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1
Jones, L. E. "Prosthetic limb use in Australia 1981-1985 under the Free Limb Scheme." Prosthetics and Orthotics International 13, no. 2 (August 1989): 76–81. http://dx.doi.org/10.3109/03093648909078216.
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A study has been made of data on 19,421 prosthetic limbs prescribed for 12,143 Australians under the Free Limb Scheme in the years 1981–1985. These prostheses consisted of 18,119 legs and 1,302 arms. The mean age of the lower limb prosthesis user was 52.8 and the upper limb prosthesis user 31.3 years. Males outnumbered females by 3 to 1 in the upper limb prosthesis users, and 2.8 to 1 with lower limb prosthesis users. Below-knee prostheses, patellar-tendon-bearing and thigh-lacing prostheses, made up 58.7% of all prostheses prescribed in the time span. Below-elbow prostheses were the commonest upper limb prostheses with children being the most frequent users. Comparisons with other studies of large number of prosthesis users show an older mean age in Australia and more below-knee prosthesis users than in American studies.
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Yan, Gongxing, Jialing Li, Hui Xie, and Minggui Zhou. "Adaptive Control System of Intelligent Lower Limb Prosthesis Based on 5G Virtual Reality." Wireless Communications and Mobile Computing 2022 (March 18, 2022): 1–12. http://dx.doi.org/10.1155/2022/4572503.
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With the rapid development of computer science and technology in our country, especially the advent of the 5G network era, the emergence of smart prostheses makes it possible for disabled, injured, or amputee people with lower limbs to walk and exercise like normal people. However, due to the different selection of prosthetic materials, the final lower limb prostheses produced will also have different performance differences. How to select prosthetic materials to optimize the performance of the intelligent lower limb prosthesis is the focus of extensive discussion in the medical community. For this reason, this article takes the research of the adaptive control system of intelligent lower limb prosthesis based on 5G virtual reality as the research object. By using the current advanced 5G communication technology and virtual reality technology, a high-performance intelligent lower limb prosthesis is produced. Provide assistance with basic walking and motor abilities in daily life of patients with lower limb disabilities. This article first gives a systematic theoretical introduction to 5G virtual reality technology, expounds the current status of patients with lower limb disabilities, and proposes to use intelligent lower limb prosthetics to replace healthy lower limbs to solve the basic walking and sports needs of disabled patients in daily life and then use 5G virtual reality technology. The selection of human knee joints and ankle joints and structural system design were carried out. Finally, it was decided to use the four-bar linkage structure as the knee joint structure of the three-dimensional modeling of the intelligent lower limb prosthesis. At the end of this article, the application and simulation of the intelligent lower limb prosthesis to the human body were also carried out. The results of the experiment found that after 45 weeks of wearing exercises, the gait of the intelligent lower limb prosthesis is consistent with the expected effect whether it is walking on level ground and up and down the stairs or uphill. Due to the strong adaptiveness of the intelligent lower limb prosthesis sexual control, it can well assist the basic life movement ability of patients with lower limb disabilities.
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Nair, A., R. S. Hanspal, M. S. Zahedi, M. Saif, and K. Fisher. "Analyses of prosthetic episodes in lower limb amputees." Prosthetics and Orthotics International 32, no. 1 (January 1, 2008): 42–49. http://dx.doi.org/10.1080/03093640701610615.
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The provision and maintenance of prostheses in 100 trans-femoral amputees and 73 trans-tibial amputees were retrospectively analysed over a 10-year period. The aim of the study was to analyse the prosthetic episodes, i.e., the need for maintenance, repairs and replacements to a trans-femoral and a trans-tibial prosthesis and frequency of new sockets prescribed over the same period of use by established adult amputees. The study showed that the trans-femoral amputees needed 0.96 new prostheses, 3.27 new sockets, 2.31 major repairs, 3.36 component changes and 21.85 minor repairs. Younger trans-femoral amputees aged less than 60 years needed 1.1 new prostheses, 3.15 new sockets, 2.06 major repairs, 4.23 component changes and 20.49 minor repairs. Younger trans-femoral amputees needed significantly more changes of prosthetic components ( p = 0.04). The associated study on 73 trans-tibial amputees showed that they needed 1.4 new prosthesis, 2.9 new sockets, 3.2 major repairs and 14.1 minor repairs over the same 10-year period. The introduction and prescription of modular prosthesis as opposed to conventional limbs used earlier has possibly allowed components to be easily replaced thus reducing the need to replace a whole new prosthesis.
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Eshraghi, Arezoo, Noor Azuan Abu Osman, Hossein Gholizadeh, Mohammad Karimi, and Sadeeq Ali. "Pistoning assessment in lower limb prosthetic sockets." Prosthetics and Orthotics International 36, no. 1 (January 22, 2012): 15–24. http://dx.doi.org/10.1177/0309364611431625.
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Background: One of the main indicators of the suspension system efficiency in lower limb prostheses is vertical displacement or pistoning within the socket. Decreasing pistoning and introducing an effective system for evaluating pistoning could contribute to the amputees’ rehabilitation process.Objectives: The main objective of this study was to review existing research studies that examine the occurrence of pistoning in lower limb prosthesis with different techniques in static (standing) and dynamic (walking and jumping) positions.Study Design: Literature review.Methods: Keywords related to slippage, suspension, pistoning and vertical movement in lower limb prosthetics were used to search the literature available in PubMed, ScienceDirect, Web of Science and Google Scholar databases. Sixteen articles were selected for further analysis according to the selection criteria.Results: The following methods have been used to measure the occurrence of pistoning in prosthetic limbs: radiological methods, photographic technique, motion analysis system, sensor and spiral computerized tomography (CT). Pistoning was measured both in standing and walking.Conclusions: The results of this review reveal that further research is needed to develop and evaluate easy, accurate and safe methods of measuring pistoning. Future studies should provide a gold standard for the acceptable range of pistoning in a prosthetic socket.Clinical relevanceThis literature review contributes to a further understanding of lower limb prosthetic biomechanics by highlighting the strengths and weaknesses of the techniques that are currently available for evaluating the occurrence of pistoning in a prosthetic socket. It provides a useful overview of the current methods of measuring residual limb movements relative to the socket and liner, and will be of use for both practitioners and researchers in prosthetics and orthotics fields.
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Resnik, Linda, Matthew Borgia, Allen W. Heinemann, and Melissa A. Clark. "Prosthesis satisfaction in a national sample of Veterans with upper limb amputation." Prosthetics and Orthotics International 44, no. 2 (January 21, 2020): 81–91. http://dx.doi.org/10.1177/0309364619895201.
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Background: Many persons with upper limb amputation reject prostheses, and many are not satisfied with their devices. Research is needed to understand modifiable factors related to device satisfaction. Myoelectric devices with multiple degrees of freedom are now available; however, no studies have examined whether they lead to greater device satisfaction. Prosthetic training contributes to more skillful prosthesis use and greater likelihood of long-term use; however, the relationship between training and device satisfaction is unclear. Objectives: (1) To describe and compare satisfaction by prosthesis and terminal device type and (2) to identify factors associated with satisfaction. Study design: Cross-sectional study. Methods: Participants were 449 persons with unilateral upper limb amputation who used a prosthesis. Participants described their prostheses, prosthetic training, device repairs, visits to a prosthetist, and rated device satisfaction using two standardized measures (Trinity Amputation and Prosthesis Experience Scales Satisfaction scale and Orthotics and Prosthetics Users’ Survey - Client Satisfaction with Devices scale). Multivariate generalized linear regression models examined the relationship between prosthesis and terminal device type and satisfaction, controlling for covariates that were meaningful in bivariate analyses. Results: There were no differences in satisfaction by prosthesis type or terminal device degrees of freedom. Satisfaction was associated with receipt of training to use the initial prosthesis, amputation level, age, and race. Conclusion: No differences in satisfaction by device or terminal device type were observed. Worse satisfaction was associated with more proximal amputation level, younger age, and black race. The association between receipt of initial prosthetic training and device satisfaction points to the critical role of occupational or physical therapy in the early stages of prosthetic care. Clinical relevance Prosthetic satisfaction did not vary by device or terminal device degrees of freedom. Proximal amputation level, younger age, and black race were associated with lower prosthetic satisfaction. Receipt of initial prosthetic training was associated with greater device satisfaction, pointing to the critical role and lasting impact of early training.
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Padhi, Jayanta Kumar, Parthasarathi Swain, and Choudhury Madhusmita Das. "Development of an Adjustable Pylon for Lower Limb Prosthesis: A Prototype." International Journal of Health Sciences and Research 12, no. 4 (April 7, 2022): 120–23. http://dx.doi.org/10.52403/ijhsr.20220414.
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Amputation of a limb is always perceived as a catastrophe. The principles underlying creation of a stump adapted to modern prosthetic fittings must be fully understood and the patient managed by a multidisciplinary team. In paediatric patients, managing the prosthetic limb length is a crucial point that should be maintained according to the expected growth potential of the child. The main problem with child amputee is the heel height and adjustment of height of prosthesis during change of foot wears and bare foot walking. Children with congenital amputation and congenital anomalies need special attention for the prosthetic fitment. As children are in the growing age, the prosthetic device is required to be changed frequently. The major constraint in frequent change of prosthetic device in developing country is lack of special prosthetic kit, paediatric prosthetics components, skilled prosthetists and low-income group of amputees. To face this challenge, we have designed and developed a new adjustable prosthetic pylon for lower limb prosthesis. Key words: Prosthesis, Component development, Prosthesis, congenital anomaly, Adjustable pylon.
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Jacobs, R., R. Brånemark, K. Olmarker, B. Rydevik, D. van Steenberghe, and PI Brånemark. "Evaluation of the psychophysical detection threshold level for vibrotactile and pressure stimulation of prosthetic limbs using bone anchorage or soft tissue support." Prosthetics and Orthotics International 24, no. 2 (August 2000): 133–42. http://dx.doi.org/10.1080/03093640008726536.
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In the present study the psychophysical detection threshold levels for mechanical stimulation of 32 prosthetic limbs were determined. Prosthetic limbs were anchored to the bone by means of an implant (n=17) or supported by a socket enclosing the amputation stump (n=15). Detection threshold levels were assessed for pressure and vibratory stimulation of the prosthesis and the limb at the contralateral side (control). Following vibratory stimulation, thresholds were increased on an avarage 20% for socket prostheses, but approached those of the control for boneanchored prostheses. For pressure stimulation, thresholds were increased up to 60% for socket prostheses and 40% for boneanchored prostheses compared to the control. While boneanchored prostheses yielded significantly lower threshold levels than socket prostheses, there was no significant difference between both treatments regarding pressure stimulation. Results were applicable to both upper and lower limb amputees. It could be concluded that detection thresholds for pressure and especially vibratory stimulation of prosthetic limbs were generally higher than for control limbs. The outcome was related to the prosthetic limb design with boneanchored prostheses yielding better perception than socket prostheses.
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Biktimirova, F. M., M. V. Fedorenko, and E. I. Aukhadeev. "Indices of physical activity, quality of life and psychological characteristics in patients with amputated lower limb." Kazan medical journal 95, no. 6 (December 15, 2014): 830–35. http://dx.doi.org/10.17816/kmj1989.
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Aim. To study the physical activity in disabled patients who underwent an amputation of the lower limb in a late period of rehabilitation and prosthetics. Methods. The study included patients with structural and functional disorders of limbs. 308 patients aged 18 to 66 years were randomly selected to participate in the study as they were referred to Prosthetic and orthopedics center «Reabilitaciya invalidov», Kazan, Russia from 2008 to 2010. Patients were allocated to five age groups: 19 to 29 years, 30 to 39 years, 40 to 49 years, 50 to 59 years old and older than 60 years. Activity level, depending on the motor capacity was investigated in 308 patients who were offered prosthetics according to the classification subdividing locomotor activity on five levels. SF-36 questionnaire (quality of life), Spielberger-Hanin reactive and personal anxiety scales, Beck Depression Inventory, the Mehrabian Achieving Tendency Scale, Smisek-Leonhard characterological test were administered. Quality of lower limbs prostheses were assessed by «TWO LEGS» prosthesis evaluation questionnaire on a 5-point scale. Results. The majority of patients who were at the remote stage of rehabilitation after prosthesis had high level of physical activity - 141 (45.7%) patients, average activity level - 81 (26.2%) patients, reduced level of activity - 63 (20.5%) patients. High level of physical activity, depending on the locomotor activity, was more typical for the second (20-29) and third (30-39 years) age groups - 60 and 54%, respectively. Very high and high levels of physical activity was equally observed in patients with one and both amputated both lower legs: 8.4 and 7%, respectively. Conclusion. Level of amputation, age and psychological characteristics, as well as prosthesis quality and the term of prosthesis use were essential for motor activity, quality of life and functional independence of the disabled with structural and functional of the lower limb disorders.
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Christensen, B., B. Ellegaard, U. Bretler, and E.-L. østrup. "The effect of prosthetic rehabilitation in lower limb amputees." Prosthetics and Orthotics International 19, no. 1 (April 1995): 46–52. http://dx.doi.org/10.3109/03093649509078231.
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The objectives of this project were to ascertain whether, to date, the views concerning the determination of prosthetic candidacy have been optimal and whether the training methods applied have been effective and have resulted in constant use of the prosthesis after conclusion of the training programme. Secondly it was intended to set up guidelines for future budgeting as well as providing a reference framework for the process of rehabilitation. An inquiry based on questionnaires was the first phase in a quality assurance project carried out among 29 amputees trained in 1990 and 1991. The result of the inquiry was that rehabilitation using PTB prostheses for 19 trans-tibial amputations in 18 cases (one patient was a bilateral trans-tibial amputee) led to constant use of the prosthesis and that advanced age was no hindrance to constant use in this group. For 10 trans-femoral amputees the inquiry revealed that advanced age combined with problems of donning the prosthesis was a hindrance to constant use in two cases. It is concluded that there is a need for testing/developing new types of femoral prostheses. The patients' evaluation of the rehabilitation process and their prostheses stresses the need for communication between the team of professionals and the patients in the decision process concerning the provision of a prosthesis as well as the provision of complete information on the patients' future functional possibilities. Qualitative measurements must include the kind and number of medical complications and the social conditions of the amputee as well as tests of physical and mental resources.
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Ali, Humera, and Saima Afzal. "An Exploration of Socio-Economic Problems Faced By Prosthetic Limb Amputees in Multan, Pakistan." Pakistan Journal of Medical and Health Sciences 16, no. 6 (June 30, 2022): 754–57. http://dx.doi.org/10.53350/pjmhs22166754.
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Amputation is a surgical operation in which a portion of the body is removed such as an arm, foot, leg, hand or finger. Amputation can be performed on any portion of the body, from a tiny area to a big area. Two types of prosthesis limb are used after amputation upper limb prostheses and lower limb prostheses. After amputation, most people use prostheses to carry out their daily activities. This research explains how people use prostheses after amputation and what difficulties people have to go through after using the prostheses. Social, economic and psychological aspects also discussed in this research. The objective of this research is to explore the problems and challenges in income climate and personal characteristics. To find out the health care with prosthetic technology, rehabilitation and satisfaction with prostheses and to investigate the established need and resources for prosthesis limb usage also focused in this research. The universe for the following study was all the prosthetic limb amputees in Multan District. All the prosthetic limb amputees were the population of the study. 15 cases were selected to investigate the study. Non probability purposive sampling technique was used. To measure the socio economic problems faced by prosthetic limb amputees, researcher used the interview guide. As a result questions were asked from the respondents during face to face meeting. In all cases, most of the amputations are due to accidents, diabetes, gunshot and amputation of any part of the body in machinery while working in factories. Most people have lower limb amputation including above or below knee amputation. In mostly cases people of lower limb amputations have severe disability. People with amputation have to go through a lot of troubles and sufferings after having their limbs amputated and having their prostheses implanted. The lives of such people are going through troubles and physical pain. Due to which such people are suffering from a lot of mental stress. The government should provide free prostheses to these disabled people and also help them so that they can meet their needs.
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Takahashi, Kota Z., John R. Horne, and Steven J. Stanhope. "Comparison of mechanical energy profiles of passive and active below-knee prostheses: A case study." Prosthetics and Orthotics International 39, no. 2 (January 13, 2014): 150–56. http://dx.doi.org/10.1177/0309364613513298.
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Background: With the recent technological advancements of prosthetic lower limbs, there is currently a great desire to objectively evaluate existing prostheses. Using a novel biomechanical analysis, the purpose of this case study was to compare the mechanical energy profiles of anatomical and two disparate prostheses: a passive prosthesis and an active prosthesis. Case description and methods: An individual with a transtibial amputation who customarily wears a passive prosthesis (Elation, Össur) and an active prosthesis (BiOM, iWalk, Inc.) and 11 healthy subjects participated in an instrumented gait analysis. The total mechanical power and work of below-knee structures during stance were quantified using a unified deformable segment power analysis. Findings and outcomes: Active prosthesis generated greater peak power and total positive work than passive prosthesis and healthy anatomical limbs. Conclusion: The case study will enhance future efforts to objectively evaluate prosthetic functions during gait in individuals with transtibial amputations. Clinical relevance A prosthetic limb should closely replicate the mechanical energy profiles of anatomical limbs. The unified deformable (UD) analysis may be valuable to facilitate future clinical prescription and guide fine adjustments of prosthetic componentry to optimize gait outcomes.
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Eberly, Valerie J., Sara J. Mulroy, JoAnne K. Gronley, Jacquelin Perry, William J. Yule, and Judith M. Burnfield. "Impact of a stance phase microprocessor-controlled knee prosthesis on level walking in lower functioning individuals with a transfemoral amputation." Prosthetics and Orthotics International 38, no. 6 (October 17, 2013): 447–55. http://dx.doi.org/10.1177/0309364613506912.
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Background: For individuals with transfemoral amputation, walking with a prosthesis presents challenges to stability and increases the demand on the hip of the prosthetic limb. Increasing age or comorbidities magnify these challenges. Computerized prosthetic knee joints improve stability and efficiency of gait, but are seldom prescribed for less physically capable walkers who may benefit from them. Objective: To compare level walking function while wearing a microprocessor-controlled knee (C-Leg Compact) prosthesis to a traditionally prescribed non-microprocessor-controlled knee prosthesis for Medicare Functional Classification Level K-2 walkers. Study design: Crossover. Methods: Stride characteristics, kinematics, kinetics, and electromyographic activity were recorded in 10 participants while walking with non-microprocessor-controlled knee and Compact prostheses. Results: Walking with the Compact produced significant increase in velocity, cadence, stride length, single-limb support, and heel-rise timing compared to walking with the non-microprocessor-controlled knee prosthesis. Hip and thigh extension during late stance improved bilaterally. Ankle dorsiflexion, knee extension, and hip flexion moments of the prosthetic limb were significantly improved. Conclusions: Improvements in walking function and stability on the prosthetic limb were demonstrated by the K-2 level walkers when using the C-Leg Compact prosthesis. Clinical relevance Understanding the impact of new prosthetic designs on gait mechanics is essential to improve prescription guidelines for deconditioned or older persons with transfemoral amputation. Prosthetic designs that improve stability for safety and walking function have the potential to improve community participation and quality of life.
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Cherni, Yosra, Simon Laurendeau, Maxime Robert, and Katia Turcot. "The Influence of Transtibial Prosthesis Type on Lower-Body Gait Adaptation: A Case Study." International Journal of Environmental Research and Public Health 20, no. 1 (December 27, 2022): 439. http://dx.doi.org/10.3390/ijerph20010439.
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Gait parameters are altered and asymmetrical in individuals with transtibial amputation. The purpose of this study was to evaluate and compare the effect of four different prosthetic feet on lower-limb biomechanics during gait. A 34-year-old man with transtibial amputation performed four gait analysis sessions with four foot–ankle prostheses (Variflex, Meridium, Echelon, and Kinterra). Kinematic and kinetic parameters and gait symmetry were analyzed in different prosthetic conditions. The type of prosthesis had little effect on the participant’s spatiotemporal parameters. Throughout the stance phase, increased hip angle, reduced knee flexion and ankle dorsiflexion were observed in the amputated leg. For kinetic parameters, reduced propulsive force (SI = 0.42–0.65), reduced knee extension moment (mainly during Echelon and Kinterra conditions, SI = 0.17 and 0.32, respectively), and increased knee abduction moment (mainly during the Variflex and Meridium, SI = 5.74 and 8.93, respectively) were measured in the amputated leg. Lower support moments were observed in the amputated leg as compared to the unaffected leg, regardless of the type of prosthesis (SI = 0.61–0.80). The prostheses tested induced different lower-limb mechanical adaptations. In order to achieve the clinical goal of better gait symmetry between lower limbs, an objective gait analysis could help clinicians to prescribe prosthetic feet based on quantitative measurement indicators to optimize gait rehabilitation.
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Ennion, Liezel, and Sarah Manig. "Experiences of lower limb prosthetic users in a rural setting in the Mpumalanga Province, South Africa." Prosthetics and Orthotics International 43, no. 2 (August 16, 2018): 170–79. http://dx.doi.org/10.1177/0309364618792730.
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Background: Ambulation with a prosthesis is the ultimate goal of rehabilitation for a person with a major lower limb amputation. Due to challenges with prosthetic service delivery in rural settings, many patients with amputations are not benefitting from prosthetic interventions. Inaccessibility to prosthetic services results in worse functional outcomes and quality of life. Learning from the experiences of current prosthetic users in this setting can assist to improve prosthetic service delivery. Objectives: To explore the experiences of lower limb prosthetic users and to understand the importance of a lower limb prosthesis to a prosthetic user in a rural area of South Africa. Study design: A generic qualitative approach and an explorative design were utilised in this study. Methods: A semi-structured interview guide was used to collect data from nine prosthetic users in a rural area in the Mpumalanga province of South Africa. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Demographic details and information related to acute in-patient rehabilitation were analysed descriptively. Results: All participants were independent in activities of daily living with their prosthesis and participated actively in their community. Participants reported that their prosthesis was essential to their functioning. High travel cost was highlighted as a barrier to the maintenance of their prosthesis. Patients were dissatisfied with being unemployed. Conclusion: Prosthetic intervention positively influences function, independence and community participation. Challenges relating to the accessibility, cost and maintenance of prosthetics should be a priority to ensure continued functional independence for prosthetic users. Clinical relevance Understanding the importance of a prosthesis to a prosthetic user validates prosthetic intervention for persons living with an amputation in a rural setting and is vital in establishing and remodelling effective systems for prosthetic service delivery.
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Malchow, Connor, and Goeran Fiedler. "Effect of observation on lower limb prosthesis gait biomechanics: Preliminary results." Prosthetics and Orthotics International 40, no. 6 (July 10, 2016): 739–43. http://dx.doi.org/10.1177/0309364615605374.
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Background: The Hawthorne effect, a subcategory of reactivity, causes human behavior to change when under observation. Such an effect may apply to gait variation of persons with prosthetics or orthotics devices. Objectives: This study investigated whether the presence of observers directly affects the gait pattern of users of lower limb prostheses. Study design: Within-subject intervention study. Methods: Primary outcome measures were gait parameters of initial double support time and upper body lateral tilt angle, which were collected with a mobile sensor attached to the subjects’ back. To make subjects feel unwatched, a certain amount of deception was necessary, and two different conditions were created and statistically compared against each other: one in which the subjects were initially unaware of the attention of observers and another one in which the same subjects were aware of a group of observers. Results: Data from two subjects using trans-femoral prosthesis are reported. Findings included a change in step initial double support percentage by up to 14.2% ( p = 0.019). Considerable changes were also noted in secondary outcome measures including speed, stride length, and stride symmetry. Conclusions: A reactivity effect of observation exists in prosthetics gait analysis. More comprehensive studies may be motivated by these preliminary findings. Clinical relevance Results of this study suggest that users of lower limb prostheses walk differently when their gait is being assessed (e.g. in the prosthetist’s office) than in situations without observers. This may in part explain the clinical experience that modifications of prosthetic fit or alignment provide only short-term betterment.
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Desmond, Deirdre, Pamela Gallagher, David Henderson-Slater, and Rob Chatfield. "Pain and psychosocial adjustment to lower limb amputation amongst prosthesis users." Prosthetics and Orthotics International 32, no. 2 (January 2008): 244–52. http://dx.doi.org/10.1080/03093640802067046.
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The aim of this study was to investigate associations between post-amputation phantom and residual limb pain and prosthesis satisfaction, activity restriction and psychosocial adjustment to amputation among lower limb prosthesis users. Eighty-nine people with a lower limb amputation completed a postal survey. Characteristics of phantom and residual limb pain, prosthesis satisfaction, activity restriction and psychosocial adjustment to amputation were assessed using the Trinity Amputation and Prosthesis Experience Scales (TAPES). Comparisons of those who experienced residual and/or phantom limb pain in the preceding assessment with those who did not revealed significant differences in prosthesis satisfaction, psychosocial adjustment but not in activity restriction. Overall, it is important for clinicians to ascertain the type and level of pain that the person is experiencing and to separate the experiences of the pain from the experiences of the prosthetic limb.
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Bilodeau, S., R. Hébert, and J. Desrosiers. "Lower limb prosthesis utilisation by elderly amputees." Prosthetics and Orthotics International 24, no. 2 (August 2000): 126–32. http://dx.doi.org/10.1080/03093640008726535.
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The goal of prosthetic rehabilitation is to compensate for the loss of a limb by amputation by, in the case of a lower limb, encouraging walking, and to achieve the same level of autonomy as prior to the amputation. However, because of difficulties walking, elderly amputees may use their prosthesis to a greater or lesser degree or simply stop using it during the rehabilitation period. The objective of this research was to study factors such as physical and mental health, rehabilitation, physical independence and satisfaction with the prosthesis to understand why amputees use their prosthesis or not. The sample was composed of 65 unilateral vascular amputees 60 years old or over living at home. The information was collected from medical records, by telephone interview and by mail questionnaire. Prosthesis use was measured by a questionnaire on amputee activities developed by Day (1981). Eightyone per cent (81%) of the subjects wore their prosthesis every day and 89% of this group wore it 6 hours or more per day. Less use of the prosthesis was significantly related to age, female gender, possession of a wheelchair, level of physical disability, cognitive impairment, poorer selfperceived health and the amputee's dissatisfaction. A multiple regression analysis showed that satisfaction, not possessing a wheelchair and cognitive integrity explained 46% of the variance in prosthesis use.
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Gafoor, S. Abdul, and M. Mohan Raj. "Upper Extremity Prosthesis — What Is New in It?" Indian Journal of Physical Medicine and Rehabilitation 27, no. 3 (2016): 67–72. http://dx.doi.org/10.5005/ijopmr-27-3-67.
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Abstract Over the past 40 years, technology has dramatically affected the field of upper limb prosthesis. With improvement in the electronics industry, along with advances in the miniaturisation and mass production of electronic components, myoelectrically controlled prosthesis has become reliable and widespread in their use. Compared to lower extremity amputees, the acceptance of prosthetic replacement is less in upper extremity amputees. This may be due to different factors like functional needs, cosmetic factors, motivation of the patient, inadequate training following conventional prosthetic fitment, etc. More and more developments are going on in upper limb extremity prosthesis which will fulfill the need of the upper limb amputees. Such developments ensure better rehabilitation though cost is a limiting factor. This article is an earnest attempt to review the recent trends in upper limb prosthetics.
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Sánchez Otero, John, Roque J. Hernández, and Jaime E. Torres S. "The mechanical design of a transfemoral prosthesis using computational tools and design methodology." Ingeniería e Investigación 32, no. 3 (September 1, 2012): 14–18. http://dx.doi.org/10.15446/ing.investig.v32n3.35934.
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Artificial limb replacement with lower limb prostheses has been widely reported in current scientific literature. There are many lower limb prosthetic designs ranging from a single-axis knee mechanism to complex mechanisms involving microcontrollers, made from many materials ranging from lightweight, high specific strength ones (e.g., carbon fibre) to traditional forms (e.g., stainless steel). However, the challenge is to design prostheses whose movement resembles the human body's natural movement as closely as possible. Advances in prosthetics have enabled many amputees to return to their everyday activities; however, such prostheses are expensive, some costing as much as $60,000. Many of the affected population in Colombia have scarce economic resources; there is therefore a need to develop affordable functional prostheses. The Universidad del Norte's Materials, Processes and Design Research Group and the Robotics and Intelligent Systems Group have been working on this line of research to develop modular prostheses which can be adjusted to each patient's requirements. This research represents an initial methodological approach to developing a prosthesis in which software tools have been used (the finite element method) with a criteria relationship matrix for selecting the best alternative while considering different aspects such as modularity, cost, stiffness and weight.
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Lundberg, Mari, Kerstin Hagberg, and Jennifer Bullington. "My prosthesis as a part of me: a qualitative analysis of living with an osseointegrated prosthetic limb." Prosthetics and Orthotics International 35, no. 2 (June 2011): 207–14. http://dx.doi.org/10.1177/0309364611409795.
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Background: Bone-anchored prosthesis is still a rather unusual treatment for patients with limb loss. Objectives: The aim of this study was to improve our understanding about the experience of living with an osseointegrated prosthesis (OI-prosthesis) compared to one suspended with a socket, through the use of qualitative research methodology. Study design: A qualitative phenomenological research method. Methods: Thirteen Swedish patients (37–67 years) with unilateral upper or lower limb amputation (10 transfemoral, 2 transhumeral, 1 transradial), who had been using OI-prostheses for 3 to 15 years, were recruited by means of purposive sampling. An audio-taped in-depth interview was performed. The guiding question was ‘How do you experience living with your osseointegrated prosthesis compared to your earlier prostheses suspended with sockets?’. The empirical phenomenological psychological method was used for data analysis. Results: The results showed that all participants described living with an OI-prosthesis as a revolutionary change. These experiences were described in terms of three typologies, called ‘Practical prosthesis’, ‘Pretend limb’ and ‘A part of me’. Conclusions: The most important finding was that the change went beyond the functional improvements, integrating the existential implications in the concept of quality of life. Clinical relevance This qualitative in-depth interview study on patients using bone-anchored prosthetic limbs showed that all described a revolutionary change in their lives as amputees and the meaning of that change went beyond the functional improvements, integrating existential implications in the concept of quality of life.
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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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Yuan, Jing, Xiaolu Bai, Abbas Alili, Ming Liu, Jing Feng, and He Huang. "Understanding the Preferences for Lower-Limb Prosthesis: A Think-Aloud Study during User-Guided Auto-Tuning." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 66, no. 1 (September 2022): 2159–63. http://dx.doi.org/10.1177/1071181322661082.
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Prostheses help amputees to maintain physical health and quality of life. Prosthesis wearers’ satisfaction and adherence to the prosthesis are closely related to the preferences for prosthesis tuning settings. However, the underlying factors that contribute to the preferences were under-explored. In this study, two able-bodied participants were asked to change the robotic prosthesis settings to their preferred state and the think-aloud technique with a mixed-method approach was used to reveal the contributing factors of preferences. We found that physical perception (e.g., positions of the prosthetic foot, balance, and stability) and subjective feelings (e.g., comfortableness, satisfaction, confidence, and worries) were two major factors. Experiences with the intact leg and other profiles were used as anchors for their preference levels. Preferences may also differ with situational context such as walking speed. The saturation points were reached with no strong approach motivation. The implications for prosthesis design and research were discussed.
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Smirnova, Ludmila, Gennadiy Ponomarenko, and Vadim Suslyaev. "Methodology and information-measuring system for personalized synthesis of lower limb prostheses." Information and Control Systems, no. 6 (December 16, 2021): 64–74. http://dx.doi.org/10.31799/1684-8853-2021-6-64-74.
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Introduction: One of the methods for managing the quality of prosthetics is optimizing the composition of a modular prosthesis components. Mistakes in choosing models for functional modules of a prosthesis lead to a limited realization of the patient's potential capabilities, or to the choice of expensive highly functional models whose potential cannot be fully realized with the given body system disabilities. One of the most effective ways to solve this problem is to use the computer technology capabilities. Purpose: Substantiation of the methodology for the development of an innovative computer technology for personalized synthesis of a lower-limb prosthesis, including the development of the structure of an information-measuring system for its implementation. Methods: Analysis, synthesis, analogy; expert survey; analytic hierarchy process (Saaty method). The conceptual language of the International Classification of Functioning, Disability and Health was used to describe the factors influencing the requirements for the characteristics of prosthetic modules. Results: In order to choose models for prosthetic modules, we should use an extended system of factors, including both the basic factors associated with the purpose of the products and indicated in the catalogs, and additional factors: impairment indicators of the body functions and structures, the capacity and performance of the patient's activity and participation, the presence of barriers and facilitators environmental factors in which the prosthesis is planned to be used. Taking this system of factors into account, a structural diagram of an information-measuring system for examining a prosthetic patient has been developed. To select the components for the prosthesis, we have substantiated the necessity of creating a global electronic catalog, combining structured information on the models of prosthetic modules supplied by various manufacturers. A matrix representation form is proposed for the knowledge base, reflecting the rules for choosing models according to the correspondence of their characteristics to the estimates of the factors. The methodology of computerized selection of models from the electronic catalog has been substantiated. Practical relevance: The results of the work are a step towards the creation of a technology for a computerized multicriteria choice of components for a modular prosthesis, taking into account the personal needs and functional capabilities of the patient. The use of this technology will improve the patient's rehabilitation level and the quality of his or her life.
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Pohjolainen, T., H. Alaranta, and J. Wikström. "Primary survival and prosthetic fitting of lower limb amputees." Prosthetics and Orthotics International 13, no. 2 (August 1989): 63–69. http://dx.doi.org/10.3109/03093648909078214.
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During the period 1984-1985 amputation of the lower limb at a level potentially requiring a prosthesis was performed on 577 patients in 16 operative units. The mean age was 75.7 years for females and 68.1 for males. The most common site of the amputation was above the knee (49.9%). The majority of amputations (93.8%) were performed for vascular diseases and diabetes. Survival figures showed that 25.5% of amputees died within 2 months of amputation, 60.7% were alive after one year and 43.2% after two years. Out of a total of 577 patients, 26.9% were fitted with a prosthesis. Out of below-knee and above-knee amputees surviving over 2 months, 61.5% and 27.2% respectively were fitted with a prosthesis. There were markedly fewer prosthetic fittings in the over-60 age group. Diabetic patients of both sexes were fitted with a prosthesis more often than arterio-sclerotic patients. Among tumour patients 82.4% received a prosthesis. In the study area more emphasis must be put on the concept of preserving the knee joint and preoperative assessment of vascular patients for selection of amputation level. Every effort must be made to avoid delay in the postoperative mobilization and rehabilitation. Prosthetic fitting of amputees could be improved by better liaison between surgical unit and specialized rehabilitation unit and by closer team approach of amputee care.
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Rommers, G. M., L. D. W. Vos, L. Klein, J. W. Groothoff, and W. H. Eisma. "A study of technical changes to lower limb prostheses after initial fitting." Prosthetics and Orthotics International 24, no. 1 (April 2000): 28–38. http://dx.doi.org/10.1080/03093640008726519.
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There is little published material in recent years about the use of lower limb prostheses in an elderly amputee population. In this study the authors were interested in the technical changes to lower limb prostheses after a first limb fitting procedure in a postrehabilitation population in the Netherlands. The process of fitting a prosthesis and the technical changes to the artificial limb in the first year afterwards are studied.
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Mayer, Á., K. Kudar, K. Bretz, and J. Tihanyi. "Body schema and body awareness of amputees." Prosthetics and Orthotics International 32, no. 3 (January 2008): 363–82. http://dx.doi.org/10.1080/03093640802024971.
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Aim: The phantom phenomenon is a well-known example of the difference between body awareness and body schema. The present study is aimed at showing how body changes and prosthesis use are reflected in body schema and body awareness–the latter relating to the image that various amputees have of their bodies.Subject and methods: (i) Examining the configuration of body schema: A trial examining the spatial location of the phantom limb (50 people with lower or upper limb loss); (ii) examining the functional aspect of body schema: The distribution of weight power between intact and prosthetic limbs (34 people with tibial amputation); (iii) examining body awareness: Body Focus Questionnaire by Fisher (44 people with lower limb amputation, 33 intact people); and (iv) Questionnaire on anamnesis- and prosthesis-wearing habits (people participating in research methods [i] and [iii] mentioned above).Results: We found that when the amputees wore their prostheses, the configuration of body schema did not change, however, the people who had not used their prosthesis for a long period of time (in our study, at least for six years), the phantom limb shortened, a phenomenon known as telescoping. The functional adaptation of the prosthesis to the body schema starts in a short time (within two weeks) after wearing it, and it becomes close to normal in carrying body weight after a longer period of time (two years). In the beginning phase of rehabilitation, the awareness of legs is similar to that of the control group, while later on it this awareness decreases. Over time, however, the lost limb, regardless of having a prosthesis or not, loses its importance. People with a more serious or vascular amputation of the upper limbs have a clearer image of them. Limb parts having a greater cortical representation appear more intensively in phantom sensations, while the strength of the cortical representation in body schema has no significance.Conclusion: From both configuration and functional aspects, wearing a prosthesis helps maintain a body schema in which the phantom limb remains similar to the intact one, which can be explained by the connectional schema model. This is needed for movements to be carried out properly. Although the amputee can see the prosthesis and senses the phantom limb, they do not consider it their own since they are aware of the loss. Therefore, the fact that a prosthesis is worn will not be represented in body awareness as the highest level of mental structure.
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Sasaki, Kazuhiko, Jutamat Pinitlertsakun, Pakwan Nualnim, Gary Guerra, Yuttapichai Sansook, Supachai Kaewdoung, Suttinun Chotirossukon, et al. "The reversible adjustable coupling: A lightweight and low-cost alignment component for the lower limb prosthesis." Journal of Rehabilitation and Assistive Technologies Engineering 4 (January 2017): 205566831770642. http://dx.doi.org/10.1177/2055668317706427.
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Background The alignment of the lower limb prosthesis is an integral part of the prosthetic fitting. A properly aligned prosthesis contributes to optimal gait and overall function of the patient. The current offering of alignment componentry is expensive for low-income countries. The purpose of this study was to develop a lightweight and low-cost alignment coupler for the lower limb prosthesis. Methods An alignment coupler called the reversible adjustable coupling was designed and manufactured. Measurements of total anterior/posterior and medial/lateral and rotation in prostheses were recorded and mechanical testing performed. Swiftness and difficulty of use was also recorded. Results The reversible adjustable coupling permitted acceptable ranges of anterior/posterior and medial/lateral translation and 30° of internal and external rotation of prosthetic componentry. Repetitive loading of the coupling at a speed of 1 Hz under 1.28 kN load for 2000 cycles was successful, as were static and strength tests. Discussion The coupler provided acceptable ranges of anterior/posterior and medial/lateral and rotation adjustment and is acceptable for potential use in the alignment of both exoskeletal and endoskeletal prosthesis. The final weight of the component was 166 g and cost of $55.00 USD is affordable for low-income countries for use in clinical and educational settings.
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Mohamed, Abeer, Andrew Sexton, Kirsten Simonsen, and Chris A. McGibbon. "Development of a Mechanistic Hypothesis Linking Compensatory Biomechanics and Stepping Asymmetry during Gait of Transfemoral Amputees." Applied Bionics and Biomechanics 2019 (February 3, 2019): 1–15. http://dx.doi.org/10.1155/2019/4769242.
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Objective. Gait asymmetry is a common adaptation observed in lower-extremity amputees, but the underlying mechanisms that explain this gait behavior remain unclear for amputees that use above-knee prostheses. Our objective was to develop a working hypothesis to explain chronic stepping asymmetry in otherwise healthy amputees that use above-knee prostheses. Methods. Two amputees (both through-knee; one with microprocessor knee, one with hydraulic knee) and fourteen control subjects participated. 3D kinematics and kinetics were acquired at normal, fast, and slow walking speeds. Data were analyzed for the push-off and collision limbs during a double support phase. We examined gait parameters to identify the stepping asymmetry then examined the external work rate (centre of mass) and internal (joint) power profiles to formulate a working hypothesis to mechanistically explain the observed stepping asymmetry. Results. Stepping asymmetry at all three gait speeds in amputees was characterized by increased stance phase duration of the intact limb versus relatively normal stance phase duration for the prosthesis limb. The prosthesis limb contributed very little to positive and negative work during the double support phase of gait. To compensate, the intact leg at heel strike first provided aid to the deficient prosthetic ankle/foot during its push-off by doing positive work with the intact knee, which caused a delayed stance phase pattern. The resulting delay in toe-off of the intact limb then facilitated the energy transfer from the more robust intact push-off limb to the weaker colliding prosthesis side. This strategy was observed for both amputees. Conclusions. There is a sound scientific rationale for a mechanistic hypothesis that stepping asymmetry in amputee participants is a result of a motor adaptation that is both facilitating the lower-leg trajectory enforced by the prosthesis while compensating for the lack of work done by the prosthesis, the cost of which is increased energy expenditure of the intact knee and both hips.
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Safari, Reza. "Lower limb prosthetic interfaces: Clinical and technological advancement and potential future direction." Prosthetics and Orthotics International 44, no. 6 (November 8, 2020): 384–401. http://dx.doi.org/10.1177/0309364620969226.
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The human–prosthesis interface is one of the most complicated challenges facing the field of prosthetics, despite substantive investments in research and development by researchers and clinicians around the world. The journal of the International Society for Prosthetics and Orthotics, Prosthetics and Orthotics International, has contributed substantively to the growing body of knowledge on this topic. In celebrating the 50th anniversary of the International Society for Prosthetics and Orthotics, this narrative review aims to explore how human–prosthesis interfaces have changed over the last five decades; how research has contributed to an understanding of interface mechanics; how clinical practice has been informed as a result; and what might be potential future directions. Studies reporting on comparison, design, manufacturing and evaluation of lower limb prosthetic sockets, and osseointegration were considered. This review demonstrates that, over the last 50 years, clinical research has improved our understanding of socket designs and their effects; however, high-quality research is still needed. In particular, there have been advances in the development of volume and thermal control mechanisms with a few designs having the potential for clinical application. Similarly, advances in sensing technology, soft tissue quantification techniques, computing technology, and additive manufacturing are moving towards enabling automated, data-driven manufacturing of sockets. In people who are unable to use a prosthetic socket, osseointegration provides a functional solution not available 50 years ago. Furthermore, osseointegration has the potential to facilitate neuromuscular integration. Despite these advances, further improvement in mechanical features of implants, and infection control and prevention are needed.
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Smirnova, L. M., E. V. Fogt, A. V. Sinegub, and H. Solieman. "A Matrix Model for Creating Logical Filters of an Electronic Catalog of Prosthetic Modules for Customized Prostheses." Journal of the Russian Universities. Radioelectronics 25, no. 1 (February 22, 2022): 54–63. http://dx.doi.org/10.32603/1993-8985-2022-25-1-54-63.
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Introduction. When synthesizing a prosthesis from ready-made prosthesis units, the prosthetist is faced with the problem of selecting from a large range of components that differ in properties and characteristics. This challenge can be overcome by the creation of a system for processing the patient's biomedical information and its further use as criteria for selecting prosthetic nodes from a global database. For this purpose, an appropriate knowledge base must be incorporated into the system software.Aim. Substantiation of the expediency of presenting the knowledge base about the requirements for the lower limb prosthesis nodes in the form of a matrix model for creating a system of logical filters in the process of selecting nodes from an electronic catalog.Materials and methods. Theoretical research methods were used, including analysis, synthesis and analogy. An expert survey among leading specialists was carried out. To unify the description of the structural and functional state of a disabled person, the terms of the International Classification of Functioning (ICF), Disability and Health were used.Results. At the main stage of filtering, prosthetic modules optimally meeting the patient’s needs are selected using a specialized software application, depending on the patient’s health status and various healthrelated factors. A model of the knowledge base is presented, which describes the logic of selecting prosthetic nodes and their filtering in an electronic catalog.Conclusion. The matrix representation of the knowledge base that contains rules for selecting components of lower limb prostheses, taking into account the patient's condition, is a basis for creating a system of logical filters when searching for prosthetic modules in an electronic catalog for creating customized prostheses. The use of the ICF conceptual language for describing the factors influencing the choice of prosthetic modules is a step towards the formation of a patient’s digital profile, which corresponds to the strategy of transition to digital medicine technologies.
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Nanayakkara, PR, KG Karunarathna, T. Gobyshanger, and MV Perera. "An autologus lower limb prosthesis." Ceylon Medical Journal 54, no. 3 (October 13, 2009): 99. http://dx.doi.org/10.4038/cmj.v54i3.1207.
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Patiniott, N., J. C. Borg, E. Francalanza, A. Gatt, P. Vella, J. Zammit, and K. Paetzold. "Towards a Product Service System Framework for Lower Limb Prosthetic Devices." Proceedings of the Design Society 2 (May 2022): 1341–50. http://dx.doi.org/10.1017/pds.2022.136.
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AbstractAmputees face challenges with prosthesis such as cost, long delivery periods, as well as social discomfort. Simultaneously, the prosthetists and manufacturers have a difficulty to handle such diverse issues. We thus contribute a Prosthetic Life-Cycle Service System (ProLiSS) Framework, prescribed to involve amputees in different life phases. From an evaluation of ProLiSS, we conclude that it influences how prosthetics need to be designed and that it is beneficial to perform further research to provide manufacturers with a systematic, amputee-centered development and servicing framework.
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SERGEEV, S. V. "Amputations of lower extremities and prosthetics." Practical medicine 19, no. 3 (2021): 126–28. http://dx.doi.org/10.32000/2072-1757-2021-3-126-128.
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Currently, the number of patients with high-energy injuries of large segments of the skeleton is increasing due to road traumas and catаtraumas. The number of patients with vascular pathology and endocrine system disorders is also increasing, which leads to a sharp increase in the number of patients who underwent limb amputation. The patients who underwent limb amputations present a significant medical and social problem. Stump malformations due to violations of surgical technique during reconstructive operations often complicate prosthetic fitting and the social adaptation of patients in this group. Limb prosthetics is a complex orthopedic, technical, biomechanical and general medical process, which results in medical and social rehabilitation. The functional results depend on the timing of prosthetics manufacturing. An important condition for safe walking is the preparation of a disabled person from the first days after amputation. An important role in the patient’s rehabilitation is played by the school of walking, the purpose of which is to form the correct stereotype of walking, to teach walking on the prosthesis on various surfaces and to master actions in emergency situations.
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Sarasvathy V and Dr.S.Visalakshi Rajeswari. "Impact of Prosthesis Fit on Nutritional Health of the Lower Limb Amputee." JOURNAL OF ADVANCED APPLIED SCIENTIFIC RESEARCH 3, no. 4 (December 15, 2021): 1–7. http://dx.doi.org/10.46947/joaasr342021123.
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Socket designs ensure optimum fit between the user and the device (prosthesis), as an interface between the human – machine system. The type that an amputee is “fit with” depends on the shape of the residual limb, the length of the residual limb, activity level, prognosis, and individual preference. Patient satisfaction and function relies on pressure and force distribution (Biomechanics) on the socket-residual limb interface. The most determinant factor of prosthetic use lies in the design of the prosthetic socket and fit depends on the degree to which the prosthesis fits the stump. Well planned socket designs and careful consideration of stump presentation had set an achievement platform for the prosthetic user by maximizing range of motion, stability during the performance of daily activities, and comfortably distributing the forces exerted on the residual limb during movement and suspension. A study was conducted to analyze the health issues and their impact on the use/ acceptance of prosthesis among select amputees’. Physiological factors, obesity, age, nutritional status and co-morbidities were found to impose mechanical implications related to accessibility and well being concepts. The study highlighted prosthetic fitting to be more challenging with increased load (obesity) to transmit through the prosthetic socket in limited pressure–tolerant anatomical areas. Hence nutritional and physiotherapy intervention on effective and efficient prosthetic use was done to enhance their health and well -being.
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Lestari, Wahyu Dwi. "Passive Prosthetic Ankle Design Based on Indonesian Anthropometry." Journal of Mechanical Engineering Science and Technology (JMEST) 6, no. 1 (July 19, 2022): 1. http://dx.doi.org/10.17977/um016v6i12022p001.
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Foot prosthesis is a replacement for the foot to overcome activity limitations due to disease, birth defects, accidents or amputations. Many foot prosthetics have been developed in recent years to treat patients. However, prostheses on the market today have drawbacks, including their high price, lack of comfort, stiff ankles, and low durability. The main objective of this study is to develop an existing ankle-foot prosthesis design that approximates the resemblance of a human foot according to the anthropometry of Asians, especially Indonesians. This study contains the design of a prosthetic foot with a skin design model and a support core. The prosthetic core supports the use of a compliance mechanism (CM) model that functions to connect the limb organs that have been amputated. The design process is carried out using the Solidwork software. Ankle foot prostheses are designed to be able to withstand a load of 100 kg and can be used for patients with a height range of 150 cm to 180 cm. Based on the design results, it is found that the prosthesis mass is lower than the lowest mass of the user, so it feels light, ergonomic and flexible when used.
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Akarsu, Selim, Levent Tekin, Ismail Safaz, Ahmet Salim Göktepe, and Kamil Yazıcıoğlu. "Quality of life and functionality after lower limb amputations: comparison between uni- vs. bilateral amputee patients." Prosthetics and Orthotics International 37, no. 1 (July 24, 2012): 9–13. http://dx.doi.org/10.1177/0309364612438795.
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Background: It is difficult for the lower limb amputee patients to adapt to their new lifestyles. Objective: To compare the life quality and functionality of patients with bilateral vs. unilateral lower extremity amputations. Study Design: Cross-sectional study. Methods: Fifteen bilateral and 15 unilateral lower extremity amputee patients were enrolled. Demographics, cause and level of amputations, frequency and duration of prosthesis use were evaluated. SF-36, Satisfaction with Prosthesis Questionnaire (SAT-PRO), Amputee Body Image Scale. (ABIS), Houghton Scale (HS), six-minute walk test (6MWT), and 10-metre walk test (10 MWT) were performed. Results: Physical function, physical and emotional role scores of SF-36 were significantly lower in the bilateral amputee group in comparison with the unilateral group. SAT-PRO and ABIS total scores were similar between the groups. There was a positive correlation between the frequency of prosthetic use and SF-36 subgroups (except pain). The unilateral amputee group had significantly better scores than the bilateral amputee group in terms of HS, 6MWT and 10 MWT. Conclusion: Physical capacity of bilateral lower extremity amputee patients is lower than the unilateral amputee patients; satisfaction with prosthesis and body image are not related with the amputation level; and the life quality and satisfaction with prostheses are increased in parallel with the use of the prostheses. Clinical relevance Although differences exist between the groups, in terms of quality of life and functionality, patients can reach an acceptable life standard with good rehabilitation and a suitable prosthesis.
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Bragaru, Mihai, Rienk Dekker, and Jan HB Geertzen. "Sport prostheses and prosthetic adaptations for the upper and lower limb amputees: an overview of peer reviewed literature." Prosthetics and Orthotics International 36, no. 3 (August 22, 2012): 290–96. http://dx.doi.org/10.1177/0309364612447093.
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Background:Sport prostheses are used by both upper- and lower-limb amputees while participating in sports and other physical activities. Although the number of these devices has increased over the past decade, no overview of the peer reviewed literature describing them has been published previously. Such an overview will allow specialists to choose appropriate prostheses based on available scientific evidence rather than on personal experience or preference.Objective:To provide an overview of the sport prostheses as they are described by the papers published in peer reviewed literature.Study Design:Literature review.Methods:Four electronic databases were searched using free text and Medical Subject Headings (MESH) terms. Papers were included if they concerned a prosthesis or a prosthetic adaptation used in sports. Papers were excluded if they did not originate from peer reviewed sources, if they concerned prostheses for body parts other than the upper or lower limbs, if they concerned amputations distal to the wrist or ankle, or if they were written in a language other than English.Results:Twenty-four papers were included in this study. The vast majority contained descriptive data and consisted of expert opinions and technical notes.Conclusion:Data concerning the energy efficiency, technical characteristics and special mechanical properties of prostheses or prosthetic adaptations for sports, other than running, are scarce.Clinical relevanceAn overview of the peer reviewed literature will enable rehabilitation specialists working with amputees to choose a prosthesis that best suits their patients’ expectations on the available scientific evidence. Identifying the information gaps present in the peer reviewed literature will stimulate new research and eventually broaden the base of scientific knowledge.
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Haque, Md Rejwanul, Greg Berkeley, and Xiangrong Shen. "Force-Moment Sensor for Prosthesis Structural Load Measurement." Sensors 23, no. 2 (January 13, 2023): 938. http://dx.doi.org/10.3390/s23020938.
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Measurement of prosthesis structural load, as an important way to quantify the interaction of the amputee user with the environment, may serve important purposes in the control of smart lower-limb prosthetic devices. However, the majority of existing force sensors used in protheses are developed based on strain measurement and thus may suffer from multiple issues such as weak signals and signal drifting. To address these limitations, this paper presents a novel Force-Moment Prosthesis Load Sensor (FM-PLS) to measure the axial force and bending moment in the structure of a lower-limb prosthesis. Unlike strain gauge-based force sensors, the FM-PLS is developed based on the magnetic sensing of small (millimeter-scale) deflection of an elastic element, and it may provide stronger signals that are more robust against interferences and drifting since such physical deflection is several orders of magnitude greater than the strain of a typical load-bearing structure. The design of the sensor incorporates uniquely curved supporting surfaces such that the measurement is sensitive to light load but the sensor structure is robust enough to withstand heavy load without damage. To validate the sensor performance, benchtop testing of the FM-PLS and walking experiments of a FM-PLS-embedded robotic lower-limb prosthesis were conducted. Benchtop testing results displayed good linearity and a good match to the numerical simulation results. Results from the prosthesis walking experiments showed that the sensor signals can be used to detect important gaits events such as heel strike and toe-off, facilitating the reliable motion control of lower-limb prostheses.
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Hafner, Brian J., Sara J. Morgan, Daniel C. Abrahamson, and Dagmar Amtmann. "Characterizing mobility from the prosthetic limb user’s perspective: Use of focus groups to guide development of the Prosthetic Limb Users Survey of Mobility." Prosthetics and Orthotics International 40, no. 5 (July 10, 2016): 582–90. http://dx.doi.org/10.1177/0309364615579315.
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Background: Input from target respondents in the development of patient-reported outcome measures is necessary to ensure that the instrument is meaningful. Objectives: To solicit perspectives of prosthetic limb users about their mobility experiences and to inform development of the Prosthetic Limb Users Survey of Mobility. Study design: Qualitative study. Methods: Four focus groups of lower limb prosthesis users were held in different regions of the United States. Focus group transcripts were coded, and themes were identified. Feedback from participants was used to develop a framework for measuring mobility with a lower limb prosthesis. Results: Focus group participants ( N = 37) described mobility as a confluence of factors that included characteristics of the individual, activity, and environment. Identified themes were defined as individual characteristics, forms of movement, and environmental situations. Prosthetic mobility was conceptualized as movement activities performed in an environmental or situational context. Conclusion: Respondent feedback used to guide development of Prosthetic Limb Users Survey of Mobility established a foundation for a new person-centered measure of mobility with a prosthetic limb. Clinical relevance Perspectives of target respondents are needed to guide development of instruments intended to measure health outcomes. Focus groups of prosthetic limb users were conducted to solicit experiences related to mobility with a lower limb prosthesis. Results were used to inform development of a clinically meaningful, person-centered instrument.
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Sreedharan, Sadhishaan, Steven Gray, and Frank Bruscino-Raiola. "Osseointegrated prostheses for lower limb amputees." Australasian Journal of Plastic Surgery 4, no. 1 (March 30, 2021): 56–62. http://dx.doi.org/10.34239/ajops.v4n1.199.
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Background: Traditional socket-based prostheses are an important rehabilitation tool in lower limb amputation, however, patients often experience skin-related problems, pain, stump volume fluctuations and poor suspension. Osseointegration offers a suitable alternative by providing direct skeletal attachment for limb prosthesis. This study aims to review the complications following osseointegration for lower limb amputation, with attention to mechanical abutment failure. Method: A retrospective chart review was undertaken of all patients who underwent transfemoral osseointegration between January 2000 and June 2019 through the osseointegration and targeted muscle reinnervation surgical and rehabilitation program at The Alfred in Victoria, Australia. Ethics approval was obtained through The Alfred’s ethics committee (414/16). In 2016 this program was redesigned and in 2017 the osseointegration implant system was modified. Patients underwent a two-stage surgical procedure followed by a rehabilitation protocol that gradually increased their activity. Results: A total of 19 limbs were osseointegrated in 18 patients during the study period. Two patients had their implant removed due to failure of osseointegration. The most common complication was a mechanical abutment failure, occurring 46 times in 11 patients. Patients who suffered an abutment failure reported higher levels of postoperative activity. Soft-tissue infections occurred in five patients: three superficial skin infections and two collections. There were no mechanical abutment failures noted in the updated program.Conclusion: Osseointegration is a good option for patients who may have difficulties with traditional socket prosthesis. However, complications such as abutment fracture can occur, and appropriate patient selection and counselling are required
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Major, Matthew J., Pooja Raghavan, and Steven Gard. "Assessing a low-cost accelerometer-based technique to estimate spatial gait parameters of lower-limb prosthesis users." Prosthetics and Orthotics International 40, no. 5 (July 10, 2016): 643–48. http://dx.doi.org/10.1177/0309364614568411.
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Background and aim:Inexpensive methods for characterizing lower-limb prosthetic gait allow clinicians to monitor gait quality. This study assessed an established method for estimating step length using a low-cost accelerometer to estimate distance walked in lower-limb prosthesis users and explore the use of subject-specific correction factors.Technique:A three-axis accelerometer was attached to participants using straps. Validity and test–retest reliability of step length was assessed in able-bodied individuals using a motion capture system. Validity of distance walked was assessed with lower-limb prosthesis users. A regression equation was developed for prosthesis users to estimate a correction factor that minimized error.Discussion:The system demonstrated excellent reliability and minimal mean error for both participant groups, but subject-specific correction factors did not provide substantial benefit. Estimate variability was high, suggesting the need for further refinement. Estimating distance walked and step length from low-cost accelerometers may be a valid, clinically accessible method for characterizing prosthetic gait.Clinical relevanceThe use of a low-cost accelerometer may provide valid means for estimating step length and distance walked of lower-limb prosthesis users in a clinical environment for monitoring patient outcomes.
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Cotrobas Dascalu, Vlad Theodor, Marius Stoica, and Adina Andreea Dreve. "Assessment of Quality of Life in Patients with Lower Limb Amputation after Work Accidents." Eastern-European Journal of Medical Humanities and Bioethics 5, no. 1 (August 26, 2022): 24–33. http://dx.doi.org/10.18662/eejmhb/5.1/30.
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Amputation is the intentional removal, by surgery, of a limb segment or part of the body. By increasing the degree of urbanization and automation around the world, accidents are the most important cause of morbidity and mortality. Lower limb amputation is a life-changing event and has an impact on functional, work, social and recreational activities. Amputation can lead people to lose self-esteem, independence and work. Quality of life it is as a wide range of human experiences related to one's general well-being. For the specific psychosocial and functional testing of people who have undergone an amputation TAPES is more frequently used. The study included 7 patients with amputation of lower limbs, prostheses, who underwent unilateral or bilateral amputation of traumatic genesis at work. Patients filled in the Trinity Amputation and Prosthesis Experience questionnaire in order to estimate quality of life and Rosenberg scale to assess self-esteem. The adaptation to wearing the prosthesis is reported by 71.42% and more than 50% of the subjects are satisfied with their prosthesis. The factors with the greatest impact on functional abilities proved to be: the level of amputation, the duration of living with the amputation limb, the presence of other pathologies and psycho-emotional status. Medical rehabilitation programs improve the functional and psycho-emotional abilities of patients with lower limb amputations.
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Scherbina, K. K., V. G. Suslyaev, Yu B. Golubeva, A. V. Sokurov, T. V. Ermolenko, and V. M. Yankovskiy. "The analysis of prosthetic and orthopedic factories production in the branch of lower extremities prothesis with possibilities of import substitution." Bulletin of the Russian Military Medical Academy 20, no. 4 (December 15, 2018): 131–37. http://dx.doi.org/10.17816/brmma12317.
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The needs and possibilities of import substitution in the prosthetic and orthopedic industry for prosthetics and orthotics of lower limbs from local and imported component materials were determined. We analyzed the stock list of special equipment, materials, and modules used in the manufacture of prostheses and orthoses of the lower limbs, indicating local and foreign suppliers. The technical characteristics of equipment, materials, and modules of lower limb prostheses that are not manufactured in the Russian Federation were determined. We indicated the stock list, components, equipment, and materials, which production is more reasonable to be organized in Russia instead of using imported products of similar purpose. We carried out operational tests and clinical trials of prosthetic and orthopedic products that were made from new thermoplastic materials. These materials are developed by local manufacturers for the production of a bucket of the prosthesis for lower and upper limbs, orthoses and orthopedic devices, actively correcting braces, stop holders, etc. We indicated the ways of implementing the state policy to eliminate reliance of local prosthetic and orthopedic industry on import. Proposals for the optimization of reference documentation were developed. The role and position of research organizations that solve the problems of import substitution and that focus on the creation of new and improvement of existing technologies of physical medical rehabilitation of patients with muscle-skeleton disorders were defined. We determined the importance of institutions of advanced training for doctors and other specialists who work in prosthetic and orthopedic enterprises and rehabilitation centers.
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Singh, Rajiv Kumar, and Guru Prasad. "Long-term mortality after lower-limb amputation." Prosthetics and Orthotics International 40, no. 5 (July 10, 2016): 545–51. http://dx.doi.org/10.1177/0309364615596067.
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Background:Mortality after amputation is known to be extremely high and is associated with a number of patient features. We wished to calculate this mortality after first-time lower-limb amputation and investigate whether any population or treatment factors are associated with worse mortality.Objective:To follow up individuals after lower limb amputation and ascertain the mortality rate as well as population or treatment features associated with mortality.Study design:A prospective cohort study.Methods:Prospective lower-limb amputations over 1 year ( N = 105) at a Regional Rehabilitation Centre were followed up for 3 years.Results:After 3 years, 35 individuals in the cohort had died, representing a mortality of 33%. On initial univariate analysis, those who died were more likely to have diabetes mellitus ( χ2 = 7.16, df = 1, p = 0.007) and less likely to have been fitted with a prosthesis ( χ2 = 5.84, df = 1, p = 0.016). There was no association with age, gender, level of amputation, social isolation, significant medical co-morbidity other than diabetes or presence of mood disorders. A multi-variable logistic regression (backward step) confirmed that diabetes (odds ratio = 3.04, confidence intervals = 1.25–7.40, p = 0.014) and absence of prosthesis-fitting (odds ratio = 2.60, confidence interval = 1.16–6.25, p = 0.028) were independent predictors of mortality.Conclusion:Mortality after amputation is extremely high and is increased in individuals with diabetes or in those who are not fitted with a prosthesis after amputation.Clinical relevanceThe link between diabetes and mortality after amputation has been noted by others, but this is the first study to find an effect from prosthetic limb-wearing. This requires further investigation to ascertain why the wearing of a prosthetic limb, confers an independent survival benefit that is not related to the presence of medical co-morbidity.
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P Fonseca, João, Pedro Figueiredo, and Pedro Lemos Pereira. "The role of Rehabilitation in pediatric amputation – A 10-year retrospective study in a Portuguese population." International Physical Medicine & Rehabilitation Journal 7, no. 1 (February 9, 2022): 21–24. http://dx.doi.org/10.15406/ipmrj.2022.07.00298.
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Introduction: Limb amputation in pediatric population, whether congenital or acquired, has a set of attributes that require a different medical approach and rehabilitation management. Objectives: To characterize the pediatric population referred to the Amputee Rehabilitation consultation and evaluate amputation type and segment relationship with prosthesis usage. Material and methods: We conducted a retrospective study based on the clinical information from patients referred to the Pediatric Rehabilitation consultation between January 2011 and March 2021. The variables analyzed included gender, type, and etiology of amputation, amputation level, age of prosthesis, time to the first prosthesis, pre-prosthetic training, number of components prescribed, waiting time per component, and prosthesis use. Results: The study included 50 patients, 68% of congenital etiology. Within the group of acquired amputations, 62.5% had neoplastic causes. The initial use of a prosthesis occurred in 91.7% of the population with upper limb amputations. However, the final adhesion of the upper limb prosthesis was only 50%. There was a statistically significant dependence and a moderate association between the amputated segment and the final use of the prosthesis. The abandonment risk of upper limb prosthesis was seven times higher than lower limb prosthesis. The remaining variables did not demonstrate any other type of significant association. Conclusion: In pediatric age, congenital amputations are more frequent than acquired causes. However, contrary to other data, malignancy was the most frequent etiology in this study within acquired amputations. Regardless of the type of amputation, the use of a prosthesis is related to the affected segment. The abandonment risk of upper limb prostheses is significant, given the development of compensatory strategies that allow the functional use of the limb. Physical and Rehabilitation Medicine plays an essential role in the assessment and management of pediatric amputation. Prescribing at the right time, carrying out an adequate program, with the child and family, is the key to their functional independence.
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Kuriakose, Nelson, and Subhasmita Sahoo. "Quality of Life with Transtibial Prosthesis: Survey Based on Gender Difference." International Journal of Health Sciences and Research 13, no. 2 (February 18, 2023): 158–62. http://dx.doi.org/10.52403/ijhsr.20230223.
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Back ground: The Quality of Life (QoL) of individuals with lower limb amputation with gender basics have been investigated and reported in literature, also some studies described the QoL of patients with over all lower limb prostheses in different level of amputation. But there is lack of information regarding the quality of life after transtibial amputation with prosthesis fitment in gender basics, which will provide a better information regarding the day to activity of patient and associated risk factor after using the transtibial prosthesis. Aim and objective: The present study was designed to compare the difference in quality of life of transtibial prosthesis user on the basis of gender. Methodology: The Study was conducted with 50 transtibial amputee with prosthesis (male= 25 and female= 25). Convenient Sampling technique was used to collect the sample. All the four domains: physical, psychological, social relationships, and environment was measured by using (QoL) WHO quality of life brief scale among all male and female transtibial prosthesis user. Results: There is no significant effect between male and female found in the domains except social relationship. Overall quality of life between male and female was almost same. But we found that even after prosthetic fitment male population was psychologically weak then female population. Conclusion: The result of this study shows that, when we compared the quality of life after transtibial lower limb amputation with prosthesis with a gender basis, found that there are no significant differences between male and female. Key words: Transtibial prosthesis, gender difference, quality of life, WHO QOL brief Scale.
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Sreekala, V. K. "A Rare Indication for Amputation." Indian Journal of Physical Medicine and Rehabilitation 27, no. 3 (2016): 90–92. http://dx.doi.org/10.5005/ijopmr-27-3-90.
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Abstract A forty-two years old housewife came to the outpatient department. She met with a very bad road traffic accident in childhood resulting in a crush injury of left lower limb and a degloving injury on the right lower limb. She had undergone transtibial amputation on the left and skin grafting on the right lower limbs. The scar has been transformed into a large keloid. Now she is ambulant with patellar tendon bearing prosthesis on the left side and a rocky hard, heavy, insensate right lower limb with a grotesque appearance. She requests amputation and prosthetic fitting on the right side.
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Alvarez-Camacho, Michelin, Victor Alvarez-Guevara, Carlos Galvan Duque Gastelum, Daniel Flores Vazquez, Gerardo Rodriguez-Reyes, and Francisco Manuel Sanchez-Arevalo. "Use of three-dimensional digital image correlation to evaluate mechanical response of prosthetic systems." Prosthetics and Orthotics International 41, no. 1 (July 10, 2016): 101–5. http://dx.doi.org/10.1177/0309364616637956.
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Background and aim:The need of comfortable and safe prosthetic systems is an important challenge for both prosthetists and engineers. The aim of this technical note is to demonstrate the use of three-dimensional digital image correlation to evaluate mechanical response of two prosthetic systems under real patient dynamic loads.Technique:This note describes the use of three-dimensional digital image correlation method to obtain full-field strain and displacement measurements on the surface of two lower limb prostheses for Chopart amputation. It outlines key points of the measurement protocol and illustrates the analysis of critical regions using data obtained on specific points of interest.Discussion:The results show that the use of three-dimensional digital image correlation can be a tool for the prosthetist to optimize the prosthesis considering features related to the material and design, in order to bear with real patient-specific load conditions.Clinical relevanceThree-dimensional digital image correlation can support decision-making on new designs and materials for prosthetics based on quantitative data. Better understanding of mechanical response could also assist prescription for appropriate prosthetic systems.
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Xu, Dongfang, and Qining Wang. "Noninvasive Human-Prosthesis Interfaces for Locomotion Intent Recognition: A Review." Cyborg and Bionic Systems 2021 (June 4, 2021): 1–14. http://dx.doi.org/10.34133/2021/9863761.
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The lower-limb robotic prostheses can provide assistance for amputees’ daily activities by restoring the biomechanical functions of missing limb(s). To set proper control strategies and develop the corresponding controller for robotic prosthesis, a prosthesis user’s intent must be acquired in time, which is still a major challenge and has attracted intensive attentions. This work focuses on the robotic prosthesis user’s locomotion intent recognition based on the noninvasive sensing methods from the recognition task perspective (locomotion mode recognition, gait event detection, and continuous gait phase estimation) and reviews the state-of-the-art intent recognition techniques in a lower-limb prosthesis scope. The current research status, including recognition approach, progress, challenges, and future prospects in the human’s intent recognition, has been reviewed. In particular for the recognition approach, the paper analyzes the recent studies and discusses the role of each element in locomotion intent recognition. This work summarizes the existing research results and problems and contributes a general framework for the intent recognition based on lower-limb prosthesis.
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Keri, McNiel-Inyani, Ahmed W. Shehata, Paul D. Marasco, Jacqueline S. Hebert, and Albert H. Vette. "A Cost-Effective Inertial Measurement System for Tracking Movement and Triggering Kinesthetic Feedback in Lower-Limb Prosthesis Users." Sensors 21, no. 5 (March 6, 2021): 1844. http://dx.doi.org/10.3390/s21051844.
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Advances in lower-limb prosthetic technologies have facilitated the restoration of ambulation; however, users of such technologies still experience reduced balance control, also due to the absence of proprioceptive feedback. Recent efforts have demonstrated the ability to restore kinesthetic feedback in upper-limb prosthesis applications; however, technical solutions to trigger the required muscle vibration and provide automated feedback have not been explored for lower-limb prostheses. The study’s first objective was therefore to develop a feedback system capable of tracking lower-limb movement and automatically triggering a muscle vibrator to induce the kinesthetic illusion. The second objective was to investigate the developed system’s ability to provide kinesthetic feedback in a case participant. A low-cost, wireless feedback system, incorporating two inertial measurement units to trigger a muscle vibrator, was developed and tested in an individual with limb loss above the knee. Our system had a maximum communication delay of 50 ms and showed good tracking of Gaussian and sinusoidal movement profiles for velocities below 180 degrees per second (error < 8 degrees), mimicking stepping and walking, respectively. We demonstrated in the case participant that the developed feedback system can successfully elicit the kinesthetic illusion. Our work contributes to the integration of sensory feedback in lower-limb prostheses, to increase their use and functionality.