The Experts below are selected from a list of 297 Experts worldwide ranked by ideXlab platform
Celene Moorer - One of the best experts on this subject based on the ideXlab platform.
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Evaluation and comparison of á priori alignment techniques for transtibial prostheses in the developing world – Field trial in Nicaragua
Disability and rehabilitation. Assistive technology, 2009Co-Authors: Kim D. Reisinger, Hector R. Casanova, Celene MoorerAbstract:Purpose. The purpose of this study was to transfer three simplified alignment techniques to prosthetic technicians in a developing country through training materials and a hands-on training workshop, and to subsequently evaluate the efficacy of the alignment systems in producing acceptably aligned monolimb prostheses.Method. Prosthetists utilized the anatomically-based-alignment (ABA)-standing, ABA-supine and vertical alignment axis (VAA) alignment systems to produce three monolimbs for each of 30 healthy and active transtibial amputees. Prosthetists assessed all three monolimbs for each subject in both static and gait conditions to determine which monolimb had the best alignment and produced the best functional gait. Subjects also selected the monolimb which they believed had the best alignment; subjects utilized each monolimb for a 1-month home assessment.Results. Twenty-eight subjects completed the study. Eighty-four monolimbs were evaluated by the Prosthetists and the subjects. A few monolimbs had min...
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Comparison of á priori alignment techniques for transtibial prostheses in the developing world - pilot study.
Disability and rehabilitation, 2007Co-Authors: Kim D. Reisinger, Hector R. Casanova, Celene MoorerAbstract:Purpose. The purpose of this study was to evaluate three alignment systems based on two alignment theories that can be utilized in the fabrication of monolimb prostheses that have acceptable alignment. A second goal was to assess the feasibility of technology transfer for providing prosthetic services to remote areas of landmine-affected countries.Method. Five Prosthetists and five healthy transtibial amputees participated in the study. Each Prosthetist was trained and then used each of the three systems to capture alignment measurements for one subject. Three monolimbs identified as X, Y and Z were fabricated for each subject and assessed during clinical static and dynamic gait conditions. Training materials and methods were also evaluated.Results. All three systems captured acceptable alignments fairly well, although the two systems that incorporated weight-bearing into the alignment process had slightly better outcomes. Each system has its own advantages in terms of ease of use, required equipment, and...
David A. Boone - One of the best experts on this subject based on the ideXlab platform.
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Prosthetists and orthotists: An evolution from mechanic to clinician.
Prosthetics and orthotics international, 2020Co-Authors: David A. BooneAbstract:Fifty years ago, the International Society for Prosthetics and Orthotics was founded in recognition that this unique niche in rehabilitation would benefit from multidisciplinary interactions between specialists in engineering, therapy, and medicine.Since then, field evolved from having a craft orientation toward a technology and clinical specialty. This anniversary provides an opportunity to look back on advances in prosthetics and orthotics, and the clear impact they have had on changing the skills needed by the Prosthetist/orthotist as new technology and techniques have emerged. The balance has clearly shifted from mechanical skills to clinical care. The training and skills of the Prosthetist/orthotist remain unique and valued in the rehabilitation team, and the primary motivation remains the same as it has been since the creation of the International Society for Prosthetics and Orthotics: the application of external devices where they are suitable to address the many varied needs of persons with disability. This historical perspective puts into context why and how the profession has changed, while also reinforcing that it is the goals set for restoring patient functions that best defines what it is to be a Prosthetist/orthotist, not the means we use.
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Dynamic alignment of transtibial prostheses through visualization of socket reaction moments.
Prosthetics and orthotics international, 2014Co-Authors: Toshiki Kobayashi, Michael S. Orendurff, David A. BooneAbstract:Background and aim: Dynamic alignment of transtibial prostheses is generally performed based on visual interpretation of gait without the benefit of any kinetic analysis in the clinic. The aim of this technical note was to present and discuss the possibilities of assisting dynamic alignment of transtibial prostheses through visualization of socket reaction moments. Technique: Smart Pyramid™ (currently Europa™) was used to measure the socket reaction moments under various alignment conditions from an amputee with transtibial prosthesis. The socket reaction moments were plotted to visualize the effect of alignment changes on them, and they were clinically interpreted. Discussion: Socket reaction moments could complement information available to Prosthetists to optimize prosthetic alignment. They could be used to reduce excessive loading on sensitive areas, to improve gait stability, or to communicate the outcome of dynamic alignment with the amputees. Further research is needed to identify the contribution of kinematics and kinetics for optimal alignment. Clinical relevance Dynamic alignment of transtibial prostheses is currently tuned subjectively based on Prosthetists' experiences and skills. Socket reaction moments may potentially provide objective information for Prosthetists to align transtibial prostheses in the clinic.
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Perception of socket alignment perturbations in amputees with transtibial prostheses
Journal of rehabilitation research and development, 2012Co-Authors: David A. Boone, Toshiki Kobayashi, Teri G. Rosenbaum Chou, Adam K. Arabian, Kim L. Coleman, Michael S. Orendurff, Ming ZhangAbstract:INTRODUCTION Alignment of the socket and shank is important for the optimal prosthetic function and comfort of a person with amputation by influencing the weight-bearing load between the residual limb and the ground. In general, the literature supports the idea that successful alignment plays one of the key roles in successful prosthetic fit [1-5]. To achieve the best prosthetic function for each person with amputation, the Prosthetist is trained to align the prosthesis to counteract the tendency of the socket to rotate about the residual limb and maximize comfort while walking [6]. For instance, the prosthetic socket may be set up slightly laterally from the neutral position in the coronal plane to generate a slight genu varum moment in stance to relieve pressure over the head of the fibula and peroneal nerve and to keep trunk stability by reducing lateral bending over the foot [7-8]. Thus, the experience of prosthetic function is in part affected by alignment and not just by its geometry, material, or structure. Perception of the person with amputation regarding the prosthetic fit and function is also an important aspect of determining the best alignment. Therefore, Prosthetists usually take verbal feedback during the dynamic alignment process to assess the person with amputation's satisfaction. Some individuals are better at communicating their perceived issue with the prosthesis with regard to comfort and performance; some cannot provide very specific information to aid the Prosthetist in achieving a fully optimized prosthetic limb system. Prosthetists generally evaluate sensations of static and dynamic balance in the sagittal and coronal planes, but there is no definitive or quantifiable method to obtain this essential information. Previous studies used perception to evaluate prosthetic functions to evaluate the effect of a teletorsion device [9], pylon flexibility [10], prosthetic knee [11-12], weight of modular prosthetic components, [13] and prosthetic feet [14-16]. One of the validated ways that has been used in a wide range of studies to evaluate a person with amputation's perception of lower-limb prosthetic function has been the Prosthesis Evaluation Questionnaire [17]. Interestingly, Hafner et al. claimed in their review article on prosthetic feet that the subject perception measures appeared to be valid to clinically support the use of a certain type of prosthetic foot over another [18]. Minimal research has been reported regarding the effect of the alignment on a person with amputation's perception of fit and comfort. Hobson reported the effect of a powered alignment device that allowed the participants with amputation (n = 12) to adjust the alignment of their foot [19]. Some of the interesting findings of his study included-- 1. All persons with amputation could arrive at their preferred alignment. 2. Disagreement often existed between the Prosthetist and the person with amputation on a preferred alignment. 3. Socket fit had a significant effect on a person with amputation's sensitivity to alignment. 4. Only a few steps were required for persons with amputation to detect malalignments. 5. Persons with amputation were unable to consistently align a prosthetic foot within 1[degrees] of angulation. 6. Best alignment was achieved through collaboration between the Prosthetist and the person with amputation. However, Zahedi et al. demonstrated that both Prosthetists and persons with amputation would accept a range of alignment as optimal [2]. To increase our understanding of transtibial prosthetic malalignment, it would be important to measure the persons with amputation's feedback regarding the perception of the alignment. The fundamental premise to quantify their perceptions was that they could directly feel and respond to the mechanical effects caused by alignment perturbations. This would be supported by the reports of changes in socket pressure with alignment perturbations [20-21]. …
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Predictive Models of Transtibial Prosthetic Malalignment Based on Socket Reaction Moments
2012Co-Authors: David A. Boone, Adam K. Arabian, T Kobayashi, Orendurff, M ZhangAbstract:Alignment is important for optimal prosthetic function (Pinzur 1995). However, it was suggested that both Prosthetists and amputees would accept a range of alignments as optimal (Zahedi 1986). A previous study demonstrated that socket reaction moments measured by an instrumented prosthesis alignment component would change systematically due to alignment perturbations (Boone 2005). Therefore, the results implied that one could develop a mathematical model that could measure the magnitude of prosthetic malalignment based on the information from socket reaction moments. This model may support Prosthetists to tune alignment of prostheses more consistently in the clinical setting. The aim of this study was therefore to evaluate the model that could predict prosthetic malalignment based on the socket reaction moments measured by the instrumented prosthesis alignment component (Boone 2005).
Kim D. Reisinger - One of the best experts on this subject based on the ideXlab platform.
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Evaluation and comparison of á priori alignment techniques for transtibial prostheses in the developing world – Field trial in Nicaragua
Disability and rehabilitation. Assistive technology, 2009Co-Authors: Kim D. Reisinger, Hector R. Casanova, Celene MoorerAbstract:Purpose. The purpose of this study was to transfer three simplified alignment techniques to prosthetic technicians in a developing country through training materials and a hands-on training workshop, and to subsequently evaluate the efficacy of the alignment systems in producing acceptably aligned monolimb prostheses.Method. Prosthetists utilized the anatomically-based-alignment (ABA)-standing, ABA-supine and vertical alignment axis (VAA) alignment systems to produce three monolimbs for each of 30 healthy and active transtibial amputees. Prosthetists assessed all three monolimbs for each subject in both static and gait conditions to determine which monolimb had the best alignment and produced the best functional gait. Subjects also selected the monolimb which they believed had the best alignment; subjects utilized each monolimb for a 1-month home assessment.Results. Twenty-eight subjects completed the study. Eighty-four monolimbs were evaluated by the Prosthetists and the subjects. A few monolimbs had min...
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Comparison of á priori alignment techniques for transtibial prostheses in the developing world - pilot study.
Disability and rehabilitation, 2007Co-Authors: Kim D. Reisinger, Hector R. Casanova, Celene MoorerAbstract:Purpose. The purpose of this study was to evaluate three alignment systems based on two alignment theories that can be utilized in the fabrication of monolimb prostheses that have acceptable alignment. A second goal was to assess the feasibility of technology transfer for providing prosthetic services to remote areas of landmine-affected countries.Method. Five Prosthetists and five healthy transtibial amputees participated in the study. Each Prosthetist was trained and then used each of the three systems to capture alignment measurements for one subject. Three monolimbs identified as X, Y and Z were fabricated for each subject and assessed during clinical static and dynamic gait conditions. Training materials and methods were also evaluated.Results. All three systems captured acceptable alignments fairly well, although the two systems that incorporated weight-bearing into the alignment process had slightly better outcomes. Each system has its own advantages in terms of ease of use, required equipment, and...
A. S. Dickinson - One of the best experts on this subject based on the ideXlab platform.
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Predictive prosthetic socket design: part 2—generating person-specific candidate designs using multi-objective genetic algorithms
Biomechanics and Modeling in Mechanobiology, 2019Co-Authors: J. W. Steer, P. R. Worsley, P. A. Grudniewski, A. J. Sobey, M Browne, A. S. DickinsonAbstract:In post-amputation rehabilitation, a common goal is to return to ambulation using a prosthetic limb, suspended by a customised socket. Prosthetic socket design aims to optimise load transfer between the residual limb and mechanical limb, by customisation to the user. This is a time-consuming process, and with the increase in people requiring these prosthetics, it is vital that these personalised devices can be produced rapidly while maintaining excellent fit, to maximise function and comfort. Prosthetic sockets are designed by capturing the residual limb’s shape and applying a series of geometrical modifications, called rectifications. Expert knowledge is required to achieve a comfortable fit in this iterative process. A variety of rectifications can be made, grouped into established strategies [e.g. in transtibial sockets: patellar tendon bearing (PTB) and total surface bearing (TSB)], creating a complex design space. To date, adoption of advanced engineering solutions to support fitting has been limited. One method is numerical optimisation, which allows the designer a number of likely candidate solutions to start the design process. Numerical optimisation is commonly used in many industries but not prevalent in the design of prosthetic sockets. This paper therefore presents candidate shape optimisation methods which might benefit the Prosthetist and the limb user, by blending the state of the art from prosthetic mechanical design, surrogate modelling and evolutionary computation. The result of the analysis is a series of prosthetic socket designs that preferentially load and unload the pressure tolerant and intolerant regions of the residual limb. This spectrum is bounded by the general forms of the PTB and TSB designs, with a series of variations in between that represent a compromise between these accepted approaches. This results in a difference in pressure of up to 31 kPa over the fibula head and 14 kPa over the residuum tip. The presented methods would allow a trained Prosthetist to rapidly assess these likely candidates and then to make final detailed modifications and fine-tuning. Importantly, insights gained about the design should be seen as a compliment, not a replacement, for the Prosthetist’s skill and experience. We propose instead that this method might reduce the time spent on the early stages of socket design and allow Prosthetists to focus on the most skilled and creative tasks of fine-tuning the design, in face-to-face consultation with their client.
Ming Zhang - One of the best experts on this subject based on the ideXlab platform.
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Perception of socket alignment perturbations in amputees with transtibial prostheses
Journal of rehabilitation research and development, 2012Co-Authors: David A. Boone, Toshiki Kobayashi, Teri G. Rosenbaum Chou, Adam K. Arabian, Kim L. Coleman, Michael S. Orendurff, Ming ZhangAbstract:INTRODUCTION Alignment of the socket and shank is important for the optimal prosthetic function and comfort of a person with amputation by influencing the weight-bearing load between the residual limb and the ground. In general, the literature supports the idea that successful alignment plays one of the key roles in successful prosthetic fit [1-5]. To achieve the best prosthetic function for each person with amputation, the Prosthetist is trained to align the prosthesis to counteract the tendency of the socket to rotate about the residual limb and maximize comfort while walking [6]. For instance, the prosthetic socket may be set up slightly laterally from the neutral position in the coronal plane to generate a slight genu varum moment in stance to relieve pressure over the head of the fibula and peroneal nerve and to keep trunk stability by reducing lateral bending over the foot [7-8]. Thus, the experience of prosthetic function is in part affected by alignment and not just by its geometry, material, or structure. Perception of the person with amputation regarding the prosthetic fit and function is also an important aspect of determining the best alignment. Therefore, Prosthetists usually take verbal feedback during the dynamic alignment process to assess the person with amputation's satisfaction. Some individuals are better at communicating their perceived issue with the prosthesis with regard to comfort and performance; some cannot provide very specific information to aid the Prosthetist in achieving a fully optimized prosthetic limb system. Prosthetists generally evaluate sensations of static and dynamic balance in the sagittal and coronal planes, but there is no definitive or quantifiable method to obtain this essential information. Previous studies used perception to evaluate prosthetic functions to evaluate the effect of a teletorsion device [9], pylon flexibility [10], prosthetic knee [11-12], weight of modular prosthetic components, [13] and prosthetic feet [14-16]. One of the validated ways that has been used in a wide range of studies to evaluate a person with amputation's perception of lower-limb prosthetic function has been the Prosthesis Evaluation Questionnaire [17]. Interestingly, Hafner et al. claimed in their review article on prosthetic feet that the subject perception measures appeared to be valid to clinically support the use of a certain type of prosthetic foot over another [18]. Minimal research has been reported regarding the effect of the alignment on a person with amputation's perception of fit and comfort. Hobson reported the effect of a powered alignment device that allowed the participants with amputation (n = 12) to adjust the alignment of their foot [19]. Some of the interesting findings of his study included-- 1. All persons with amputation could arrive at their preferred alignment. 2. Disagreement often existed between the Prosthetist and the person with amputation on a preferred alignment. 3. Socket fit had a significant effect on a person with amputation's sensitivity to alignment. 4. Only a few steps were required for persons with amputation to detect malalignments. 5. Persons with amputation were unable to consistently align a prosthetic foot within 1[degrees] of angulation. 6. Best alignment was achieved through collaboration between the Prosthetist and the person with amputation. However, Zahedi et al. demonstrated that both Prosthetists and persons with amputation would accept a range of alignment as optimal [2]. To increase our understanding of transtibial prosthetic malalignment, it would be important to measure the persons with amputation's feedback regarding the perception of the alignment. The fundamental premise to quantify their perceptions was that they could directly feel and respond to the mechanical effects caused by alignment perturbations. This would be supported by the reports of changes in socket pressure with alignment perturbations [20-21]. …
