Thirst and blood pressure regulation in a novel angiotensin II receptor type 1a knockout rat.

Quality of life (QOL) can be negatively affected by limb injury and loss, and dissatisfaction with orthotic or prosthetic devices prescribed to support rehabilitation and restoration of function is an important factor relevant for understanding health-related QOL (HRQOL) in these patients [, ]. Likewise, when individuals feel satisfied with their devices, this has been shown to be positively associated with HRQOL []. The impacts of prosthetic and orthotic device use on HRQOL for individuals with limb injuries and limb loss are complex, and include both physical components (e.g., functioning, activities of daily living [ADLs]) as well as psychosocial factors (e.g., body image, self-esteem) []. Comprehensive, standardized measurement of patients’ experiences with prosthetic and orthotic devices are important to evaluate treatment outcomes and perform comparative research [, ]. Developing a patient reported outcome measure (PROM) of prosthetic and orthotic device satisfaction for the Limb Injury Measurement Battery for Quality of Life (LIMB-QOL) [] is the goal of this project. For many individuals who experience major extremity injuries, prosthetic and/or orthotic devices are crucial for rehabilitation, whether limb loss and/or limb preservation/reconstruction are involved [–]. Prosthetic devices can be myoelectric, body powered, or cosmetic for the upper limb and passive or powered system [, ] or cosmetic devices for the lower limb. Each type of prosthesis serves different functions and provides different benefits [–]. Orthotic devices are used when the injured part of the limb is still present to provide support, as they can align, prevent, or correct limb pathologies, or aid return to function [, , ]. Orthoses can be used on the intact leg of individuals following unilateral lower limb loss [], and have been used successfully in people with complex limb injuries to return to high levels of activity, including military service [, , ]. Some individuals have multiple devices for specific tasks/settings [, ]. Prosthetic devices that involve a socket as the interface between the user of the device have many different design considerations (e.g., prosthetic shape, suspension, and terminal device [–]), although osseointegration is becoming more widely available as a method to directly connect the prosthesis to the amputated bone [–]. Orthotic devices have many design considerations as well, including the intended purpose (e.g., support, protection, immobilization), the device’s function (i.e., dynamic, static, neurophysiologic), and physical factors (e.g., weight, material, appearance, ease of use) []. Having and using a prosthetic device has been found to be associated with higher HRQOL [–]. These devices may reduce experience of secondary physical conditions, which are common for both limb loss and reconstruction [], and can also reduce neuropathic symptoms when well-fitted [], but their use may also be associated with development of complications (e.g., osteoarthritis, osteopenia and osteoporosis, and back pain are common for individuals with lower-limb loss who use prosthetic devices [, ]). The therapeutic benefits of device use for individuals with lower-limb injuries center on ambulation [, , , , , , ], with prosthetic device use also being positively associated with social activities and independent living in individuals with lower-limb loss [, ]. Similarly, in studies of lower-limb orthosis users, participants reported improved ambulation, fewer falls, and improved HRQOL [, , ], although pain and psychosocial challenges can persist despite successful orthotics training [–]. For individuals with upper-limb loss, self-care tasks and activities of daily living (ADLs) are a major focus of device prescription [, –]. Furthermore, research has shown that employment rates are higher for individuals with upper- and lower-limb loss who use a prosthesis [, ].