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https://www.readbyqxmd.com/read/28814050/segmental-contributions-to-sagittal-plane-whole-body-angular-momentum-when-using-powered-compared-to-passive-ankle-foot-prostheses-on-ramps
#1
Nathaniel T Pickle, Anne K Silverman, Jason M Wilken, Nicholas P Fey
Understanding the effects of an assistive device on dynamic balance is crucial, particularly for robotic leg prostheses. Analyses of dynamic balance commonly evaluate the range of whole-body angular momentum (H). However, the contributions of individual body segments to overall H throughout gait may yield futher insights, specifically for people with transtibial amputation using powered prostheses. We evaluated segment contributions to H using Statistical Parametric Mapping to assess the effects of prosthesis type (powered vs passive) and ramp angle on segmental coordination...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28814037/design-of-a-power-asymmetric-actuator-for-a-transtibial-prosthesis
#2
Harrison L Bartlett, Brian E Lawson, Michael Goldfarb
This paper presents the design and characterization of a power-asymmetric actuator for a transtibial prosthesis. The device is designed to provide the combination of: 1) joint locking, 2) high power dissipation, and 3) low power generation. This actuator functionality allows for a prosthesis to be designed with minimal mass and power consumption relative to a fully-powered robotic prosthesis while maintaining much of the functionality necessary for activities of daily living. The actuator achieves these design characteristics while maintaining a small form factor by leveraging a combination of electromechanical and hydraulic components...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813975/a-lightweight-robotic-ankle-prosthesis-with-non-backdrivable-cam-based-transmission
#3
Tommaso Lenzi, Marco Cempini, Jeremy Newkirk, Levi J Hargrove, Todd A Kuiken
Below-knee level amputation significantly impacts the ability of an individual to ambulate. Transtibial amputees are typically prescribed energetically passive ankle-foot prostheses that behave as a spring or controlled damper, and therefore cannot fully replace the function of the missing limb. More recently, fully-powered devices have been proposed to more closely match the power generation ability of intact limbs. However, these fully-powered devices are significantly heavier than passive devices, thus increasing the stress on the socket-residual limb interface...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813971/feasibility-study-of-transtibial-amputee-walking-using-a-powered-prosthetic-foot
#4
Martin Grimmer, Matthew Holgate, Jeffrey Ward, Alexander Boehler, Andre Seyfarth
Passive prosthetic feet are not able to provide non-amputee kinematics and kinetics for the ankle joint. Persons with amputations show reduced interlimb symmetry, slower walking speeds, and increased walking effort. To improve ankle range of motion and push off, various powered prosthetic feet were introduced. This feasibility study analyzed if predefined motor reference trajectories can be used to achieve non-amputee ankle biomechanics during walking with the powered prosthetic foot, Walk-Run Ankle. Trajectories were calculated using the desired ankle angle and ankle moment based spring deflection at a given spring stiffness...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28801704/no-clinical-differences-between-anteromedial-portal-and-transtibial-technique-for-femoral-tunnel-positioning-in-anterior-cruciate-ligament-reconstruction-a-prospective-randomized-controlled-trial
#5
Peter MacDonald, Chris Kim, Sheila McRae, Jeff Leiter, Ryan Khan, Daniel Whelan
PURPOSE: The anteromedial (AMP) portal technique was introduced to position the femoral tunnel in anterior cruciate ligament (ACL) reconstruction to more closely replicate the original ACL footprint compared to the transtibial (TT) approach. Few randomized trials have evaluated differences in these techniques with respect to clinical outcomes. The purpose of this study was to determine if there are any differences in clinical outcome between the AMP and TT approaches. METHODS: This is a single-blinded, prospective, randomized controlled trial...
August 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28797673/trunk-kinetic-effort-during-step-ascent-and-descent-in-patients-with-transtibial-amputation-using-angular-momentum-separation
#6
Brecca M M Gaffney, Cory L Christiansen, Amanda M Murray, Bradley S Davidson
BACKGROUND: Patients with transtibial amputation adopt trunk movement compensations that alter effort and increase the risk of developing low back pain. However, the effort required to achieve high-demand tasks, such as step ascent and descent, remains unknown. METHODS: Kinematics were collected during bilateral step ascent and descent tasks from two groups: 1) seven patients with unilateral transtibial amputation and 2) seven healthy control subjects. Trunk kinetic effort was quantified using translational and rotational segmental moments (time rate of change of segmental angular momentum)...
July 29, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28795882/medial-gastrocnemius-muscle-flap-for-the-reconstruction-of-unhealed-amputation-stumps
#7
B Tosun, O Selek, U Gok, O Tosun
OBJECTIVE: Unhealed amputation stumps after transtibial amputation are common and often require reamputation futher up the leg. The aim of our study is to describe our experience with medial gastrocnemius muscle flap coverage following a transtibial amputation. METHOD: We retrospectively examined the records of patients who had an unhealed transtibial amputation stump who were then treated with a medial gastrocnemius muscle flap. RESULTS: We identified seven patients, all had diabetes mellitus and an initial amputation by the long posterior flap technique...
August 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28759600/anatomic-tunnel-placement-can-be-achieved-with-a-modification-to-transtibial-technique-in-single-bundle-anterior-cruciate-ligament-reconstruction-a-cadaver-study
#8
Joon Kyu Lee, Sahnghoon Lee, Ki Tae Kim, Myung Chul Lee
Placing the tunnels in the anatomic positions is important for successful restoration of knee function after anterior cruciate ligament reconstruction (ACLR). It has been shown that it is difficult to place the tunnels in the anatomic position using the transtibial technique. The purpose of this study was to evaluate the effect of each step of our modified transtibial technique (mTT) on the positioning of the femoral tunnel so as to assess whether the mTT could achieve anatomic placements of the tunnels without tibial tunnel expansion...
2017: PloS One
https://www.readbyqxmd.com/read/28750586/a-controlled-clinical-trial-of-a-clinically-tuned-powered-ankle-prosthesis-in-people-with-transtibial-amputation
#9
Emily S Gardinier, Brian M Kelly, Jeffrey Wensman, Deanna H Gates
OBJECTIVE: To determine whether there are changes in level walking performance for people using a powered ankle prosthesis that was tuned by an independent, manufacturer-certified prosthetist in accordance with device recommendations. DESIGN: Intervention study with cross-over design. SETTING: Laboratory. PARTICIPANTS: Convenience sample of 10 individuals with unilateral, transtibial amputation, and 10 age- and gender-matched control participants...
July 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28748490/a-simple-cinch-is-superior-to-a-locking-loop-for-meniscus-root-repair-a-human-biomechanical-comparison-of-suture-constructs-in-a-transtibial-pull-out-model
#10
Aaron J Krych, Nick R Johnson, Isabella T Wu, Patrick A Smith, Michael J Stuart
PURPOSE: To determine the cyclic displacement and ultimate failure loads of two clinically relevant suture configurations for repair of medial and lateral meniscus root tears. METHODS: A total of 10 matched pair fresh-frozen, human meniscus specimens were randomly assigned to either simple cinch or locking loop meniscus-suture fixation techniques for transtibial pull-out repair in either medial (n = 10 matched pairs) or lateral (n = 10 matched pairs) meniscal root tears...
July 26, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28736682/standardized-approach-to-quantitatively-measure-residual-limb-skin-health-in-individuals-with-lower-limb-amputation
#11
Cameron L Rink, Matthew M Wernke, Heather M Powell, Mark Tornero, Surya C Gnyawali, Ryan M Schroeder, Jayne Y Kim, Jeffrey A Denune, Alexander W Albury, Gayle M Gordillo, James M Colvin, Chandan K Sen
Objective: (1) Develop a standardized approach to quantitatively measure residual limb skin health. (2) Report reference residual limb skin health values in people with transtibial and transfemoral amputation. Approach: Residual limb health outcomes in individuals with transtibial (n = 5) and transfemoral (n = 5) amputation were compared to able-limb controls (n = 4) using noninvasive imaging (hyperspectral imaging and laser speckle flowmetry) and probe-based approaches (laser doppler flowmetry, transcutaneous oxygen, transepidermal water loss, surface electrical capacitance)...
July 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28721590/high-non-anatomic-tunnel-position-rates-in-acl-reconstruction-failure-using-both-transtibial-and-anteromedial-tunnel-drilling-techniques
#12
Vera Jaecker, Tabea Zapf, Jan-Hendrik Naendrup, Thomas Pfeiffer, Ajay C Kanakamedala, Arasch Wafaisade, Sven Shafizadeh
INTRODUCTION: Although it is well known from cadaveric and biomechanical studies that transtibial femoral tunnel (TT) positioning techniques are associated with non-anatomic tunnel positions, controversial data exist as so far no clinical differences could have been found, comparing transtibial with anteromedial techniques (AM). The purpose of the study was to analyze if graft failure following TT ACL reconstruction was more commonly associated with non-anatomic tunnel position in comparison with the AM technique...
July 18, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28707050/tensile-strength-of-the-pullout-repair-technique-for-the-medial-meniscus-posterior-root-tear-a-porcine-study
#13
Masataka Fujii, Takayuki Furumatsu, Haowei Xue, Shinichi Miyazawa, Yuya Kodama, Tomohito Hino, Yusuke Kamatsuki, Toshifumi Ozaki
PURPOSE: The purpose of this study was to compare the load-to-failure of different common suturing techniques with a new technique for the medial meniscus posterior root tear (MMPRT). METHODS: Thirty porcine medial menisci were randomly assigned to three suturing techniques used for transtibial pullout repair of the MMPRT (n = 10 per group). Three different meniscal suture configurations were studied: the two simple suture (TSS) technique, the conventional modified Mason-Allen suture (MMA) technique, and the new MMA technique using the FasT-Fix combined with the Ultrabraid (F-MMA)...
July 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28706841/technique-for-transtibial-knotless-repair-of-lateral-meniscus-root-avulsion
#14
Emily Harnden, Timothy Lin, Adam Wilson, John B Reid
Tear of the meniscal root results in loss of circumferential hoop tension in the meniscus and increased tibiofemoral contact pressure, leading to cartilage wear. Repair of the meniscal root can restore function of the meniscus. Many techniques for root repair have recently been described. We present a technique for root repair using a transtibial socket and knotless suture technique that can be performed through standard arthroscopy portals.
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706808/transosseous-posterior-meniscal-root-reinsertion-using-knotless-anchor-for-tibial-fixation
#15
Alejandro Espejo-Baena, Alejandro Espejo-Reina, María Josefa Espejo-Reina, María Belén Martín-Castilla, Jaime Dalla-Rosa Nogales, Enrique Sevillano-Pérez
A technique for posterior meniscal root reinsertion is presented. With the arthroscope in the central transtendinous portal for a better view, a 5-mm transtibial tunnel is created with the aid of an anterior cruciate ligament guide open to 45°. A suture device, which consists of a long needle with an eyelet on its tip, is introduced through the tunnel with a suture thread inserted through the eyelet, while the meniscus is stabilized with a grasper inserted through the anterior portal. The meniscus is pierced with the device, and the suture thread is recovered with said grasper...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706793/medial-meniscus-posterior-root-repair-using-a-transtibial-technique
#16
Jarret M Woodmass, Rohith Mohan, Michael J Stuart, Aaron J Krych
The meniscal roots are critical in maintaining the normal shock absorbing function of the meniscus. If a meniscal root tear is left untreated, meniscal extrusion can occur rendering the meniscus nonfunctional resulting in degenerative arthritis. Two main repair techniques are described: (1) suture anchors (direct fixation) and (2) sutures pulled through a tibial tunnel (indirect fixation). Meniscal root repair using a suture anchor technique is technically challenging requiring a posterior portal and a curved suture passing device that can be difficult to manipulate within the knee...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28705487/amputee-locomotion-frequency-content-of-prosthetic-vs-intact-limb-vertical-ground-reaction-forces-during-running-and-the-effects-of-filter-cut-off-frequency
#17
Dovin Kiernan, Ross H Miller, Brian S Baum, Hyun Joon Kwon, Jae Kun Shim
Compared to intact limbs, running-specific prostheses have high resonance non-biologic materials and lack active tissues to damp high frequencies. These differences may lead to ground reaction forces (GRFs) with high frequency content. If so, ubiquitously applying low-pass filters to prosthetic and intact limb GRFs may attenuate veridical high frequency content and mask important and ecologically valid data from prostheses. To explore differences in frequency content between prosthetic and intact limbs we divided signal power from transtibial unilateral amputees and controls running at 2...
June 21, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28704685/dynamic-balance-changes-within-three-weeks-of-fitting-a-new-prosthetic-foot-component
#18
Jenny A Kent, Nicholas Stergiou, Shane R Wurdeman
Balance during walking is of high importance to prosthesis users and may affect walking during baseline observation and evaluation. The aim of this study was to determine whether changes in walking balance occurred during an adaptation period following the fitting of a new prosthetic component. Margin of stability in the medial-lateral direction (MOSML) and an anterior instability margin (AIM) were used to quantify the dynamic balance of 21 unilateral transtibial amputees during overground walking. Participants trialled two prosthetic feet presenting contrasting movement/balance constraints; a Higher Activity foot similar to that of their own prosthesis, and a Lower Activity foot...
July 5, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28704467/locomotor-adaptability-in-persons-with-unilateral-transtibial-amputation
#19
Benjamin J Darter, Amy J Bastian, Erik J Wolf, Elizabeth M Husson, Bethany A Labrecque, Brad D Hendershot
BACKGROUND: Locomotor adaptation enables walkers to modify strategies when faced with challenging walking conditions. While a variety of neurological injuries can impair locomotor adaptability, the effect of a lower extremity amputation on adaptability is poorly understood. OBJECTIVE: Determine if locomotor adaptability is impaired in persons with unilateral transtibial amputation (TTA). METHODS: The locomotor adaptability of 10 persons with a TTA and 8 persons without an amputation was tested while walking on a split-belt treadmill with the parallel belts running at the same (tied) or different (split) speeds...
2017: PloS One
https://www.readbyqxmd.com/read/28704265/limits-of-stability-in-patients-with-vascular-due-to-diabetes-and-nonvascular-unilateral-transtibial-amputation-a-cross-sectional-study
#20
Francisco Molina-Rueda, Alberto Molero-Sánchez, María Carratalá-Tejada, Alicia Cuesta-Gómez, Juan C Miangolarra-Page, Isabel M Alguacil-Diego
The aim of the study was to investigate the differences in the stability limits between patients with vascular and nonvascular unilateral transtibial amputation (UTA) and patients without amputation. Eighteen patients with UTA who used a prosthesis were divided into two groups: vascular (n=9) and nonvascular (n=9). Twenty-four patients without amputation served as the control group. Computerized dynamic posturography Smart EquiTest System, version 8.0 was used for measuring stability limits. The limits of stability test was used to assess the participants' ability to voluntarily sway to various locations in space...
July 12, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
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