Spears Prosthetics and Orthotics
Hablamos Español con fluidez! When people think of Prosthetics- they think Spears.The highest techn
I'm trying to "will" a cold front in here late next week, but the data hasn't all lined up yet. Near record temps possible until it arrives, especially Tue and Wed.
May is American stroke awareness month, we know many people have experienced strokes and we appreciate them trusting us to help them gain their independence and physical function back.
This is our first test run with our new 3D printer. With this printer we are able to make devices in house faster! The entire process from measuring the patient to printing the socket took only 4 hours.
April is Limb loss awareness month so we wanted to not only raise awareness about limb loss but we also wanted to take a moment to thank all of our patients who have trusted us to help them throughout their journeys.
Spears Prosthetics and Orthotics Hablamos Español con fluidez! When people think of Prosthetics- they think Spears.The highest techn
Emergence PRO 3D Printer The Emergence PRO™ Multi-Platform 3D Printing System offers intuitive 3D printing and digital solutions across multiple industries. This innovative printing ...
Learning to walk without holding on to anything
1st step
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Hablamos Español con fluidez!
For May 2021, we are offering FREE lamination of your Covid19 vaccine card
We are now in-network with BCBS Garnet
COMPLIANCE MONITORS MOTIVATE SCOLIOSIS BRACE WEAR
By Maria St. Louis-Sanchez
March 31, 2021
A 2008 study in the Journal of Pediatric Orthopaedics found that patients wore their braces 47 percent of their prescribed time. However, their estimates were they had worn it 75 percent of the prescribed time.1
To help track the patients' wear times, and keep them motivated, it has become increasingly common for orthotists to put compliance monitors into the braces. The sensors, which detect a body's heat when a brace is worn, report how much time the braces are worn. The experts called the addition of the monitors a game changer in helping with compliance.
"Before using data loggers, we were dependent on a patients' self-report of adherence to wearing time and treatment plan," says Luke Stikeleather, CO, president and chief orthotist of the National Scoliosis Center, headquartered in Fairfax, Virginia. "While some patients are very accurate and honest, the literature shows that self-report is very inaccurate and prone to overestimation."
With the compliance monitors, there is no subjectivity.
"Now we have factual data that's objective, and we can share that information to encourage them to keep doing well or do better," he says.
At Texas Scottish Rite Hospital for Children in Dallas, it is standard practice to include a compliance monitor on every scoliosis brace.
"It's pretty much become the gold standard to have a data logger to monitor how many hours they are wearing it," says Kara Davis, CPO/L, FAAOP, clinical coordinator at the hospital. She says the monitors help hold the patients accountable and thus, they are more likely to wear their brace more.
"It's all about accountability," she says. "Will you cheat if you think you will be caught, or will you cheat if you don't think you will be caught?"
When the staff at Scottish Rite first used the sensors, they did not share the data with the patients and used it simply to confirm or deny if the self-reported adherence was correct.
The monitors truly became effective when the healthcare team discussed the data with the patients and their families, and they all worked together to use the data to improve compliance.
"We saw a three-hour a day increase in wear time when patients were given their sensor feedback," Davis says. "That's significant."
She says that its helpful to look at the data and ask patients why they might not be wearing their braces on certain days or at certain times.
"We can identify when they are struggling and can talk about intervention techniques to try to improve during those times."
We offer the Aspen Peak Scoliosis bracing system for non-surgical candidates with Medicare coverage.
Want to walk? Let's talk!
Call or Text: (901) 763-6999
I have a patient that has taken 4,196,761 steps with his Micro-processor Plie above knee prosthesis. That's just that leg!
Amazing!!!
Quadriplegic footballer first in Australia to try new exoskeleton Quadriplegic footballer first in Australia to try new exoskeletonBy Freya Noble • Senior Producer8:45pm Mar 10, 2021 Tweet Facebook Mail A 27-year-old football player is one of the first in the country to use a new exoskeleton to help him overcome paralysis.Shaun Greentree, from NSW, was injured o...
Have a question-send us a text to: (901) 763-6999 F-A-S-T response.
Vacuum forming the clear plastic evaluation socket
Treating a distal tibial bursa
Hip disarticulation
Spears Prosthetics and Orthotics will be closed Thursday 2/18/2021 due to the weather.
Diabetes Etiology Varies by Race/Ethnicity
— Risk of complications differed among diabetes subgroups
by Kristen Monaco, Staff Writer, MedPage Today January 27, 2021
Ethnic differences emerged among subgroups of diabetes characteristics, a new study found.
In an analysis of nearly 1,300 people with diabetes, five distinct types of diabetes cases were identified -- older age at diabetes onset (43%), severe hyperglycemia (26%), severe obesity (20%), younger age at onset (1%), and requiring insulin medication use (9%), reported Michael Bancks, PhD, MPH, of Wake Forest School of Medicine in Winston-Salem, North Carolina, and colleagues.
The distribution of patients within each diabetes subgroup varied vastly according to ethnicity and clinical characteristics, they noted in the Journal of Clinical Endocrinology & Metabolism.
"Prior research on diabetes subgroups has shown that some subgroups have different risks for diabetes complications but has largely been limited to white study populations," Bancks explained in a statement. "The topic of diabetes subgroups is an important research question, and our work expanded the study population to include South Asians, non-Hispanic whites, Chinese, Hispanic, and Black people to make this area of research more applicable to a broader population."
Pooling two U.S.-based observational studies of people with diabetes -- the Mediators of Atherosclerosis in South Asians Living in America (MASALA) and the Multi-Ethnic Study of Atherosclerosis (MESA) -- this analysis included survey data on 217 South Asian, 240 non-Hispanic white, 125 Chinese, 387 Black, and 324 Hispanic patients.
Diabetes status was defined as use of an antidiabetic medication, fasting glucose levels ≥126 mg/dL, and HbA1c ≥6.5%. Structured questionnaires were utilized to gather patient data on demographics, medical history, medication, and health-related behaviors like physical activity, smoking, and alcohol consumption.
While the most common subgroup was having an older age at the onset of diabetes -- where nearly half the cohort fell -- this was unlikely to be the case for people of South Asian descent. Instead, South Asians were most likely to fall into the "severe hyperglycemia" subgroup.
People in the severe hyperglycemia subgroup were also less likely to be women.
And while few people across the board fell into the subgroup of being younger at the onset of their diabetes, this category notably didn't have any Chinese patients. Of all ethnicities, South Asian patients had the youngest average age at diabetes diagnosis.
As for body mass index (BMI), Chinese and South Asian patients had the lowest average BMI, while Hispanic people with diabetes had the highest average BMIs.
Beyond demographics, certain clinical factors were more prevalent in specific diabetes subgroups.
Not surprisingly, the severe hyperglycemia group had the highest HbA1c levels (8.3%), followed by those who used insulin (7.8%), and those who were younger at diabetes onset (7.7%).
Looking specifically at cardiovascular-related factors, those in the severe hyperglycemia subgroup had the highest total cholesterol levels (193.8 mg/dL; 5.02 mmol/L). Those in the severe obesity subgroup had the lowest high-density lipoprotein cholesterol levels (43.2 mg/dL; 1.12 mmol/L).
Patients who were a younger age at diabetes onset had the lowest average 10-year predicted risk for atherosclerotic cardiovascular disease; this risk was highest for those in the severe hyperglycemia group.
More than 60% of the total cohort had presence of coronary artery calcium (CAC) at baseline, suggesting plaque buildup, with a third of patients having a CAC score of over 100.
Those with severe hyperglycemia and South Asian patients were determined to be most likely to develop CAC, while Chinese and Hispanic patients had the lowest risk for incident CAC.
Looking at kidney function, patients on insulin had the lowest average estimated glomerular filtration rate (eGFR) of all diabetes subgroups, while those with severe hyperglycemia had the highest average eGFR. The prevalence of chronic kidney disease was most common in white patients at baseline, but Black and Hispanic patients had the highest predicted probability for developing chronic kidney disease in the future.
Over 5-7 years of follow-up, those on insulin were determined to be most likely to develop chronic kidney disease, while those at a younger age at diabetes onset were least likely.
"While our goal was to assess diabetes cluster differences by race and ethnicity, these constructs encompass an array of factors, including ancestry, cultural heritage influencing such aspects as dietary preferences, differences in access and affordability of medical care, migration, and possible influence by racism," the researchers wrote.
"Findings should not be interpreted as attributing different underlying genetic mechanisms to race/ethnicity," they noted.
•
Kristen Monaco is a staff writer, focusing on endocrinology, psychiatry, and dermatology news. Based out of the New York City office, she’s worked at the company for nearly five years.
The neuroscientist changing the meaning of spinal cord injury
By Hilary Lamb
Published Friday, January 22, 2021
Grégoire Courtine and his colleagues developed an electrical stimulation treatment that restores voluntary leg mobility to people with paralysis following spinal cord injuries. This could be merely the first step towards transforming how we conceive these injuries.
In 2018, former athlete David M’Zee stood from his wheelchair, spoke into his smart watch, and started to walk with the support of a rollator. Several years before, he had suffered a spinal cord injury during a trampolining accident which left him paralysed from the waist down.
M’Zee’s convalescence came from decades of research, including 10 years of work on spinal cord dynamics by Professor Grégoire Courtine, a neuroscientist at the Swiss Federal Institute of Technology (EPFL) in Lausanne. Courtine – who trained in mathematics and physics before transitioning to experimental medicine – works on restoring function to people with paralysis following spinal cord injuries.
“Even as of now, there’s still no treatment for spinal cord injuries,” he explained. “You can go through rehabilitation, which means a robotic exoskeleton moving your leg, and sometimes there is spontaneous recovery and you can move around a little bit. But in 50 per cent of cases people are completely paralysed.”
Courtine and his colleagues focused on the few centimetres of spinal cord within the lumbar region. This section, which controls walking, is left intact after the majority of spinal cord injuries. It had previously been shown that this could be reactivated with electrical stimulation; this was the starting point for the scientists.
“At the beginning, we used a very simple approach; we stimulate the spinal cord,” Courtine said. “And through time we really understood what the structures are in the spinal cord which are recruited with the stimulation, meaning we gain a scientific understanding of the principles activated by the electrical stimulation in the spinal cord.”
Rather than simply delivering a constant current, the researchers experimented with patterns of stimulation. They learned where and when to provide stimulation to enable locomotion, developing a pattern of stimulation to activate the relevant groups of leg muscles at the correct times in the step cycle. In 2012, Courtine and his colleagues administered this stimulation – along with some pharmaceutical agents – to paralysed rats, which were able to walk again.
This set in motion the long “nightmare” of moving from rats to humans.
According to Courtine, they encountered every possible challenge imaginable. In addition to the obvious engineering challenge, they wrangled with ethical committees, funding applications, recruitment, and finding a large dedicated space at Lausanne University Hospital. Courtine had always been aware that this was not a purely academic effort, and had started collaborating with neurosurgeon Jocelyn Bloch at an early stage to ensure that the treatment would work in patients. The two founded a start-up, GTX Medical (now Onward) in 2014 to develop the technology and manage the administrative side of the project.
In a crucial stepping stone between rats and humans, Courtine had to demonstrate that the treatment would work in non-human primates: “The way we stimulate the human spinal cord is different to rats, it’s based on what we observed in monkeys, so this was a critical step to the translation to humans,” he said.
This introduced many of the challenges they would encounter in human trials: a more complex central nervous system, high ethical standards, and intelligent subjects who could not be conveniently restrained, controlled, and euthanised as rats can. This was also the point at which Bloch surgically implanted the system (previously wired), meaning that it had to be medical-grade.
After a successful non-human primate trial, in 2018 they implanted the flexible electrodes in three human patients and applied the stimulation pattern.
The treatment not only allowed the unprecedented restoration of mobility – in itself a scientific marvel – but this activity also triggered the natural regeneration of nerve fibres. Nerves grew spontaneously, bypassing damaged tissue to carry electrical signals between the brain and spinal cord. This allowed the patients to regain control over previously paralysed muscles, even when the stimulation was switched off.
“This was a surprise,” Courtine said. “You are able to stimulate the spinal cord in the way you reactivate this dormant site, which enables the immediate production of movement. It means you can train and generate activity.”
“That is a process where local activity depends on plasticity, meaning that when the system is active it triggers the growth of new connections: the reorganisation of neuronal pathways in a way that after this long period training with stimulation enables this very activity. You have the growth of new connections that enable the recovery of some function without stimulation.”
After five months of training and physical therapy, all three patients were able to voluntarily control their leg muscles and walk for as long as an hour without muscle exhaustion, even leaving the laboratory and walking outdoors. Ten patients have now recovered voluntary leg mobility through this approach.
Since then, Courtine and Onward have been working towards commercialising their approach such that it can reach thousands of people. They improved the technology, replacing their previous electron array with a version better suited to facilitating movement and refining the stimulator. They realise that this technology needs to be convenient to use; they envision the user simply saying “stim[ulation] on” or “stim[ulation] off” to their smart watch to begin training.
Meanwhile, they are setting up clinical trials to try this treatment in people with fresh spinal cord injuries, as data from rats and non-human primates suggest there is a window of opportunity (with greater plasticity) following the injury. They hope to begin the two-year trial in 2022.
Courtine and his colleagues are also experimenting with applying electrical stimulation to other types of paralysis. As the recipient of the 2020 IET A F Harvey Prize, Courtine will have £350,000 to help broaden the scope of his research: “The idea is to accelerate this understanding and technology to move this to a different location to target new function, in this case upper limb movement.”
Over the next decade, Courtine hopes that Onward will be able to provide a range of treatments to improve the lives of people with spinal cord injuries in every way that matters to them. This transcends limb movement to include things like sexual function and bowel and bladder control. Asked whether he hopes to change how we conceive of spinal cord injuries as a life sentence of restricted function, Courtine chuckles.
“Maybe that’s a big statement,” he said. “But we are at least working towards that as a dream objective of our lives. Hopefully [that will happen] before I am constrained to retire.”
Medicare has awarded Spears Prosthetics & Orthotics a Spinal Bracing competitive bid for 2021-2023
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