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Limb prosthesis

D S V Bandara, Jumpei Arata, Kazuo Kiguchi
Robotic prostheses are expected to allow amputees greater freedom and mobility. However, available options to control transhumeral prostheses are reduced with increasing amputation level. In addition, for electromyography-based control of prostheses, the residual muscles alone cannot generate sufficiently different signals for accurate distal arm function. Thus, controlling a multi-degree of freedom (DoF) transhumeral prosthesis is challenging with currently available techniques. In this paper, an electroencephalogram (EEG)-based hierarchical two-stage approach is proposed to achieve multi-DoF control of a transhumeral prosthesis...
March 22, 2018: Bioengineering
Philip Jefferies, Pamela Gallagher, Mark Philbin
PURPOSE: Research on prosthesis use is largely focused on understanding how persons manage the loss of a limb and begin their prosthesis use. We sought to elaborate an important aspect of a common concern of prosthesis users as they live day to day with their artificial limbs; specifically, the nature and management of threats that have implications for staying "just normal". METHODS: Grounded Theory methodology was employed to collect and analyse data from 24 interviewees, 17 weblogs, 17 autobiographies, and posts from four internet discussion forums...
March 20, 2018: Disability and Rehabilitation. Assistive Technology
Linda Resnik, He Helen Huang, Anna Winslow, Dustin L Crouch, Fan Zhang, Nancy Wolk
BACKGROUND: Although electromyogram (EMG) pattern recognition (PR) for multifunctional upper limb prosthesis control has been reported for decades, the clinical benefits have rarely been examined. The study purposes were to: 1) compare self-report and performance outcomes of a transradial amputee immediately after training and one week after training of direct myoelectric control and EMG pattern recognition (PR) for a two-degree-of-freedom (DOF) prosthesis, and 2) examine the change in outcomes one week after pattern recognition training and the rate of skill acquisition in two subjects with transradial amputations...
March 15, 2018: Journal of Neuroengineering and Rehabilitation
Fiona M Z van den Heiligenberg, Tanya Orlov, Scott N Macdonald, Eugene P Duff, David Henderson Slater, Christian F Beckmann, Heidi Johansen-Berg, Jody C Culham, Tamar R Makin
The human brain contains multiple hand-selective areas, in both the sensorimotor and visual systems. Could our brain repurpose neural resources, originally developed for supporting hand function, to represent and control artificial limbs? We studied individuals with congenital or acquired hand-loss (hereafter one-handers) using functional MRI. We show that the more one-handers use an artificial limb (prosthesis) in their everyday life, the stronger visual hand-selective areas in the lateral occipitotemporal cortex respond to prosthesis images...
March 9, 2018: Brain: a Journal of Neurology
Christina Enciso Holm, Christian Bardram, Anja Falk Riecke, Peter Horstmann, Michael Mørk Petersen
PURPOSE: Previous studies reported variable outcome and failure rates after mega-prosthetic reconstructions in the lower extremities. The purpose of this study was to make a long-term single-center evaluation of patients treated with limb-sparing surgery and reconstruction with mega-prostheses in the lower extremities. METHODS: We identified 50 patients (osteosarcoma (n = 30), chondrosarcoma (n = 9), osteoclastoma (n = 6), Ewing sarcoma (n = 4), angiosarcoma (n = 1)), who underwent limb-sparing reconstruction of the lower extremities (proximal femur (n = 9), distal femur (n = 29), proximal tibia (n = 9), and the entire femur (n = 3)) between 1985 and 2005...
March 12, 2018: International Orthopaedics
Bo Geng, Jian Dong, Winnie Jensen, Strahinja Dosen, Dario Farina, Ernest Nlandu Kamavuako
This paper evaluated the psychophysical properties of subdermal electrical stimulation to investigate its feasibility in providing sensory feedback for limb prostheses. The detection threshold (DT), pain threshold (PT), just noticeable difference (JND), as well as the elicited sensation quality, comfort, intensity, and location were assessed in 16 healthy volunteers during stimulation of the ventral and dorsal forearm with subdermal electrodes. Moreover, the results were compared with those obtained from transcutaneous electrical stimulation...
March 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
B González-García, S García-Isidoro, J Contreras-Alcántara, J A Martínez-Gil, M A Díaz Y Orea, V O Castellanos-Sánchez
The most frequent diabetes-related complications are diabetic foot and glaucoma, which lead to amputation and loss of vision, respectively. Current scientific and technologic developments have permitted the design and implementation of prosthetic systems that are optimal for these patients, as the latter adapt themselves to them and can resume activities of daily living. The lack of economic resources compromises the quality of the prostheses patients can afford, as they resort to «artisanal» or «rustic» systems that hamper their adaptation process...
September 2017: Acta Ortopédica Mexicana
Matthew Davidson, Cathy Bodine, Richard F Ff Weir
AIM: Prosthetic devices are not meeting the needs of people with upper limb amputations. Due to controlsidelimitations, prosthetic wrists cannot yet be fully articulated. This study sought to determine which wrist motions users felt were most important for completing activities of daily living. We specifically invstigated whether adding a combinationof flexion and deviation known as the Dart Thrower's Motion to a prosthetic wrist would help improve functionality. METHODS: Fifteen participants with a trans-radial amputation, aged 25-64 years, who use a prosthesis completed an online survey and answered interview questions to determine which types of tasks pose particular challenges...
March 7, 2018: Disability and Rehabilitation. Assistive Technology
Minxun Lu, Yongjiang Li, Yi Luo, Wenli Zhang, Yong Zhou, Chongqi Tu
BACKGROUND: Currently, it is challenging to treat massive bone defects of proximal tibia. Although numerous methods are available for reconstruction with epiphysis preservation, limitations in knee function and complications are noted with these methods. Our paper describes our attempt to reconstruct a marked defect in the proximal tibia with an uncemented three-dimensional (3D)-printed prosthesis and to evaluate the prosthesis design and short-term outcomes. CASE PRESENTATION: A 15-year-old boy with metaphyseal osteosarcoma of the tibia underwent intercalary allograft reconstruction following wide tumour resection with epiphysis preservation...
March 6, 2018: World Journal of Surgical Oncology
Keum-Shik Hong, Nida Aziz, Usman Ghafoor
During the last few decades, substantial scientific and technological efforts have been focused on the development of neuroprostheses. The major emphasis has been on techniques for connecting the human nervous system with a robotic prosthesis via natural-feeling interfaces. The peripheral nerves provide access to highly processed and segregated neural command signals from the brain that can in principle be used to determine user intent and control muscles. If these signals could be used, they might allow near-natural and intuitive control of prosthetic limbs with multiple degrees of freedom...
March 2, 2018: Journal of Neural Engineering
Srinivas Pandit, Anoop Kant Godiyal, Amit Kumar Vimal, Upinderpal Singh, Deepak Joshi, Dinesh Kalyanasundaram
This paper proposes a novel and an affordable lower limb prosthesis to enable normal gait kinematics for trans-femoral amputees. The paper details the design of a passive prosthesis with magneto-rheological (MR) damping system and electronic control. A new control approach based on plantar insole feedback was employed here. Strategically placed sensors on the plantar insole provide required information about gait cycle to a finite state controller for suitable action. A proportional integral (PI) based current controller controls the required current for necessary damping during gait...
February 27, 2018: Sensors
Sophie Wang, Janice Hsu, Lauren Trent, Tiffany Ryan, Nathan Kearns, Eugene Civillico, Kimberly Kontson
Objective performance-based outcome measures (OMs) have the potential to provide unbiased and reproducible assessments of limb function. However, very few of these performance-based OMs have been validated for upper limb (UL) prosthesis users. OMs validated in other clinical populations (e.g. neurological or musculoskeletal conditions) could be used to fill gaps in existing performance-based OMs for UL amputees. Additionally, a joint review might reveal consistent gaps across multiple clinical populations. Therefore, the objective of this review was to systematically characterize prominent measures utilized in both sets of clinical populations with regard to (1) location of task performance around the body, (2) possible grips employed, (3) bilateral vs...
February 20, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Todd A Kuiken, Nicholas P Fey, Timothy Reissman, Suzanne B Finucane, Gregory A Dumanian
Background: Excess residual limb fat is a common problem that can impair prosthesis control and negatively impact gait. In the general population, thighplasty and liposuction are commonly performed for cosmetic reasons but not specifically to improve function in amputees. The objective of this study was to determine if these procedures could enhance prosthesis fit and function in an overweight above-knee amputee. Methods: We evaluated the use of these techniques on a 50-year-old transfemoral amputee who was overweight...
January 2018: Plastic and Reconstructive Surgery. Global Open
Hong Yang, Xi-Bin Li, Jie Tan, Hao Li, Yin-Chu Shao, Feng Shuang
OBJECTIVE: To investigate the influential factors of total blood loss during unilateral artificial total hip arthroplasty (THA). METHODS: From January 2014 to July 2016, 131 patients undergwent primary unilateral total hip arthroplasty, including 55 males and 76 females, ranging in age from 40 to 89 years old, with an average of 64.5 years old. The data of patients with unilateral total hip arthroplasty were collected, and the data of hemodynamics, coagulation function, hemoglobin and hematocrit values were recorded according to the observation data...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Manelle Merad, Étienne de Montalivet, Amélie Touillet, Noël Martinet, Agnès Roby-Brami, Nathanaël Jarrassé
Most transhumeral amputees report that their prosthetic device lacks functionality, citing the control strategy as a major limitation. Indeed, they are required to control several degrees of freedom with muscle groups primarily used for elbow actuation. As a result, most of them choose to have a one-degree-of-freedom myoelectric hand for grasping objects, a myoelectric wrist for pronation/supination, and a body-powered elbow. Unlike healthy upper limb movements, the prosthetic elbow joint angle, adjusted prior to the motion, is not involved in the overall upper limb movements, causing the rest of the body to compensate for the lack of mobility of the prosthesis...
2018: Frontiers in Neurorobotics
Courtney E Shell, Glenn K Klute, Richard R Neptune
Advanced prosthetic foot designs often incorporate mechanisms that adapt to terrain changes in real-time to improve mobility. Early identification of terrain (e.g., cross-slopes) is critical to appropriate adaptation. This study suggests that a simple classifier based on linear discriminant analysis can accurately predict a cross-slope encountered (0°, -15°, 15°) using measurements from the residual limb, primarily from the prosthesis itself. The classifier was trained and tested offline using motion capture and in-pylon sensor data collected during walking trials in mid-swing and early stance...
2018: PloS One
Erica Schvirtz, Laurent Bensoussan, Bertrand Tourret Couderc, Jean-Michel Viton, Alain Delarque, Marjorie Kerzoncuf
BACKGROUND: Surfing with transfemoral knee prosthesis requires flexion of the hip, knee, and ankle and balance between flexibility and stiffness of the prosthetic limb. We report on Mr D, a transfemoral amputee, who wanted to surf again. Case Description and Methods: Technical specifications were based on Mr D's complaint. The prosthesis is salt water resistant and combines a shock absorber associated with elastic tendons to permit the knee to bend easily and to facilitate eccentric braking...
February 1, 2018: Prosthetics and Orthotics International
Laurent Frossard, Gregory Merlo, Tanya Quincey, Brendan Burkett, Debra Berg
BACKGROUND: Governmental organizations are facing challenges in adjusting procedures providing equitable assistance to consumers with amputation choosing newly available osseointegrated fixations for bone-anchored prostheses (BAPs) over socket-suspended prostheses. OBJECTIVES: The aims of this study were to (1) present a procedure focusing on tasks, documents and costs of prosthetic care, and (2) share observed obstacles and facilitators to implementation. METHODS: This research aimed at developing a governmental procedure for the provision of BAPs was designed as an action research study...
December 2017: PharmacoEconomics Open
Tallie M J van der Laan, Sietke G Postema, Michiel F Reneman, Raoul M Bongers, Corry K van der Sluis
STUDY DESIGN: Reliability study. INTRODUCTION: Quantifying compensatory movements during work-related tasks may help to prevent musculoskeletal complaints in individuals with upper limb absence. PURPOSE OF THE STUDY: (1) To develop a qualitative scoring system for rating compensatory shoulder and trunk movements in upper limb prosthesis wearers during the performance of functional capacity evaluation tests adjusted for use by 1-handed individuals (functional capacity evaluation-one handed [FCE-OH]); (2) to examine the interrater and intrarater reliability of the scoring system; and (3) to assess its feasibility...
February 10, 2018: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Jonathan Dallas, John J Block, Gerasimos Bastas
We describe the case of a patient with an actively bleeding pseudoaneurysm associated with remnants of a polytetrafluoroethylene (PTFE) femoral bypass graft in their transfemoral residual limb. Initial graft placement was due to peripheral arterial disease. During subsequent transfemoral amputation, remnants of the non-patent graft were retained in the residuum. Following four years of lower limb prosthesis use, a proximal anastomosis pseudoaneurysm developed (with avulsion of graft remnants). The patient presented to clinic with a 5-day history of increased left groin fullness and largely non-radiating pain (rated 10/10)...
February 8, 2018: American Journal of Physical Medicine & Rehabilitation
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