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1
Philippe, C., J. M. Collet, I. Bonafe, V. Cochen De Cock, S. Rekik, O. Roca, and N. Huynh. "Comparaison de l’efficacité entre orthèse d’avancée mandibulaire active vs titrable dans le traitement du syndrome d’apnées obstructives du sommeil." Médecine du Sommeil 15, no. 1 (March 2018): 38–39. http://dx.doi.org/10.1016/j.msom.2018.01.100.
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Amat, Philippe, and Éric Tran Lu Y. "Apport de la rééducation myofonctionnelle orofaciale au traitement du syndrome d’apnées obstructives du sommeil : une revue systématique de la littérature." L'Orthodontie Française 90, no. 3-4 (September 2019): 343–70. http://dx.doi.org/10.1051/orthodfr/2019035.
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Introduction : Le syndrome d’apnées obstructives du sommeil (SAOS) est une affection très répandue et insuffisamment diagnostiquée, ce qui en fait un problème majeur de santé publique et de sécurité. La rééducation myofonctionnelle orofaciale (RMO) a été montrée efficace dans le traitement multidisciplinaire des SAOS de l’enfant, de l’adolescent et de l’adulte et elle est prescrite à plusieurs étapes de ces prises en charge. Objectifs : L’objectif principal de cette revue systématique de la littérature était d’évaluer l’efficacité de la rééducation myofonctionnelle orofaciale (RMO), active ou passive, dans le traitement du syndrome d’apnées obstructives du sommeil chez les enfants, les adolescents et les adultes. Matériel et méthodes : La revue systématique de la littérature fut entreprise à partir des trois bases de données électroniques : Medline (via PubMed),Cochrane Library, Web of Science Core Collection, et complétée par une recherche limitée de la littérature grise (Google Scholar) afin d’identifier les études évaluant l’efficacité de la RMO sur le SAOS. Le critère de jugement principal était une diminution de l’indice d’apnées/hypopnées (IHA) d’au moins cinq épisodes par heure par rapport à l’état initial. Les critères de jugement secondaires étaient une amélioration de la qualité subjective du sommeil, de la qualité du sommeil mesurée par polysomnographie nocturne et de la qualité de vie mesurée subjectivement. Résultats : Seulement dix études répondaient à tous les critères d’inclusion. Huit étaient des essais cliniques contrôlés randomisés, une était une étude de cohorte prospective et une autre était une étude de cohorte rétrospective. Six études étaient consacrées au SAOS de l’adulte et quatre au SAOS pédiatrique. Toutes les études incluses ont été évaluées à « faible risque de biais » d’après les douze critères de risque de biais du Cochrane Back Review Group. D’après les données probantes disponibles, la RMO permet une réduction significative de l’IAH, jusqu’à 90,6 % chez l’enfant et jusqu’à 92,06 % chez l’adulte. Elle permet une diminution significative de l’intensité et de la fréquence du ronflement, participe à une réduction de la somnolence diurne, limite la réapparition des symptômes d’apnée obstructive du sommeil (AOS) après adénoamygdalectomie chez l’enfant et améliore l’adhésion au traitement par ventilation en pression positive continue (PPC). La RMO passive, avec l’assistance apportée au patient par le port d’une orthèse sur mesure à bille, augmente l’observance à la rééducation, permet une réduction significative de l’intensité du ronflement, de l’IAH et un accroissement significatif des voies aérifères supérieures. Conclusions : Les données publiées montrent que la rééducation myofonctionnelle orofaciale est efficace dans les traitements multidisciplinaires des SAOS de l’enfant, de l’adolescent et de l’adulte et devrait être largement prescrite à plusieurs étapes de ces prises en charge. La RMO passive, avec l’orthèse d’avancée mandibulaire à bille conçue par Michèle Hervy-Auboiron, aide à pallier les fréquents défauts d’observance observés lors des traitements par RMO active.
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Petcu, Alin, Marius Georgescu, and Daniela Tarniţă. "Actuation Systems of Active Orthoses Used for Gait Rehabilitation." Applied Mechanics and Materials 880 (March 2018): 118–23. http://dx.doi.org/10.4028/www.scientific.net/amm.880.118.
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In this paper three types of actuation systems of active orthoses used for human gait rehabilitation are presented. This paper analyzes different lower-limb active orthoses used for gait rehabilitation function of actuation system.
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Hoang, Ngoc-Tuyet-Trinh, Shuya Chen, and Li-Wei Chou. "The Impact of Foot Orthoses and Exercises on Pain and Navicular Drop for Adult Flatfoot: A Network Meta-Analysis." International Journal of Environmental Research and Public Health 18, no. 15 (July 29, 2021): 8063. http://dx.doi.org/10.3390/ijerph18158063.
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Background: Adult flatfoot leads to injury and decreased quality of life. The most widely applied noninvasive approaches are wearing foot orthoses or exercising. Both interventions raise controversy about reducing pain and neutralizing foot posture. This study investigated the impact of foot orthoses and exercise on pain and navicular drop (present for foot posture). Methods: Four databases were used: MEDLINE, PubMed, Web of Science, and Cochrane, from the earliest records to November 2020. Randomized controlled studies focused on adult flatfoot that evaluated the effect of exercise and foot orthoses on pain and navicular drop were extracted. We used data analysis to estimate the relative effect of heterogeneity using I2 and publication bias using funnel plots. Results: Ten studies were identified through to November 2020. Active interventions (AIs) were exercise and exercise combined with foot orthoses; passive interventions (PIs) were foot orthoses and added stretching. Both AIs and PIs decreased pain significantly (SMD −0.94, 95% CI −1.35, −0.54 and SMD −1.4, 95% CI −1.87, −0.92). The AIs reduced pain level better than PIs. Controversially, no treatment was found to affect navicular drop. Conclusion: Both exercise and foot orthoses can reduce pain but not realign foot posture. Exercise alone or combined with foot orthoses showed a better effect on adult flatfoot than only wearing foot orthoses. Active intervention was shown to have better efficacy in reducing pain than passive intervention.
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Janzen, Swantje, Kent Stewart, and Peter P. Pott. "Low-cost active knee orthoses – a systematic evaluation." Current Directions in Biomedical Engineering 4, no. 1 (September 1, 2018): 649–52. http://dx.doi.org/10.1515/cdbme-2018-0156.
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AbstractThe aging of humans induces muscle weakness. Muscle weakness results the inability to climb stairs or stand up from a chair and thus, is one of the first steps towards elderly having a less autonomous and self-sufficient life. Therefore, an accessible active knee orthosis, which especially supports these movements would be of great assistance. Recent research projects have focused on feasibility, perfection of motion control and imitation of human movement. For active knee orthoses to be accessible it must be affordable. Hence, this paper systematically evaluates the current research projects around active knee orthosis and discuss the possibilities of implementing a lowcost active knee orthosis.
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AKIYOSHI, Norimasa, and Shinsaku FUJIMOTO. "0711 Development of Active Orthoses : Control Method for Orthoses Control Valve (On/Off Valve)." Proceedings of the Bioengineering Conference Annual Meeting of BED/JSME 2009.22 (2010): 114. http://dx.doi.org/10.1299/jsmebio.2009.22.114.
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Jenkins, Walter L., Dorsey Shelton Williams, Alex Durland, Brandon Adams, and Kevin O’Brien. "Foot Orthotic Devices Decrease Transverse Plane Motion during Landing from a Forward Vertical Jump in Healthy Females." Journal of Applied Biomechanics 25, no. 4 (November 2009): 387–95. http://dx.doi.org/10.1123/jab.25.4.387.
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The use of foot orthoses has been evaluated during a variety of functional activities. Twelve college-aged active females wore two types of foot orthoses and performed a vertical jump to determine the biomechanical effect of the orthoses on lower extremity transverse plane movement during landing. Data collection included three-dimensional analysis of the tibia, knee, and hip. A repeated-measures ANOVA was performed to determine the differences between no orthoses, over-the-counter, and custom-made orthoses with transverse plane motion. At the hip joint, there was significantly less internal rotation (p< .05) in the over-the-counter condition as compared with the no orthoses condition. There was significantly less tibial internal rotation (p< .05) in the custom-made condition as compared with no orthoses. Over-the-counter devices decreased transverse plane motion at the hip, whereas custom-made devices decreased transverse plane motion of the tibia.
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Ali, Athar, Vigilio Fontanari, Marco Fontana, and Werner Schmölz. "Spinal Deformities and Advancement in Corrective Orthoses." Bioengineering 8, no. 1 (December 25, 2020): 2. http://dx.doi.org/10.3390/bioengineering8010002.
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Spinal deformity is an abnormality in the spinal curves and can seriously affect the activities of daily life. The conventional way to treat spinal deformities, such as scoliosis, kyphosis, and spondylolisthesis, is to use spinal orthoses (braces). Braces have been used for centuries to apply corrective forces to the spine to treat spinal deformities or to stabilize the spine during postoperative rehabilitation. Braces have not modernized with advancements in technology, and very few braces are equipped with smart sensory design and active actuation. There is a need to enable the orthotists, ergonomics practitioners, and developers to incorporate new technologies into the passive field of bracing. This article presents a review of the conventional passive braces and highlights the advancements in spinal orthoses in terms of improved sensory designs, active actuation mechanisms, and new construction methods (CAD/CAM, three-dimensional (3D) printing). This review includes 26 spinal orthoses, comprised of passive rigid/soft braces, active dynamics braces, and torso training devices for the rehabilitation of the spine.
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AKIYOSHI, Norimasa, and Shinsaku FUJIMOTO. "308 Development of Active Orthoses- Control System Design for Orthoses Control Valve(On/Off Valve)-." Proceedings of Conference of Chugoku-Shikoku Branch 2011.49 (2011): 83–84. http://dx.doi.org/10.1299/jsmecs.2011.49.83.
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Grün, Markus, and Ulrich Konigorski. "Observer Based Method for Joint Torque Estimation in Active Orthoses." IFAC Proceedings Volumes 45, no. 2 (2012): 199–204. http://dx.doi.org/10.3182/20120215-3-at-3016.00035.
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Pott, Peter P., Laura Schwenkel, Swantje Janzen, and Pia Mühlbauer. "Mobile compressed gas supply for active orthoses and exo-skeletons." Current Directions in Biomedical Engineering 5, no. 1 (September 1, 2019): 613–16. http://dx.doi.org/10.1515/cdbme-2019-0154.
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AbstractIn this study a basic principle for the gas supply of a pneumatic actuation for a mobile active knee joint orthosis is described. Instead of using a compressor or a bulky pressure reservoir, the system is supplied with pressurized gas directly from a thermodynamic process to reduce size and weight of the device. To achieve this goal a literature search was performed identifying chemical processes. These options were then analysed and evaluated considering the aspects energy density, safety, eco-friendliness, and technical feasibility of the construction. The expansion of liquified carbon dioxide with phase change achieves the best result due to its high level of safety and the simple technical feasibility of the system. However, CO2cools down considerably during the expansion, so heating up again to room temperature is necessary. Therefore, the technical construction includes a passive and an active heat exchanger.
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Villa-Parra, A. C., L. Broche, D. Delisle-Rodríguez, R. Sagaró, T. Bastos, and A. Frizera-Neto. "Design of active orthoses for a robotic gait rehabilitation system." Frontiers of Mechanical Engineering 10, no. 3 (September 2015): 242–54. http://dx.doi.org/10.1007/s11465-015-0350-1.
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Ögce, F., and H. Özyalçin. "Case study: A myoelectrically controlled shoulderelbow orthosis for unrecovered brachial plexus injury." Prosthetics and Orthotics International 24, no. 3 (December 2000): 252–55. http://dx.doi.org/10.1080/03093640008726557.
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Two myoelectrically controlled battery powered shoulderelbow orthoses manufactured individually for two traumatic unilateral brachial plexus injury cases are reported. The first case was 24 years old and the other was 6 years old. Both patients had undergone unsuccessful microsurgical nerve repair procedures leaving them with elbow and shoulder paralysis and some residual hand motion. Manufactured orthoses were made of lightweight thermoplastic polyethylene. They stabilised the affected shoulder joint in the neutral position. Elbow extension and flexion were activated by a myoelectrically controlled battery powered orthosis, and the active range of motion of the elbow was between 60 and 140 degrees. These orthoses achieved elbow motions at a speed of 16 degrees per second. The rehabilitation time was 3 months in both patients. The older patient was rehabilitated using a 1kg mass, and the younger one with 0.5kg mass, throughout the full range of active elbow motions. After 21 months it was found, in both cases, that the orthotic treatment had been successful and that the patients had been given the ability to engage in twohanded activities of daily living.
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Dionyssiotis, Yannis, Georgios Trovas, Sofia Thoma, George Lyritis, and Nikolaos Papaioannou. "Prospective study of spinal orthoses in women." Prosthetics and Orthotics International 39, no. 6 (August 19, 2014): 487–95. http://dx.doi.org/10.1177/0309364614545416.
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Background: There are not many clinical trials investigating the efficiency and compliance of using spinal orthoses in the management of osteoporosis. Objectives: The purpose of this study was to investigate the effect of long-term use and the compliance of spinal orthoses in postmenopausal women with vertebral fractures. Study design: Clinical trial of spinal orthoses in postmenopausal women. Methods: Women were separated into groups wearing different types of orthoses (Spinomed, Osteomed, Spinomed active, and Spine-X). Isometric maximum strength of trunk muscles (F/Wabdominals–extensors) was calculated and back pain was assessed in all women. In addition, women completed a compliance questionnaire about the use of the orthoses. Results: Spinomed decreased pain ( p = 0.001) and increased trunk muscle strength (F/Wabdominals, p = 0.005 and F/Wextensors, p = 0.003, respectively). The compliance of wearing an orthosis for 6 months was 66%. Conclusion: The results suggest that orthoses could be an effective intervention for back pain and muscle strengthening in osteoporotic women. Clinical relevance In women with established osteoporosis, wearing Spinomed orthosis for at least 2 h/day for 6 months decreased back pain significantly and increased personal isometric trunk muscle strength. All spinal orthoses could be valuable instruments to help all requested rehabilitation programs like spine muscles’ strengthening and postural correct behavior, but only when used properly.
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Ophaswongse, Chawin, Rosemarie C. Murray, Victor Santamaria, Qining Wang, and Sunil K. Agrawal. "Human Evaluation of Wheelchair Robot for Active Postural Support (WRAPS)." Robotica 37, no. 12 (June 26, 2019): 2132–46. http://dx.doi.org/10.1017/s0263574719000948.
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SummaryPeople with severe neuromuscular trunk impairment cannot maintain or control upright posture of the upper body in sitting while reaching. Passive orthoses are clinically available to provide support and promote the use of upper extremities in this population. However, these orthoses only position the torso passively without any degree of trunk movement.We introduce for the first time a novel active-assistive torso brace called Wheelchair Robot for Active Postural Support (WRAPS). It consists of two rings over the hips and chest connected by a 2RPS-2UPS parallel robotic device. WRAPS can modulate the displacement of the upper ring and/or the forces applied on the torso through the ring in four degrees-of-freedom (DOF), including rotations and translation in the sagittal and frontal planes.In the present study, we evaluate the design of WRAPS and its functions. Moreover, we discuss the potential effectiveness of WRAPS as a therapeutic robotic tool in people with severe trunk control deficits. The performance of WRAPS was evaluated in seated healthy subjects. Kinematics and surface electromyography (sEMG) were collected when the participants performed selective trunk movements. First, the torso range of motion (tROM) was calculated with WRAPS in transparent mode—zero-force control mode—which was compared with free-guided tROM (no WRAPS) with motion capture system. Second, a position control mode was configured to mobilize the torso along the trajectories obtained with the transparent mode.Our results show that the design of WRAPS suited well the subject’s anthropometrics while supporting the weight of the torso. Importantly, WRAPS can be programmed to replicate the subject’s tROM, without the full activation of torso muscles. This can be critical in individuals with no trunk control. Altogether, these preliminary results indicate the potential applicability of WRAPS to promote active-assistive trunk mobility in people who cannot sit independently because of trunk dysfunction.
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Antonelli, Michele Gabrio, Pierluigi Beomonte Zobel, Francesco Durante, and Terenziano Raparelli. "Additive Manufacturing Applications on Flexible Actuators for Active Orthoses and Medical Devices." Journal of Healthcare Engineering 2019 (March 24, 2019): 1–11. http://dx.doi.org/10.1155/2019/5659801.
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This paper describes the results of research projects developed at the University of L’Aquila by the research group of the authors in the field of biomedical engineering, which have seen an important use of additive manufacturing technologies in the prototyping step and, in some cases, also for the realization of preindustrialization prototypes. For these projects, commercial 3D printers and technologies such as fused deposition modelling (FDM) were used; the most commonly used polymers in these technologies are acrylonitrile butadiene styrene (ABS) and polylactic acid (PLA). The research projects concern the development of innovative actuators, such as pneumatic muscles and soft pneumatic actuators (SPAs), the development of active orthoses, such as a lower limb orthosis and, finally, the development of a variable-stiffness grasper to be used in natural orifice transluminal endoscopic surgery (NOTES). The main aspects of these research projects are described in the paper, highlighting the technologies used such as the finite element analysis and additive manufacturing.
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Dollar, Aaron M., and Hugh Herr. "Lower Extremity Exoskeletons and Active Orthoses: Challenges and State-of-the-Art." IEEE Transactions on Robotics 24, no. 1 (February 2008): 144–58. http://dx.doi.org/10.1109/tro.2008.915453.
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Eby, Wesley R., and Eric Kubica. "Modeling and Control Considerations for Powered Lower-Limb Orthoses: A Design Study for Assisted STS." Journal of Medical Devices 1, no. 2 (September 1, 2006): 126–39. http://dx.doi.org/10.1115/1.2735969.
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Lower-limb orthotic devices may be used to aid or restore mobility to the impaired user. Powered orthoses, in particular, hold great potential in improving the quality of life for individuals with locomotor difficulties because active control of an orthosis can aid limb movement in common tasks that may even be impossible if unaided. However, these devices have primarily remained the products of research labs with the number of effective commercial applications for the laity being nearly nonexistent. This paper provides an overview of the current status of powered orthoses and goes on to discuss key issues in modeling and control of powered orthoses so that designers can have a unified framework in developing user-oriented devices. Key concepts are demonstrated for a powered knee-orthosis intended for assisting the sit-to-stand task, and both pneumatic muscle and dc motor actuators are considered in this conceptual design study. In the final analysis, we conclude that the ability to provide sit-to-stand assistance is profoundly dependent on the type of control signal employed to control the actuator from the user–orthosis interface.
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Lugrís, Urbano, Jairo Carlín, Alberto Luaces, and Javier Cuadrado. "Gait analysis system for spinal cord-injured subjects assisted by active orthoses and crutches." Proceedings of the Institution of Mechanical Engineers, Part K: Journal of Multi-body Dynamics 227, no. 4 (July 25, 2013): 363–74. http://dx.doi.org/10.1177/1464419313494935.
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Wiegand, Roland, Bastian Schmitz, Christian Pylatiuk, and Stefan Schulz. "Mechanical Performance of Actuators in an Active Orthosis for the Upper Extremities." Journal of Robotics 2011 (2011): 1–7. http://dx.doi.org/10.1155/2011/650415.
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The aim of the project OrthoJacket is to develop a lightweight, portable, and active orthosis for the upper limps. The system consists of two special designed fluidic actuators which are used for supporting the elbow function and the internal rotation of the shoulder. A new design of flexible fluid actuator (FFA) is presented that enables more design options of attaching parts, as it is allowed by conventional actuators with a stationary centre of rotation. This advantage and the inherent flexibility and the low weight of this kind of actuator predestined them for the use in exoskeletons, orthoses, and prostheses. The actuator for the elbow generates a maximum torque of 32 Nm; the internal rotation is supported with 7 Nm. Both actuators support the movement with up to 100% of the necessary power. The shells for the arm and forearm are made of carbon reinforced structures in combination with inflatable cushions.
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Pittaccio, Simone, Stefano Viscuso, Elena Beretta, Anna Carla Turconi, and Sandra Strazzer. "Pilot Studies Suggesting New Applications of NiTi in Dynamic Orthoses for the Ankle Joint." Prosthetics and Orthotics International 34, no. 3 (September 2010): 305–18. http://dx.doi.org/10.3109/03093641003702253.
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NiTi is a metal alloy with unconventional functional characteristics: Shape memory and pseudoelasticity. Its use in the field of rehabilitation is very innovative. This work presents applications in lower limb orthotics. Three different devices were assembled and tested: An equinus gait dynamic splint, a compliant ankle positioning brace, and a dual-mode haptic/active exerciser for the dorsiflexors. Results are derived from technical and preclinical trials. The gait splint improves several walking parameters even better than a traditional flexible ankle-foot orthoses (AFO). In particular, it supports mid-stance and propulsion biomechanics and affects physiological activation of tibialis anterior during swing much less than posterior leaf AFO. The haptic/active exerciser, able to provide dorsiflexion through a suitable articular range, could be controlled on the basis of minimal surface electromyo-graphic (sEMG) signals, suggesting its use as an aid for early active workouts as soon as patients start to recover voluntary control of tibialis anterior. Further evidence must be sought in future to confirm for the ankle joint the promising results obtained in repositioning applications in prior upper limb studies. The work done so far on the tested prototypes is encouraging: Material characteristics and dimensioning will be optimized so that customized NiTi devices can be prescribed to best meet individual patients' requirements.
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Davis, Priya Chantal, Timothy Michael Bach, and Darren Mark Pereira. "The Effect of Stance Control Orthoses on Gait Characteristics and Energy Expenditure in Knee-Ankle-Foot Orthosis Users." Prosthetics and Orthotics International 34, no. 2 (June 2010): 206–15. http://dx.doi.org/10.3109/03093641003773189.
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Stance Control knee-ankle foot orthoses (SCO) differ from their traditional locked knee counterparts by allowing free knee flexion during swing while providing stability during stance. It is widely accepted that free knee flexion during swing normalizes gait and therefore improves walking speed and reduces the energy requirements of walking. Limited research has been carried out to evaluate the benefits of SCOs when compared to locked knee-ankle foot orthoses (KAFOs). The purpose of this study was to evaluate the effectiveness of SCOs used for patients with lower limb pathology. Energy expenditure and walking velocity were measured in 10 subjects using an orthosis incorporating a Horton Stance Control knee joint. A GAITRite walkway was used to measure temporospatial gait characteristics. A Cosmed K4b2 portable metabolic system was used to measure energy expenditure and heart rate during walking. Two conditions were tested: Walking with stance control active (stance control) and walking with the knee joint locked. Ten subjects completed the GAITRite testing; nine subjects completed the Cosmed testing. Walking velocity was significantly increased in the stance control condition ( p < 0.001). There was no difference in the energy cost of walking ( p = 0.515) or physiological cost index (PCI) ( p = 0.093) between conditions. This study supports previous evidence that stance control knee-ankle foot orthoses increase walking velocity compared to locked knee devices. Contrary to expectation, the stance control condition did not decrease energy expenditure during walking.
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Larsen, Lars E., Lydia A. Jakobsen, Anne Jensen, Benjamin M. Lambden, Morten R. Sørensen, and Jens Ellrich. "Inhibition of soleus Hoffmann reflex by ankle–foot orthosis application in healthy volunteers." Prosthetics and Orthotics International 39, no. 6 (June 4, 2014): 444–53. http://dx.doi.org/10.1177/0309364614535621.
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Background: An ankle–foot orthosis is suggested to actively assist dorsiflexion of the foot by induction of a positive proprioceptive impact to ankle dorsiflexor muscles. However, an objective proof is missing. Objectives: To assess the proprioceptive impact of an ankle–foot orthosis application by Hoffmann reflex recordings of the soleus muscle under static conditions. It was hypothesized that the use of an ankle–foot orthosis facilitated dorsiflexor motor function and thus a decreased the soleus Hoffmann reflex. Study design Experimental study in healthy volunteers, pre–post test design. Methods: In all, 20 healthy volunteers were enrolled in order to assess the proprioceptive impact of orthosis application. The Hoffmann reflex was recorded before, during, and after orthosis application. Results: Under orthosis application, the Hoffmann reflex significantly decreased as compared to before ( p < 0.05) and after application ( p < 0.05). Conclusions: Findings indicate an inhibition of plantarflexors probably induced by facilitation of ankle dorsiflexors under static conditions. At first glance, it seems that foot orthoses primarily have a stabilizing effect on ankle joints in terms of simple mechanical bandages. However, the present results suggest an additional active impact on proprioceptive control. Clinical relevance The putative neuromodulatory effect on motor control may support the application of such ankle–foot orthoses in, for example, drop foot. Furthermore, the objective assessment of a neurophysiological mode of action of orthoses by Hoffmann reflex recordings might be an appropriate primary outcome parameter in clinical trials.
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Brinckmann, Paul, Burkhard Drerup, Thomas Kretschmer, Daniel Schulze-Frenking, Andre Wohlatz, and Hans Henning Wetz. "Locating the Axis of Rotation when Fitting an Elbow Orthosis: A Comparison of Measurement and Palpation." Prosthetics and Orthotics International 31, no. 1 (March 2007): 36–44. http://dx.doi.org/10.1080/03093640600982354.
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No other previously published studies consider the relative motion of orthotic components positioned on the upper arm and the forearm. This study therefore measured the location and direction of the axis of rotation of an orthotic component fixed to the forearm in relation to an orthotic component fixed to the upper arm, and compared the results with those obtained by palpation. A plane flexion or extension motion of the forearm component in relation to the component on the upper arm can be described as a pure rotation about a fixed centre. However, activation of the biceps or triceps shifts that centre by around 2 cm, due to a displacement of the humerus within the orthotic component on the upper arm. Within a range of approximately 1 cm, the location of the axis of rotation was similar to that obtained by palpation. Neither custom-made plastic/foam orthoses with their hinges aligned to the measured axis, nor orthoses with their hinges aligned to the palpated axis, exhibited any difference in the wearer's comfort. It is concluded that the best choice for the location of the axis of a hinge-type orthosis for the elbow constitutes a compromise between the axes for active flexion and active extension. In view of the large influence that muscle activation has on axis location, errors in the order of 1 cm seem to be negligible when adjusting the hinge of an orthosis in individual cases.
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García-Vallejo, D., J. M. Font-Llagunes, and W. Schiehlen. "Dynamical analysis and design of active orthoses for spinal cord injured subjects by aesthetic and energetic optimization." Nonlinear Dynamics 84, no. 2 (November 27, 2015): 559–81. http://dx.doi.org/10.1007/s11071-015-2507-1.
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Jett, David A., James D. Nichols, and James E. Hines. "Effect of Orthene® on an unconfined population of the meadow vole (Microtus pennsylvanicus)." Canadian Journal of Zoology 64, no. 1 (January 1, 1986): 243–50. http://dx.doi.org/10.1139/z86-038.
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The possible impact on Microtus pennsylvanicus of ground applications of Orthene® insecticide was investigated in old-field habitats in northern Maryland during 1982 and 1983. The treatment grids in 1982 and 1983 were sprayed at 0.62 and 0.82 kg active ingredient/ha, respectively. A capture–recapture design robust to unequal capture probabilities was utilized to estimate population size, survival, and recruitment. Data on reproductive activity and relative weight change were also collected to investigate the effect of the insecticide treatment. There were no significant differences in population size or recruitment between control and treatment grids which could be directly related to the treatment. Survival rate was significantly lower on the treatment grid than on the control grid after spraying in 1983; however, survival rate was higher on the treatment grid after spraying in 1982. Significantly fewer pregnant adults were found on the treatment grid after spraying in 1982, whereas the proportions of voles lactating or with perforate vaginas or open pubic symphyses were slightly higher or remained unchanged during this period. Relative weight change was not affected by the treatment. Results do not indicate any pattern of inhibitory effects from the insecticide treatment. Field application of Orthene® did not have an adverse effect on this Microtus population.
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Redaelli, Davide Felice, Sara Gonizzi Barsanti, Emilia Biffi, Fabio Alexander Storm, and Giorgio Colombo. "Comparison of geometrical accuracy of active devices for 3D orthopaedic reconstructions." International Journal of Advanced Manufacturing Technology 114, no. 1-2 (March 12, 2021): 319–42. http://dx.doi.org/10.1007/s00170-021-06778-0.
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AbstractThe use of 3D digitizing tools is becoming the base for subject-specific products, such as the orthopaedic production process of orthoses and prostheses. This paper aims at comparing the metrological behaviour of low-cost devices (Kinect 1 and 2 by Microsoft, Structure Sensor by Occipital) and high-resolution active sensors (O&P Scan by Rodin4D, NextEngine Ultra HD, Konica Minolta Vivid 9i, GOM ATOS II 400 and Artec Leo) for the survey of human body parts. A calibrated flat plane and a test-field composed of eight calibrated spheres of different radii and placed at different heights were used to evaluate the standard quality parameters (flatness, probing errors in form and size and the standard deviation) for each device as recommended by the VDI/VDE 2634 guidelines. Subsequently, three different parts of a mannequin were surveyed as samples of human body parts. The results demonstrated the higher accuracy of fixed devices with respect to handheld ones, among which Artec Leo and Structure Sensor provided a satisfying level of accuracy for the orthopaedic application. Moreover, the handheld devices enabled performing a fast reconstruction of the mannequin parts in about 20 s, which is acceptable for a person that has to remain as still as possible. For this reason, the Structure Sensor was further tested with five motion approaches which identified that smooth motion provides the lowest deviation and higher reliability. The work demonstrated the appropriateness of handheld devices for the orthopaedic application requirements in terms of speed, accuracy and costs.
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Lourenço, Bruno, Vitorino Neto, and Rafhael de Andrade. "A Concept Design of an Adaptive Tendon Driven Mechanism for Active Soft Hand Orthosis." Proceedings 64, no. 1 (November 21, 2020): 21. http://dx.doi.org/10.3390/iecat2020-08504.
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The Hands exert a vital role in the simplest to most complex daily tasks. Losing the ability to make hand movements, which is usually caused by spinal cord injury or stroke, dramatically impacts the quality of life. In order to counteract this problem, several assisting devices have been proposed, but they still present several usage limitations. The marketable orthoses are generally either the static type or over-expensive active orthosis that cannot perform the same degrees of freedom (DoF) that a hand can do. This paper presents a conceptual design of a tendon-driven mechanism for hand’s active orthosis. This study is a part of an effort to develop an effective and low-cost hand’s orthosis for people with hand paralysis. The tendon design proposed was thought to comply with some requisitions such as lightness and low volume, as well as fit with the biomechanical constraints of the hand joints to enable a comfortable use. The mechanism employs small cursors on the phalanges to allow the tendons to run on the dorsal side and by both sides of the fingers, allowing 2 DoF for each finger, and one extra tendon enlarges the hands’ adduction nuances. With this configuration, it is simple enough to execute the flexion and extension movements, which are the most used movements in daily actives, using one single DC actuator for one DoF to reduce manufacturing costs, or with more DC actuators to enable more natural hand coordination. This system of actuation is suitable to create soft exoskeletons for hands easily embedded into 3D printed parts, which could be merged over statics thermoplastic orthosis. The final orthosis design allows dexterous finger movements and force to grasp objects and perform tasks comfortably.
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Du, Gang, Jinchen Zeng, Cheng Gong, and Enhao Zheng. "Locomotion Mode Recognition with Inertial Signals for Hip Joint Exoskeleton." Applied Bionics and Biomechanics 2021 (May 22, 2021): 1–11. http://dx.doi.org/10.1155/2021/6673018.
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Recognizing locomotion modes is a crucial step in controlling lower-limb exoskeletons/orthoses. Our study proposed a fuzzy-logic-based locomotion mode/transition recognition approach that uses the onrobot inertial sensors for a hip joint exoskeleton (active pelvic orthosis). The method outputs the recognition decisions at each extreme point of the hip joint angles purely relying on the integrated inertial sensors. Compared with the related studies, our approach enables calibrations and recognition without additional sensors on the feet. We validated the method by measuring four locomotion modes and eight locomotion transitions on three able-bodied subjects wearing an active pelvic orthosis (APO). The average recognition accuracy was 92.46% for intrasubject crossvalidation and 93.16% for intersubject crossvalidation. The average time delay during the transitions was 1897.9 ms (28.95% one gait cycle). The results were at the same level as the related studies. On the other side, the study is limited in the small sample size of the subjects, and the results are preliminary. Future efforts will be paid on more extensive evaluations in practical applications.
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Pina, Daniel F., António A. Fernandes, Renato M. Natal Jorge, and Joaquim Gabriel Mendes. "A STATISTICAL STUDY REGARDING THE STATE-OF-THE-ART OF ACTIVE MOTION-ORIENTED ASSISTIVE DEVICES." Biomedical Engineering: Applications, Basis and Communications 26, no. 03 (March 17, 2014): 1450047. http://dx.doi.org/10.4015/s1016237214500471.
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Active orthoses and powered exoskeletons, among other denominations, are devices made to attach to one or several human limbs in order to assist their movement through means of electronically controlled actuators and/or mechanical brakes. The technology developed for these devices can be used in many situations, such as rehabilitation, industrial and general strength enhancement purposes. In order to create a comprehensive state-of-the-art work, several online scientific databases were used to gather articles related to this subject, using the terms "Exoskeleton", "Orthosis", "Orthesis" and "Rehabilitation Robot". This survey resulted in the retrieval of 169 articles. Afterward, a custom database was created to contain, organize and cross the information gathered from each relevant article. This work presents statistical results regarding research development localization, actuation technologies and the man-machine interface. Out of the 123 identified projects/prototypes, 89 are primarily dedicated to rehabilitation activities and 14 refer to strength enhancement. From 2005 onwards, the results show that the DC Motor is the most used, being present in 56% of all the projects and in 47% of mobile devices with weight constraints. The electromyographic sensor is the most used sensor type. By grouping all sensors into physical variable classes, the force-related sensors show a higher number of occurrences. Regarding the localization of the research and development over these devices, the United States of America is the country with the largest dedication, followed by Japan.
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Wong, M. S., and W. C. Liu. "Critical review on non-operative management of adolescent idiopathic scoliosis." Prosthetics and Orthotics International 27, no. 3 (December 2003): 242–53. http://dx.doi.org/10.1080/03093640308726688.
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There are a number of different non-operative interventions which aim to control moderate adolescent idiopathic scoliosis (AIS) from progression. Clinicians may find difficulties in the selection of appropriate interventions for AIS. A comprehensive literature review was carried out to study all contemporary non-operative interventions, it was noted that rigid spinal orthoses apparently give more curve control; however, it would compromise the patient's quality of life via those inevitable factors - physical constraint, poor acceptance and psychological disturbance. There is a trend to develop more effective, acceptable and user-friendly interventions. Under such an aspiration, the theories and clinical evidence of different interventions should be developed along the clinical pathway of early intervention with reliable indicators/predictors, patient's active participation, dynamic control mechanism, holistic psychological and psychosocial considerations, and effective and long-lasting outcome.
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Scirè, Vincenzo, Elisa Leporati, Ilaria Teobaldi, Laura Ambrosini Nobili, Loredana Rizzo, and Alberto Piaggesi. "Effectiveness and Safety of Using Podikon Digital Silicone Padding in the Primary Prevention of Neuropathic Lesions in the Forefoot of Diabetic Patients." Journal of the American Podiatric Medical Association 99, no. 1 (January 1, 2009): 28–34. http://dx.doi.org/10.7547/0980028.
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Background: In diabetic patients with complications from peripheral neuropathy, the hyperpressure areas can rapidly lead to ulcerative lesions in the absence of protective sensation. Partial digital silicone orthoses could provide an innovative and functional therapeutic solution in the management of preulcerative areas of the forefoot in neuropathic diabetic patients. We clinically tested this hypothesis. Methods: Digital off-loading silicone padding was prepared for 89 neuropathic patients with deformities and localized hyperkeratosis in the forefoot. After 3 months and in basal conditions, the number of areas of hyperkeratosis was evaluated together with the hardness of the skin, the number of active lesions, and any adverse events associated with use of the orthosis. The patients were compared to a control group of 78 randomized patients undergoing standard therapy. In a subgroup of 10 patients, a static and dynamic biomechanical evaluation was also conducted with a computerized podobarometric platform. Results: Both the number of lesions and the prevalence of hyperkeratosis and skin hardness were significantly lower (P < .01) in the group treated with the silicone orthoses than in the control group. No adverse events were reported during the 3 months of observation. The podobarometric analysis highlighted a significant (P < .001) reduction of peak pressure in the areas undergoing orthotic correction. Conclusions: Silicone padding is effective and safe in the prevention of lesions in neuropathic patients at high risk of ulceration and significantly reduces the incidence of new lesions in the 3-month follow-up period compared to standard treatment. (J Am Podiatr Med Assoc 99(1): 28–34, 2009)
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Arazpour, Mokhtar, Fardin Ahmadi, Monireh Ahmadi Bani, Stephen William Hutchins, Mahmood Bahramizadeh, Farhad Tabatabai Ghomshe, and Reza Vahab Kashani. "Gait evaluation of new powered knee–ankle–foot orthosis in able-bodied persons: A pilot study." Prosthetics and Orthotics International 38, no. 1 (May 9, 2013): 39–45. http://dx.doi.org/10.1177/0309364613486917.
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Background: Knee–ankle–foot orthoses are utilized for walking by patients with lower limb weakness. However, they may be rejected by patients due to the lack of knee flexion available when using them for walking activities. Aim: The aim of this study was to perform a pilot study investigating the effect of a new powered knee–ankle–foot orthosis on walking in healthy persons before testing with patients with lower limb weakness. Methods: Walking evaluation was performed on five healthy subjects (mean age: 26 ± 5.6 years). Walking trials were randomly performed in three test conditions: normal walking without an orthosis, walking with a conventional knee–ankle–foot orthosis unilaterally, and also with a new powered knee–ankle–foot orthosis applied to the same leg. Results: The means of walking speed, cadence, and knee flexion during swing and step length were all decreased. Compensatory motions were increased by both orthoses compared to normal walking. More knee flexion was observed in both swing and stance phases when walking with the powered knee–ankle–foot orthosis compared to the conventional knee–ankle–foot orthosis. Conclusion: The results demonstrated the potential of a powered orthosis in providing improvements in gait parameters compared to a conventional device in healthy subjects but are yet untested in subjects with lower limb weakness. Clinical relevance The results of this study demonstrated that a powered knee–ankle–foot orthosis could lock the knee during stance and provide active knee flexion during swing to potentially reduce the tripping during ambulation.
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Scheer, Nicole A., Lucas R. Alstat, and Robert S. Van Zant. "Astym Therapy Improves Bilateral Hamstring Flexibility and Achilles Tendinopathy in a Child with Cerebral Palsy: A Retrospective Case Report." Clinical Medicine Insights: Case Reports 9 (January 2016): CCRep.S40623. http://dx.doi.org/10.4137/ccrep.s40623.
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Purpose The purpose of this case report was to describe the use of Astym therapy to improve hamstring flexibility and Achilles tendinopathy in a child with cerebral palsy. Case Description An eight-year-old female with cerebral palsy was referred to physical therapy for the treatment of bilateral hamstring inflexibility and Achilles tendinopathy. Treatment focused on an Astym therapy protocol of eccentric exercise, stretching, active and passive range of motion, gait training, and a home exercise program. The patient underwent a total of 11 physical therapy treatment sessions. Outcomes At the conclusion of treatment, the patient demonstrated improved resting muscle tone in bilateral lower extremities with active 90/90 hamstring flexibility measured at 165° and ankle dorsiflexion active range of motion of 5° without pain at 0° and 90° knee flexion. The patient exhibited an improved gait pattern with even stride length and diminished genu recurvatum, decreased pain with standing and walking, discontinued use of ankle–foot orthoses, and improved activity tolerance and overall function for daily activities. Discussion The results of this case report indicate that physical therapy rehabilitation utilizing an Astym therapy protocol can successfully achieve gains in flexibility and strength and allow for improved function of bilateral lower extremities in a patient with cerebral palsy. Conclusion Based on the findings of this case report, clinicians should consider the use of Astym therapy in treating musculoskeletal soft tissue dysfunction in pediatric patients with cerebral palsy.
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Ward, Charles R., Damon McGinn, Suzanne Walters, and Dawn Van Leeuwen. "Control of Rough Harvester Ants in Low Water-Use Urban Parks, New Mexico, 1994." Arthropod Management Tests 21, no. 1 (January 1, 1996): 390. http://dx.doi.org/10.1093/amt/21.1.390.
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Abstract Rough harvester ant control was evaluated in an urban forest park in the city of Albuquerque. Treatments were randomized within blocks and replicated 4 times. Ant mounds were checked for activity, selected and marked, and counts made of active ants on and in the clear area of each mound prior to treatment. Treatments were made on 2 June under sunny weather conditions while ants were active (7:30-11:30 a.m.). Broadcast granular treatments were made by applying measured amounts to a 100 ft2 area around each mound with an Ortho® Whirly-Bird® granular applicator. The broadcast spray treatment was applied with a CO2 pressured back-pack, small-plot sprayer with 6 X-4 tips spaced 20 inches apart. At 60 psi and 4 mph the sprayer delivered 5.63 gal of finished spray per acre. However, the 10 ft by 10 ft (100 ft2) area around each plot was sprayed in each direction to give a spray volume of 11.3 gal per acre. Dry Mound (M) treatments were made by sprinkling measured amounts of each form on the mound area around the entrance hole only. The Orthene 75SP mound drench was applied in 3.78 liters of water sprinkled over a 0.37 m2 area around the center of each mound.
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Nubé, Vanessa L., Lynda Molyneaux, and Dennis K. Yue. "Biomechanical Risk Factors Associated with Neuropathic Ulceration of the Hallux in People with Diabetes Mellitus." Journal of the American Podiatric Medical Association 96, no. 3 (May 1, 2006): 189–97. http://dx.doi.org/10.7547/0960189.
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In this study of people with diabetes mellitus and peripheral neuropathy, it was found that the feet of patients with a history of hallux ulceration were more pronated and less able to complete a single-leg heel rise compared with the feet of patients with a history of ulceration elsewhere on the foot. The range of active first metatarsophalangeal joint dorsiflexion was found to be significantly lower in the affected foot. Ankle dorsiflexion, subtalar joint range of motion, and angle of gait differed from normal values but were similar to those found in other studies involving diabetic subjects and were not important factors in the occurrence of hallux ulceration. These data indicate that a more pronated foot type is associated with hallux ulceration in diabetic feet. Further studies are required to evaluate the efficacy of footwear and orthoses in altering foot posture to manage hallux ulceration. (J Am Podiatr Med Assoc 96(3): 189–197, 2006)
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DeCarlo, Mark, Kathy Malone, Brad Gerig, and Mike Hunker. "Evaluation of Shoulder Instability Braces." Journal of Sport Rehabilitation 5, no. 2 (May 1996): 143–50. http://dx.doi.org/10.1123/jsr.5.2.143.
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The comparative abilities of three types of shoulder orthoses to limit motion following isokinetic exercise were studied on 10 male subjects. Maximum active abduction, forward flexion, and external rotation were measured under a control and three braced conditions. Braced conditions included Sawa, Duke Wyre, and Shoulder Subluxation Inhibitor. Subjects performed 10 repetitions each of flexion/extension and abduction/adduction exercise at isokinetic speeds of 120 and 180°/s. Data were analyzed using a pairedt-test and ANOVA. Significant differences were found for each of the devices in pre/post gonio-metric measurements of forward shoulder flexion. Only the Sawa brace demonstrated significant pre/post change for shoulder abduction. No significant differences were detected in any of the devices for external rotation. A trainer who is selecting a motion-limiting shoulder device for an athlete returning to competition following injury should consider the “loosening” effect that may occur during activity as well as the desire for overhead motion.
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Miller, Mandi M., Jessica M. Ray, and R. Scott Van Zant. "The Effects of Astym Therapy® on a Child With Spastic Diplegic Cerebral Palsy." Clinical Medicine Insights: Case Reports 10 (January 1, 2017): 117954761774699. http://dx.doi.org/10.1177/1179547617746992.
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Purpose: Limited research exists regarding use of Astym® therapy with neurologic conditions. The purpose of this case was to describe using Astym therapy in treating spastic diplegic cerebral palsy (CP). Case description: A 6-year-old female was treated more than 9 months (36 sessions) for decreased flexibility, muscle weakness, spasticity, and abnormal gait. Examination findings: Gait performed with articulated ankle-foot orthoses (75% of the time) or foot orthosis (25%); lack of active dorsiflexion (DF); lack of heel strike during gait; spasticity in hamstrings, gastrocnemius, hip adductors; hamstring flexibility (90/90 test position) 50° right and 60° left; gastrocnemius flexibility neutral bilaterally; and Peabody Developmental Motor Scales, second edition (PDMS-2) age equivalence (in months) 23 locomotion, 25 object manipulation, and 21 stationary tasks. Therapeutic interventions included Astym therapy, stretching, strengthening, neuromuscular reeducation, and gait training. Outcomes: At 6 months, flexibility improved bilaterally to 10° past neutral in gastrocnemius and 0° in hamstrings. The PDMS-2 age equivalence scores were 27 locomotion, 32 object manipulation, and 28 stationary tasks. At discharge, patient ambulated full-time with foot orthosis, exhibiting improved stride length bilaterally with active ankle DF to initiate heel strike. Spasticity was unchanged. Discussion: Astym therapy was effective in treating a child with spastic diplegic CP, resulting in enhanced strength, flexibility, and gait.
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Aole, Sumit, Irraivan Elamvazuthi, Laxman Waghmare, Balasaheb Patre, and Fabrice Meriaudeau. "Improved Active Disturbance Rejection Control for Trajectory Tracking Control of Lower Limb Robotic Rehabilitation Exoskeleton." Sensors 20, no. 13 (June 30, 2020): 3681. http://dx.doi.org/10.3390/s20133681.
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Neurological disorders such as cerebral paralysis, spinal cord injuries, and strokes, result in the impairment of motor control and induce functional difficulties to human beings like walking, standing, etc. Physical injuries due to accidents and muscular weaknesses caused by aging affect people and can cause them to lose their ability to perform daily routine functions. In order to help people recover or improve their dysfunctional activities and quality of life after accidents or strokes, assistive devices like exoskeletons and orthoses are developed. Control strategies for control of exoskeletons are developed with the desired intention of improving the quality of treatment. Amongst recent control strategies used for rehabilitation robots, active disturbance rejection control (ADRC) strategy is a systematic way out from a robust control paradox with possibilities and promises. In this modern era, we always try to find the solution in order to have minimum resources and maximum output, and in robotics-control, to approach the same condition observer-based control strategies is an added advantage where it uses a state estimation method which reduces the requirement of sensors that is used for measuring every state. This paper introduces improved active disturbance rejection control (I-ADRC) controllers as a combination of linear extended state observer (LESO), tracking differentiator (TD), and nonlinear state error feedback (NLSEF). The proposed controllers were evaluated through simulation by investigating the sagittal plane gait trajectory tracking performance of two degrees of freedom, Lower Limb Robotic Rehabilitation Exoskeleton (LLRRE). This multiple input multiple output (MIMO) LLRRE has two joints, one at the hip and other at the knee. In the simulation study, the proposed controllers show reduced trajectory tracking error, elimination of random, constant, and harmonic disturbances, robustness against parameter variations, and under the influence of noise, with improvement in performance indices, indicates its enhanced tracking performance. These promising simulation results would be validated experimentally in the next phase of research.
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Arazpour, Mokhtar, Ahmad Chitsazan, Monireh Ahmadi Bani, Gholamreza Rouhi, Farhad Tabatabai Ghomshe, and Stephen W. Hutchins. "The effect of a knee ankle foot orthosis incorporating an active knee mechanism on gait of a person with poliomyelitis." Prosthetics and Orthotics International 37, no. 5 (January 17, 2013): 411–14. http://dx.doi.org/10.1177/0309364612469140.
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Background: The aim of this case study was to identify the effect of a powered stance control knee ankle foot orthosis on the kinematics and temporospatial parameters of walking by a person with poliomyelitis when compared to a knee ankle foot orthosis. Case description and methods: A knee ankle foot orthosis was initially manufactured by incorporating drop lock knee joints and custom molded ankle foot orthoses and fitted to a person with poliomyelitis. The orthosis was then adapted by adding electrically activated powered knee joints to provide knee extension torque during stance and also flexion torque in swing phase. Lower limb kinematic and kinetic data plus data for temporospatial parameters were acquired from three test walks using each orthosis. Findings and outcomes: Walking speed, step length, and vertical and horizontal displacement of the pelvis decreased when walking with the powered stance control knee ankle foot orthosis compared to the knee ankle foot orthosis. When using the powered stance control knee ankle foot orthosis, the knee flexion achieved during swing and also the overall pattern of walking more closely matched that of normal human walking. The reduced walking speed may have caused the smaller compensatory motions detected when the powered stance control knee ankle foot orthosis was used. Conclusion: The new powered SCKAFO facilitated controlled knee flexion and extension during ambulation for a volunteer poliomyelitis person. Clinical relevance The powered stance control knee ankle foot orthosis has the potential to improve knee joint kinematics in persons with poliomyelitis when ambulating.
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Armbruster, Pascal, Yannick Oster, Marcel Vogt, and Christian Pylatiuk. "Design of a mechanism for converting the energy of knee motions by using electroactive polymers." Biomedical Engineering / Biomedizinische Technik 62, no. 6 (November 27, 2017): 643–52. http://dx.doi.org/10.1515/bmt-2016-0138.
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AbstractHarvesting energy from human body motions has become a promising option to prolong battery life for powering medical devices for autonomy. Up to now, different generating principles including dielectric electroactive polymers (DEAPs) have been suggested for energy conversion. However, there is a lack of mechanisms that are specifically designed to convert energy with DEAPs. In a proof of concept study, a mechanical system was designed for stretching DEAPs in those phases of the gait cycle, in which the muscles mainly perform negative work. Rotational movements of the knee joint are transformed into linear movements by using a cable pull. The DEAP can be charged during the stretching phase and discharged during releasing and allows for the conversion of kinetic energy into electric energy. To evaluate the concept, tests were conducted. It was found that the developed body energy harvesting (BEH) system has a performance in the range of 24–40 μW at normal walking speed. The converted energy is sufficient for powering sensors in medical devices such as active orthoses or prostheses.
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Seel, Thomas, David Graurock, and Thomas Schauer. "Realtime assessment of foot orientation by Accelerometers and Gyroscopes." Current Directions in Biomedical Engineering 1, no. 1 (September 1, 2015): 446–69. http://dx.doi.org/10.1515/cdbme-2015-0112.
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AbstractFoot orientation can be assessed in realtime by means of a foot-mounted inertial sensor. We consider a method that uses only accelerometer and gyroscope readings to calculate the foot pitch and roll angle, i.e. the foot orientation angle in the sagittal and frontal plane, respectively. Since magnetometers are avoided completely, the method can be used indoors as well as in the proximity of ferromagnetic material and magnetic disturbances. Furthermore, we allow for almost arbitrary mounting orientation in the sense that we only assume one of the local IMU coordinate axes to lie in the sagittal plane of the foot. The method is validated with respect to a conventional optical motion capture system in trials with transfemoral amputees walking with shoes and healthy subjects walking barefoot, both at different velocities. Root mean square deviations of less than 4° are found in all scenarios, while values near 2° are found in slow shoe walking. This demonstrates that the proposed method is suitable for realtime application such as the control of FES-based gait neuroprostheses and active orthoses.
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Wong, M. S., A. F. T. Mak, K. D. K. Luk, J. H. Evans, and B. Brown. "Effectiveness of audio-biofeedback in postural training for adolescent idiopathic scoliosis patients." Prosthetics and Orthotics International 25, no. 1 (April 2001): 60–70. http://dx.doi.org/10.1080/03093640108726570.
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The possibility of using learned physiological responses in control of progressive adolescent idiopathic scoliosis (AIS) was investigated. Sixteen (16) AIS patients with progressing or high-risk curves (Cobb's angle between 25° and 35° at start and reducible by lateral bending) were fitted with a device with tone alarm for poor posture. In the first 18 months of application, 3 patients defaulted and 4 showed curve progression > 10° (2 changed to rigid spinal orthoses and 2 underwent surgery). The curves for the other 9 patients were kept under control (within ±5° of Cobb's angle) and 5 of them have reached skeletal maturity and terminated the application. The remaining 4 patients were still using the devices until skeletal maturity or curve progression. The curve control rate was 69%. A long-lasting active spinal control could be achieved through the patient's own spinal muscles. Nevertheless, before the postural training device could become a treatment modality, a long-term study for more AIS patients was necessary. This project is ongoing in the Duchess of Kent Children's Hospital, Sandy Bay, Hong Kong.
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Calanca, A., S. Piazza, and P. Fiorini. "A Motor Learning Oriented, Compliant and Mobile Gait Orthosis." Applied Bionics and Biomechanics 9, no. 1 (2012): 15–27. http://dx.doi.org/10.1155/2012/123579.
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People affected by Cerebral Palsy suffer from physical disabilities due to irreversible neural impairment since the very beginning of their life. Difficulties in motor control and coordination often relegate these patients to the use of a wheelchair and to the unavoidable upcoming of disuse syndromes. As pointed out in recent literature Damiano [7] physical exercise, especially in young ages, can have a deep impact on the patient health and quality of life. For training purposes is very important to keep an upright position, although in some severe cases this is not trivial. Many commercial mobile orthoses are designed to facilitate the standing, but not all the patients are able to deploy them. ARGO, the Active Reciprocated Gait Orthosis we developed, is a device that overcomes some of the limitations of these devices. It is an active device that is realized starting from a commercial reciprocated Gait Orthosis applying sensors and actuators to it. With ARGO we aim to develop a device for helping limbs in a non-coercive way accordingly to user’s intention. In this way patients can drive the orthosis by themselves, deploying augmented biofeedback over movements. In fact Cerebral Palsy patients usually have weak biofeedback mechanisms and consequently are hardly inclined to learn movements. To achieve this behavior ARGO deploys a torque planning algorithm and a force control system. Data collected from a single case of study shows benefits of the orthosis. We will show that our test patient reaches complete autonomous walking after few hour of training with prototype.
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van Netten, Jaap J., Anthony Francis, Ashley Morphet, Lauren V. Fortington, Klaas Postema, and Anita Williams. "Communication techniques for improved acceptance and adherence with therapeutic footwear." Prosthetics and Orthotics International 41, no. 2 (June 8, 2016): 201–4. http://dx.doi.org/10.1177/0309364616650080.
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Background and aim: Clients’ acceptance and adherence with orthoses can be influenced by a clinician’s communication skills. In this clinical note, we describe two communication techniques, in the context of therapeutic footwear. Technique: Person-centred communication involves engaging with and listening to the attitudes of the client towards their condition, as well as discussing acceptance and expectations, in a structured consultation. Building a relationship is crucial and requires clients to feel heard and understood. An important influence on the acceptance and adherence is that a client makes a conscious decision to receive their device. This active receipt can be facilitated through shared decision making, wherein clinicians give clear, relevant and meaningful examples, based on clinical evidence, and ensure this is understood. Discussion: Two communication techniques for clinicians providing therapeutic footwear are described. These can be adapted for use with provision of other assistive technologies to improve client acceptance and adherence. Clinical relevance Small changes in how clinicians communicate to their clients in daily practice can have a big influence on the subsequent acceptance and adherence with therapeutic footwear and indeed other prescribed assistive technologies.
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Weber, Michelle L., Kelsey J. Picha, and Tamara C. Valovich McLeod. "Heel Pain in Youth: A Guide to Potential Management Strategies." International Journal of Athletic Therapy and Training 19, no. 5 (September 2014): 44–52. http://dx.doi.org/10.1123/ijatt.2014-0012.
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Calcaneal apophysitis, or Sever's disease, is common among physically active youth between the ages of 8-15. This condition is related to skeletal growth during maturation and relief often comes once growth is complete. However, it is not feasible to limit participation in physical activity until growth ceases; therefore, it is important to determine effective interventions to regulate pain while continuing participation. A search of the literature yielded nine studies that met the inclusion criteria and were included for data analysis. Within these publications, many treatment methods were suggested, including nonsteroidal anti-inflammatory drugs (NSAIDs), taping, orthoses, heel lifts, stretching, activity modification, and ice. However, few of the treatment options were compared with a control group. Analysis revealed that clinicians should provide treatments with caution when treating patients suffering from Sever's disease, understanding that strong evidence is not supportive of one treatment option alone. Data are limited for individual treatments related to calcaneal apophysitis and more research in this area is warranted. Clinicians should work with patients on an individual basis to determine if one form of treatment provides a reduction of pain and allows that patient to continue with activity.
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Manocha, Ranita H. K., James A. Johnson, and Graham J. W. King. "The Effectiveness of a Hinged Elbow Orthosis in Medial Collateral Ligament Injuries: An In Vitro Biomechanical Study." American Journal of Sports Medicine 47, no. 12 (August 28, 2019): 2827–35. http://dx.doi.org/10.1177/0363546519870517.
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Background: Medial collateral ligament (MCL) injuries are common after elbow trauma and in overhead throwing athletes. A hinged elbow orthosis (HEO) is often used to protect the elbow from valgus stress early after injury and during early return to play. However, there is minimal evidence regarding the efficacy of these orthoses in controlling instability and their influence on long-term clinical outcomes. Purpose: (1) To quantify the effect of an HEO on elbow stability after simulated MCL injury. (2) To determine whether arm position, forearm rotation, and muscle activation influence the effectiveness of an HEO. Study Design: Controlled laboratory study. Methods: Seven cadaveric upper extremity specimens were tested in a custom simulator that enabled elbow motion via computer-controlled actuators and motors attached to relevant tendons. Specimens were examined in 2 arm positions (dependent, valgus) and 2 forearm positions (pronation, supination) during passive and simulated active elbow flexion while unbraced and then while braced with an HEO. Testing was performed in intact elbows and repeated after simulated MCL injury. An electromagnetic tracking device measured valgus angulation as an indicator of elbow stability. Results: When the arm was dependent, the HEO increased valgus angle with the forearm in pronation (+1.0°± 0.2°, P = .003) and supination (+1.5°± 0.0°, P = .006) during active motion. It had no significant effect on elbow stability during passive motion. In the valgus position, the HEO had no effect on elbow stability during passive or active motion in pronation and supination. With the arm in the valgus position with the HEO, muscle activation reduced instability during pronation (–10.3°± 2.5°, P = .006) but not supination ( P = .61). Conclusion: In this in vitro study, this HEO did not enhance mechanical stability when the arm was in the valgus and dependent positions after MCL injury. Clinical Relevance: After MCL injury, an HEO likely does not provide mechanical elbow stability during rehabilitative exercises or when the elbow is subjected to valgus stress such as occurs during throwing.
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Arazpour, Mokhtar, Alireza Moradi, Mohammad Samadian, Mahmood Bahramizadeh, Mahmoud Joghtaei, Monireh Ahmadi Bani, Stephen W. Hutchins, and Mohammad A. Mardani. "The influence of a powered knee–ankle–foot orthosis on walking in poliomyelitis subjects: A pilot study." Prosthetics and Orthotics International 40, no. 3 (July 16, 2015): 377–83. http://dx.doi.org/10.1177/0309364615592703.
Full textAbstract:
Background:Traditionally, the anatomical knee joint is locked in extension when walking with a conventional knee–ankle–foot orthosis. A powered knee–ankle–foot orthosis was developed to provide restriction of knee flexion during stance phase and active flexion and extension of the knee during swing phase of gait.Objective:The purpose of this study was to determine differences of the powered knee–ankle–foot orthosis compared to a locked knee–ankle–foot orthosis in kinematic data and temporospatial parameters during ambulation.Study design:Quasi—experimental design.Methods:Subjects with poliomyelitis (n = 7) volunteered for this study and undertook gait analysis with both the powered and the conventional knee–ankle–foot orthoses. Three trials per orthosis were collected while each subject walked along a 6-m walkway using a calibrated six-camera three-dimensional video-based motion analysis system.Results:Walking with the powered knee–ankle–foot orthosis resulted in a significant reduction in both walking speed and step length (both 18%), but a significant increase in stance phase percentage compared to walking with the conventional knee–ankle–foot orthosis. Cadence was not significantly different between the two test conditions ( p = 0.751). There was significantly higher knee flexion during swing phase and increased hip hiking when using the powered orthosis.Conclusion:The new powered orthosis permitted improved knee joint kinematic for knee–ankle–foot orthosis users while providing knee support in stance and active knee motion in swing in the gait cycle. Therefore, the new powered orthosis provided more natural knee flexion during swing for orthosis users compared to the locked knee–ankle–foot orthosis.Clinical relevanceThis orthosis has the potential to improve knee joint kinematics and gait pattern in poliomyelitis subjects during walking activities.
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Arazpour, Mokhtar, Ahmad Chitsazan, Stephen W. Hutchins, Farhad Tabatabai Ghomshe, Mohammad Ebrahim Mousavi, Esmaeil Ebrahimi Takamjani, Gholamreza Aminian, Mehdi Rahgozar, and Monireh Ahmadi Bani. "Evaluation of a novel powered hip orthosis for walking by a spinal cord injury patient: a single case study." Prosthetics and Orthotics International 36, no. 1 (January 10, 2012): 105–12. http://dx.doi.org/10.1177/0309364611431482.
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Background: The aim of this case study was to identify the effect of a powered hip orthosis on the kinematics and temporal-spatial parameters of walking by a patient with spinal cord injury (SCI).Case Description and Methods: Two orthoses were evaluated while worn by an incomplete SCI subject with a T-8level of injury. Gait evaluation was performed when walking with an Isocentric Reciprocating Gait Orthosis (IRGO) and compared to that demonstrated by a newly powered version of the orthosis; based on the IRGO superstructure but incorporating powered hip joints using an electrically motorized actuator that produced active hip joint extension and flexion.Findings and Outcomes: The powered hip orthosis, when compared to the IRGO, increased the speed of walking, the step length and also the cadence demonstrated by this subject. Vertical and horizontal compensatory motions with new orthosis decreased. Hip angles when walking with this orthosis were comparative to those demonstrated by normal walking patterns.Conclusions: The hip actuator produced positive effects on the kinematics and temporal-spatial parameters of gait during level-ground walking trials, resulting in an alternative approach to walking by SCI patients.Clinical relevanceThis orthosis has the potential to improve hip joint kinematics, the temporal-spatial parameters of gait in SCI patients walking.
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Uğurlu, Ümit, Mehmed Özkan, and Huri Özdoğan. "The Development of a New Orthosis (Neuro-Orthosis) for Patients with Carpal Tunnel Syndrome: Its Effect on the Function and Strength of the Hand." Prosthetics and Orthotics International 32, no. 4 (January 2008): 403–21. http://dx.doi.org/10.1080/03093640802366166.
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Static wrist orthoses (SWOs) are used in the treatment of carpal tunnel syndrome (CTS) with some drawbacks. As an alternate approach to SWOs, an active closed-loop wrist control strategy based on the principles of functional electrical stimulation was proposed to limit wrist movements. The purpose of the study was to determine whether the proposed ‘neuro-orthosis’ (NeO) system resulted in less restriction in the hand compared to clinically accepted custom-made SWOs while limiting the wrist movements. A case-control study was designed to determine the specific effects of the system on patients with CTS. A total of 24 right-handed female volunteers (12: CTS, 12: healthy) participated in the study. Function, dexterity, and strengths were measured under three different testing conditions: without orthosis, with SWO, and with the NeO system. Maximum angles in one subtest while the NeO system was on and off and general discomfort levels in SWO and NeO test conditions were recorded. The NeO system resulted in less restriction with respect to SWO and provided considerable angular limitation compared to placebo. It was concluded that the proposed prototype control system can be a good candidate to limit the wrist movements in place of SWOs with a better degree of freedom in patients with CTS.