Advanced Prosthetics by Alasdair Gilbertson
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Alisdair Gilbertson -- a senior prosthetist and manager with Ottobock - talks at Meningitis Research Foundation's Life beyond limb loss day - Pushing the Boundaries 2014
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O documento discute a reabilitação de pacientes amputados. Ele descreve as causas comuns de amputação, incluindo problemas vasculares, traumatismos, diabetes e tumores. Ele também discute a biomecânica dos pacientes amputados e as etapas da reabilitação, como alívio da dor, fortalecimento muscular, alongamento e uso de próteses ou cadeiras de rodas. Casos de estudo de cães e gatos amputados ilustram o processo de reabilitação.
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O documento discute as visões atuais sobre amputações. Ele fornece estatísticas sobre amputações, principais causas e níveis de amputação. Também aborda os riscos envolvidos e a importância da reabilitação após a amputação.
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A história da amputação remonta à Grécia Antiga, quando Hipócrates descreveu a primeira amputação de joelho. Ao longo dos séculos, diferentes técnicas foram desenvolvidas para melhorar os resultados e a sobrevida após a amputação. Atualmente, as principais causas de amputação são doenças vasculares como diabetes, traumas e tumores. Existem diferentes tipos de amputação dependendo da causa, como amputação vascular, traumática ou congênita.
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O documento discute as causas, níveis e reabilitação de amputações. Ele define amputação como a remoção cirúrgica total ou parcial de um membro e lista as principais causas como doenças vasculares, diabetes, traumas, tumores e congênitas. Também descreve os diferentes níveis de amputação em membros superiores e inferiores e as etapas da reabilitação com foco em preparação do coto e uso de próteses.
Rehabilitation of lower limb amputee
1. Rehabilitation after lower limb amputation involves pre-op, post-op, and long-term phases aimed at preventing complications, educating the patient, and improving functional mobility and independence.
2. The post-op phase focuses on managing pain, increasing range of motion and strength, promoting wound healing, and training the patient in mobility and prosthetic use.
3. Long-term rehabilitation involves community and vocational reintegration, lifelong prosthetic management, and psychological support through follow-ups and support groups.
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14th Experts "Live" CTO
September 2nd- 3rd, 2022 - Mainz, Germany
Main Session - Session 2:
Selecting the patient and planning the procedure B
What are the limitations of CTO-PCI?
Gerald S. Werner, Darmstadt, Germany
Room:
Guteberg Hall (Auditorium) - Friday 13:30
Chairmen:
Alexander Bufe, Krefeld, Germany;
Leszek Bryniarski, Krakow, Poland;
Hans Bonnier, Nuenen, Belgium
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This document discusses optimal schedules for controlling pneumococcal infection in countries with high and low carriage. It notes that the African Meningitis Belt has seen sub-optimal pneumococcal conjugate vaccine (PCV) coverage due to geopolitical factors and vulnerable populations. Outbreaks in Ghana pre- and post-PCV introduction show that herd protection may be inadequate. Research is needed to better understand pneumococcal biology and prevention. Improving PCV access and coverage, including schedules with boosters and catch-up campaigns targeting 5-29 year olds, may help prevent outbreaks. Strengthening surveillance systems allows rapid response.
Professor Muhamed-Kheir Taha
Professor Muhamed-Kheir TAHA MD, PhD, HDR presented on lessons and impacts for meningitis in the COVID-19 era. Data showed cumulative cases of invasive meningococcal disease (IMD) from 2014-2020 in France as well as distribution of IMD cases from 2011-2020. Vaccine use in France declined during the COVID-19 pandemic in 2020, with reduced doses of the 5-month and 12-month vaccines. Distribution of IMD cases by age group from 2011-2021 showed an immunity gap in childhood due to the pandemic. Conclusions were that reduced pathogen circulation may decrease herd immunity, social distancing was associated with lower vaccine uptake, and countries need plans to promote
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Progress is being made on developing a combined MenABCWY vaccine. Studies are underway evaluating the immunogenicity and safety of combining different meningococcal vaccines that target serogroups A, C, W, Y. Combining the vaccines could simplify immunization schedules, reduce costs by needing fewer doses, and increase vaccination uptake by reducing the number of required injections. However, a combined vaccine may also increase reactogenicity and interfere with the immune response to other concomitant vaccines. Ongoing studies are evaluating different potential MenABCWY vaccine combinations to determine the optimal formulation.
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This document summarizes changes in invasive meningococcal disease (IMD) cases in Germany during the COVID-19 pandemic. It finds that overall IMD cases decreased during the first pandemic period (PP) in 2020 compared to pre-pandemic levels, with the largest declines in children ages 1-4 and 5-9. However, IMD cases increased again after restrictions eased. The decrease in IMD cases during increased restrictions correlates with decreased mobility based on Google mobility indices.
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1) The PSERENADE project analyzed surveillance data from over 50 sites in 34 countries to assess the impact of PCV10 and PCV13 introduction on pneumococcal meningitis incidence globally in children under 5 years old and adults 18 years and older.
2) For both age groups, PCV10 and PCV13 significantly reduced meningitis caused by serotypes covered by the vaccines, with almost elimination in children under 5 years old within 5 years. Herd protection was observed in adults as well.
3) PCV13 significantly reduced meningitis from additional serotypes it covers compared to PCV10, though serotype 19A increased with PCV10 and serotype 3 trends were unclear
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Xin Wang Chief, Bacterial Meningitis Laboratory Director WHO Collaborating Center for Meningitis MVPDB/DBD/NCIRD/CDC Meningitis Research Foundation Conference Nov 1-3, 2021
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The document discusses Nepal's introduction of the PCV 10 vaccine using a 2+1 schedule of administration at 6 weeks, 10 weeks, and 9 months. A trial found this schedule to be equally effective as a 3+0 schedule. Surveillance data showed declines in invasive pneumococcal disease cases and pneumonia with consolidation following vaccine introduction. Pneumococcal carriage among children with clinical pneumonia under 2 years old declined significantly, but no decrease was seen in older children. Short term impact was observed using the 2+1 schedule, but continued surveillance is needed to assess long term vaccine impact.
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Advanced Prosthetics by Alasdair Gilbertson
- 1. Advanced Prosthetics By Alasdair Gilbertson Senior Prosthetist ottobock Healthcare
- 2. Berlin 1919 Duderstadt 2014. Lower Saxony
- 3. CAD/CAM Paralympics service provider Car components Information Technology
- 4. Orthotics
- 6. Upper limb amputees 11,000 Lower limb amputees 52,000 Number of UK amputees
- 7. 1000 900 800 700 600 500 400 300 200 100 0 Number Under 16 16-54 55-64 65-74 75+ Age Female Male Age distribution of UK amputees
- 8. 60 50 40 30 20 10 0 % Causes of lower limb amputation PVD Diabetes + PVD Trauma Malignancy Congenital Other Cause Aetiology of lower limb amputation
- 9. Annual number of UK young amputees 200-300 children every year in the UK • Congenital absence • Congenital deformity resulting in amputation • Sarcoma, infection • Acquired amputation
- 10. Acquired limb deficiency or amputation is not as common as congenital limb deficiency in children. Frequent causes of trauma are hands or feet caught in machinery, or motor vehicle and lawn mower injuries. Severe infections and interruptions to the blood supply to limbs, such as occurs in meningococcal septicaemia, can cause multiple limb loss. Approximately 3200 cases of bacterial meningitis and associated septicaemia in the UK each year. 10%-15% of cases result in amputation Bone or soft tissue tumours may require amputation as a life-saving measure along with other cancer treatment. Phantom pain can occur after amputation in children and may require medication along with other types of treatment.
- 11. • Restore function • Stabilize joints • Cosmetic appearance
- 13. 13 Egyptian prosthetic toe 950-710 BC Capua Leg 300 BC World War 1 Circa 1950 gas powered prostheses
- 15. Residual limb is wrapped in Plaster of Paris bandage. Plaster model is modified.
- 19. 19 Carbon fibre Titanium Silicones Plastics
- 20. Components
- 22. Computer Aided Design and manufacture 22 (CAD/CAM)
- 25. Otto Bock Michelangelo Hand
- 27. 27 Genium Genium X3
- 28. 28 Microprocessor controlled knees ……the next generation. Gyroscope, Acceleration Sensor and Angle Sensor Knee Moment Sensor AXON Tube Adapter Hydraulic Cylinder Battery and Electronics BluetoothR Inductive Charging
- 33. 33
- 37. 37
- 38. 38
- 39. Getting back to normal life
- 41. Multi-Disciplinary Team approach Upper limb Amputee • Patient • Rehabilitation consultant • Prosthetist • Occupational Therapist • Parents & Teachers • Counsellor Lower limb Amputee • Patient • Rehabilitation consultant • Prosthetist • Physiotherapist and/or Occupational Therapist • Parents & Teachers • Counsellor
- 42. Prosthetic management • Work with your clinical team
- 44. Problems with wearing a Prosthesis • Increase in energy levels • Phantom limb pain • Folliculitis • etc
- 45. 45 Outcomes data Maintain or improve mobility, socket comfort, gait and satisfaction as measured by valid reliable, standardised outcome measures
- 46. 46 Outcome are evaluated via patient performance tests and questionnaires Performance based tests Self-reported Questionnaires
- 47. 47 Fitness App for Lower Limb Amputees • The app consists of 2 modules: “Strength & Endurance” and “Coordination & Balance” and offers 16 exercises and three difficulty levels. • The exercises require no workout equipment beyond a cushion or a football, and the instructions are simple to follow. • Amputees can take this ‘personal trainer’ with them anywhere, and integrate the exercises into their everyday fitness or therapeutic routine.
- 48. 48
- 49. Thank You Any Questions?