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Instructor lesson plan detailing regulatory instruction and training procedures for applying the amputation rule, avoiding pyramiding, and evaluating muscle disabilities within the VA disability rating framework.
Document Type:
Instructor Lesson Plan
TMS Number:
1209937
Time Required:
4.5 Hours
Target Audience:
Rating Veteran Service Representatives (RVSR), Decision Review Officers (DRO), Rating Quality Review Specialists (RQRS), Veterans Service Representatives (VSR)
Prerequisites:
Completion of RVSR Challenge curriculum
Training Format:
Classroom instruction with participatory discussions and practical exercises
Materials:
PowerPoint presentation, trainee handouts, VMBS Job Aid – Amputation Rule for VBMS-R
Assessment Method:
VA TMS assessment and practical exercise
Regulatory References:
38 CFR 4.14, 38 CFR 4.55, 38 CFR 4.56, 38 CFR 4.68, 38 CFR 4.71a, 38 CFR 4.73, 38 CFR 4.96, 38 CFR 4.115, 38 CFR 4.114, 38 CFR 3.310(d), 38 CFR 4.126, 38 CFR 4.150
Manual References:
M21-1 Part III, Subpart iv, Sections 4.A, 4.B.2.b, 4.G, 4.J
Training Objectives:
Application of the amputation rule, avoidance of pyramiding, evaluation and combined ratings of muscle disabilities
Responsible Office:
Regional Office Training Managers
Price: 8 / 10 USD
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2022
Field:
Vascular Surgery; Rehabilitation Medicine
Topic:
Prosthetic Mobility and Functional Outcomes After Major Lower Limb Amputation
Document Type:
Scientific Research Article
Manuscript Category:
Original Article
Authors:
Arsalan Wafi; Luis Ribeiro; Vijay Kolli; Bilal Azhar; James Budge; Ian M. Loftus; Peter J. E. Holt
Institutions:
St George’s Vascular Institute, St George’s University Hospital, London, United Kingdom; Douglas Bader Rehabilitation Unit, Queen Mary’s Hospital, London, United Kingdom
Study Design:
Retrospective Cohort Study of a Prospectively Maintained Database
Study Period:
2007–2020
Follow-up End Date:
April 2021
Population:
Patients with unilateral major lower limb amputation due to advanced ischaemia or diabetic foot disease
Sample Size:
771 Patients
Clinical Conditions Studied:
Acute Limb Ischaemia; Chronic Limb-Threatening Ischaemia; Peripheral Arterial Disease; Diabetic Foot Disease
Outcome Measure:
Independent Prosthetic Mobility After Rehabilitation
Secondary Outcome:
Association Between Prosthetic Mobility and Long-Term Survival
Presentation Event:
Veith Symposium, New York, 2022
Keywords:
Amputation; Prosthetic Mobility; Rehabilitation; Functional Outcome; Survival; Gender Differences
Conflicts of Interest:
None
Year:
2012
Region / City:
United States, multiple VISNs
Subject:
Amputation System of Care training and educational materials
Document Type:
Federal solicitation / sources sought notice
Agency:
Department of Veterans Affairs, Veterans Health Administration
Contracting Office:
SAO East, PCAE STL
Point of Contact:
Wanakee Strickland, [email protected]
Response Date:
12-26-2012
Period of Performance:
One year with four optional one-year extensions
Scope:
Provision of ACA and CARF memberships, training materials, and publications for 22 VISNs, 7 Regional Amputation Centers, and 15 Polytrauma Amputation Networks
Place of Performance:
Contractor’s site
Contract Type:
Firm Fixed-Price
Included Materials:
“First Step”, “Side Step”, “Primer Paso”, “Pain Brochure”, “Living Well With Limb Loss”
Holidays Observed:
Federal holidays as specified in the document
Year:
2026
Region / City:
Sydney, NSW, Australia
Theme:
Falls, Balance, Gait, Aging
Document Type:
Research Study
Institution:
Neuroscience Research Australia, University of New South Wales
Author:
Steven Phu, Daina L Sturnieks, Patrick YH Song, Stephen R Lord, Yoshiro Okubo
Target Audience:
Researchers, Healthcare Professionals, Aging Specialists
Period of Validity:
N/A
Approval Date:
N/A
Date of Changes:
N/A
Year:
2023
Region / City:
Not specified
Topic:
Food Safety
Document Type:
HACCP Plan
Organization / Institution:
Not specified
Author:
Not specified
Target Audience:
Food safety professionals, food processing industry
Validity Period:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2023
Region / city:
Not specified
Topic:
Cancer research, muscle index, and treatment effects
Document type:
Research table
Organization / institution:
Not specified
Author:
Not specified
Target audience:
Researchers, medical professionals
Period of validity:
Not applicable
Approval date:
Not specified
Date of changes:
Not specified
Year:
2019
Region / city:
United States
Topic:
Stress reduction, psychotherapy
Document type:
Research paper
Institution:
The George Washington University
Author:
Hannah K. Greenbaum
Target audience:
Psychology students, researchers, mental health professionals
Period of validity:
N/A
Approval date:
N/A
Modification date:
N/A
Year:
2023
Region / City:
Nanjing, China
Topic:
Solid state fermentation, feed additives, Ginkgo biloba, poultry health
Document Type:
Research Paper
Organization / Institution:
Nanjing Forestry University
Author:
Qi Li, Shufeng Gao, Fuqiang Zhang, Ran Chen, Xuhui Zhang, Linguo Zhao
Target Audience:
Researchers, academics, professionals in animal feed industry
Period of Validity:
Not specified
Date of Approval:
Not specified
Date of Changes:
Not specified
Year:
2010–2022
Region / City:
Hyogo, Japan
Subject:
Biliary Tract Cancer, Sarcopenia, Surgical Outcomes
Document Type:
Clinical Study
Institution:
Meiwa Hospital, Department of Surgery
Authors:
Shinichi Ikuta, Tsukasa Aihara, Takayoshi Nakajima, Meidai Kasai, Naoki Yamanaka
Target Audience:
Oncologists, Surgeons, Clinical Researchers
Patient Cohort:
211 patients undergoing BTC resection
Primary Tumor Sites:
Intrahepatic bile duct, Extrahepatic bile duct, Gallbladder, Ampulla of Vater
Follow-up Method:
Disease-specific survival (DSS), Relapse-free survival (RFS)
Ethics Approval:
Institutional Ethics Committee of Meiwa Hospital, approval No. 2022-36
Year:
2026
Location:
London, UK
Subject:
Distal Hereditary Motor Neuropathy, muscle function, gait analysis, rehabilitation
Document Type:
Participant Information Sheet
Institution:
Queen Square Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery
Chief Investigator:
Dr Gita Ramdharry
Researcher:
Aljwhara Alangary
Target Audience:
Patients with distal hereditary motor neuropathy
Study Duration:
16 months
Measurement Sessions:
0 months, 12 months, 16 months
Intervention:
4-month therapeutic exercise program, ankle braces, physical therapy
Data Collection Methods:
Gait analysis, muscle strength measurement, MRI scans
Consent Required:
Yes
Confidentiality:
Maintained according to privacy regulations; data may be shared anonymously for future research
Year:
2026
Region / City:
Global
Subject:
Human Anatomy and Physiology
Document Type:
Lecture Notes
Institution:
University / Medical Faculty
Author:
Not specified
Target Audience:
Medical students
Period Covered:
Recent lecture series
Date of Compilation:
2026-03-03
Related Topics:
Cardiac and smooth muscle physiology, Clinical muscle disorders
Year:
2019
Region / City:
Washington, D.C.
Theme:
Psychological Techniques, Stress Reduction, Group Psychotherapy
Document Type:
Research Review
Author:
Hannah K. Greenbaum
Target Audience:
Psychologists, Researchers, Students in Clinical Psychology
Approval Date:
October 1, 2019
Date of Changes:
Not specified
Institution:
The George Washington University
Department:
Department of Psychology
Year:
2026
Region / City:
Not specified
Topic:
Burn Patient Clinical Study
Document Type:
Research Report
Institution:
Not specified
Author:
Not specified
Target Audience:
Medical professionals, researchers
Study Period:
Not specified
Sample Size:
56 participants
Patient Grouping:
Study group and control group
Clinical Intervention:
Inspiratory muscle training
Burn Severity:
Severe (>30% body surface area, 2nd/3rd degree)
Primary Burn Causes:
Fire, hot liquids
Data Analysis Methods:
Descriptive statistics, normality tests, variance tests
Year:
2026
Region:
Not specified
Study population:
Patients with peripheral artery disease (PAD)
Variables analyzed:
Muscle mass, muscle strength, BMI, age, sex, race, smoking status, diabetes, hypertension, SBP, CVD, CKD, PAD severity, hs-CRP, medication use
Document type:
Supplementary tables of a research study
Data source:
Clinical cohort
Statistical methods:
Univariate and multivariate hazard ratio analyses
Adjustments:
PAD severity, age, sex, BMI categories, race, smoking, diabetes, hypertension, SBP, CVD, CKD, marital status
Outcome measures:
All-cause mortality, cardiovascular disease mortality
Sample exclusions:
Subjects with missing laboratory variables
Context:
Statistical tables from a clinical research article detailing hazard ratios for mortality outcomes associated with muscle mass and strength in PAD patients
Year:
2026
Target Audience:
Individuals aiming for lean muscle gain
Daily Caloric Intake:
2300 Calories
Protein Intake:
0.8–1g per pound of body weight
Meal Frequency:
5 meals per day with 2–3 protein feedings
Food Type:
Whole foods with minimal processing
Macronutrient Distribution:
Flexible carbohydrate and fat ratio
Supplement Recommendations:
Protein powder, fish oil optional
Hydration Guidance:
Adjust based on urine clarity and activity level
Document Type:
Personal nutrition guideline
Source:
Fitness and nutrition advisory content
Year:
2026
Region:
International
Topic:
Sports medicine / Genetics
Document type:
Research supplementary material
Institution:
Academic research group
Author:
Not specified
Population:
Female athletes
Genetic marker:
COL1A1 rs1107946
Outcome measured:
Muscle injury incidence and hazard ratio
Study design:
Observational cohort study
Statistical methods:
Cox proportional hazards model, Fisher’s exact test
Data points:
Training-exposure hours, player-hours, incidence per 1,000 player-hours
Context:
Supplementary research table presenting hazard ratios of muscle injury for female athletes based on COL1A1 rs1107946 genotypes with training exposure and statistical analysis.
Year:
2019
Institution:
The George Washington University
Department:
Department of Psychology
Course:
PSYC 3170: Clinical Psychology
Instructor:
Dr. Tia M. Benedetto
Author:
Hannah K. Greenbaum
Type of document:
Literature Review
Audience:
Psychology students and professionals
Focus:
Stress reduction techniques in group psychotherapy
Methods discussed:
Guided imagery, Progressive muscle relaxation
Context:
Group psychotherapy settings
References:
American Psychological Association, McGuigan & Lehrer, Jacobson, Yalom & Leszcz
Note:
Year