Motor performance benefits of matched limb imitation in prosthesis users

Our previous work demonstrated that the action encoding parietofrontal network, which is crucial in planning and executing motor tasks, is less active in prosthesis users who imitate movements of intact actors (mismatched limb) versus prosthesis users (matched limb). Such activation could have behavioral consequences in prosthesis users rehabilitating with intact therapists. The goal was to identify behavioral effects of matched versus mismatched limb action imitation in naïve users of prostheses. Intact subjects donned a specially adapted prosthetic device to simulate the wrist and forearm movement that transradial amputees experience. While electrogoniometry was recorded, non-amputated prosthesis users (NAPUs) observed and imitated demonstrations of a skillful motor task performed by either an intact actor or NAPU. We hypothesized that NAPUs would elicit less motion variability when performing matched versus mismatched imitation. Matched imitation resulted in a significant decrease in shoulder motion variability compared with mismatched imitation. The matched group also developed elbow motion patterns similar to the NAPU demonstrator, while the mismatched group attempted patterns similar to the intact demonstrator. This suggests a behavioral advantage to matched imitation when adapting to a prosthetic device, as it yielded more consistent movements and facilitated development of new motor patterns. Further, these results suggest that when prosthesis users are faced with the impossible task of imitating movements of an intact hand, they perform this action with greater variability and poorer technique. This work has implications on how prosthetic device operation is conveyed to persons with amputation as their clinical interactions often involve mismatched limb imitation.     

Postoperative Remote Automated Monitoring: Need for and State of the Science

Worldwide, more than 230 million adults have major noncardiac surgery each year. Although surgery can improve quality and duration of life, it can also precipitate major complications. Moreover, a substantial proportion of deaths occur after discharge. Current systems for monitoring patients postoperatively, on surgical wards and after transition to home, are inadequate. On the surgical ward, vital signs evaluation usually occurs only every 4-8 hours. Reduced in-hospital ward monitoring, followed by no vital signs monitoring at home, leads to thousands of cases of undetected/delayed detection of hemodynamic compromise. In this article we review work to date on postoperative remote automated monitoring on surgical wards and strategy for advancing this field. Key considerations for overcoming current barriers to implementing remote automated monitoring in Canada are also presented.     

Children's health care: Book and media reviews

Let's Remember Corky, Fine, Polly Delson, Shaker Heights, Ohio, 1981. Paperback, unpaged, $4.75.

The Tenth Good Thing about Barney, Viorst, Judith, Hartford, Atheneum, 1971. Paperback, 20 pages, illustrated by Erik Blegvad.

Jasper Enters the Hospital, 16½ mins., The Day of Jasper's Operation, 13½ mins., Wellness: It's Not Magic, 15 mins., Video Cassettes‐ 16 mm. Available from: Kids Corner, 2027 North Tejon Street, Colorado Springs, Colorado 80907, (303) 475–2499.

First Do No Harm, produced by Pierce Atkins Corporation, 45 mins., S400 (purchase), S45 (daily rental). Distributed by Children's Hospital National Medical Center, 111 Michigan Avenue, N.W., Washington, D.C. 20010.

Pediatric Diagnostic Procedures With Guidelines for Preparing Children for Clinical Tests, Droske, Susan C. and Francis, Sally A. Toronto, John Wiley and Sons Inc., 1981.

The Children's Medical Series ‐ a series of eight videotapes with Susan Linn and her puppets.     

Bridging the Gap: Innovative Approaches to Continuing Education in Rural,Remote, and Isolated First Nation Communities

Access to education, communication, and support is essential for achieving and maintaining a skilled healthcare workforce. Delivering affordable and accessible continuing education for healthcare providers in rural, remote, and isolated First Nation communities is challenging due to barriers such as geography, isolation, costs, and staff shortages. The innovative use of technology, such as on‐line courses and webinars, will be presented as a highly effective approach to increase access to continuing education for healthcare providers in these settings. A case study will be presented demonstrating how a national, not‐for‐profit health care organization has partnered with healthcare providers in these communities to support care at the local level through various technology‐based knowledge exchange activities.