Recent Posts

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81
Wish List (and discussion) / Services Performed Annual Report
« Last post by elroy on August 17, 2016, 10:12:22 AM »
This report is already in the database.  However, it's not a very "smart" report as it is.  The following is needed:  Add new questionnaires, dig deeper to make sure service has been done (beyond mere existence of db record), more breakdown of 3D services, include patients included in research, etc.
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Wish List (and discussion) / Add entire ASIA SCI assessment to database.
« Last post by elroy on August 17, 2016, 10:11:06 AM »
An abbreviated form of this questionnaire was added to the database at the request of SHC-Chicago.  I just post this here in case there's interest to have the complete questionnaire incorporated into the database.
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Wish List (and discussion) / Add PSI questionnaire to the database
« Last post by elroy on August 17, 2016, 10:09:41 AM »
The PSI is the Prosthesis Satisfaction Inventory questionnaire.  This is another questionnaire I have where I've got all I need to add it to the database.

I've just heard very little interest to have it.  It would take me a couple of days work to include it.

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Wish List (and discussion) / Add PUFI questionnaire to the database
« Last post by elroy on August 17, 2016, 10:05:50 AM »
PUFI is the the Prosthetic Upper Extremity Functional Index questionnaire.  It is for upper extremity deficiency patients.

I have all I need to add this questionnaire to the database, as well as permission from the author to use it in an open-source way.  It's just approximately a 2 day process to do this, and, as far as I know, SHC-Sacramento is the only hospital who may make use of it.  If there is other interest, please post a reply, and I'll see about finding time to get this done.
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Wish List (and discussion) / Re: Calculate Muscle Tendon Lengths using OpenSim
« Last post by Adam Graf on August 16, 2016, 10:14:02 AM »
This analysis would call on OpenSim (free download) to run muscle tendon length (MTL) estimations based on gait trials. The program applies the kinematic data to the OpenSim model and outputs patient MTLs compared to optimal MTLs. We display this data as a graph for each muscle of interest over one gait cycle. The Y axis is 'Normalized MTL (%)' so a value of 1 would mean that the MTL is operating at an optimal lenth, below 1 would be short and above 1 would be long.
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Wish List (and discussion) / Re: The KINETIC Gait Deviation Index
« Last post by Adam Graf on August 15, 2016, 10:37:21 AM »
The GDI-Kinetic: A new index for quantifying kinetic deviations from normal gait
Adam Rozumalski a,b,*, Michael H. Schwartz a,b,c

A B S T R A C T
This article introduces a new index, the GDI-Kinetic; a direct analog of the GDI based on joint kinetics
rather than kinematics. The method consists of: (1) identifying ‘‘features’’ of the raw gait kinetic data
using singular value decomposition, (2) identifying a subset of features that account for a large
percentage of the information in the raw gait kinetic data, (3) expressing the raw data from a group of
typically developing children as a linear combination of these features, (4) expressing a subject’s raw
data as a linear combination of these features, (5) calculating the magnitude of the difference between
the subject and the mean of the control, and (6) scaling and transforming the difference, in order to
provide a simple, and statistically well-behaved, measure. Linear combinations of the first 20 gait
features produced a 91% faithful reconstruction of the data. Concurrent and face validity for the GDIKinetic
are presented through comparisons with the GDI, Gillette Functional Assessment Questionnaire
Walking Scale (FAQ), and topographic classifications within the diagnosis of Cerebral Palsy (CP). The GDIKinetic
and GDI are linearly related but not strongly correlated (r2 = 0.24). Like the GDI, the GDI-Kinetic
scales with FAQ level, distinguishes levels from one another, and is normally distributed across FAQ
levels six to ten, and among typically developing children. The GDI-Kinetic also scales with respect to
clinical involvement based on topographic CP classification in Hemiplegia types I–IV, Diplegia, Triplegia,
and Quadriplegia. The GDI-Kinetic complements the GDI in order to give a more comprehensive measure
of gait pathology.
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Wish List (and discussion) / Re: Coleman Block test section with pictures, description, comments
« Last post by Adam Graf on August 15, 2016, 10:34:49 AM »
http://www.wheelessonline.com/ortho/coleman_block_test

The Coleman Block test is a foot alignment test where the patient's foot is placed on a wood block, 2.5 to 4 cm thick, with the heel and lateral border of foot on the block and bearing full weight while the first, second, & 3rd metatarsals are allowed to hang freely into plantar flexion and pronation.

- Interpretation:
    - test is based on premise that there is fixed flexion of 1st metatarsal;
    - this test negates effect that forefoot (first metatarsal in plantar flexion) may have on the hindfoot in stance;
    - if heel varus corrects while the patient is standing on the block, hindfoot is considered flexible;
    - if subtalar joint is supple & correct w/ block test, then surgical procedures may be directed to correcting forefoot pronation, which is usually due to plantar flexion of 1st metatarsal;
    - if hindfoot is rigid, then surgical correction of both forefoot & hindfoot are required


For this I am envisioning a small section of the PT Eval to ask about whether or not the heel varus corrects or not when on the blocks for each involved foot. Then there would be a small section in the report template that would get included if there was a Coleman block test performed. This section would included the interpretation and the picture of the posterior view of the hindfoot on the block.
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Wish List (and discussion) / Re: Greenville's GAS Static program which analyzes the static trial for proper marke
« Last post by Adam Graf on August 15, 2016, 10:18:07 AM »
In Chicago we used this for a while and found it quite useful, but we switched computers, lost the program and never got it back running. I will ask Roy to comment on this as well, but basically the GAS static program takes a close look at the static trail and helps check static alignment and marker placement. It is a good way to check your work and also get some valuable information about the patient's static standing posture.
We also used this for awhile for marker placement competencies.
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Wish List (and discussion) / Re: Salt Lake City's improved foot pressure analysis method using motion capture and
« Last post by Adam Graf on August 15, 2016, 10:13:54 AM »
SLC presented on this in July 2016 for the SMALnet Educational Presentation. I have asked Bruce to stop by here and fill in some details, but the basics are that the patient wears foot markers during the emed testing and you collect motion data simultaneously. Bruce has written an executable file that takes the c3d file and foot pressure file and syncs them up to more accurately orientate and scale the foot pressure picture onto the pedobarography report. He pretty conclusively showed that we are prone to errors when trying to place the foot pressure pictures on to the report templates by hand.
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Wish List (and discussion) / Balance Service/Protocol
« Last post by elroy on August 12, 2016, 06:04:48 PM »
In Houston, there's been discussion for years about developing a "balance" protocol.  However, there are many issues to be worked out with such a protocol.
  • Is it performed on a standard pedobarograph mat?  This means it must be big enough for both feet to stand.
  • Is it sit-to-stand?  Or just standing after a "start" signal?
  • How are lab distractions managed?  Stare at a dot on the wall?
  • How long should the assessment be?
  • Is it done per-foot, or just overall?
  • Is it done both eyes-open and eyes-closed?
  • What are the actual measurements?  (Discussed below)

Regarding the measurements, this can be a nettlesome discussion.  Most agree that a COP path is initially calculated, resulting in a series of X,Y coordinates.  From there, one can take many directions:
  • Velocity of the path?
  • Do a best fit ellipse and take its area?

These are just a couple of things that can be calculated.  There is an extensive (although nascent) literature on this.  However, if a protocol is to be developed, the measures to appear on a patient report must be decided upon.
 
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