The Influence of Socioeconomic Factors on Fear of Falling and Mobility Outcomes after Lower Limb Loss: a Preliminary Study

Background and Purpose: Current research has revealed that as much as 52.4% of individuals with lower limb loss report falling at least once in the past year. Previous research has also indicated that rehabilitation, including physical therapy (PT), generally improves patient outcomes after definitive amputation. Socioeconomic status has been shown to be an important factor in accessing healthcare but has yet to be investigated in this population. The purpose of this study was to investigate the effects of socioeconomic status and access to PT, and how limb loss affects mobility and fear of falling perception. We hypothesized: [1] individuals with socioeconomic difficulty would have reduced access to PT after amputation, and [2] individuals with limb loss will have increased fear of falling and decreased mobility performance when compared to non-amputee, age-matched controls. Subjects: 23 participants (7 females,16 males) mean age 51.30 years old (+ 13.17 SD, range 22-70) with lower limb loss ambulating with a definitive prosthesis. Materials/Methods: Participants completed a survey that included the Fear of Falling Avoidance Behavior Questionnaire (FFABQ), questions to determine their socioeconomic status, and whether they received PT after amputation. Mobility outcomes were measured using the standardized Timed Up and Go test (TUG) and the Six Minute Walk Test (6MWT). Results: There was no statistically significant difference in access to PT after amputation between those with and without financial difficulty (p=.354). However, 75% of participants who had no socioeconomic difficulty reported receiving PT, in comparison to only 25% in those who had socioeconomic difficulty. Additionally, 34.8% of our participants reported socioeconomic difficulties. When comparing the participants with amputation to the non-amputee, age-matched controls, there was a significant difference in the TUG (p\u3c.001), 6MWT (p\u3c.001), and FFABQ (p=.008). On average, participants with limb loss were 4.4 seconds slower on the TUG, walked 136.4m less on the 6MWT, and had an increased FFABQ score of 6.6 points out of 56 points. Discussion: Access to physical therapy and socioeconomic status have been overlooked in current literature for individuals after amputation. While the effect of socioeconomic status on PT access did not reach statistical significance in this preliminary study, only 25% of those who reported socioeconomic difficulty received physical therapy after amputation, compared to 75% in those who reported no difficulty. Further research is needed to determine whether low socioeconomic status is predictive of receiving rehabilitation services post-amputation and long-term outcomes. Our findings also showed that when compared to age-matched non-amputees, amputees tend to have impaired mobility and higher degree of fear of falling. These findings agree with current literature. Conclusion: Although not statistically significant, our preliminary findings showed that socioeconomic difficulty may affect access to physical therapy after amputation. Furthermore, our data demonstrated that individuals with lower limb loss exhibit reduced mobility performance and increased fear of falling when compared to the age-matched controls

The rabbit : an illustrated anatomical guide

This study on the anatomy of the rabbit was based on dissected material from the biological laboratories of the College of the Pacific. Because of existing errors in many of the present references to rabbit anatomy, the guide was prepared to meet the expressed need for a concise, illustrated outline of basic anatomy of the rabbit which might be used by students in an introductory course in mammalian or human anatomy. Since it is assumed that the guide would be supplemented by a dissection manual, syllabus, or textbook, textural material of such an outline is presented here in outline form

Piezoelectric devices for vibration suppression: Modeling and application to a truss structure

For a space structure assembled from truss members, an effective way to control the structure may be to replace the regular truss elements by active members. The active members play the role of load carrying elements as well as actuators. A piezo strut, made of a stack of piezoceramics, may be an ideal active member to be integrated into a truss space structure. An electrically driven piezo strut generates a pair of forces, and is considered as a two-point actuator in contrast to a one-point actuator such as a thruster or a shaker. To achieve good structural vibration control, sensing signals compatible to the control actuators are desirable. A strain gage or a piezo film with proper signal conditioning to measure member strain or strain rate, respectively, are ideal control sensors for use with a piezo actuator. The Phase 0 CSI Evolutionary Model (CEM) at NASA Langley Research Center used cold air thrusters as actuators to control both rigid body motions and flexible body vibrations. For the Phase 1 and 2 CEM, it is proposed to use piezo struts to control the flexible modes and thrusters to control the rigid body modes. A tenbay truss structure with active piezo struts is built to study the modeling, controller designs, and experimental issues. In this paper, the tenbay structure with piezo active members is modelled using an energy method approach. Decentralized and centralized control schemes are designed and implemented, and preliminary analytical and experimental results are presented

Self-transformation and external forms of worldview dialogue

Vicente Hao Chin Jr. is the President of Golden Link College Foundation in the Philippines. He has established and is the president of several foundations engaged in education, scholarship and community development. In addition to Golden Link College, he oversees five other theosophical schools in the Philippines, using educational approaches that do not use fear, anger, competition or ranking, but rather foster a loving and caring atmosphere that bring out excellence in the student. He had served as consultant of the Philippine Department of Education and the Office of the Presidential Adviser on Peace Process

Talk on white lotus day, may 8, 2019

Helena Blavatsky was certainly one of the most remarkable human beings in recent history, particularly for the past several centuries. She is not not as famous or influential as Einstein or Gandhi, but she was one who, more than anyone in the past centuries, have opened a closed door to a reality beyond the scientific and cultural world; it is a reality which humanity has been blind to for many centuries

Transport Phenomena in Solids

Contains reports on summary of research and two research projects.Joint Services Electronics Program (Contract DAAB07-71-C-0300