Happenings

RESEARCH ROUNDUP

VR Training Aids in Prosthetic Rehab

Virtual reality (VR) may be leveraged to improve motor function outcomes and assist in clinical decision making among individuals with amputation, according to a team of U.S. and Chinese researchers. The researchers, led by Jie Hao, DPT, from the University of Nebraska Medical Center, examined 10 clinical studies involving VR: seven lower-extremity amputation and three upper-extremity amputation studies.

“Results reveal the positive effects of VR on improving motor function in prosthesis training, including balance, gait, and upper-extremity outcomes,” the authors reported. Participants also reported enjoying the VR interventions.

The authors noted that more properly designed randomized controlled trials with larger sample sizes are needed to determine whether VR induces better therapeutic outcomes than conventional rehabilitation. The study was published in November in the American Journal of Physical Medicine & Rehabilitation.

Limb Loss Patients Report Low-Back Pain

Researchers from the University of Genoa in Italy conducted a cross-sectional study based on an online questionnaire to investigate the prevalence and intensity of low-back pain among individuals with lower-limb amputation. The questionnaire, completed by 239 participants, included questions regarding demographic information, comorbid conditions, amputation history, low-back pain history, and acceptance of amputation.

Results indicated a prevalence of low-back pain among 82% of participants, with 70% reporting pain in the past year. “This study shows that the prevalence of low-back pain in lower-limb amputees appears to be higher than in the general population, with similar levels of pain and frequency,” reported the authors. “The highest percentage of people with a sedentary lifestyle not practicing any kind of sports emphasizes the importance of educating this patient population on the importance of physical activity.” Thestudy was published in November in Spine.

Researchers Study CostEffectiveness of Implants

Researchers conducted an initial cost-effectiveness analysis of above-knee limb loss patients in the United States using the OPRATM Implant System and concluded that for active individuals with transfemoral amputation, the implant is a cost-effective alternative to a socket prosthesis when evaluated with a disease-specific health instrument. The research team presented its findings in November via poster presentation at the annual meeting of the American Congress of Rehabilitation Medicine.

Jeff Voight, MBA, MPH, lead author of the study, participated in conducting Markov health state transition models as well as probabilistic sensitivity analyses to perform the cost-effectiveness analyses in an array of health states that could arise over a typical 42-year life span, wearing a socket prosthesis or having an implant. The researchers found values of $228/QALY (Quality Adjusted Life Years) for treatment refractory (for those patients who had problems with a socket prosthesis and then switched to an implant) and $84/QALY for those patients who have not had a socket prosthesis. Researchers are developing a more comprehensive manuscript on this study. INSURANCE INSIGHTS

NEW ACA ENROLLMENTS UP 40%

The number of individuals who signed up for new health insurance coverage via the Affordable Care Act on healthcare.gov increased by 40% in 2022 compared to 2021. Total plan selections, including those continuing from previous plans, increased 17% over the previous year.

SOURCE: HHS.GOV

O&P ATHLETICS

Athletes Prepare for 2024 Paralympics

More than 4,400 athletes from 184 nations are expected to compete at the 2024 Summer Paralympic Games, slated for Aug. 28 through Sept. 8, 2024, in Paris, France. Competitors will take part in 22 sports at 549 events, with more than 3 million spectators watching the competition.

The Paris 2024 Committee recently unveiled the mascots for the event: the Paralympic Phryge and the Olympic Phryge, who will be the primary ambassadors of the Games. A Phyrgian cap is a symbol of liberty and is present at the heart of major historical events in France. “The Olympic Phryge and the Paralympic Phryge are the leaders of a tribe who always have their trainers on. The Paris 2024 mascots aim to lead a revolution through sport,” noted the Paris 2024 Committee.

The Paralympic Phryge wears a running blade. “By choosing to have a mascot with a visible disability, Paris 2024 aims to give maximum representation to people who are living with disabilities and to promote the inclusivity of the Paralympic Games and of sport as a whole,” noted the committee.

As in past years, Ottobock is expected to be present with a technical repair service in the Paralympic Village and in several competition venues.

DIABETES DOWNLOAD

COVID-19 Increases Diabetes Risk

Several recent studies have found evidence of an increased risk of diabetes among individuals who had contracted COVID-19, according to an article published in The Lancet Diabetes & Endocrinology in December.

In one study, a CDC analysis of a large electronic healthcare database of 353,000 adults who had had COVID-19 and 1.6 million controls with no evidence of infection suggested that people with COVID-19 had an increased risk of new onset Type 1 diabetes and Type 2 diabetes.

In a German investigation, a cohort study of 36,000 people with COVID-19 indicated higher risk of newly diagnosed Type 2 diabetes than an equal number of matched controls with acute upper respiratory tract infections.

In a third study, investigators reviewed data from the U.S. Department of Veterans Affairs and discovered that people with COVID-19 had increased risk of incident diabetes and incident use of antihyperglycemic therapy in the postacute phase. The increased risk of diabetes “was evident even in people who had very low baseline risk of diabetes, according to traditional risk factors,” according to the authors.

“Before the pandemic, the global burden of diabetes was high and rising; the possible increased incidence of diabetes due to the pandemic could further compound the already staggering prepandemic burden,” noted author Ziyad Al-Aly, MD. “In turn, this could lead to substantial ramifications on health systems, healthcare costs, life expectancy, and economic indicators such as employment and labor participation.” FAST FACT

TYPE 1 DIABETES ON THE RISE

Between 13.5 million and 17.4 million cases of Type 1 diabetes are expected by the year 2040, according to an international team of experts—an increase of 60% to 107% over 2021 numbers, with the largest increases expected in low-income and lower-middleincome countries.

SOURCE: THE LANCET DIABETES & ENDOCRINOLOGY

O&P By the Numbers

Trends in C-Fab, 3D Printing, and Outcome Measurement Collection

USE OF CENTRAL FABRICATION USE OF 3D PRINTING

82%

Average percentage of companies that use outside central fabrication for any items

Average percentage of facilities that use additive manufacturing/3D printing in fabrication

49%

COLLECTION OF OUTCOME MEASURES

Average percentage of facilities that collect outcome measures

For Prosthetics Patients

For Orthotics Patients

77%

67%

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