Satisfaction with cosmesis and priorities for cosmesis design reported by lower limb amputees in the United Kingdom : instrument development and results

Study Design: Cross sectional questionnaire study. Background: Amputee satisfaction with cosmesis and the importance they place on cosmesis design has not been published in the literature. Objectives: Investigate the current satisfaction levels of amputees in the United Kingdom with their cosmesis and the importance placed on attributes of cosmesis design to inform future cosmesis redesign. Methods: Questionnaires were administered to lower limb amputees in the United Kingdom. Satisfaction scores and the overall importance ranking of cosmesis features were calculated. Statistically significant relationships between two demographic, satisfaction, or importance variables were tested using Fisher’s Exact tests (one-tailed) at a significance level p=0.05. Results: Between 49% and 64% of respondents reported neutral or dissatisfied opinions with the cosmesis features (greater than 50% for five of the nine features). The three most important features identified were shape matching the cosmesis to the sound limb, free prosthetic joint movement underneath the cosmesis and natural fit of clothing over the cosmesis. Conclusions: The results indicate that current cosmesis satisfaction levels of amputees in the U.K. are below what the medical device industry and clinical community would desire. The most important cosmesis features identified by the sample can be used to direct future cosmesis design research

Consensus paper on postural dysfunction: recommendations for prevention, diagnosis and therapy

Good fundamentals of posture and balance are essential for the efficient performance of both simple daily tasks and more complex movement patterns. In particular, postural balance is the ability to keep the body in equilibrium and to regain balance after the shift of body segments: postural control mechanisms of integration of the visual, vestibular and foot afferential channels contribute to this. This document provides recommendations based on scientific evidence, clinical practice, and consensus between experts concerning the prevention, diagnosis, and treatment of postural dysfunction at the three stages of life as the developmental age, adult age, and old age > 65 years and follows the “National Guidelines on Classification and Measuring of Posture and its Dysfunctions” per the Italian Ministry of Health (December 2017). The paper answers four main questions: i) “Which measures can be adopted to prevent postural dysfunctions?” ii) “What can we do in order to make a correct diagnosis of postural dysfunction?” iii) “What are the correct treatment programs for postural dysfunctions?” iv) Which professional competencies and experiences are useful for preventing, diagnosing and treating postural dysfunctions? By the Consensus of the Experts and the scientific evidence, emerge that the approach to postural dysfunctions requires a multidisciplinary and interdisciplinary team. Furthermore, rehabilitation treatment interventions must be specific to the age groups that have been indicated, to consider the integration of the main systems and subsystems of postural control that change with age