The effect of transverse prosthetic alignment changes on socket reaction moments during gait in individuals with transtibial amputation

Publication date: Available online 23 June 2018
Source:Gait & Posture
Author(s): Hiroshi Hashimto, Toshiki Kobayashi, Fan Gao, Masataka Kataoka, Michael S. Orendurff, Kuniharu Okuda
BackgroundAlignment affects gait of individuals with transtibial prostheses. Sagittal and coronal alignment changes of the transtibial prostheses were demonstrated to affect socket reaction moments. However, the effects of transverse alignment changes on the socket reaction moments are not known.Research questionThe aim of this study was to investigate the effects of transverse alignment changes on the socket reaction moments and temporal-spatial parameters of gait in transtibial prostheses.MethodsThe effects of transverse prosthetic alignment changes (i.e. 10 degrees and 5 degrees of internal and external rotations: toe-in and toe-out of the foot relative to the socket from a baseline alignment) on the sagittal and coronal socket reaction moments and temporal-spatial parameters (gait speed, cadence and step width) while walking in 9 individuals with transtibial amputation were investigated using an instrumented prosthetic pyramid adaptor and 3D motion capture system.ResultsThe transverse alignment changes demonstrated significant effects on the socket reaction moments in the coronal plane at 5% (P =  0.04), 20% (P =  0.04) and 75% (P =  0.0001) of stance phase. No significant effects were found in the socket reaction moments in the sagittal plane and the temporal-spatial parameters. The internal and external rotations of the prosthetic feet may have opposite effect in early and mid- to late-stance potentially due to changes in the spatial position of the heel (rear foot) and toe (forefoot) of the prosthetic foot relative to the socket.SignificanceTransverse alignment of the transtibial prostheses should be tuned not only considering the symmetry in toe-out angles of the feet, but also considering the potential effects of transverse alignment changes that may affect the coronal socket reaction moments.



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The effect of transverse prosthetic alignment changes on socket reaction moments during gait in individuals with transtibial amputation

Publication date: Available online 23 June 2018
Source:Gait & Posture
Author(s): Hiroshi Hashimto, Toshiki Kobayashi, Fan Gao, Masataka Kataoka, Michael S. Orendurff, Kuniharu Okuda
BackgroundAlignment affects gait of individuals with transtibial prostheses. Sagittal and coronal alignment changes of the transtibial prostheses were demonstrated to affect socket reaction moments. However, the effects of transverse alignment changes on the socket reaction moments are not known.Research questionThe aim of this study was to investigate the effects of transverse alignment changes on the socket reaction moments and temporal-spatial parameters of gait in transtibial prostheses.MethodsThe effects of transverse prosthetic alignment changes (i.e. 10 degrees and 5 degrees of internal and external rotations: toe-in and toe-out of the foot relative to the socket from a baseline alignment) on the sagittal and coronal socket reaction moments and temporal-spatial parameters (gait speed, cadence and step width) while walking in 9 individuals with transtibial amputation were investigated using an instrumented prosthetic pyramid adaptor and 3D motion capture system.ResultsThe transverse alignment changes demonstrated significant effects on the socket reaction moments in the coronal plane at 5% (P =  0.04), 20% (P =  0.04) and 75% (P =  0.0001) of stance phase. No significant effects were found in the socket reaction moments in the sagittal plane and the temporal-spatial parameters. The internal and external rotations of the prosthetic feet may have opposite effect in early and mid- to late-stance potentially due to changes in the spatial position of the heel (rear foot) and toe (forefoot) of the prosthetic foot relative to the socket.SignificanceTransverse alignment of the transtibial prostheses should be tuned not only considering the symmetry in toe-out angles of the feet, but also considering the potential effects of transverse alignment changes that may affect the coronal socket reaction moments.



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Do Personality Factors Assessed Before Cochlear Implantation Predict Hearing-Related Quality Of Life After Cochlear Implantation in Postlingually Deafened Adults?

Background: Studies have shown that cochlear implants improve deaf patients’ hearing-related quality of life (hrQoL), but the degree of improvement varies considerably between patients. This study investigated whether personality factors contribute to hrQoL outcome after cochlear implantation. Method: Fifty adult patients with postlingual hearing loss who received a unilateral cochlear implant were administered the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI; a personality inventory) and the Nijmegen Cochlear Implant Questionnaire (NCIQ; a hrQoL questionnaire). The NEO-FFI was administered only before implantation; the NCIQ was administered before implantation and 12 months after implant activation. A linear regression analysis was computed to detect whether NCIQ scores at 12 months were predicted by the NEO-FFI personality factors (i.e., Extraversion, Neuroticism, Openness to Experience, Agreeableness, and Conscientiousness) assessed before implantation. Results: HrQoL scores had significantly improved 12 months after cochlear implantation in all subdomains of the NCIQ. Of the five personality factors, solely Neuroticism was negatively associated to the NCIQ subdomain self-esteem (β = −0.34; p = 0.013) at 12 months after cochlear implantation. Conclusions: While significant improvement of hrQoL was seen 12 months after implant activation, this improvement was barely predicted by the Big-Five personality traits measured before implantation. Only Neuroticism was found to moderately influence postimplantation hrQoL in our patients, in the way that higher degrees of Neuroticism tend to go along with lower degrees of self-esteem (as conceptualized by the NCIQ). The failure to detect personality effects on hrQoL could partly be due to the low levels of Extraversion and Openness to Experience observed in our sample of patients with hearing loss. Received April 10, 2017; accepted May 4, 2018. ACKNOWLEDGMENTS: The authors would like to thank Dr. Anke Hirschfelder, Berlin, for providing a German version of the Nijmegen Cochlear Implant Questionnaire. The authors have no conflicts of interest to disclose. Address for correspondence: Franz Muigg, Department for Hearing, Speech and Voice Disorders, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria. E-mail: franz.muigg@tirol-kliniken.at Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Do Personality Factors Assessed Before Cochlear Implantation Predict Hearing-Related Quality Of Life After Cochlear Implantation in Postlingually Deafened Adults?

Background: Studies have shown that cochlear implants improve deaf patients’ hearing-related quality of life (hrQoL), but the degree of improvement varies considerably between patients. This study investigated whether personality factors contribute to hrQoL outcome after cochlear implantation. Method: Fifty adult patients with postlingual hearing loss who received a unilateral cochlear implant were administered the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI; a personality inventory) and the Nijmegen Cochlear Implant Questionnaire (NCIQ; a hrQoL questionnaire). The NEO-FFI was administered only before implantation; the NCIQ was administered before implantation and 12 months after implant activation. A linear regression analysis was computed to detect whether NCIQ scores at 12 months were predicted by the NEO-FFI personality factors (i.e., Extraversion, Neuroticism, Openness to Experience, Agreeableness, and Conscientiousness) assessed before implantation. Results: HrQoL scores had significantly improved 12 months after cochlear implantation in all subdomains of the NCIQ. Of the five personality factors, solely Neuroticism was negatively associated to the NCIQ subdomain self-esteem (β = −0.34; p = 0.013) at 12 months after cochlear implantation. Conclusions: While significant improvement of hrQoL was seen 12 months after implant activation, this improvement was barely predicted by the Big-Five personality traits measured before implantation. Only Neuroticism was found to moderately influence postimplantation hrQoL in our patients, in the way that higher degrees of Neuroticism tend to go along with lower degrees of self-esteem (as conceptualized by the NCIQ). The failure to detect personality effects on hrQoL could partly be due to the low levels of Extraversion and Openness to Experience observed in our sample of patients with hearing loss. Received April 10, 2017; accepted May 4, 2018. ACKNOWLEDGMENTS: The authors would like to thank Dr. Anke Hirschfelder, Berlin, for providing a German version of the Nijmegen Cochlear Implant Questionnaire. The authors have no conflicts of interest to disclose. Address for correspondence: Franz Muigg, Department for Hearing, Speech and Voice Disorders, Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria. E-mail: franz.muigg@tirol-kliniken.at Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Neuroplastic change of cytoskeleton in inferior colliculus after auditory deafferentation

Publication date: Available online 23 June 2018
Source:Hearing Research
Author(s): Jae Joon Han, Ho Sun Lee, Min-Hyun Park
Neural plasticity is a characteristic of the brain that helps it adapt to changes in sensory input. We hypothesize that auditory deafferentation may induce plastic changes in the cytoskeleton of the neurons in the inferior colliculus (IC). In this study, we evaluated the dynamic status of neurofilament (NF) phosphorylation in the IC after hearing loss. We induced auditory deafferentation via unilateral or bilateral cochlear ablation in rats, aged 4 weeks. To evaluate cytoskeletal changes in neurons, we evaluated mRNA fold changes in NF heavy chain expression, non-phosphorylated NF protein fold changes using SMI-32 antibody, and the ratio of SMI-32 immunoreactive (SMI-32-ir) neurons to the total neuronal population in the IC at 4 and 12 weeks after deafness. In the bilateral deafness (BD) group, the ratios of SMI-32-ir neurons significantly increased at 4 weeks after ablation in the right and left IC (6.1 ± 4.4%, 5.0 ± 3.4%, respectively), compared with age-matched controls (P < 0.01, P < 0.01). At 12 weeks after ablation, the ratio of SMI-32 positive neurons was higher (right, 3.4 ± 2.0%; left, 3.2 ± 2.3%) than that in the age-matched control group, albeit not significant in the right and left side (P = 0.38, P = 0.24, respectively). Consistent with the results of the ratio of SMI-32-ir neurons, SMI-32-ir protein expression was increased at 4 weeks after BD, and the changes at 12 weeks after bilateral ablation were not significant in the right or left IC. The age-matched control fold changes of NF mRNA expression after bilateral deafness were not significant at 4 and 12 weeks after deafness in right and left IC. Unilateral deafness did not induce significant change of NF mRNA expression, SMI-32-ir protein expression, and the ratio of SMI-32-ir neurons in the IC at 4 and 12 weeks after hearing loss. Bilateral auditory deafferentation induces structural changes in the neuronal cytoskeleton within the IC, which is prominent at 4 weeks after BD. The structural remodeling of neurons stabilized at 12 weeks after BD. Unlike BD, unilateral auditory deafferentation did not affect the dynamic status of NFs in the IC.



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Neuroplastic change of cytoskeleton in inferior colliculus after auditory deafferentation

Publication date: Available online 23 June 2018
Source:Hearing Research
Author(s): Jae Joon Han, Ho Sun Lee, Min-Hyun Park
Neural plasticity is a characteristic of the brain that helps it adapt to changes in sensory input. We hypothesize that auditory deafferentation may induce plastic changes in the cytoskeleton of the neurons in the inferior colliculus (IC). In this study, we evaluated the dynamic status of neurofilament (NF) phosphorylation in the IC after hearing loss. We induced auditory deafferentation via unilateral or bilateral cochlear ablation in rats, aged 4 weeks. To evaluate cytoskeletal changes in neurons, we evaluated mRNA fold changes in NF heavy chain expression, non-phosphorylated NF protein fold changes using SMI-32 antibody, and the ratio of SMI-32 immunoreactive (SMI-32-ir) neurons to the total neuronal population in the IC at 4 and 12 weeks after deafness. In the bilateral deafness (BD) group, the ratios of SMI-32-ir neurons significantly increased at 4 weeks after ablation in the right and left IC (6.1 ± 4.4%, 5.0 ± 3.4%, respectively), compared with age-matched controls (P < 0.01, P < 0.01). At 12 weeks after ablation, the ratio of SMI-32 positive neurons was higher (right, 3.4 ± 2.0%; left, 3.2 ± 2.3%) than that in the age-matched control group, albeit not significant in the right and left side (P = 0.38, P = 0.24, respectively). Consistent with the results of the ratio of SMI-32-ir neurons, SMI-32-ir protein expression was increased at 4 weeks after BD, and the changes at 12 weeks after bilateral ablation were not significant in the right or left IC. The age-matched control fold changes of NF mRNA expression after bilateral deafness were not significant at 4 and 12 weeks after deafness in right and left IC. Unilateral deafness did not induce significant change of NF mRNA expression, SMI-32-ir protein expression, and the ratio of SMI-32-ir neurons in the IC at 4 and 12 weeks after hearing loss. Bilateral auditory deafferentation induces structural changes in the neuronal cytoskeleton within the IC, which is prominent at 4 weeks after BD. The structural remodeling of neurons stabilized at 12 weeks after BD. Unlike BD, unilateral auditory deafferentation did not affect the dynamic status of NFs in the IC.



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