Dr. med. habil.

BG Clinics Bergmannstrost - Clinic for Plastic Surgery

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Symposium: P&O considerations in the treatment of patients with severe burns

Tuesday 2012/05/15 15:00 - 16:15 | Subtopic / Track: Compression Therapy

Congress Lecture [4193-1230]

Complex stationary rehabilitation of severe burn injuries in

rehabilitation clinics

Author

Ziegenthaler, Hans (Bad Klosterlausnitz DE)

Moritz Clinic - Specialist clinic for orthopedic-traumatological rehabilitation

Abstract

In Germany around 20,000 children and adults suffer burn injuries every year

Impairments of body functions and structures, of functional abilities and of

social integrity. Of these, around 1,600 can be assessed as difficult and all in one

Intensive therapy for burn injuries center. And like the skin, it also reacts

the soul sensitive. This results in a special need for rehabilitation.

Introduction

And like the skin, the soul is also sensitive. This results in a special one

Rehabilitation needs. From deep burns (IIb), dermal structures are used as the basis

Physiological regeneration largely destroyed by epithelialization. Excessive

Repair mechanisms lead to hypertrophic (excessive) scarring. From 18 to 24

The process of scar maturation, the longest phase of wound healing, takes months

underlying a restructuring of the scar. The result is a thickened and solidified, more elastic and

mechanically more resilient scar.

Treatment: An indication for inpatient rehabilitation is from 2nd degree burns

15 percent and in the 3rd grade from 10 percent and more of the body surface can be seen.

Methods

In problem areas such as the hands, face, front neck and / or shoulder area

as well as cross-joint z. B. on the elbow, knee or ankle sometimes have an effect

small-area scars are particularly detrimental to functional results. In such cases, like

also in the case of multiple trauma, high voltage accidents or additional amputations

Rehabilitation needs primarily based on the functional objectives. Rehabilitation process and that

Rehabilitation teams: therapists from the most diverse

Occupational groups are divided into medical, social and

vocational rehabilitation as well as psychological care in the complex and varied

Rehabilitation process involved:

Results

Rehabilitative Nursing: With daily living activities (ADL) training on

Morning, skin and wound care after scar treatment as well as skin, wound and

Personal hygiene in the evening reach the time scope and intensity of nursing a

extraordinary extent. Specific scar treatment: an integral part of the individual

Treatment is daily full medical baths and a special scar massage with elements of the

Lymph and connective tissue massage. The locally decongesting effect improves the trophic situation and

promotes scar maturation as well as mobility in tissue and joints. In the course is then mostly

the use of negative pressure vacuum massage (UVM) under the above Objective setting possible.

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Physiotherapy: With the aim of promoting joint mobilization, stretching

Soft tissue structures, the stimulation of proprioceptive afferents and the initiation

Everyday-relevant functions come predominantly but also individually therapeutic

Group treatments are used.

Occupational therapy: Here, functional disorders in the area of ​​the upper extremities are superficial

treated. In addition to active and passive movement exercises are the treatment of the scarring and

contract structures, positioning and splint treatment, proprioception, fine motor skills and

Sensitivity training as well as the provision of necessary aids with a focus on functional, everyday and

job-oriented occupational therapy.

Conclusion

Compression therapy: In the process of scar maturation a continuous pressure of

an average of 25 mm Hg against hypertrophic scarring by textile knitted fabrics.

Silicone application: on contoured body regions such as B. in the face and hand area

Made-to-measure products made of silicone prove themselves, which have a positive influence on the

Have scarring.

Psychological aspects: scars, the burn injury itself but also its consequences

have far-reaching psychological consequences. Sleep disorders, self-esteem crises, shame and

Feelings of guilt, as well as social withdrawal, depression, and adjustment disorders are felt in the

Literature cites 30 to 50 percent of burn injuries. Less common (< 20="" prozent)="">

the full picture of a post-traumatic stress reaction (PTSD), more often it is prolonged

Adjustment disorders and depression. Specialized knowledge and clinical experience in psychology

traumatized victims are essential.

References

Follow-up care: Despite a 4 to 8-week inpatient rehabilitation, a consistent one

further outpatient treatment with scar massage, compression therapy and, accordingly, the

Functional restrictions, including further medical and / or occupational therapy, mostly over the age of 12

up to 18 months required. The self-help groups provide valuable advice.

Conclusion

Just a complex and specialized as well as individual and at the same time versatile

The rehabilitation concept can meet the specific demands of the burn victim. This

needs support with the first steps in the "new life", who can get through

Expertise, professionalism, experience, purposeful action and empathy

excels.

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Symposium: P&O considerations in the treatment of patients with severe burns

Tuesday 2012/05/15 15:00 - 16:15 | Subtopic / Track: Compression Therapy

Congress Lecture [4194-1200]

Silicone and compression in the post-treatment of severe burn

injuries

Author

Meier, Patrick (Bellikon CH)

Rehabilitation Clinic Bellikon Switzerland - OHR / orthopedic technology

Coauthors

John Blasel

Abstract

When treating people with severe burns, care should be taken to ensure that they are treated as soon as possible

Compression and silicone treatment can be started. During the scar healing process

(12-24 months) it is important to accompany the patient and at regular intervals the

To check pressure conditions as well as the silicone pads, so that the fit is guaranteed.

Introduction

Especially with deep burns it is important after wound healing with the compression and

Begin silicone therapy. Such burns are mostly associated with skin grafts,

these tend to proliferate in the course of scar healing (hypertrophic, keloids) by means of compression

we succeed in reorganizing the disordered connective tissue structure. With the silicone treatment

we ensure that particularly hardened scars become soft and elastic again.

Methods

It is important in compression scar therapy as well as in silicone scar therapy

To see patients at regular intervals and to check the pressure conditions. This can

by means of a pressure measuring device such as the KIKUHIMME from TT MediTrade. The

Pressure measurements should be measured statically as well as dynamically.

Results

Experience confirms that if you consistently use

Compression clothing as well as the correct use of silicone pads increase the number of operational

Scar corrections can be reduced.

Conclusion

The optimal interaction of all treatment methods (compression treatment,

Silicone treatment, scar-oriented tissue treatment, wound treatment) gives the desired result

Result.

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Symposium: P&O considerations in the treatment of patients with severe burns

Tuesday 2012/05/15 15:00 - 16:15 | Subtopic / Track: Compression Therapy

Congress Lecture [4195]

The frequently difficult psychological condition of patients with

serve burn injuries

Author

Ullmann, Utz (Hall DE) | Dr. phil. Dipl.-Psych.

BG Clinics Bergmannstrost - Medical Psychology

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Abstracts

Congress: ORTHOPAEDIE + REHA-TECHNIK 2012

Tuesday 2012/05/15 - Friday 2012/05/18

Session [4562]

Foot and Shoe 1

Session chair

Tettke, Martin (Berlin DE) | Dipl.-Ing.

Technical University of Berlin - Department of Medical Technology

Session chair

Greitemann, Bernhard (Bad Rothenfelde DE) | Prof. Dr. med. Dipl. Oec.

Rehabilitation Clinic Bad Rothenfelde, Clinic Münsterland of DRV Westphalia - Clinic management

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Session: Foot and Shoe 1

Tuesday 2012/05/15 15:00 - 16:15 | Topic: Foot and Shoe | Subtopic / Track: Foot and Shoe

Congress Lecture [4318-977]

Effectiveness of an arch supporting insole in metatarsalgia, a

randomized controlled study

Author

Greitemann, Bernhard (Bad Rothenfelde DE) | Prof. Dr. med. Dipl. Oec.

Rehabilitation Clinic Bad Rothenfelde, Clinic Münsterland of DRV Westphalia - Clinic management

Coauthors

Sprekelmeyer T, Eger T, Ullrich M

Abstract

In a controlled, randomized and blinded study on 183 patients, the effectiveness of a

individually made supportive insoles for splayfoot complaints and metatarsalgias

a comparative cohort.

Introduction

Orthopedic shoe technology has a long tradition in Germany. So far, however, there are no studies

who can prove the effectiveness of appropriate shoe and insole supplies. A

of the disease entities where insoles are considered efficient and effective, at least

from clinical use, are splayfoot complaints, especially metatarsalgias. Here

become supportive insoles with retrocapital elevation and thereby relief of the metatarsal heads

often used. The aim of the study should be to determine whether the effect of such

Can prove deposit supply.

Methods

The present study was designed as an initial randomized study in a

Patient collective of 183 subjects examined. The patients were randomized to one group

supplied with an effectively supportive insole treatment, the control group received one

Soft bedding insert, which, however, was matched to the verum insert in terms of design. The practitioner

were each blinded and did not know which foot orthoses their patients were receiving. The

Insoles were worn for a period of 2 months, the patients were standardized with

Questionnaires (SF36 large version) as well as additional questions about foot complaint symptoms were examined.

The evaluation was carried out by an independent scientific institute.

Results

The results could have a significant effect in terms of group and time interaction

(P = 0.039) are shown, that is, that the study group a statistically significant significant

Reduction of her foot problems compared to the control group. In both groups

the foot problems could be reduced, also the examined feeling of burning and heat in the

Foot decreased in both study groups. The study group gave a slight feeling of

Burning and heat, also sweating, tired calves, feeling of tightness in the foot and pain in the

the knee joints were each lower in the study group than in the control group, achieved here

however, in terms of group and time interaction, this is not a significant level.

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Conclusion

The present study is the first study to be carried out in the context of insole care with a high

methodologically standing randomized controlled procedure the effect of a corresponding

Was able to demonstrate care of insoles with a special clinical picture.

Online version: http://www.confairmed.de/e3470463/e3711658/e3711651/cg3725160/cg3723456?

long = narrow

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Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Session: Foot and Shoe 1

Tuesday 2012/05/15 15:00 - 16:15 | Topic: Foot and Shoe | Subtopic / Track: Foot and Shoe

Congress Lecture [4516-1181]

Effects on postural control and plantar pressure of rigid plantar

orthoses thermomoulded directly on the foot.

Author

Berger, Loetitia (Voiron FR)

Center Orthopedie du Sport - Laboratoire Physiologie de l’exercice (EA4338), Université de Savoie,

campus scientifique

Coauthors

Calleja Jb

Abstract

Study evaluates the impact of thermomoulded rigid orthoses, used inside ski boots, on the body balance

and plantar pressure distribution on top athletes. Wearing these orthoses may be linked to an enhancement

of the neuromuscular activity and revealed a better distribution of plantar pressure.

Introduction

A variety of sensory sources, including visual, proprioceptive and vestibular information, contributes to

the overall control of posture and gait in humans. Plantar cutaneous inputs also contribute to balance

control during standing (1), walking (2, 3) and running (2). Previous study showed (4) that stimulation of

The plantar arch may induce a perception that the body’s center of mass has shifted toward the stimulated

foot. The aim of this study was to evaluate the impact of thermomoulded rigid orthoses on top athletes. The

postural control was investigated by measuring the CoP displacements without shoes by dissociated, the

CoP signal which into two elementary motions: the center of gravity (CG) and the difference between CoP

and CG (CoP-CG) motions by a biomechanical modelization in the frequency domain (5). Then, plantar

pressure distribution was recorded by insertion of the foot In-Shoe pressure system (Footscan®) in the

ski boots.

Methods

10 young top right-handed athletes volunteered, following a foot examination, received a pair of orthotics

was tailor made and adjusted to fit the shape of the arch of the foot. The orthotics made of a podiafix®

base and podialène® 160 top layer was realized in corrected position by thermoshaping directly on the

foot. The CoP displacements were measured by a force platform in a quiet standing posture, eyes closed,

Bare feet during without (REF) and with plantar orthotics (O). The amplitudes of

the CG and of the CoP-CG motions were evaluated by the Root Mean Square (RMS) in the two axes

medio-lateral (ML) and antero-posterior (AP). The data insoles of the In-Shoe were collected for both legs,

the maximum, mean Forces (N) and the percentage of contact time (% T) were calculated for the sensors

corresponding to nine foot regions in two conditions with (0S) and without orthotics (S). All values ​​were

compared using a Wilcoxon T-test (statistical significance: p


Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

amplitude of the CoP-CG motions along ML axis reveals an increase of the acceleration communicated to

the CG and greater neuro-muscular means. Change in the muscular stiffness and / or the muscular activity

were suggested. The lack of effect on CG motions showed

absence of deterioration of the control of the body sway.

No significant difference was recorded in the AP direction for all motions. The in-shoe system revealed

changes in the distribution of the plantar pressure. For the right foot, wearing orthotics does not change

the mean or maximum pressure for all foot regions. However, a significant increase in the percentage of

the time contact on the arch appeared

(OS vs S, p


Congress ORTHOPAEDIE + REHA-TECHNIK 2012

Abstracts

Session: Foot and Shoe 1

Tuesday 2012/05/15 15:00 - 16:15 | Topic: Foot and Shoe | Subtopic / Track: Foot and Shoe

Congress Lecture [4364-1022]

The "Knee Concept", an applied analytical procedure to prove the

effect of insoles on the knee condition

Author

Molitor, Dirk (Osnabrück DE) | OSM

Schuh und Sport Molitor GmbH - motion analysis, orthopedic shoe technology

Coauthors

Blunt J, Sarah L

Abstract

At the quadriceps angle, it is possible to apply the insole to the entire leg axis

quantify

Introduction

The knee concept is particularly successful where imaging procedures, such as MRI,

there is no clear indication of the underlying complaint.

Movement is focused in order to look for functional causes.

After analyzing the pain-producing movement on the treadmill, it becomes clear whether the knee is controlled