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Effectiveness of Lateral Heel Wedge in Patient Suffering from Knee Osteoarthritis Faim, Zarmina; Khan, Muhammad Kamran; Shah, Wisal; Uzma, Bibi
Journal of Prosthetics Orthotics and Science Technology Vol. 2 No. 2 (2023): Journal of Prosthetics Orthotics and Science Technology (JPOST)
Publisher : Poltekkes Kemenkes Jakarta I

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36082/jpost.v2i2.1194

Background: Knee osteoarthritis, which most commonly affects the medial compartment of the knee, is a chronic joint disorder that imposes a major healthcare burden. As no cure exists, traditional management aims to reduce pain, improve function, and enhance the quality of life while minimizing the adverse effects of therapy. Non-drug conservative interventions are considered the first-line approach to osteoarthritis management. Patients with medial compartment osteoarthritis of the knee typically exhibit genu varum on weight-bearing. This misalignment shifts the mechanical axis medially at the level of the knee joint, increasing the stresses on the medial compartment of the knee and potentially exacerbating knee osteoarthritis. Methods: The study design was a cross-sectional survey to determine the effectiveness of the lateral heel wedge in patients suffering from knee osteoarthritis. This study was conducted at the Pakistan Institute of Prosthetic and Orthotic Sciences in Peshawar. Results: This study concluded that there is a considerable effectiveness of the lateral heel wedge in patients with OA knee. There is some evidence to suggest that they do have some symptomatic effect, and it also shows that the ratio of females to males is high. Additionally, the rate of Knee OA is greater in older age.

The Etiology of Upper Extremity Amputation in Lower Punjab Pakistan Khan, Muhammad Kamran; Israr, HM; Shah, Wisal; Uzma, Bibi
Journal of Prosthetics Orthotics and Science Technology Vol. 3 No. 1 (2024): Journal of Prosthetics Orthotics and Science Technology (JPOST)
Publisher : Poltekkes Kemenkes Jakarta I

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36082/jpost.v3i1.1510

Background: Amputation, a common orthopedic procedure, is often necessary due to severe trauma or vascular diseases, yet it can lead to psychological issues. This study investigates the causes of upper limb amputation in a specific region of Pakistan to raise awareness and mitigate risks. Aims: To identify causes of upper limb amputation in a specific region of Pakistan and raise awareness to prevent such occurrences. Methods: A cross-sectional study was conducted on upper limb amputations in South Punjab between January 2015 and June 2017. Data from 1174 patients, collected at the Physical Rehabilitation Centre in Muzaffargarh, were analyzed based on age, gender, amputation level, and affected side using HMIS, PMRN, and Microsoft Excel. Results: Analysis revealed a male-to-female ratio of 824:350, with the highest incidence among individuals aged 31 to 45. Crush injuries, primarily caused by the "TOKKA" machine, accounted for 66.4% of cases, followed by road traffic accidents at 10.7%. Domestic violence and electric shocks were also observed. Conclusion: Crush injuries from the "TOKKA" machine were the leading cause of upper limb amputations, highlighting the need for machinery safety awareness. Additionally, promoting protective gear use like helmets and early intervention in domestic violence can help reduce such injuries.

Challenges Linked to Post-Polio-Paralysis in Khyber Pakhtunkhwa Region Khan, Muhammad Kamran; Khan , Alamgeer
Journal of Prosthetics Orthotics and Science Technology Vol. 3 No. 2 (2024): Journal of Prosthetics Orthotics and Science Technology (JPOST)
Publisher : Poltekkes Kemenkes Jakarta I

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36082/jpost.v3i2.1786

Background: Poliomyelitis is a highly infectious viral disease often causing permanent paralysis. Post-Polio Paralysis (PPP) involves the delayed onset of new or worsening neuromuscular symptoms years after the initial attack. Polio survivors face numerous physical disabilities and significant social, financial, and human rights barriers. Aims: To identify the challenges faced by individuals with PPP in the Khyber Pakhtunkhwa region. Methods: The study employed a cross-sectional survey design with a sample size of n=200, selected through non-probability convenience sampling. Data were collected using the Post-Polio Clinic Questionnaire and analyzed with SPSS 22. Results: The gender distribution was 21.50% female and 78.50% male. New health and physical problems (neurological, arthritis, and physiological) were observed in 64.5% (n=129) of participants. Aggravated previous complications, such as pain, fatigue, and muscular atrophy, were reported by 91.5% (n=183). Difficulty performing heavy tasks was noted by 49.5% (n=99). Using public transport was a challenge for 46.5% (n=93), and driving a car was deemed impossible by 70% (n=140). Using an Indian commode as a toilet was a complication for 58% (n=116) of participants. Conclusion: The study reveals significant health and daily life challenges for polio survivors in Khyber Pakhtunkhwa, including a high prevalence of new and worsening neuromuscular symptoms, aggravated complications like pain and fatigue, and difficulties with heavy tasks, public transport, driving, and using certain toilets. These findings underscore the urgent need for targeted interventions to improve the quality of life for polio survivors by addressing their physical health and social and financial barriers.

Comparing the Effect of Leaf Spring and Swedish AFO in Patient with Drop Foot Deformity (Peroneal Nerve Injury) Khan, Muhammad Kamran; Bibi , Uzma; Shah , Wisal
Journal of Prosthetics Orthotics and Science Technology Vol. 2 No. 1 (2023): Journal of Prosthetics Orthotics and Science Technology (JPOST)
Publisher : Poltekkes Kemenkes Jakarta I

Background: Injection-molded polypropylene splint in Swedish AFO provides static dorsiflexion assistance and lateral stability for the entire foot-ankle area. It prevents foot drop while walking. Purpose: Comparing the effect of leaf spring and Swedish AFO in patient with drop foot deformity (Peroneal nerve injury). Objectives: To determine better controlling of planter flexion during Initial contact and Mid Swing of the Gait. Methodology: Four (4) participants with Drop Foot (Peroneal nerve injury) were selected through simple random sampling and they were allowed to walk at their self-selected speed with Swedish AFO and with PLS AFO in order to compare their controlling of Planter Flexion at Initial Contact and at Mid Swing under experimental design. The study is conducted at Pakistan Institute of Prosthetic and Orthotic Sciences Peshawar. Paired sample “t” test is used to compare the result. Results: By observing both the AFO’s i.e. Swedish AFO and Posterior Leaf Spring AFO at Initial Contact Phase of the Gait the deviation’s results for Swedish AFO’s are 3.82, 4.40, 11.22 and 9.18 degrees and deviations results for Posterior Leaf Spring AFO’s are 2.32, 3.34, 8.71 and 8.53 degrees. Statistical results implied that the impact of Leaf Spring AFO is bigger than Leaf spring AFO. Conclusion: Posterior leaf Spring AFO is more effective design for Persons with Drop foot (Peroneal nerve injury) as compare to Swedish AFO.

Comparison the Posterior Shell and Posterior Leaf Spring Socket Design for Syme’s Amputee in Terms of Normal Gait Kinematics: Case Study Shah, Wisal; Uzma, Bibi; Khan, Muhammad Kamran
Journal of Prosthetics Orthotics and Science Technology Vol. 2 No. 1 (2023): Journal of Prosthetics Orthotics and Science Technology (JPOST)
Publisher : Poltekkes Kemenkes Jakarta I

Background: Syme’s amputee patient commonly walks on the distal end of the stump. Two types of sockets are commonly prescribed to these patients; Syme socket with either complete posterior shell or leaf spring design. The purpose of this kinematic study was to compare the effectiveness of both these socket designs in terms of different gait variables. Methods: The study design was a case study, therefore, only a single syme’s amputee was selected for data collection. Both posterior shell and posterior leaf spring sockets were made for the study participant. The study participant was given the opportunity to use each socket for 15 days before data collection in 2D gait analysis lab. The data was compared with normal gait values, so the socket which had gait parameter values was closer to the normal gait kinematic values. That was considered as the most effective socket. Results: The results of this study showed that the posterior leaf spring socket design has closer to normal Stance phase (62%) as compared to complete posterior shell design (65%). Similarly, the values of swing phase were 38% for leaf spring design and 35% for posterior shell design which clearly indicate that the posterior leaf spring socket design is more effective than posterior shell socket design.

A Descriptive Study on Assessment of Functional Status in Cerebral Palsy Patients Using Knee Ankle Foot Orthosis Arshad, Zeenat; Khan, Muhammad Kamran
Journal of Prosthetics Orthotics and Science Technology Vol. 3 No. 1 (2024): Journal of Prosthetics Orthotics and Science Technology (JPOST)
Publisher : Poltekkes Kemenkes Jakarta I

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36082/jpost.v3i1.1503

Background: Cerebral Palsy (CP) is the most prevalent motor disability in childhood, arising from abnormal brain development or damage, affecting muscle control. Knee Ankle Foot Orthoses (KAFO) is a lower limb orthosis extending from foot plate to thigh level, designed to support weakened leg muscles and stabilize knee and ankle joints, potentially halting deformity progression or rectifying flexibility. This study aims to elucidate the functional status of lower limb CP patients utilizing KAFO. Aims: This study aimed to describe the functional level of lower limb CP patients wearing KAFO. Methods: Informed consent was obtained, and data of 110 cerebral palsy patients were collected using non-random consecutive sampling. Patients were divided into two groups: one with 80 patients utilizing KAFO with 4PPS (four-point pressure system), and the other with 30 patients not using KAFO with 4PPS. Observational gait analysis was conducted, and subjective and objective details were recorded on a specially designed questionnaire. The OPUS scale evaluated the functional status of CP patients, and statistical analysis employed chi-square tests to examine the role of KAFO in their functional status using SPSS version 21.0. Results: Statistical analysis revealed a significant relationship between total functional score and KAFO use. Among the 80 KAFO users, 71 patients scored >40, while 9 scored <40. In the non-KAFO group, 28 patients scored <40, and 2 scored >40. KAFO users exhibited higher total functional scores, indicating improved functionality and independence in daily activities (p<0.05). Conclusion: The study concludes that KAFO utilization enhances the functional status of cerebral palsy patients, facilitating independent engagement in daily activities. Comparison of total scores between KAFO users and non-users underscores the association between functional improvement and KAFO use.

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