The lived experience of military beneficiaries with amputations at the hip and pelvic level.

BACKGROUND: Hip- and pelvic-level amputations are devastating injuries that drastically alter patient function and quality of life. This study examined the experience of military beneficiaries with a hip- or pelvic-level amputation to better characterize their challenges and specific needs and to optimize treatment in the future. METHODS: We conducted a retrospective review of the Military Health System and identified 118 patients with a history of one or more amputation(s) at the hip or pelvic level between October 2001 and September 2017. Surviving participants (n = 97) were mailed a letter which explained the details of the study and requested participation in a telephonic interview. A total of six individuals (one female, five males) participated in structured interviews. RESULTS: The study group included four participants with hip disarticulations and two participants with hemipelvectomies (one internal, one external). All six participants reported significant challenges with activities related to prosthetic use, mobility, residual limb health, pain, gastrointestinal and genitourinary function, psychiatric health, and sexual function. CONCLUSIONS: These interviews highlight the unique needs of individuals with hip- and pelvic-level amputations and may improve access to higher echelons of care that would enhance the function and quality of life for these participants.

Bodywide fluctuations support manual exploration: Fractal fluctuations in posture predict perception of heaviness and length via effortful touch by the hand.

The human haptic perceptual system respects a bodywide organization that responds to local stimulation through full-bodied coordination of nested tensions and compressions across multiple nonoverlapping scales. Under such an organization, the suprapostural task of manually hefting objects to perceive their heaviness and length should depend on roots extending into the postural control for maintaining upright balance on the ground surface. Postural sway of the whole body should thus carry signatures predicting what the hand can extract by hefting an object. We found that fractal fluctuations in Euclidean displacement in the participants' center of pressure (CoP) contributed to perceptual judgments by moderating how the participants' hand picked up the informational variable of the moment of inertia. The role of fractality in CoP displacement in supporting heaviness and length judgments increased across trials, indicating that the participants progressively implicate their fractal scaling in their perception of heaviness and length. Traditionally, we had to measure fractality in hand movements to predict perceptual judgments by manual hefting. However, our findings suggest that we can observe what is happening at hand in the relatively distant-from-hand measure of CoP. Our findings reveal the complex relationship through which posture supports manual exploration, entailing perception of the intended properties of hefted objects (heaviness or length) putatively through the redistribution of forces throughout the body.