Happenings

INSURANCE INSIGHTS

Record Enrollment in ACA Marketplaces

More than 14.5 million

Americans signed up or were automatically reenrolled in 2022 individual market health insurance coverage through the Affordable Care Act marketplaces during the open enrollment period. Approximately 11.5 million returning consumers and 3 million new consumers will be covered by ACA plans this year.

SOURCE: “Marketplace 2022 Open Enrollment Period Report,” CMS.gov.

RESEARCH ROUNDUP Researchers To Develop Measure of Prosthesis Awareness

The Department of Defense has awarded a $1.97 million grant to Benjamin Darter, PhD, to study the impact of microprocessorcontrolled knees on prosthesis awareness and overall health. Darter, an associate professor at Virginia Commonwealth University’s College of Health Professions, will collaborate with the University of Washington and Hanger Institute for Clinical Research and Education to develop a measure assessing how much individuals with lower-limb loss need to “pay attention” to their prosthesis during activities, as well as how much they need to pay attention to changes when using a microprocessorcontrolled knee. Darter and his team are in the initial stages of developing a measurement tool to assess elements of function and to understand how technological advances benefit prosthesis users. The measure will be designed to assist clinicians in their ability to understand the walking abilities of patients with lower-limb loss, to ultimately improve mobility.

Scientists Create Anthropomorphic Robotic Hand

South Korean researchers Uikyum Kim, PhD, from Ajou University and Dawoon Jung from Korea University have developed the ILDA hand, an integrated linkage-driven dexterous anthropomorphic robotic hand. The prosthesis has been designed to be dexterous, with a high degree of control, while remaining low cost and low maintenance, according to the researchers.

The compact design features 15 degrees of freedom in 20 joints and a fingertip force of 24 newtons. Five fingers with fingertip sensors are integrated with 15 motors. Kim and Jung led experiments demonstrating that the hand can hold an egg without cracking it, pour drinks, cut paper using scissors, and manipulate tweezers.

“Existing prosthetic hands have implemented the simple function of grasping objects. The ILDA hand is capable of delicately or strongly grasping objects of various shapes, as well as manipulating complex tools used in daily life,” said Kim. “It is expected that future prosthetic hands will be developed in such a way that most of the tasks currently performed by human hands are possible.” Kim and his team plan to expand this project by developing a flexible, artificial skin to cover the current prototype. Details were published in December in Nature Communications.

Study Finds MPKs Reduce Injurious Falls Among Individuals With Diabetes

Researchers from Hanger Institute for Clinical Research and Education completed the Stability and Falls Evaluation After Amputation (SAFE-AMP) 1 study to evaluate the impact of microprocessorcontrolled knees (MPKs) on rates of injurious falls among diabetic and dysvascular people with above-knee amputations. Results were published in January in Assistive Technology Journal.

The researchers—Shane Wurdeman, MSPO, PhD, CP, FAAOP(D); Taavy A. Miller, PhD; Phillip M. Stevens, MEd; and James Campbell, PhD—analyzed data associated with nearly 900 diabetic prosthesis users with above-knee amputations who were eligible for MPKs, and studied their gender, age, time since amputation, and body mass index adjusted for limb loss. They concluded that an MPK can decrease odds of an injurious fall by 250% for individuals with amputation due to diabetes or dysvascular disease. In addition, not providing a diabetic patient with an MPK increases their risk of falling, more than the risk associated with aging.

The study is anticipated to be the first in a series that will examine the need for greater access to appropriate rehabilitation solutions for below- and above-knee amputees in the diabetes community. “Hanger is committed to conducting innovative research to advance clinical care for patients relying on orthoses and prostheses,” said Campbell, who is Hanger chief clinical officer. “Our SAFE-AMP findings illustrate that further work is warranted to better understand how all possible orthotic and prosthetic care solutions can help improve clinical outcomes and quality of life for the diabetic patient population.”

DIABETES DOWNLOAD Children With COVID-19 at Increased Risk for Diabetes

Patients younger than 18 with COVID-19 were more likely to receive a new diabetes diagnosis 30 days or longer after infection than were individuals without COVID-19 and those with prepandemic acute respiratory infections, according to a study released in January by CDC.

CDC researchers estimated diabetes incidence among patients younger than 18 with diagnosed COVID-19 from retrospective cohorts constructed from two sources: IQVIA healthcare claims between March 1, 2020, and Feb. 26, 2021, and data from HealthVerity that included patients who had any health encounter related to COVID-19 between March 1, 2020, and June 28, 2021. Among these patients, diabetes incidence was 166% higher among those with COVID-19 than among those without in the IQVIA database, and 31% higher among those with COVID-19 in the HealthVerity data.

The researchers noted the findings were consistent with previous research demonstrating an association between COVID-19 infection and diabetes in adults. The observed association between diabetes and COVID-19 “might be attributed to the effects of SARS-CoV-2 infection on organ systems involved in diabetes risk,” according to the researchers. They suggest that healthcare providers should screen for diabetes symptoms in individuals younger than 18. “SARS-CoV-2 infection might lead to type 1 or type 2 diabetes through complex and different mechanisms,” they concluded. The full study was published in Morbidity and Mortality Weekly Report.

RAISING AWARENESS

Celebrate Patients in April

The O&P community is preparing to celebrate Limb Loss Awareness Month. Started by the Amputee Coalition in 2010, Limb Loss and Limb Difference Awareness Month takes place each year in April.

The Amputee Coalition is asking that individuals with limb loss share their “moments that matter” by writing a story, recording a video, or talking about a time in their life when they felt strong, scared, confident, in pain, or happy. Encourage patients to visit amputee-coaliton. org to participate this year.

FAST FACT

Amputation Causes

More than half of amputations in the United States are caused by vascular disease, which includes diabetes and peripheral arterial disease.

54%

45%

Vascular disease 2%

Trauma Cancer

SOURCE: “Limb Loss in the U.S.,” Amputee Coalition