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Journal articles on the topic 'Foot prosthesis'
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1
Major, Matthew J., Joel Scham, and Michael Orendurff. "The effects of common footwear on stance-phase mechanical properties of the prosthetic foot-shoe system." Prosthetics and Orthotics International 42, no. 2 (May 9, 2017): 198–207. http://dx.doi.org/10.1177/0309364617706749.
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Background:Prosthetic feet are prescribed based on their mechanical function and user functional level. Subtle changes to the stiffness and hysteresis of heel, midfoot, and forefoot regions can influence the dynamics and economy of gait in prosthesis users. However, the user’s choice of shoes may alter the prosthetic foot-shoe system mechanical characteristics, compromising carefully prescribed and rigorously engineered performance of feet.Objectives:Observe the effects of footwear on the mechanical properties of the prosthetic foot-shoe system including commonly prescribed prosthetic feet.Study design:Repeated-measures, Mechanical characterization.Methods:The stiffness and energy return was measured using a hydraulic-driven materials test machine across combinations of five prosthetic feet and four common shoes as well as a barefoot condition.Results:Heel energy return decreased by an average 4%–9% across feet in all shoes compared to barefoot, with a cushioned trainer displaying the greatest effect. Foot designs that may improve perceived stability by providing low heel stiffness and rapid foot-flat were compromised by the addition of shoes.Conclusion:Shoes altered prosthesis mechanical characteristics in the sagittal and frontal planes, suggesting that shoe type should be controlled or reported in research comparing prostheses. Understanding of how different shoes could alter certain gait-related characteristics of prostheses may aid decisions on footwear made by clinicians and prosthesis users.Clinical relevanceShoes can alter function of the prosthetic foot-shoe system in unexpected and sometimes undesirable ways, often causing similar behavior across setups despite differences in foot design, and prescribing clinicians should carefully consider these effects on prosthesis performance.
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Naseri, Amirreza, Majid Mohammadi Moghaddam, Mohammad Gharini, and Maziar Ahmad Sharbafi. "A Novel Adjustable Damper Design for a Hybrid Passive Ankle Prosthesis." Actuators 9, no. 3 (August 24, 2020): 74. http://dx.doi.org/10.3390/act9030074.
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Specifications of actuators when interacting with biological systems such as the human body are entirely different from those used in industrial machines or robots. One important instance of such applications is assistive devices and prostheses. Among various approaches in designing prostheses, recently, semi-active systems attracted the interest of researchers. Even more, some commercial systems benefit from designs such as implementing an adjustable damper in the ankle prosthesis to increase range of motion. The main reason for adding damper is to assist amputees’ walking locomotion on slopes (especially downward). In this paper, we introduce a hydraulic damper design for use in the transtibial prosthetic foot. In the fabricated hydraulic prosthetic foot, two one-way flow control valves are exploited to tune the damping ratio in the plantar flexion and dorsiflexion, independently. Using the carbon prosthetic foot in series to a damper and spring could improve mimicking intact foot movement. First, we present the details of the damper and the prosthesis mechanical design. Then, we introduce experiment-based modeling for the damper’s conceptual design in the proposed prosthesis using SIM-Hydraulic and MATLAB. This device is fabricated and tested in a pilot experiment. The compact design with reduced weight and size of the prosthetic foot are additional advantages of the proposed prosthetic foot.
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Fridman, A., I. Ona, and E. Isakov. "The influence of prosthetic foot alignment on trans-tibial amputee gait." Prosthetics and Orthotics International 27, no. 1 (April 2003): 17–22. http://dx.doi.org/10.3109/03093640309167973.
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An optimally aligned prosthesis, as accomplished by the subjective judgment of the prosthetist, guarantees the best quality of gait. Yet, amputees can adapt to a large variety of geometrical configurations of the prosthetic components. Different external rotation angles of the foot in trans-tibial (TT) prostheses were investigated. The study tried to identify (a) the relationship between foot angle and other gait parameters and (b) the compensating pattern of the amputees to excessive external rotation of the foot. Eight (8) TT amputees, fitted with an identical type of prosthesis, were investigated during ambulation. The prosthetic foot was externally rotated as follows: optimal angle (10.94°±5.21°), optimal angle plus another 18°, and optimal angle plus another 36°. Analysis of gait was performed with the aid of an electronic walkway. Speed of gait, stance and swing time, and foot angle were monitored in 4 runs for each of the three foot angles. Speed of gait remained almost constant in the three tests. Stance and swing time, as well as step length, significantly changed when 36° were added to the optimal foot angle. This foot position significantly influenced inter-legs time difference and symmetry between the legs. During ambulation, prosthetic foot external rotation was decreased by internal rotation of the limb at the hip joint level. It is concluded that TT amputees can maintain an efficient speed of gait even when the prosthetic foot is malpositioned in excessive external rotation. Although such a malalignment significantly influences other gait parameters during walking, amputees are able to adapt themselves by internal rotation of the hip joint in the amputated leg.
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Herr, Hugh M., and Alena M. Grabowski. "Bionic ankle–foot prosthesis normalizes walking gait for persons with leg amputation." Proceedings of the Royal Society B: Biological Sciences 279, no. 1728 (July 13, 2011): 457–64. http://dx.doi.org/10.1098/rspb.2011.1194.
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Over time, leg prostheses have improved in design, but have been incapable of actively adapting to different walking velocities in a manner comparable to a biological limb. People with a leg amputation using such commercially available passive-elastic prostheses require significantly more metabolic energy to walk at the same velocities, prefer to walk slower and have abnormal biomechanics compared with non-amputees. A bionic prosthesis has been developed that emulates the function of a biological ankle during level-ground walking, specifically providing the net positive work required for a range of walking velocities. We compared metabolic energy costs, preferred velocities and biomechanical patterns of seven people with a unilateral transtibial amputation using the bionic prosthesis and using their own passive-elastic prosthesis to those of seven non-amputees during level-ground walking. Compared with using a passive-elastic prosthesis, using the bionic prosthesis decreased metabolic cost by 8 per cent, increased trailing prosthetic leg mechanical work by 57 per cent and decreased the leading biological leg mechanical work by 10 per cent, on average, across walking velocities of 0.75–1.75 m s −1 and increased preferred walking velocity by 23 per cent. Using the bionic prosthesis resulted in metabolic energy costs, preferred walking velocities and biomechanical patterns that were not significantly different from people without an amputation.
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De Pauw, Kevin, Pierre Cherelle, Bart Roelands, Dirk Lefeber, and Romain Meeusen. "The efficacy of the Ankle Mimicking Prosthetic Foot prototype 4.0 during walking: Physiological determinants." Prosthetics and Orthotics International 42, no. 5 (April 6, 2018): 504–10. http://dx.doi.org/10.1177/0309364618767141.
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Background: Evaluating the effectiveness of a novel prosthetic device during walking is an important step in product development. Objective: To investigate the efficacy of a novel quasi-passive ankle prosthetic device, Ankle Mimicking Prosthetic Foot 4.0, during walking at different speeds, using physiological determinants in transtibial and transfemoral amputees. Study design: Nonrandomized crossover design for amputees. Methods: Six able-bodied subjects, six unilateral transtibial amputees, and six unilateral transfemoral amputees underwent a 6-min walk test at normal speed, followed by series of 2-min walking at slow, normal, and fast speeds. The intensity of effort and subjective measures were determined. Amputees performed all walking tests on a treadmill with current and novel prostheses. Shapiro–Wilk normality tests and parametric and nonparametric tests were conducted (p < 0.05). Results: Compared to able-bodied individuals, the rating of perceived exertion levels were significantly elevated in transtibial and transfemoral amputees for both prostheses (p ≤ 0.016). Compared to able-bodied individuals transfemoral amputees also showed significantly elevated heart rate for both prostheses at normal speed (p ≤ 0.043). Within-group comparisons demonstrated that walking with Ankle Mimicking Prosthetic Foot significantly increased the heart rate in transfemoral amputees and transtibial compared to current prosthesis (p = 0.002). Furthermore, transfemoral amputees reached a significantly higher rating of perceived exertion levels. Conclusion: Intensity of effort during walking with Ankle Mimicking Prosthetic Foot is higher compared to current prostheses. Clinical relevance Ankle Mimicking Prosthetic Foot 4.0 is a novel quasi-passive ankle prosthesis with state-of-the-art technological parts. Subjective measures show the importance of this technology, but the intensity of effort during walking still remains higher compared to current passive prostheses, especially in transfemoral amputees.
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Verheul, Floor Jacoba Marie-Georgette, Olaf Verschuren, Maremka Zwinkels, Mariska Herwegh, Anka Michielsen, Marieke de Haan, and Iris van Wijk. "Effectiveness of a crossover prosthetic foot in active children with a congenital lower limb deficiency: an explorative study." Prosthetics and Orthotics International 44, no. 5 (May 6, 2020): 305–13. http://dx.doi.org/10.1177/0309364620912063.
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Background: Children with lower limb prostheses cannot always keep up with their peers during active play. A pediatric crossover foot may be a promising prosthetic alternative for children engaging in high-intensity movements necessary for active play. Objectives: To compare children’s walking performance, running performance, experienced competence, and cosmesis using their prescribed prosthesis compared with the crossover foot. Study Design: Pretest-posttest study. Methods: Children with lower limb amputation or deficiency were recruited. Measurements were taken at baseline with the prescribed prosthesis and 6 weeks later with the crossover foot. Walking speed, energy cost of walking, anaerobic muscle power, stair climbing speed, ankle power, and cosmesis were evaluated. Results: Four children participated in the study. Two children had increased walking speed with the same energy cost, one child had decreased speed with increased energy cost, and one child had the same speed with decreased energy cost. Muscle power increased for three of the four children and ankle power increased for all children while using the crossover foot compared to the prescribed prosthesis. Two children reported knee pain or feeling excessive knee flexion when running with the crossover foot. One child reported negative feelings toward cosmesis of the crossover foot. Conclusions: This study suggests crossover foot may benefit active children by improving walking and running performance, and decreasing energy cost. However, knee pain reports or negative feelings toward the atypical design suggest the crossover foot may not be ideal for every child. Further research is needed to determine which pediatric users would benefit from this type of prosthetic foot. Clinical relevance Children with lower limb deficiencies are active prosthetic users who often switch between low- and high-intensity movements in their daily activities. Therefore, they might benefit from a crossover prosthetic design. The preliminary findings of this study suggest the crossover foot (XF) may be a promising foot for active children.
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Verhoeff, T. T., P. A. Poetsma, L. Gasser, and H. Tung. "Evaluation of use and durability of polypropylene trans-tibial prostheses." Prosthetics and Orthotics International 23, no. 3 (December 1999): 249–55. http://dx.doi.org/10.3109/03093649909071642.
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Forty-three (43) trans-tibial prostheses with a mean period of use of 33 months were evaluated in terms of utilisation and durability. The majority of the prostheses (80%) were worn by amputees with demanding occupations, such as farmers, fishermen and tradesmen. The prostheses were in use approximately 9 hours per day. No major or frequent breakdowns of the polypropylene prosthetic components were found. The suspension belts were the parts most frequently affected; a total of 32 needed replacement after an average 11 months of use. Eleven (11) prostheses were completely replaced, more than half at least partly because of socket-fitting problems. In all, socket-fitting problems were found in 15 prostheses, causing pain and consequently limitation of use. While the prosthetic polypropylene components were satisfactory, the rubber foot was a major cause of early breakdown. A total of 40 feet were replaced; their mean period of use before breakdown was 9 months. In practice, parts were frequently replaced at a later stage than desirable, meaning that there was frequent “overuse” of prostheses with worn parts. Measures were taken to increase the life span of the prosthesis: change in the design of the foot; issuing a spare foot with the prosthesis; strengthening the suspension belt. Additional evaluations are necessary to confirm the degree to which the findings are representative.
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Prince, F., P. Allard, R. G. Therrien, and B. J. McFadyen. "Running gait impulse asymmetries in below-knee amputees." Prosthetics and Orthotics International 16, no. 1 (April 1992): 19–24. http://dx.doi.org/10.3109/03093649209164303.
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In running, large gait asymmetry is expected due to the inability of the foot prosthesis to comply with the kinematic demands and produce a powerful plantarflexion moment. In this work, interlimb asymmetry in below-knee (BK) amputee running gait was assessed for one rigid and three flexible keel prostheses, using vertical and anteroposterior ground reaction forces and respective impulses. Nine BK amputees and 6 controls participated in this study. The running speed was monitored by two light sensitive detectors while the ground reaction forces were measured with a Kistler force plate. Between the prosthetic side and the sound limb the impulse indicator showed greater asymmetry than the force. Interlimb asymmetry was very much present in all types of prosthesis tested but is less pronounced in the flexible keel prostheses. In the latter, the asymmetry may be associated with the forcetime history modulation rather than its magnitude alone. Generally, the impulses better describe interlimb asymmetry and the forces allow a greater discrimination between prosthetic foot types.
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Sin, S. W., D. H. K. Chow, and J. C. Y. Cheng. "A new alignment jig for quantification and prescription of three-dimensional alignment for the patellar-tendon-bearing trans-tibial prosthesis." Prosthetics and Orthotics International 23, no. 3 (December 1999): 225–30. http://dx.doi.org/10.3109/03093649909071638.
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Clinically, it is hard to achieve and reproduce prosthesis alignment at will during daily prosthesis fitting. A new alignment jig was designed and developed to facilitate quantification and prescription of prosthesis alignment for patellar-tendon-bearing (PTB) trans-tibial prostheses. The alignment jig provided instantaneous readings of the three-dimensional orientation and position of the socket relative to the prosthetic foot in standardised units. The inter- and intra-tester errors of the alignment jig in measuring prosthesis alignment were evaluated and demonstrated to have good reliability. The alignment jig was recommended to be used clinically after the conventional dynamic alignment procedure to document the prosthesis alignment. Further application of the alignment jig for systematic evaluation of the effects of prosthesis alignment on gait for trans-tibial amputees is suggested.
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Scheepers, Lisan G., Joep O. Storcken, Frans Rings, Yvette van Horn, and Henk A. Seelen. "New socket-less prosthesis concept facilitating comfortable and abrasion-free cycling after Van Nes rotationplasty." Prosthetics and Orthotics International 39, no. 2 (January 15, 2014): 161–65. http://dx.doi.org/10.1177/0309364613515494.
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Background and aim:Current leg prostheses in rotationplasty typically feature a thigh cuff, which, in cycling, may cause perspiration problems and friction-related abrasions of the skin. The aim has been to develop a socket-less prosthetic device for persons with a rotationplasty to be able to engage in high-intensity cycling without contracting abrasions.Technique:The new device (Socket-Less Rotationplasty Prosthesis for Cycling) features a standard cycling shoe on the rotationplasty foot, replacing the conventional socket and thigh cuff. A reinforced 12-layer carbon fibre frame bolted to the aforementioned shoe, replacing the standard tube, connects to a prosthetic foot and a second cycling shoe. Alignment of the Socket-Less Rotationplasty Prosthesis for Cycling is done both statically and dynamically.Discussion:The Socket-Less Rotationplasty Prosthesis for Cycling is lightweight and more ventilated relative to conventional sockets. All components can be replaced easily. Most important, however, is that the current user now can cycle 135 km on end without skin abrasions.Clinical relevanceThe Socket-Less Rotationplasty Prosthesis for Cycling concept enables patients with a leg rotationplasty to engage in high-intensity cycling without contracting skin problems, thereby facilitating clients’ participation.
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Tuan, Le Van, Kengo Ohnishi, Hiroshi Otsuka, Yukio Agarie, Shinichiro Yamamoto, and Akihiko Hanafusa. "Finite Element Analysis for the Estimation of the Ground Reaction Force and Pressure Beneath the Foot Prosthesis during the Gait of Transfemoral Patients." Journal of Biomimetics, Biomaterials and Biomedical Engineering 33 (July 2017): 1–11. http://dx.doi.org/10.4028/www.scientific.net/jbbbe.33.1.
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Ground reaction forces (GRF) and pressure beneath the foot prosthesis are the main parameters used in biomechanical analysis to estimate the joint load and evaluate the quality of the prosthesis, especially with transfemoral patient who have amputation that occurs through the femur. The information of ground reaction forces and beneath pressure of foot prosthesis is conventionally achieved using dynamics method or the experimental method. However, these methods have some limitation for a prosthetist and designers to choose the best prosthesis solution for transfemoral patient. In the dynamics method, the deformation of the foot prosthesis and the variation in the shape of the residual limb in the socket is neglected and the center of gravity of the prosthesis component is estimated; thus, the method is less accurate because the prosthesis consists of several parts with different materials and shapes. The experimental method involves time and cost in setting-up the device. Data can be acquired only after the patient wears the prosthesis. In this study, the authors were implemented a finite element (FE) method for computing the GRF, and the pressure beneath the foot prosthesis and its distribution. The finite element model of all components of transfemoral of the prosthesis was created. The ground reaction forces, beneath pressure of foot prosthesis and other parameters were disclosed after solving by explicit solver of LS-Dyna software. The results of the vertical ground reaction forces exhibit consistently similar data between the simulation and the measurement. A correlation coefficient of 0.91 between them denotes their correspondence. The reaction force at knee joint, distribution of beneath pressure of foot prosthesis were included in results and discussion. These results can be used for prosthesis design and optimization; they can assist the prosthetist in selecting a comfortable prosthesis for the patient and in improving the rehabilitation training.
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Russell Esposito, Elizabeth, Jennifer M. Aldridge Whitehead, and Jason M. Wilken. "Step-to-step transition work during level and inclined walking using passive and powered ankle–foot prostheses." Prosthetics and Orthotics International 40, no. 3 (January 27, 2015): 311–19. http://dx.doi.org/10.1177/0309364614564021.
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Background: Individuals with leg amputations who use passive prostheses have greater metabolic demands than non-amputees likely due to limited net positive work compared to a biological ankle. New powered ankle–foot prostheses can perform net positive mechanical work to aid push-off capabilities, which may reduce metabolic demands. Objectives: Compare step-to-step transition work and metabolic demand during level and inclined walking using passive and powered ankle-foot prostheses. Study Design: Repeated measures. Methods: Six individuals with transtibial amputation and six able-bodied controls walked at a standardized speed across level ground and up a 5° incline. Calculated measures included mechanical work during step-to-step transitions from the trailing prosthetic to leading intact limb, steady state metabolic rate, and ankle joint kinetics and kinematics. Results: The powered prosthesis generated 63% greater trailing limb step-to-step transition work than the passive during level walking only (p = 0.004). Metabolic rate was lower with the powered prosthesis during level (p = 0.006) but not inclined walking (p = 0.281). The powered prosthesis increased ankle power compared to the passive, to the extent that power was normalized to controls during inclined walking and greater than controls during level walking. Conclusion: The powered prosthesis improved ankle power, metabolic rate, and step-to-step transition work on level ground, with few negative consequences on inclines. These results may be used to guide the development and use of actively powered prosthetic devices in high-functioning individuals. Clinical relevance Overall, powered devices offer biomechanical and metabolic benefits over passive energy storage and return designs on level ground and perform as well as a passive model on inclines. The lower metabolic demand when using the powered device may delay fatigue for individuals with transtibial amputation when walking over level ground.
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Sedki, Imad, and Raymond Moore. "Patient evaluation of the Echelon foot using the Seattle Prosthesis Evaluation Questionnaire." Prosthetics and Orthotics International 37, no. 3 (October 8, 2012): 250–54. http://dx.doi.org/10.1177/0309364612458448.
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Background: The introduction of the Echelon prosthetic foot with a hydraulic self-aligning ankle adds improved adaptability to varied terrains and uneven walking surfaces. However, the specific indications for prescribing such components and the potential benefits are yet to be fully established. Case Description and Methods: Nine amputees including three bilateral amputees evaluated their standard prostheses using the Seattle Prosthesis Evaluation Questionnaire. They were then provided with Echelon feet, and they evaluated them after 4 weeks of use. Findings and Outcomes: Improved satisfaction in all categories of use in relation to the Echelon foot with the greatest increase reported by bilateral amputees. Conclusion: The use of prosthetic feet with hydraulic self-aligning ankle improves prosthetic users’ satisfaction in general with a particular benefit in bilateral amputees. Clinical relevance Establish the clinical impact and user satisfaction after using Echelon feet in prosthetic users with different levels of amputations.
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Cohen-Sobel, E., MA Caselli, and J. Rizzuto. "Prosthetic management of a Chopart amputation variant." Journal of the American Podiatric Medical Association 84, no. 10 (October 1, 1994): 505–10. http://dx.doi.org/10.7547/87507315-84-10-505.
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The history and prosthetic difficulties of a patient with an unusual Chopart amputation variant have been presented. Although it is possible for the Chopart amputee to walk with just a shoe and filler, this patient does best with a formal prosthesis. The Chopart amputation, which has been surgically stabilized with Achilles tendon lengthening to prevent equinus contractures, can be fitted successfully with a lightweight circumferential plastic or silicone prosthesis or more traditionally with a solid ankle foot orthosis with filler. This partial foot prosthesis is worn with a sturdy shoe with a rocker and solid ankle cushion heel or a well constructed running shoe. The Chopart amputee with equinus contractures must be fitted with a Chopart clamshell prosthesis or solid ankle patellar tendon bearing orthosis with filler and the above shoe prescription. Recent variants of the partial foot prosthesis including the Imler partial foot prosthesis, the Lange silicone prosthesis, and the ankle corset prosthesis were described.
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Abdelaal, Osama, Saied Darwish, Khaled Abd Elmougoud, and Saleh Aldahash. "A new methodology for design and manufacturing of a customized silicone partial foot prosthesis using indirect additive manufacturing." International Journal of Artificial Organs 42, no. 11 (May 24, 2019): 645–57. http://dx.doi.org/10.1177/0391398819847682.
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The production of customized prostheses for the foot and ankle still relies on slow and laborious steps of the traditional plaster molding fabrication techniques. Additive manufacturing techniques where three-dimensional objects can be constructed directly based on the object’s computer-aided-design data in a layerwise manner has opened the door to new opportunities for manufacturing of novel and personalized medical devices. The purpose of the present study was to develop a new methodology for design and manufacturing of a customized silicone partial foot prosthesis via an indirect additive manufacturing process. Furthermore, the biomechanics of gait of a subject with partial foot amputation wearing the custom silicone foot prosthesis manufactured by the indirect additive manufacturing was characterized, in comparison with a matched healthy participant. This study has confirmed the possibility of producing silicone partial foot prosthesis by indirect additive manufacturing procedure. The amputated subject reported total comfort using the custom prosthesis during walking, as well as cosmetic advantages. The prosthesis restored the foot geometry and normalized many of gait characteristics. The findings presented here contribute to introduce a proper understanding of biomechanics of walking after wearing silicone partial foot prosthesis and are useful for prosthetists and rehabilitation therapists when treating patients after partial foot amputation.
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Mulder, Inge A., Herman R. Holtslag, Leonardus FA Beersma, and Bart FJM Koopman. "Keep moving forward: A new energy returning prosthetic device with low installation height after Syme or Pirogoff amputation." Prosthetics and Orthotics International 38, no. 1 (April 26, 2013): 12–20. http://dx.doi.org/10.1177/0309364613485112.
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Background:The incidence of foot amputations increased in the Netherlands to 3.3/100,000 people up to 1994. Despite these numbers, only a few basic prosthetic and orthotic devices are available, and all lack functionality to restore ankle and foot mobility.Objectives:The aim of this explorative study was to design and test a unique prosthesis for Syme or Pirogoff amputees with the necessary low installation height but restoring ankle and foot mobility.Study design:A case study was performed.Methods:The new prosthesis was designed and numerically analyzed on aspects concerning strength and deformation. A prototype was tested in a case study to assess the biomechanical behavior of the new foot. As a reference, six Syme/Pirogoff amputees were measured. Additionally, all volunteers filled out a questionnaire to evaluate their prosthetic feet.Results:The self-selected and maximum walking speed of the case subject at 0° and 5° slopes was higher using the new foot (0.36 m/s and 0.53 m/s, respectively) comparing to the Low Rider (Otto Bock HealthCare) (0.31 m/s and 0.31 m/s, respectively). Using the new foot, a more symmetrical walking pattern was achieved.Conclusion:The case study shows that this new prosthetic foot could be an improvement compared to existing prosthetic feet.Clinical relevanceFoot amputees with low available installation height still experience daily the inconvenience of missing ankle and foot mobility. Their low velocity and cosmetically poor walking pattern influence on their sound leg and overall walking functionality. A more functional prosthesis would have a great impact on their daily activities.
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Kijkusol, D. "Simplified, low cost below-knee prosthesis." Prosthetics and Orthotics International 10, no. 2 (August 1986): 96–98. http://dx.doi.org/10.3109/03093648609164507.
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Problems are encountered in using standard prostheses in developing countries, especially when the prostheses need repair and the amputees cannot come back to the workshop. Very simple, low cost and durable prostheses can solve this problem. The solution described has worked well with villagers in some rural areas of Thailand, where the inexpensive prosthesis permits walking bare-foot and through water and mud.
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Pullen, J. J. "A low profile paediatric partial foot." Prosthetics and Orthotics International 11, no. 3 (December 1987): 137–38. http://dx.doi.org/10.3109/03093648709078197.
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A low profile prosthesis was designed using a flexible liner in conjunction with a rigid shell, with a toe extension. Thus far, two paediatric patients have been fitted with the device, at the University of Virginia Medical Center. One patient is a five year old with a Lisfranc level amputation and the other, a sixteen year old with a Chopart level amputation. Both patients have successfully worn their prostheses, full time, for over two years. The prostheses these children have been wearing are comfortable, functional and cosmetic. The prostheses provide excellent suspension, a good weight-bearing surface and an anterior lever arm for push-off during late stance phase.
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Au, Samuel, and Hugh Herr. "Powered ankle-foot prosthesis." IEEE Robotics & Automation Magazine 15, no. 3 (September 2008): 52–59. http://dx.doi.org/10.1109/mra.2008.927697.
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Sobel, Ellen, Christopher J. Japour, Renato J. Giorgini, Steven J. Levitz, and Hugh L. Richardson. "Use of Prostheses and Footwear in 110 Inner-City Partial-Foot Amputees." Journal of the American Podiatric Medical Association 91, no. 1 (January 1, 2001): 34–49. http://dx.doi.org/10.7547/87507315-91-1-34.
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The number of partial-foot amputations performed is increasing, and many recommendations have been made regarding the use of prostheses and footwear designed to prevent higher-level amputations in this population. The present study investigated the use of prostheses and shoe inserts and the types of footwear worn by partial-foot amputees in the inner city to determine whether previous recommendations are being followed as well as whether new prosthetic styles are being used. The study surveyed 110 patients (73 men and 37 women) with a mean age of 58.6 years (range, 21 to 86 years) with partial-foot amputations of all levels. The results showed that about one-half of all patients wore a shoe-insert orthosis. Although 54% wore some form of special footwear to accommodate and protect the residual foot, no patient in this study wore a shoe with a rocker-bottom sole. Only one patient with a transmetatarsal amputation used a brace and only one patient in the entire study wore a modern cosmetic foot prosthesis. (J Am Podiatr Med Assoc 91(1): 34-49, 2001)
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Major, Matthew J., David Howard, Rebecca Jones, and Martin Twiste. "The effects of transverse rotation angle on compression and effective lever arm of prosthetic feet during simulated stance." Prosthetics and Orthotics International 36, no. 2 (March 2, 2012): 231–35. http://dx.doi.org/10.1177/0309364611435996.
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Background and Aim: Unlike sagittal plane prosthesis alignment, few studies have observed the effects of transverse plane alignment on gait and prosthesis behaviour. Changes in transverse plane rotation angle will rotate the points of loading on the prosthesis during stance and may alter its mechanical behaviour. This study observed the effects of increasing the external transverse plane rotation angle, or toe-out, on foot compression and effective lever arm of three commonly prescribed prosthetic feet.Technique: The roll-over shape of a SACH, Flex and single-axis foot was measured at four external rotation angle conditions (0°, 5°, 7° and 12° relative to neutral). Differences in foot compression between conditions were measured as average distance between roll-over shapes.Discussion: Increasing the transverse plane rotation angle did not affect foot compression. However, it did affect the effective lever arm, which was maximized with the 5° condition, although differences between conditions were small.Clinical relevanceIncreasing the transverse plane rotation angle of prosthetic feet by up to 12° beyond neutral has minimal effects on their mechanical behaviour in the plane of walking progression during weight-bearing.
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Montgomery, Jana R., and Alena M. Grabowski. "Use of a powered ankle–foot prosthesis reduces the metabolic cost of uphill walking and improves leg work symmetry in people with transtibial amputations." Journal of The Royal Society Interface 15, no. 145 (August 2018): 20180442. http://dx.doi.org/10.1098/rsif.2018.0442.
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People with transtibial amputations (TTAs) who use a powered ankle–foot prosthesis have equivalent metabolic costs and step-to-step transition work for level-ground walking over a range of speeds compared to non-amputees. The effects of using a powered compared to passive-elastic prosthesis for sloped walking are unknown. We sought to understand how the use of passive-elastic compared to powered ankle–foot prostheses affect metabolic cost and step-to-step transition work during sloped walking. Ten people (six M, four F) with TTAs walked 1.25 m s −1 at 0°, ±3°, ±6° and ±9° using their own passive-elastic prosthesis and the BiOM powered ankle–foot prosthesis, while we measured metabolic rates, kinematics and kinetics. We calculated net metabolic power, individual leg step-to-step transition work and individual leg net work symmetry. The net metabolic power was 5% lower during walking on +3° and +6° uphill slopes when subjects used the BiOM compared to their passive-elastic prosthesis ( p < 0.05). The use of the BiOM compared to a passive-elastic prosthesis did not affect individual leg step-to-step transition work ( p > 0.05), but did improve individual leg net work symmetry on +6° and +9° uphill slopes ( p < 0.01). People with TTAs who use a powered ankle–foot prosthesis have the potential to reduce metabolic costs and increase symmetry during walking on uphill slopes.
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Weerakkody, Thilina H., Thilina Dulantha Lalitharatne, and R. A. R. C. Gopura. "Adaptive Foot in Lower-Limb Prostheses." Journal of Robotics 2017 (2017): 1–15. http://dx.doi.org/10.1155/2017/9618375.
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The human foot consists of complex sets of joints. The adaptive nature of the human foot enables it to be stable on any uneven surface. It is important to have such adaptive capabilities in the artificial prosthesis to achieve most of the essential movements for lower-limb amputees. However, many existing lower-limb prostheses lack the adaptive nature. This paper reviews lower-limb adaptive foot prostheses. In order to understand the design concepts of adaptive foot prostheses, the biomechanics of human foot have been explained. Additionally, the requirements and design challenges are investigated and presented. In this review, adaptive foot prostheses are classified according to actuation method. Furthermore, merits and demerits of present-day adaptive foot prostheses are presented based on the hardware construction. The hardware configurations of recent adaptive foot prostheses are analyzed and compared. At the end, potential future developments are highlighted.
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Hansen, Andrew. "Effects of Alignment on the Roll-Over Shapes of Prosthetic Feet." Prosthetics and Orthotics International 32, no. 4 (January 2008): 390–402. http://dx.doi.org/10.1080/03093640802366158.
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Recent work suggests that a prosthetic ankle-foot component's roll-over shape – the effective rocker it conforms to between initial contact and opposite initial contact (the ‘roll-over’ interval of walking) – is closely linked to its final alignment in the prosthesis (as determined by a skilled prosthetist using heuristic techniques). If true, this information may help to determine the appropriate alignment for a lower limb prosthesis before it is built, or a priori. Knowledge is needed for future models that will incorporate the roll-over shape including the relative effect of alignment on the roll-over shape's radius of curvature and arc length. The purpose of this study was to evaluate the hypotheses that: (i) Changes in prosthesis alignment alter the position and orientation of a foot's roll-over shape in prosthesis-based coordinates, and (ii) these changes occur without changing the radius of curvature or arc length of the roll-over shape. To examine the hypotheses, this study examined the effects of nine alignment settings on the roll-over shapes of two prosthetic feet. The idea that alignment changes move and rotate roll-over shapes of prosthetic feet in prosthesis coordinates is supported by this work, but the hypothesis that the radius of curvature and arc length do not change for different alignments is not strongly supported by the data. A revised approach is presented that explains some of the changes to the roll-over shape parameters due to changes in rotational alignment.
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Geil, M. D., and A. Lay. "Plantar foot pressure responses to changes during dynamic trans-tibial prosthetic alignment in a clinical setting." Prosthetics and Orthotics International 28, no. 2 (August 2004): 105–14. http://dx.doi.org/10.1080/03093640408726695.
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Alignment of a lower limb prosthesis refers to the spatial orientation of the prosthetic components and socket with respect to one another. During the process of dynamic alignment, a prosthetist repeatedly modifies this spatial orientation and observes the amputee's resulting walking pattern, eventually arriving at an alignment that is judged to be optimal. Quantification of the effect of each alignment modification and correlation of the magnitude of modification with the changes in gait could improve understanding of the process and promote an evidential base for practice. This investigation quantified bilateral plantar foot pressures in six trans-tibial amputee subjects during the process of dynamic alignment at prosthetists’ clinics during regularly scheduled appointments. Outcomes of changes in prosthetic alignment during the clinical dynamic alignment process were determined to be quantifiable via plantar pedobarography. Changes in the angle between the pylon and the socket in the frontal plane produced predictable shifts in foot pressure between medial and lateral foot regions under the prosthesis, and typically shifted pressure to the lateral region of the contralateral foot, regardless of the direction of the modification. Temporal parameters revealed that subjects initially adopt a conservative locomotor pattern after an alignment change but within a few steps begin to refine their gait and approach more symmetrical single limb support times. Plantar pedobarography provides the clinician with potentially useful information to augment dynamic alignment and provides a tangible record of the results of the process.
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Hernández Martin, John Alexander, Luis Parra Piñero, César Pinzón Pinzón, Oscar Bejarano Peña, Jairo Romero Gutiérrez, and Pedro García Benavides. "Analysis and construction of a prosthetic foot." I+D Tecnológico 14, no. 1 (June 11, 2018): 76–82. http://dx.doi.org/10.33412/idt.v14.1.1805.
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The assistive devices for people with disabilities are configured as a set of mechanical, electromechanical, orthotic and prosthetic parts designed to assist in the rehabilitation process of patients who suffered amputation of their lower limbs, whether the injury generates The implementation of a transtibial or transfemoral prosthesis these elements must be performed with proper analysis of pre-amputation, amputation and post amputation in order to achieve specific objectives for each patient, achieving the best possible treatment. It is important to ensure that in the treatment of lower limb disability by amputation, the best decisions are generated for the patient, with the objective of bringing the patient closer to a normal gait pattern. Considering these characteristics it will be possible to elaborate a prosthetic element that meets the physical and personal characteristics of the patient such as activity level, age, weight ... etc. Taking into account each of these variables we have decided to analyze in depth a crucial element in the implementation of lower limb prosthesis such as the foot, which we carry from a phase of analysis, design, to implementation in carbon fiber where we currently perform tests with our patients under study.
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Debta, Sanghamitra, and Kaushik Kumar. "Design and Analysis of Powered Ankle-Foot Mechanism Using Hydraulic System." Applied Mechanics and Materials 877 (February 2018): 384–90. http://dx.doi.org/10.4028/www.scientific.net/amm.877.384.
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Currently available foot prosthesis model are more than 50 in number. In order to perform some extraordinary errands, for example, strolling, moving, cycling, golfing, swimming, snow skiing or running they are employed. Many are waterproof and made of lightweight materials, for example, plastic, metal combinations and carbon-fiber composites. Prosthetic feet can be essential (unmoving), explained (moving in at least one bearings), or element reaction (putting away and returning vitality when strolling, giving a feeling of "pushing off," much like the human foot). However there are certain problems which are not completely tackled by the currently available prosthesis for which the walking pattern remains strongly disturbed. Today's prosthetic feet may have toe and heel springs to permit more lower leg development and movable heel statures, and to assimilate stun but the load distribution is not proper which leads to fatigue. In this paper, a powered ankle-foot prosthesis mechanism that aims at the equal distribution of the load using a hydraulic system in order to store the energy in the spring over the movement of prosthetic ankle was presented. Although the prosthetic foot presented in this paper is driven by an electric-motor it is made lighter and robust than the currently available ones. Some primary experiments were conducted by taking the forces acting to account. A 3-D model of the proposed design was made using piston cylinder arrangement in order to get a real ankle like movement, thereafter the stress analysis of the same was done and results were discussed.
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Mendez, Joel, Sarah Hood, Andy Gunnel, and Tommaso Lenzi. "Powered knee and ankle prosthesis with indirect volitional swing control enables level-ground walking and crossing over obstacles." Science Robotics 5, no. 44 (July 22, 2020): eaba6635. http://dx.doi.org/10.1126/scirobotics.aba6635.
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Powered prostheses aim to mimic the missing biological limb with controllers that are finely tuned to replicate the nominal gait pattern of non-amputee individuals. Unfortunately, this control approach poses a problem with real-world ambulation, which includes tasks such as crossing over obstacles, where the prosthesis trajectory must be modified to provide adequate foot clearance and ensure timely foot placement. Here, we show an indirect volitional control approach that enables prosthesis users to walk at different speeds while smoothly and continuously crossing over obstacles of different sizes without explicit classification of the environment. At the high level, the proposed controller relies on a heuristic algorithm to continuously change the maximum knee flexion angle and the swing duration in harmony with the user’s residual limb. At the low level, minimum-jerk planning is used to continuously adapt the swing trajectory while maximizing smoothness. Experiments with three individuals with above-knee amputation show that the proposed control approach allows for volitional control of foot clearance, which is necessary to negotiate environmental barriers. Our study suggests that a powered prosthesis controller with intrinsic, volitional adaptability may provide prosthesis users with functionality that is not currently available, facilitating real-world ambulation.
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Isakov, E., J. Mizrahi, Z. Susak, and I. Onna. "A Swedish knee-cage for stabilizing short below-knee stumps." Prosthetics and Orthotics International 16, no. 2 (August 1992): 114–17. http://dx.doi.org/10.3109/03093649209164322.
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Stump length is an important factor in attaining successful prosthetic rehabilitation in below- knee (BK) amputees. Stability of the stump- prosthesis complex is impaired in the case of a stump shorter than 10 cm. Thus, fitting a prosthesis to a BK amputee with a stump which is very short often requires the use of different prosthetic techniques. In this work, the authors suggest the use of a Swedish knee-cage attached to a conventionai patellar-tendon-bearing prosthesis as an alternative solution in the case of a short BK stump. Objective evaluation was performed by an analysis of gait and the foot- ground reaction forces. The results obtained indicate an improvement in all the measured parameters resulting from the modified stump- prosthesis complex.
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Cherelle, Pierre, Karen Junius, Victor Grosu, Heidi Cuypers, Bram Vanderborght, and Dirk Lefeber. "The AMP-Foot 2.1 : actuator design, control and experiments with an amputee." Robotica 32, no. 8 (September 2, 2014): 1347–61. http://dx.doi.org/10.1017/s026357471400229x.
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SUMMARYThe Ankle Mimicking Prosthetic (AMP-) Foot 2 is a new energy efficient, powered transtibial prosthesis mimicking intact ankle behavior. The author's research is focused on the use of a low power actuator which stores energy in springs during the complete stance phase. At push-off, this energy can be released hereby providing propulsion forces and torques to the amputee. With the use of the so-called catapult actuator, the size and weight of the drive can be decreased compared to state-of-the-art powered prostheses, while still providing the full power necessary for walking.In this article, the authors present a detailed description of the catapult actuator followed by a comparison with existing actuator technology in powered prosthetic feet with regard to torque and power requirements. The implication on the actuator's design will then be outlined. Further, a description of the control strategy behind the AMP-Foot 2 and 2.1 will be given. In the last section of the article, the actuation principle and control are illustrated by experimental validation with a transfemoral amputee. Conclusions and future work complete the paper.
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Alleva, Stefano, Michele Gabrio Antonelli, Pierluigi Beomonte Zobel, and Francesco Durante. "Biomechanical Design and Prototyping of a Powered Ankle-Foot Prosthesis." Materials 13, no. 24 (December 19, 2020): 5806. http://dx.doi.org/10.3390/ma13245806.
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Powered ankle-foot prostheses for walking often have limitations in the range of motion and in push-off power, if compared to a lower limb of a healthy person. A new design of a powered ankle-foot prosthesis is proposed to obtain a wide range of motion and an adequate power for a push-off step. The design methodology for this prosthesis has three points. In the first one, a dimensionless kinematic model of the lower limb in the sagittal plane is built, through an experimental campaign with healthy subjects, to calculate the angles of lower limb during the gait. In the second point a multibody inverse dynamic model of the lower limb is constructed to calculate the foot-ground contact force, its point of application and the ankle torque too, entering as input data the calculated angles of the lower limb in the previous point. The third point requires, as input of the inverse dynamic model, the first dimensioning data of the ankle-foot prosthesis to obtain the load acting on the components of the prosthesis and the angle torque of the actuator during the gait cycle. Finally, an iteration cycle begins with the inverse dynamic model modifying the ankle torque and angle until these quantities during the gait are as close as possible to the physiological quantities. After the mechanical design and the construction of the prototype of the prosthesis, an experimental methodology was used for preliminary validation of the design. The preliminary tests in the laboratory on the prototype alone show that the range of motion of the ankle angle during the gait is close to a healthy person’s: 27.6° vs. 29°. The pushing force of the distal area of the prototype is 1.000 N, instead of 1.600 N, because a budget reduction forced us to choose components for the prototype with lower performance.
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Eilenberg, Michael F., Jiun-Yih Kuan, and Hugh Herr. "Development and Evaluation of a Powered Artificial Gastrocnemius for Transtibial Amputee Gait." Journal of Robotics 2018 (2018): 1–15. http://dx.doi.org/10.1155/2018/5951965.
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Existing robotic transtibial prostheses provide only ankle joint actuation and do not restore biarticular function of the gastrocnemius muscle. This paper presents the first powered biarticular transtibial prosthesis, which is a combination of a commercial powered ankle-foot prosthesis and a motorized robotic knee orthosis. The orthosis is controlled to emulate the human gastrocnemius based on neuromuscular models of matched nonamputees. Together with the ankle-foot prosthesis, the devices provide biarticular actuation. We evaluate differences between this biarticular condition and a monoarticular condition with the orthosis behaving as a free-joint. Six participants with transtibial amputation walk with the prosthesis on a treadmill while motion, force, and metabolic data are collected and analyzed for differences between conditions. The biarticular prosthesis reduces affected-side biological knee flexion moment impulse and hip positive work during late-stance knee flexion, compared to the monoarticular condition. The data do not support our hypothesis that metabolism decreases for all participants, but some participants demonstrate large metabolic reductions with the biarticular condition. These preliminary results suggest that a powered artificial gastrocnemius may be capable of providing large metabolic reductions compared to a monoarticular prosthesis, but further study is warranted to determine an appropriate controller for achieving more consistent metabolic benefits.
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Safaeepour, Zahra, Ali Esteki, Farhad Tabatabai Ghomshe, and Mohammad E. Mousavai. "Design and development of a novel viscoelastic ankle-foot prosthesis based on the human ankle biomechanics." Prosthetics and Orthotics International 38, no. 5 (February 14, 2014): 400–404. http://dx.doi.org/10.1177/0309364613505108.
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Background and aim: In the present study, a new approach was applied to design and develop a viscoelastic ankle-foot prosthesis. The aim was to replicate the intact ankle moment–angle loop in the normal walking speed. Technique: The moment–angle loop of intact ankle was divided into four parts, and the appropriate models including two viscoelastic units of spring-damper mechanism were considered to replicate the passive ankle dynamics. The developed prototype was then tested on a healthy subject with the amputee gait simulator. The result showed that prosthetic ankle moment–angle loop was similar to that of intact ankle with the distinct four periods. Discussion: The findings suggest that the prototype successfully provided the human ankle passive dynamics. Therefore, the viscoelastic units could imitate the four periods of a normal gait. Clinical relevance The novel viscoelastic foot prosthesis could provide natural ankle dynamics in a gait cycle. Applying simple but biomechanical approach is suggested in conception of new designs for prosthetic ankle-foot mechanisms.
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Hawkins, James, Siamak Noroozi, Mihai Dupac, and Philip Sewell. "Development of a Wearable Sensor System for Dynamically Mapping the Behavior of an Energy Storing and Returning Prosthetic Foot." Measurement Science Review 16, no. 3 (June 1, 2016): 174–82. http://dx.doi.org/10.1515/msr-2016-0021.
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Abstract It has been recognized that that the design and prescription of Energy Storing and Returning prosthetic running feet are not well understood and that further information on their performance would be beneficial to increase this understanding. Dynamic analysis of an amputee wearing a prosthetic foot is typically performed using reflective markers and motion-capture systems. High-speed cameras and force plates are used to collect data of a few strides. This requires specialized and expensive equipment in an unrepresentative environment within a large area. Inertial Measurement Units are also capable of being used as wearable sensors but suffer from drift issues. This paper presents the development of a wearable sensing system that records the action of an Energy Storing and Returning prosthetic running foot (sagittal plane displacement and ground contact position) which could have research and/or clinical applications. This is achieved using five standalone pieces of apparatus including foot-mounted pressure sensors and a rotary vario-resistive displacement transducer. It is demonstrated, through the collection of profiles for both foot deflection and ground contact point over the duration of a stride, that the system can be attached to an amputee’s prosthesis and used in a non-laboratory environment. It was found from the system that the prosthetic ground contact point, for the amputee tested, progresses along the effective metatarsal portion of the prosthetic foot towards the distal end of the prosthesis over the duration of the stride. Further investigation of the effective stiffness changes of the foot due to the progression of the contact point is warranted.
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Hansen, Andrew H., Margrit R. Meier, Pinata H. Sessoms, and Dudley S. Childress. "The Effects of Prosthetic Foot Roll-Over Shape Arc Length on the Gait of Trans-Tibial Prosthesis Users." Prosthetics and Orthotics International 30, no. 3 (December 2006): 286–99. http://dx.doi.org/10.1080/03093640600816982.
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The Shape&Roll prosthetic foot was used to examine the effect of roll-over shape arc length on the gait of 14 unilateral trans-tibial prosthesis users. Simple modifications to the prosthetic foot were used to alter the effective forefoot rocker length, leaving factors such as alignment, limb length, and heel and mid-foot characteristics unchanged. Shortening the roll-over shape arc length caused a significant reduction in the maximum external dorsiflexion moment on the prosthetic side at all walking speeds ( p < 0.001 for main effect of arc length), due to a reduction in forefoot leverage (moment arm) about the ankle. Roll-over shape arc length significantly affected the initial loading on the sound limb at normal and fast speeds ( p = 0.001 for the main effect of arc length), with participants experiencing larger first peaks of vertical ground reaction forces on their sound limbs when using the foot with the shortest effective forefoot rocker arc length. Additionally, the difference between step lengths on the sound and prosthetic limbs was larger with the shortest arc length condition, although this difference was not statistically significant ( p = 0.06 for main effect). It appears that prosthesis users may experience a drop-off effect at the end of single limb stance on prosthetic feet with short roll-over shape arc lengths, leading to increased loading and/or a shortened step on the contralateral limb.
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Blumentritt, S. "A new biomechanical method for determination of static prosthetic alignment." Prosthetics and Orthotics International 21, no. 2 (August 1997): 107–13. http://dx.doi.org/10.3109/03093649709164538.
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A new static alignment method for trans-tibial prostheses is suggested using the individual load line as a reference. Standing posture and static alignment of 18 experienced trans-tibial prosthetic users with good walking ability were determined and compared with 20 healthy persons. The individual load line was defined by means of the new Otto Bock alignment system “L.A.S.A.R. Posture”. The sagittal standing posture of trans-tibial amputees and non-amputees differs. Normally only a prosthesis worn by the trans-tibial amputee and dynamically aligned over an extended period of time satisfies biomechanical rules of alignment. In contrast, prostheses aligned during one session in the traditional subjective manner seem to lack any recognizable biomechanical systematics. Initial results suggest the knee centre should be 10 to 30mm behind the load line, depending on patient's weight. This knee position is independent on the type of the prosthetic foot.
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Rajula, Vamsidhar Reddy, Logan Springgate, Aman Haque, Mst Kamrunnahar, Stephen J. Piazza, and Brian Kaluf. "A Biomimetic Adapter for Passive Self-alignment of Prosthetic Feet." Military Medicine 186, Supplement_1 (January 1, 2021): 665–73. http://dx.doi.org/10.1093/milmed/usaa230.
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ABSTRACT Introduction Dynamic alignment of lower limb prostheses is subjective and time-consuming. Compensatory gait strategies caused by prosthesis misalignment can negatively affect lower limb amputees who cannot access a certified prosthetist for alignment adjustments. The objective of this study is to evaluate a novel six-degrees-of-freedom passive transtibial prosthetic adapter that self-aligns during various phases of gait. This self-aligning adapter may benefit service members and veterans stationed or living far from a clinical facility. Methods Four transtibial amputee subjects, aged 47 to 62 (mean: 55.75) years with mean weight of 163.6 lbs and mean K-level of 3.25, walked at self-selected speeds on a 10-m level walkway. Subjects walked with the self-aligning and a size- or weight-matched control adapter, assembled to a commercially available energy-storing-and-returning foot and their own socket, with 22-mm alignment perturbations in the anterior, posterior, medial, or lateral directions. Subjects were blinded to both adapter type and misalignment. Socket moments, spatiotemporal gait parameters, and subjective socket comfort were recorded. Results Preliminary results showed improvements in mean peak socket moments and step length differential with the self-aligning adapter across all alignments. Walking speed and prosthesis-side base of support showed little change in all configurations. Prosthesis-side stance duration and Functional Ambulation Profile Score increased with the self-aligning adapter in some alignments. Patient-reported socket comfort increased slightly with the self-aligning adapter across all misalignments. Conclusion Subjects maintained similar walking speeds and experienced greater gait symmetry and reduced sagittal plane peak moments with the self-aligning adapter when exposed to misalignments. These trends suggest a benefit to transtibial amputees from a reduction in secondary gait effects from prosthesis misalignments. Additionally, a wider range of acceptable prosthesis alignments may be possible with the self-aligning adapter. Subsequent trials are underway to evaluate the self-aligning adapter in real-world environments like walking on uneven terrains, stairs, ramps, and abrupt turns.
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Hitzeroth, S., M. Rehg, A. Hogan, and U. Trinler. "3D-printed foot prosthesis during gait: Comparison with two standard prostheses." Gait & Posture 81 (September 2020): 147–48. http://dx.doi.org/10.1016/j.gaitpost.2020.07.108.
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Werner, D. "A ceramic prosthesis for hallux rigidus." Foot 11, no. 1 (March 2001): 24–27. http://dx.doi.org/10.1054/foot.2000.0655.
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Paradisi, Francesco, Anna Sofia Delussu, Stefano Brunelli, Marco Iosa, Roberto Pellegrini, Daniele Zenardi, and Marco Traballesi. "The Conventional Non-Articulated SACH or a Multiaxial Prosthetic Foot for Hypomobile Transtibial Amputees? A Clinical Comparison on Mobility, Balance, and Quality of Life." Scientific World Journal 2015 (2015): 1–10. http://dx.doi.org/10.1155/2015/261801.
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The effects of a non-articulated SACH and a multiaxial foot-ankle mechanism on the performance of low-activity users are of great interest for practitioners in amputee rehabilitation. The aim of this study is to compare these two prosthetic feet and assess possible improvements introduced by the increased degrees of freedom provided by the multiaxial foot. For this purpose, a group of 20 hypomobile transtibial amputees (TTAs) had their usual SACH replaced with a multiaxial foot. Participants’ functional mobility, involving ambulatory skills in overground level walking, ramps, and stairs, was evaluated by performing Six-Minute Walking Test (6MWT), Locomotor Capability Index-5 (LCI-5), Hill Assessment Index (HAI), and Stair Assessment Index (SAI). Balance performances were assessed using Berg Balance Scale (BBS) and analysing upper body accelerations during gait. Moreover, the Prosthesis Evaluation Questionnaire (PEQ) was performed to indicate the prosthesis-related quality of life. Results showed that participants walked faster using the multiaxial foot(p<0.05)maintaining the same upright gait stability. Significant improvements with the multiaxial foot were also observed in BBS, LCI-5, and SAI times and 4 of 9 subscales of the PEQ. Our findings demonstrate that a multiaxial foot represents a considerable alternative solution with respect to the conventional SACH in the prosthetic prescription for hypomobile TTAs.
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Kam, A. "40. The evolution of prosthetics." Clinical & Investigative Medicine 30, no. 4 (August 1, 2007): 49. http://dx.doi.org/10.25011/cim.v30i4.2800.
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Throughout history, prosthetic limbs have undergone significant changes in design and function. For example, an ancient bronze and iron prosthesis with a wooden core, discovered in Italy and dated back to 300 BC, has evolved into a modern shock-absorbing multi-axis prosthetic foot for walking on uneven ground. Recent advances in “neuro-controlled” prosthetics with microprocessor controllers further allow their users to produce smooth, multi-joint movements, simulating “real limbs”. With an increase in government funding focusing on researches in independent mobility, it is expected that new designs will improve immensely the quality of life of amputees. Are we approaching closer to the “ideal prosthetic limb”? The objective of this paper is to examine the evolution of various prosthetic designs and to re-apply some of the old concepts into new designs. The method used is mainly literature review. Results/conclusion: N/A.
Wetz H, Gisbertz D. History of artificial limbs for the leg. Orthopade 2000; 29(12):1018-32.
Pascual G. Amputations, walking and prosthesis development. An R Acad Nac Med (Madr) 2003; 120(3):593-607.
Cottrell-Ikerd V, Ikerd F, Jenkins DW. The Syme’s amputation: a correlation of surgical technique and prosthetic management with an historical perspective 1994; 33(4):355-64.
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Leestma, Jennifer K., Katherine Heidi Fehr, and Peter G. Adamczyk. "Adapting Semi-Active Prostheses to Real-World Movements: Sensing and Controlling the Dynamic Mean Ankle Moment Arm with a Variable-Stiffness Foot on Ramps and Stairs." Sensors 21, no. 18 (September 8, 2021): 6009. http://dx.doi.org/10.3390/s21186009.
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(1) Background: Semi-active prosthetic feet can provide adaptation in different circumstances, enabling greater function with less weight and complexity than fully powered prostheses. However, determining how to control semi-active devices is still a challenge. The dynamic mean ankle moment arm (DMAMA) provides a suitable biomechanical metric, as its simplicity matches that of a semi-active device. However, it is unknown how stiffness and locomotion modes affect DMAMA, which is necessary to create closed-loop controllers for semi-active devices. In this work, we develop a method to use only a prosthesis-embedded load sensor to measure DMAMA and classify locomotion modes, with the goal of achieving mode-dependent, closed-loop control of DMAMA using a variable-stiffness prosthesis. We study how stiffness and ground incline affect the DMAMA, and we establish the feasibility of classifying locomotion modes based exclusively on the load sensor. (2) Methods: Human subjects walked on level ground, ramps, and stairs while wearing a variable-stiffness prosthesis in low-, medium-, and high-stiffness settings. We computed DMAMA from sagittal load sensor data and prosthesis geometric measurements. We used linear mixed-effects models to determine subject-independent and subject-dependent sensitivity of DMAMA to incline and stiffness. We also used a machine learning model to classify locomotion modes using only the load sensor. (3) Results: We found a positive linear sensitivity of DMAMA to stiffness on ramps and level ground. Additionally, we found a positive linear sensitivity of DMAMA to ground slope in the low- and medium-stiffness conditions and a negative interaction effect between slope and stiffness. Considerable variability suggests that applications of DMAMA as a control input should look at the running average over several strides. To examine the efficacy of real-time DMAMA-based control systems, we used a machine learning model to classify locomotion modes using only the load sensor. The classifier achieved over 95% accuracy. (4) Conclusions: Based on these findings, DMAMA has potential for use as a closed-loop control input to adapt semi-active prostheses to different locomotion modes.
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Michael, John W. "The Henry Ford Cosmetic Foot Prosthesis." JPO Journal of Prosthetics and Orthotics 3, no. 4 (1991): xvii. http://dx.doi.org/10.1097/00008526-199100340-00007.
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Lange, Lawrence R. "The Lange Silicone Partial Foot Prosthesis." JPO Journal of Prosthetics and Orthotics 4, no. 1 (1991): 56. http://dx.doi.org/10.1097/00008526-199100410-00007.
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Lange, Lawrence R. "The Lange Silicone Partial Foot Prosthesis." JPO Journal of Prosthetics and Orthotics 4, no. 1 (1991): xxiv. http://dx.doi.org/10.1097/00008526-199104000-00011.
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Michael, John W. "The Henry Ford Cosmetic Foot Prosthesis." JPO Journal of Prosthetics and Orthotics 3, no. 4 (1991): xvii. http://dx.doi.org/10.1097/00008526-199107000-00007.
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Lange, Lawrence R. "The Lange Silicone Partial Foot Prosthesis." JPO Journal of Prosthetics and Orthotics 4, no. 1 (1991): xxiv. http://dx.doi.org/10.1097/00008526-199110000-00007.
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Di Gregorio, Raffaele, and Lucas Vocenas. "Identification of Gait-Cycle Phases for Prosthesis Control." Biomimetics 6, no. 2 (March 26, 2021): 22. http://dx.doi.org/10.3390/biomimetics6020022.
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The major problem with transfemoral prostheses is their capacity to compensate for the loss of the knee joint. The identification of gait-cycle phases plays an important role in the control of these prostheses. Such control is completely up to the patient in passive prostheses or partly facilitated by the prosthesis in semiactive prostheses. In both cases, the patient recovers his/her walking ability through a suitable rehabilitation procedure that aims at recreating proprioception in the patient. Understanding proprioception passes through the identification of conditions and parameters that make the patient aware of lower-limb body segments’ postures, and the recognition of the current gait-cycle phase/period is the first step of this awareness. Here, a proposal is presented for the identification of the gait-cycle phases/periods under different walking conditions together with a control logic for a possible active/semiactive prosthesis. The proposal is based on the detection of different gait-cycle events as well as on different walking conditions through a load sensor, which is implemented by analyzing the variations in some gait parameters. The validation of the proposed method is done by using gait-cycle data present in the literature. The proposal assumes the prosthesis is equipped with an energy-storing foot without mobility.
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Rochlitz, Bence, and Dávid Pammer. "Design and Analysis of 3D Printable Foot Prosthesis." Periodica Polytechnica Mechanical Engineering 61, no. 4 (August 8, 2017): 282. http://dx.doi.org/10.3311/ppme.11085.
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3D printing manufacturing process has the possibilities to produce individual medical devices, especially implants and prosthesis with short production time. The aim of this study is to design a 3D printable Energy Storage and Return (ESAR) foot prosthesis for transtibial amputees with a novel geometry. The criteria of the prosthesis were 3D printable, low cost, simply geometry and satisfying mechanical properties for low activity use. The finite element analysis of the designed foot prosthesis was conducted in each of the three support phases of the walking cycle (controlled plantarflexion, controlled dorsiflexion, powered plantarflexion or push-off phase). Besides of the simulations the prototype was printed by fused deposit modeling (FDM) technology, used ABS material and the produced prototype was investigated in quasi-static and cyclic compression. It can be stated after the investigation (simulation and test) that the 3D printed prototype fulfill the requirements and it can be used as passive ESAR foot prosthesis.
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Endo, Ken, and Hugh Herr. "1P1-J13 A Powered Ankle-foot Prosthesis with an Artificial Gastrocnemius." Proceedings of JSME annual Conference on Robotics and Mechatronics (Robomec) 2009 (2009): _1P1—J13_1—_1P1—J13_2. http://dx.doi.org/10.1299/jsmermd.2009._1p1-j13_1.
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