Articles
Moulodi, N.,
Sarrafzadeh, J.,
Azadinia, F.,
Shakourirad, A.,
Jalali, M. Physiotherapy Theory and Practice (15325040)41(1)pp. 44-53
Background: In hallux valgus, morphological changes and functional weakness of intrinsic foot muscles occur, especially in the abductor hallucis muscle. Objectives: This study aimed to investigate how a conservative treatment with the addition of neuromuscular electrical stimulation affects the volume and strength of the muscle, the correction of deformity, passive range of motion, pain, and disability. Methods: Twenty-eight female participants (48 feet) were randomly assigned to two groups. The interventions included orthoses and exercise (Ortho) in both groups. One group received additional neuromuscular electrical stimulation of abductor hallucis muscle to activate it. Each group received the treatments for one month and was assessed two times, at baseline before starting and after one month of treatment. Mixed within-between ANOVA, analysis of covariance, and nonparametric tests were used for data analysis. Results: The muscle volume, abduction strength, goniometric angle, and passive hallux dorsi/plantar flexion showed significant changes in both groups (p <.001). Subscales of the foot and ankle ability questionnaire, significantly changed (p ≤.05). Pain decreased significantly in the two groups (p <.001 and p =.02). Intermetatarsal angle did not significantly differ between the two groups (p =.86, partial eta effect size = 0.001). But, the hallux valgus angle mean (on MRI) in the Ortho group was less than that of the orthoNMES group (p =.007, partial eta effect size = 0.15). Conclusion: Both groups showed nearly identical treatment effects in the primary volume and hallux valgus correction outcome measures. In this study, adding neuromuscular electrical stimulation did not have an additional effect compared to conservative in the treatment of hallux valgus. Trial registration number: The RCT Code is IRCT20200915048725N1. © 2024 Taylor & Francis Group, LLC.
PLoS ONE (19326203)20(7 July)
Purpose Quality of life is a crucial outcome in evaluating adjustment to prostheses for individuals with non-traumatic lower limb amputation (LLA). This study aimed to identify prostheses-related factors that predict the quality of life in people with non-traumatic, unilateral, transtibial amputation. Materials and methods This cross-sectional study surveyed 168 people who have experienced nontraumatic, unilateral, transtibial amputations and use prosthesis. They completed the 12-item short-form (SF-12) health survey and the comprehensive lower limb amputee socket survey (CLASS). We did correlation analyses to explore relationships between the variables and quality of life, followed by multiple regression analyses to assess their impact on quality of life outcomes. Results Quality of life had a strong positive association with comfort (r = 0.65, p = 0.001). There was a moderate positive association with socket stability (r = 0.46, p < 0.001) and suspension (r = 0.48, p = 0.001), as well as a weak positive association with appearance (r = 0.35, p = 0.001). In the final regression model, the comfort subscale of CLASS was the strongest predictor of quality of life (β = 0.51, p = 0.001). Conclusion This study highlights that prosthesis socket comfort is the primary prosthesis-related factor predicting the quality of life for individuals with non-traumatic, unilateral, transtibial amputation. Thus, rehabilitation should prioritize modifiable factors, especially optimal socket fitting. Identifying user needs is essential for better prosthesis use, as enhancements in other prosthetic components do not necessarily improve quality of life without considering socket comfort. © 2025 Alavi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Nabizadeh, S.,
Jalali, M.,
Kamali, M.,
Shahabi, S.,
Babaee, T. Prosthetics and Orthotics International (17461553)48(2)pp. 230-239
Purpose: This study investigated the barriers, challenges, and facilitators in receiving prosthetic services in people with lower limb amputation during Covid-19 pandemic. Materials and methods: In this qualitative study, we conducted in-depth semistructured face-to-face interviews with individuals with lower limb amputation who needed prosthetic services during Covid-19 pandemic. We discussed about challenges and barriers that the participants had encountered during this period. The collected data were analyzed using a conceptual framework. Results: Six broad themes of availability, accessibility, acceptability, affordability, accommodation, and awareness emerged from the analysis. Staff shortage, lack of remote services, accommodation, insurance and governmental support, and cost of services were the main concerns. Moreover, long waiting lists, postponed referrals, noncompliance with Covid-19 protocols and preventive measures, and lockdowns were the other important concerns that were noted. In addition, unsatisfactory services in hometown, distance to capital, transportation permit in lockdowns, traffic jam, and public transport problems were other reasons of service not being accessible. The positive aspects were the facilitators such as having home visits, social work and charity, and using private drive services. Conclusion: It seems that after the beginning of Covid-19 pandemic, people with lower limb amputation have faced more drastic challenges in accessing and receiving prosthetic services than in the prepandemic situations. © 2023 International Society for Prosthetics and Orthotics.
Medical Journal Of The Islamic Republic Of Iran (22516840)38(1)pp. 102-102
Background: Limb loss can negatively affect the psychological and physical well-being, mobility, and social life of people with lower limb amputation. Participating in physical activities is of great importance for these people. This study aimed to explore factors affecting the physical activity of Iraqi lower-limb amputees. Methods: In this cross-sectional study, the participants were asked to fill out the Oswestry disability index (ODI) questionnaire, the 12-item short-form health survey (SF-12), the Trinity Amputation and Prosthesis Experience Scales (TAPES), and the International Physical Activity Questionnaire (IPAQ). The performance-based Timed Up and Go (TUG) test was also assessed. We used a hierarchical regression model to estimate the effect of some parameters on physical activity considering age, sex, and level of amputation. Results: A total of 376 lower limb amputees, aged 20 to 67 years old, completed the tests. The TUG time (beta = 0.406; P < 0.001), mental component score of the SF-12 (beta = 0.214; P < 0.001), ODI (beta = –0.201; P < 0.001), and physical activity component of SF-12 (beta = 0.131; P = 0.002) had significant associations with physical activity. Conclusion: The TUG time was the most critical factor in predicting physical activity. The mental score component of the SF-12 ranked second, showing the importance of family and social support for amputees in their physical activity and emphasizing the importance of including mental and psychosocial plans in the rehabilitation program of lower limb amputees. Low back pain should be taken seriously in lower limb amputees because of its prevalence and the effect of its related disability on the physical activity of amputees. Residual limb pain was also very prevalent. Although it did not contribute to our model, its negative effect on physical activity should not be underestimated. © Iran University of Medical Sciences
Chami, S.,
Babaee, T.,
Jalali, M.,
Saeedi, H.,
Kamali, M. Prosthetics and Orthotics International (17461553)48(3)pp. 320-328
Purpose:Children's and adolescents' level of activity, the type of activity, and other features are special to them and can result in unique experiences with lower-limb prosthesis. The specific objective of this study was to explore the lived experience of children and adolescents with lower-limb loss (LLL) who used a prosthesis.Methods:We used a descriptive qualitative study design and in-depth, semistructured, face-to-face interviews. Accordingly, 35 participants, including children and adolescents with LLL who used a prosthesis, their parents, and prosthetists, were interviewed. The collected data were analyzed thematically.Results:One hundred sixty-eight codes about the experiences of children, parent(s), and prosthetists were extracted from the transcripts and categorized into 32 subthemes. Finally, 7 broad themes including suitability, provoke reactions, intrinsic nature, infrastructures, the school, availability, and parenting role were extracted.Conclusion:The experiences of children and adolescents with lower-limb prosthesis are specific as each may face unique challenges and deal with different difficulties. In this study that has been conducted in a developing country, the main challenges faced by children using lower-limb prosthesis and their parents are the prosthetic components, social reactions, long distance, and costs of services. Moreover, designing a more natural prosthesis and gait training for children with LLL were the most important issues faced by prosthetists. However, close relationships with friends and family members, and children's amazing ability to adapt can aid in facilitating prosthetic management. Copyright © 2023 International Society for Prosthetics and Orthotics.