Feeling legs again improves amputees’ health

While walking, people with intact legs can feel when they move their knee or when their feet touch the ground. The nervous system constantly draws on sensory feedback of this sort to control muscles precisely. People using a leg prosthesis, however, do not know precisely where the prosthesis is located, how it is moving, or what type of terrain it is standing on. They often cannot trust their prosthesis completely when walking, leading them to rely too often on their intact leg, which in turn reduces their mobility and causes them to tire quickly.

A simple walk on pebbles or sand, for example, can prove very exhausting for people using a prosthesis. Furthermore, people with amputations can experience phantom limb pain, a condition that existing medications often cannot treat. Savo Panic, who experiences this phenomenon, says he wakes up at night due to the phantom pain: “The toe that I don’t have hurts. My big toe, foot, heel, ankle, calf—they all hurt, and I don’t even have them.”

An international team of researchers led by ETH Zurich and Lausanne-based start-up company Sen-sArs has now developed an interface to connect a leg prosthesis with the residual nerves present in the user’s thigh, thus providing sensory feedback. In a study conducted in collaboration with the University of Belgrade, the scientists tested this neurofeedback system with two volunteers who have an above-knee leg amputation and use a leg prosthesis, Panic among them.

Full story at Medical Xpress

Study of Health System Reveals Good Functional Outcomes for Patients in Bundled Care Model

Bundled care models for total joint arthroplasty (TJA) may be popular with payers and policy makers, but do they work for patients? A new study says yes.

Researchers arrived at their conclusion after tracking TJA episodes in the University of Utah health care system during its switch from a more traditional approach to Medicare’s Bundled Payment Care Improvement (BCPI) model 2. Similar to other bundled care models, the BPCI reimburses providers a set amount for an entire episode of care, from admission to 90 days after the patient is discharged, rather than for specific services provided during care.

The before-and-after pictures focus on functional recovery, based on data from 680 prebundle and 1,216 postbundle patients gathered between 2014 and 2016 (the health system launched the BCPI in July 2015). Researchers used the Activity Measure for Post Acute Care (AMPAC) mobility assessment and the PROMIS Physical Function Computer Adaptive Test (PF-CAT) to track function outcomes. The AMPAC was used at various points during the hospital stay, and the PF-CAT tracked function presurgery and then 2 weeks, 6 weeks, and 12 months afterwards. Results were published in Arthroplasty Today.

Full story at APTA