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Limb prosthesis

Robert Tyler Youngblood, Brian J Hafner, Katheryn J Allyn, John C Cagle, Paul Hinrichs, Christian Redd, Andrew C Vamos, Marcia A Ciol, Nate Bean, Joan E Sanders
BACKGROUND: The volume of a prosthesis user's residual limb changes during the day and may affect the fit of the prosthesis. These changes must be managed by the user to prevent discomfort, skin breakdown, and falls. OBJECTIVES: The objectives were to test how activity, time of day, and intermittent doffing affected residual limb fluid volume in people with transtibial amputation. STUDY DESIGN: Standardized, repeated measure (A-B-A) out-of-laboratory protocol...
July 1, 2018: Prosthetics and Orthotics International
Sanne Kikkert, Heidi Johansen-Berg, Irene Tracey, Tamar R Makin
Phantom limb pain (PLP) is commonly considered to be a result of maladaptive brain plasticity. This model proposes that PLP is mainly caused by reorganisation in the primary somatosensory cortex, presumably characterised by functional degradation of the missing hand representation and remapping of other body part representations. In the current study, we replicate our previous results by showing that chronic PLP correlates with maintained representation of the missing hand in the primary sensorimotor missing hand cortex...
May 31, 2018: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
Mihail-Lazar Mioc, Radu Prejbeanu, Dinu Vermesan, Horia Haragus, Marius Niculescu, Daniel Laurentiu Pop, Andrei Dan Balanescu, Daniel Malita, Bogdan Deleanu
BACKGROUND: Deep vein thrombosis is a well-known complication of fracture occurrence, lower limb surgery and periods of prolonged immobilisation. Its incidence can be increased even more in specific cases with metastatic bone disease and adjuvant treatment. There is a small amount of literature that addresses the incidence of DVT by comparing osteosynthesis and arthroplasty as surgical treatments. Current recommended anticoagulation protocols might be inadequate for specific groups of cancer patients undergoing osteosynthesis or arthroplasty...
July 11, 2018: BMC Musculoskeletal Disorders
Elissa Ledoux
OBJECTIVE: This paper presents a method for walking gait event detection using a single inertial measurement unit (IMU) mounted on the shank. METHODS: Experiments were conducted to detect heel strike (HS) and toe off (TO) gait events of 10 healthy subjects and 5 transfemoral amputees walking at various speeds and slopes on an instrumented treadmill. The performance of three different algorithms (thresholding (THR), linear discriminant analysis (LDA), and quadratic discriminant analysis (QDA)) were evaluated on both timing and frequency of gait event detections compared to data collected using force plates...
March 9, 2018: IEEE Transactions on Bio-medical Engineering
Yerzhan Massalin, Madina Abdrakhmanova, Huseyin Atakan Varol
OBJECTIVE: The intent recognizers of advanced lower limb prostheses utilize mechanical sensors on the prosthesis and/or electromyographic measurements from the residual limb. Besides the delay caused by these signals, such systems require user-specific databases to train the recognizers. In this work, our objective is the development and validation of a user-independent intent recognition framework utilizing depth sensing. METHODS: We collected a depth image dataset from 12 healthy subjects engaging in a variety of routine activities...
November 21, 2017: IEEE Transactions on Bio-medical Engineering
Ulla Riis Madsen, Carina Baath, Connie Boettcher Berthelsen, Ami Hommel
AIM: This study investigates the effect of time and age on health-related quality of life, general self-efficacy, and functional level 12 months following dysvascular major lower limb amputation (LLA). METHODS: A prospective cohort study design with assessments at baseline and follow-up 3, 6, and 12 months post-amputation. Data were collected via in-person interviews using Short Form 36, the General Self-efficacy scale and Barthel Index 100. Out of a consecutive sample of 103 patients having dysvascular major LLA (tibia, knee, or femoral), 38 patients completed the study...
June 29, 2018: Disability and Rehabilitation
Emily L Graczyk, Linda Resnik, Matthew A Schiefer, Melissa S Schmitt, Dustin J Tyler
The loss of a hand has many psychosocial repercussions. While advanced multi-articulated prostheses can improve function, without sensation, they cannot restore the full experience and connection of a hand. Direct nerve interfaces can restore naturalistic sensation to amputees. Our sensory restoration system produced tactile and proprioceptive sensations on the hand via neural stimulation through chronically implanted electrodes. In this study, upper limb amputees used a sensory-enabled prosthesis in their homes and communities, autonomously and unconstrained to specific tasks...
June 29, 2018: Scientific Reports
Jaclyn Megan Sions, Tara Jo Manal, John Robert Horne, Frank Bernard Sarlo, Ryan Todd Pohlig
OBJECTIVE: To explore relationships between balance-confidence and: 1) community participation; 2) self-perceived mobility; and 3) performance-based physical function among individuals with a lower-limb amputation using a prosthetic. DESIGN: Retrospective, cross-sectional study. SETTING: Outpatient, multidisciplinary amputee clinic. PARTICIPANTS: Patients (n = 45) using a prosthesis, aged ≥ 18 years, with a unilateral transfemoral or transtibial amputation of ≥1 year, were included...
June 28, 2018: Physiotherapy Theory and Practice
Ivan Vujaklija, Dario Farina
In the last fifteen years, the market for prosthetic arms and hands has shifted towards systems with greater degrees of actuation. There has also been a progressive use of emerging technologies to overcome hardware design challenges. Moreover, the proliferation of rapid prototyping has resulted in applications in the prosthetic market. Even though there are concerns on robustness and wide-user acceptance, the affordable and customizable solution offered by rapid prototyping, combined with the possibility for easy maintenance and repair, is very attractive for prosthesis design...
June 27, 2018: Expert Review of Medical Devices
Myriam Raboldt
Within the field of the history of technology, much has been written about the so-called "prosthesis boom" of the First World War. Most of these studies claim that the main motive of the mass supply of artificial limbs to amputee soldiers was primarily aimed at restoring the work force. However, because these studies often lack a gender perspective, it stays unmentioned to what extent this also served to reconstruct a hegemonic masculinity that had become fragile, if not destroyed by the consequences of the war...
June 11, 2018: Der Urologe. Ausg. A
H Houdijk, I Blokland, S A Nazier, S Castenmiller, I van den Heuvel, T Ijmker
No abstract text is available yet for this article.
June 19, 2018: Gait & Posture
Iason Batzianoulis, Nili E Krausz, Ann M Simon, Levi Hargrove, Aude Billard
BACKGROUND: Active upper-limb prostheses are used to restore important hand functionalities, such as grasping. In conventional approaches, a pattern recognition system is trained over a number of static grasping gestures. However, training a classifier in a static position results in lower classification accuracy when performing dynamic motions, such as reach-to-grasp. We propose an electromyography-based learning approach that decodes the grasping intention during the reaching motion, leading to a faster and more natural response of the prosthesis...
June 26, 2018: Journal of Neuroengineering and Rehabilitation
Cécile Philandrianos, Jean-Camille Mattei, Alexandre Rochwerger, Baptiste Bertrand, Charlotte Jaloux, Dominique Casanova
BACKGROUND: Infection is a common complication of major lower limb-sparing surgery with massive total knee prosthesis (MTKP) reconstruction after extensive tumour resection. When free tissue transfer is required to cover the prosthesis, musculo-cutaneous flaps are usually preferred based on proven efficacy when used in both one-stage and two-stage procedures. The use of a free fascio-cutaneous antero-lateral thigh (FC-ALT) flap in 3 patients with infected knee reconstructions is reported here...
June 18, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Timothy Reissman, Elizabeth Halsne, Robert Lipschutz, Laura Miller, Todd Kuiken
We present the development and evaluation of a gel liner system for upper limb prosthesis users that enables acquisition of electromyographic (myoelectric) control signals through embedded electrodes and flexible, conductive fabric leads. This liner system is constructed using a manufacturing approach rather than by modifying a commercially available liner. To evaluate the efficacy, eight male individuals with transhumeral amputations used this system, with standard myoelectric prostheses, for home trials lasting an average of 7...
2018: PloS One
R Glenn Gaston, John W Bracey, Mark A Tait, Bryan J Loeffler
Control of independent digital flexion and extension has remained an elusive goal in myoelectric prosthetics for upper extremity amputees. We first performed a cadaver study to determine the feasibility of transferring the interossei muscles for each digit to the dorsum of the hand without damaging the neurovascular pedicles. Once this capability was ensured, a clinical case was performed transferring the interossei of the middle and ring fingers to the dorsum of the hand where they could serve as a myoelectric signal for a partial hand amputee to allow individual digital control with a myoelectric prosthesis...
June 13, 2018: Journal of Hand Surgery
Zahraa M Abdulhasan, Andy J Scally, John G Buckley
BACKGROUND: Walking down ramps is a demanding task for transfemoral-amputees and terminating gait on ramps is even more challenging because of the requirement to maintain a stable limb so that it can do the necessary negative mechanical work on the centre-of-mass in order to arrest (dissipate) forward/downward velocity. We determined how the use of a microprocessor-controlled limb system (simultaneous control over hydraulic resistances at ankle and knee) affected the negative mechanical work done by each limb when transfemoral-amputees terminated gait during ramp descent...
May 30, 2018: Clinical Biomechanics
Gabrielle Thibault, Hossein Gholizadeh, Emily Sinitski, Natalie Baddour, Edward D Lemaire
Walking on various surfaces encountered in everyday life requires lower limb prosthesis users to continually adapt their movement patterns. Elevated vacuum suspension systems could improve transtibial amputee gait on non-level surfaces; however, research is lacking to guide clinical practice. Twelve transtibial amputees were fitted with the Össur sleeveless vacuum suspension system (Unity). After a one month accommodation period, the CAREN-Extended system was used to evaluate gait on a self-paced treadmill when walking with continuous perturbations (medial-lateral translations, rolling hills, simulated uneven ground) with an active or inactive vacuum suspension system...
2018: PloS One
Abdulkadir Aydın, Sibel Çağlar Okur
BACKGROUND The aim of this retrospective study was to investigate the frequency of admissions, reason for admissions, and test socket satisfaction in patients who received a lower-limb prosthesis with or without a test socket in our unit. MATERIAL AND METHODS A total of 88 patients (54 men, 34 women) were included in the study. Patients were divided into 2 groups: the group with test socket (Group I, 44 patients) and the group without test socket (Group II, 44 patients). Variables related to the functional status, frequency of complaints, and test socket satisfaction were investigated in the 2 groups...
June 13, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Joong-Myung Lee, Tae-Ho Kim
The rate of acetabular cup revision arthroplasty is gradually rising along with an increased risk of osteolysis and prosthesis loosening over time and an increase in life expectancy. The goals of revision total hip arthroplasty are: i) implant stability through reconstruction of large bone defects, ii) restoration of range of motion and biomechanics of the hip joint, and iii) normalization of uneven limb lengths. In acetabular cup revision arthroplasty, stable fixation of acetabular components is difficult in the presence of severe bone loss (e...
June 2018: Hip & Pelvis
Omar Amado, Maria Bautista, Jose Moore, Guillermo Bonilla, Nicolas Jimenez, Adolfo Llinás
Introduction: Joint dislocation is one of the most frequent complications after hip arthroplasty. Multiple strategies have demonstrated ability to prevent instability when used in isolation, but the effect when more than one intervention is implemented has not been measured. The purpose of this study is to assess the rate of dislocation after implementation of a protocol of combined strategies for prevention of instability. Materials and methods: Consecutive patients undergoing primary total hip replacement for hip osteoarthritis between February 2012 and June 2014 were included...
April 2018: Journal of Clinical Orthopaedics and Trauma
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