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Sample records for amputees

  1. Amputee Coalition of America

    Science.gov (United States)

    ... for this free service Ask an Information Specialist Browse Resources by Topic , Browse Resources by Amputation Level Prosthetist Finder More Connect ... are testing ... Read More 2017 Amputee Coalition National Conference Call for Presentations The Amputee Coalition invites professionals ...

  2. Rehabilitation of lower limb amputees

    OpenAIRE

    Kovač, Ida; KAUZLARIĆ, NEVEN; Živković, Ognjen; Mužić, Vedrana; ABRAMOVIĆ, Marina; VULETIĆ, Zoran; Vukić, Tamara; IŠTVANOVIĆ, Neven; LIVAKOVIĆ, BRANKO

    2015-01-01

    Rehabilitation of amputees represents a complex process during the course of which an amputee receives professional aid and support, so as to adapt to the use of prosthesis, i.e. an artificial supplement for the lost body part. The process aims at achieving an independent performance of the amputee in all areas of everyday life and as high quality of life as possible. The rehabilitation encompasses not only the pre-amputation, postoperative, pre-prosthetic and prosthetic stage, within which a...

  3. Gait initiation in lower limb amputees

    NARCIS (Netherlands)

    Vrieling, A.H.; van Keeken, H.G.; Schoppen, T.; Otten, E.; Halbertsma, J.P.; Hof, A.L.; Postema, K.

    2008-01-01

    Objective: To study limitations in function and adjustment strategies in lower limb amputees during gait initiation. Design: Observational cohort study. Setting: University Medical Center. Participants: Amputees with a unilateral transfemoral or transtibial amputation, and able-bodied subjects. Main

  4. Obstacle crossing in lower limb amputees

    NARCIS (Netherlands)

    Vrieling, A.H.; van Keeken, H.G.; Schoppen, Tanneke; Otten, Egbert; Halbertsma, J.P.; Hof, A.L.; Postema, K.

    2007-01-01

    Objective: To study limitations in function and adjustment strategies in lower limb amputees during obstacle crossing. Design: Observational cohort study. Subjects: Transfemoral and transtibial amputees and able-bodied control subjects. Methods: In a motion analysis laboratory unimpeded and obstacle

  5. Gait termination in lower limb amputees

    NARCIS (Netherlands)

    Vrieling, A. H.; van Keeken, H. G.; Schoppen, T.; Otten, E.; Halbertsma, J. P. K.; Hof, A. L.; Postema, K.

    2008-01-01

    Objective: To study the limitations in function and adjustment strategies of lower limb amputees in gait termination. Design: Observational cohort study. Setting: University Medical Centre. Participants: Unilateral transfemoral and transtibial amputees, and able-bodied control subjects. Main outcome

  6. The Winter Park Amputee Ski Teaching System.

    Science.gov (United States)

    O'Leary, Hal

    The three track method of teaching amputees to ski is presented in the illustrated manual. Problems unique to amputee skiers--care of hands, conditioning, care of stump, fatigue, excessive standing, wind, and balance--are discussed in terms of their implications to the amputee skier and practical solutions in attempting to solve them. Specific…

  7. Body mass index in amputees.

    Science.gov (United States)

    Tzamaloukas, A H; Patron, A; Malhotra, D

    1994-01-01

    Whereas estimates of percent deviation of body weight from ideal (F delta weight) are corrected for amputation, those of body mass index (BMI) are not, creating discrepancies in evaluating obesity. A correction of the BMI formula for amputation is proposed. The formula for BMI was corrected for amputation mathematically. The mathematical model predicts that the uncorrected BMI formula underestimates body fat in unilateral amputees and overestimates body fat in subjects with bilateral amputations at the same length of the legs. F delta weight and corrected and uncorrected BMI estimates were computed in 15 subjects with unilateral leg amputation and in 8 subjects with multiple amputations. BMI estimates were as follows: in unilateral amputees, corrected 24.1 +/- 4.1 kg/m2, uncorrected 22.2 +/- 3.9 kg/m2 (p amputees, corrected 21.6 +/- 2.4 kg/m2, uncorrected 32.6 +/- 11.8 kg/m2 (p = .043). Linear regressions of F delta weight obtained from standard nutrition assessment on F delta weight computed from uncorrected and corrected BMI values were as follows: in unilateral amputees, uncorrected F delta weight = -0.079 + 0.932 x actual F delta weight, r = .974, p amputees, uncorrected F delta weight = 0.528 + 1.930 x actual F delta weight, r = .607, p is not significant, and corrected F delta weight = -0.010 + 0.920 x actual F delta weight, r = .936, p < .01.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Sprint Start Kinetics of Amputee and Non-Amputee Sprinters

    OpenAIRE

    Willwacher, Steffen; Herrmann, Volker; Heinrich, Kai; Funken, Johannes; Strutzenberger, Gerda; Goldmann, Jan-Peter; Braunstein, Björn; Brazil, Adam; Irwin, Gareth; Potthast, Wolfgang; Brüggemann, Gert-Peter

    2016-01-01

    The purpose of this study was to explore the relationship between the forces applied to the starting blocks and the start performances (SPs) of amputee sprinters (ASs) and non-amputee sprinters (NASs). SPs of 154 male and female NASs (100-m personal records [PRs], 9.58–14.00 s) and 7 male ASs (3 unilateral above knee, 3 unilateral below knee, 1 bilateral below knee; 100 m PRs, 11.70–12.70 s) with running specific prostheses (RSPs) were analysed during full-effort sprint starts using instrumen...

  9. Pain Management and the Amputee

    Science.gov (United States)

    Pain Management and the Amputee Translated into plain language by Helen Osborne, 2006 Health Literacy Consulting, www.healthliteracy.com ... Purdue Pharma L.P. A7158 6/03 Pain Management This Fact Sheet provides important—and practical—information ...

  10. Sports participation of Dutch lower limb amputees

    NARCIS (Netherlands)

    Bragaru, Mihail; Meulenbelt, Hendrik; Dijkstra, Pieter U.; Geertzen, Jan H.B.; Dekker, Rienk

    2013-01-01

    Objective: To analyze sports participation of Dutch lower limb amputees and factors influencing sports participation. Study design: A cross-sectional survey was performed. Dutch lower limb amputees (N = 2039) were invited to participate in a postal survey addressing personal and amputation character

  11. The gait of unilateral transfemoral amputees.

    Science.gov (United States)

    Boonstra, A M; Schrama, J; Fidler, V; Eisma, W H

    1994-12-01

    The aim of this study was to describe the gait of persons with a unilateral transfemoral amputation by means of a questionnaire, gait analysis and measurement of energy expenditure, and to find correlations among the variables studied. The study included 29 transfemoral amputees amputated for other reasons than a chronic vascular disease. The patients were assessed using the following methods: 1) A questionnaire rating the walking distance and walking difficulty in different circumstances. 2) Gait analysis measuring temporal variables and goniometry of hips and knees. 3) Measurement of energy expenditure during sitting and walking. Scores on the questionnaire showed a correlation with socket design, a negative correlation with age and energy expenditure, and a positive correlation with fast speed. The gait of transfemoral amputees was asymmetrical as far as temporal variables were concerned, and for most amputees also for the range of motion of hip and knee. The walking speed of the amputees was lower than that of non-amputees and showed a positive correlation with hip extension-flexion range of motion and a negative correlation with age and stride time. The energy expenditure of the amputees during ambulation was higher than that of non-amputees, and seemed to correlate with residual limb length and the hip abduction-adduction range of motion.

  12. Sprint Start Kinetics of Amputee and Non-Amputee Sprinters.

    Science.gov (United States)

    Willwacher, Steffen; Herrmann, Volker; Heinrich, Kai; Funken, Johannes; Strutzenberger, Gerda; Goldmann, Jan-Peter; Braunstein, Björn; Brazil, Adam; Irwin, Gareth; Potthast, Wolfgang; Brüggemann, Gert-Peter

    2016-01-01

    The purpose of this study was to explore the relationship between the forces applied to the starting blocks and the start performances (SPs) of amputee sprinters (ASs) and non-amputee sprinters (NASs). SPs of 154 male and female NASs (100-m personal records [PRs], 9.58-14.00 s) and 7 male ASs (3 unilateral above knee, 3 unilateral below knee, 1 bilateral below knee; 100 m PRs, 11.70-12.70 s) with running specific prostheses (RSPs) were analysed during full-effort sprint starts using instrumented starting blocks that measured the applied forces in 3D. Using the NAS dataset and a combination of factor analysis and multiple regression techniques, we explored the relationship between force characteristics and SP (quantified by normalized average horizontal block power). Start kinetics were subsequently compared between ASs and NASs who were matched based on their absolute 100 m PR and their 100 m PR relative to the world record in their starting class. In NASs, 86% of the variance in SP was shared with five latent factors on which measured parameters related to force application to the rear and front blocks and the respective push-off directions in the sagittal plane of motion were loaded. Mediolateral force application had little influence on SP. The SP of ASs was significantly reduced compared to that of NASs matched on the basis of relative 100-m PR (-33.8%; d = 2.11, p < 0.001), while a non-significant performance reduction was observed when absolute 100-m PRs were used (-17.7%; d = 0.79, p = 0.09). These results are at least partially explained by the fact that force application to the rear block was clearly impaired in the affected legs of ASs.

  13. Myoelectric walking mode classification for transtibial amputees.

    Science.gov (United States)

    Miller, Jason D; Beazer, Mahyo Seyedali; Hahn, Michael E

    2013-10-01

    Myoelectric control algorithms have the potential to detect an amputee's motion intent and allow the prosthetic to adapt to changes in walking mode. The development of a myoelectric walking mode classifier for transtibial amputees is outlined. Myoelectric signals from four muscles (tibialis anterior, medial gastrocnemius (MG), vastus lateralis, and biceps femoris) were recorded for five nonamputee subjects and five transtibial amputees over a variety of walking modes: level ground at three speeds, ramp ascent/descent, and stair ascent/descent. These signals were decomposed into relevant features (mean absolute value, variance, wavelength, number of slope sign changes, number of zero crossings) over three subwindows from the gait cycle and used to test the ability of classification algorithms for transtibial amputees using linear discriminant analysis (LDA) and support vector machine (SVM) classifiers. Detection of all seven walking modes had an accuracy of 97.9% for the amputee group and 94.7% for the nonamputee group. Misclassifications occurred most frequently between different walking speeds due to the similar nature of the gait pattern. Stair ascent/descent had the best classification accuracy with 99.8% for the amputee group and 100.0% for the nonamputee group. Stability of the developed classifier was explored using an electrode shift disturbance for each muscle. Shifting the electrode placement of the MG had the most pronounced effect on the classification accuracy for both samples. No increase in classification accuracy was observed when using SVM compared to LDA for the current dataset.

  14. Prosthetic Frequently Asked Questions for the New Amputee

    Science.gov (United States)

    ... Resource Center > Prosthetic FAQs for the New Amputee Prosthetic FAQs for the New Amputee Web Development June ... HELPFUL TO SPEAK WITH OTHERS WHO USE A PROSTHETIC DEVICE? Don’t underestimate the value of talking ...

  15. Lower limb strength in sports-active transtibial amputees.

    Science.gov (United States)

    Nolan, Lee

    2009-09-01

    The aim of this study was to compare hip strength in sports-active transtibial (TT) amputees, sedentary TT amputees and sports-active non-amputees. Three 'active' (exercising recreationally at least three times per week) TT amputees, four 'inactive' or sedentary TT amputees and nine 'active' able-bodied persons (AB) underwent concentric and eccentric hip flexion and extension strength testing on both limbs on an isokinetic dynamometer at 60 and 120 degrees /s. Little strength asymmetry was noted between the limbs of the active TT amputees (8% and 14% at 60 and 120 degrees /s, respectively), their residual limb being slightly stronger. Inactive TT amputees demonstrated up to 49% strength asymmetry, their intact limb being the stronger. Active TT amputees demonstrated greater peak hip torques (Nm/kg) for all conditions and speeds compared to inactive TT amputees. Peak hip torques (Nm/kg), were greater in the active TT amputees' residual limb compared to AB. While inactive TT amputees and AB had similar flexion/extension ratios, active TT amputees exhibited a lower ratio indicating overdeveloped hip extensors with respect to their hip flexors. It is not known whether this is due to the demands of sport or exercise with a prosthetic limb, or remaining residual thigh atrophy.

  16. Assessment of Self-Esteem and Satisfaction in Amputee Children

    Science.gov (United States)

    Spencer, C. D.; And Others

    1977-01-01

    The study involving six single and multiple amputee children (10 to 14 years old) was conducted to provide information on how situations affect the self esteem of amputee children, how situations affect satisfaction with their prostheses, and the relationship between amputee self esteem and their satisfaction with their prosthetic device.…

  17. Lower limb prosthesis utilisation by elderly amputees.

    Science.gov (United States)

    Bilodeau, S; Hébert, R; Desrosiers, J

    2000-08-01

    The goal of prosthetic rehabilitation is to compensate for the loss of a limb by amputation by, in the case of a lower limb, encouraging walking, and to achieve the same level of autonomy as prior to the amputation. However, because of difficulties walking, elderly amputees may use their prosthesis to a greater or lesser degree or simply stop using it during the rehabilitation period. The objective of this research was to study factors such as physical and mental health, rehabilitation, physical independence and satisfaction with the prosthesis to understand why amputees use their prosthesis or not. The sample was composed of 65 unilateral vascular amputees 60 years old or over living at home. The information was collected from medical records, by telephone interview and by mail questionnaire. Prosthesis use was measured by a questionnaire on amputee activities developed by Day (1981). Eighty-one per cent (81%) of the subjects wore their prosthesis every day and 89% of this group wore it 6 hours or more per day. Less use of the prosthesis was significantly related to age, female gender, possession of a wheelchair, level of physical disability, cognitive impairment, poorer self-perceived health and the amputee's dissatisfaction. A multiple regression analysis showed that satisfaction, not possessing a wheelchair and cognitive integrity explained 46% of the variance in prosthesis use.

  18. Transtibial amputee joint motion has increased attractor divergence during walking compared to non-amputee gait.

    Science.gov (United States)

    Wurdeman, Shane R; Myers, Sara A; Stergiou, Nicholas

    2013-04-01

    The amputation and subsequent prosthetic rehabilitation of a lower leg affects gait. Dynamical systems theory would predict the use of a prosthetic device should alter the functional attractor dynamics to which the system self-organizes. Therefore, the purpose of this study was to compare the largest Lyapunov exponent (a nonlinear tool for assessing attractor dynamics) for amputee gait compared to healthy non-amputee individuals. Fourteen unilateral, transtibial amputees and fourteen healthy, non-amputee individuals ambulated on a treadmill at preferred, self-selected walking speed. Our results showed that the sound hip (p = 0.013), sound knee (p = 0.05), and prosthetic ankle (p = 0.023) have significantly greater largest Lyapunov exponents than healthy non-amputees. Furthermore, the prosthetic ankle has a significantly greater (p = 0.0.17) largest Lyapunov exponent than the sound leg ankle. These findings indicate attractor states for amputee gait with increased divergence. The increased attractor divergence seems to coincide with decreased ability for motor control between the natural rhythms of the individual and those of the prosthetic device. Future work should consider the impact of different prostheses and rehabilitation on the attractor dynamics.

  19. THE GAIT OF UNILATERAL TRANSFEMORAL AMPUTEES

    NARCIS (Netherlands)

    BOONSTRA, AM; SCHRAMA, J; FIDLER, [No Value; EISMA, WH

    1994-01-01

    The aim of this study was to describe the gait of persons with a unilateral transfemoral amputation by means of a questionnaire, gait analysis and measurement of energy expenditure, and to find correlations among the variables studied. The study included 29 transfemoral amputees amputated for other

  20. Claimed walking distance of lower limb amputees

    NARCIS (Netherlands)

    Geertzen, JHB; Bosmans, JC; Van der Schans, CP; Dijkstra, PU

    2005-01-01

    Purpose: Walking ability in general and specifically for lower limb amputees is of major importance for social mobility and ADL independence. Walking determines prosthesis prescription. The aim of this study was to mathematically analyse factors influencing claimed walking distance of lower limb amp

  1. Rehabilitation of a triple amputee including a hip disarticulation.

    Science.gov (United States)

    Shin, J C; Park, C I; Kim, Y C; Jang, S H; Bang, I K; Shin, J S

    1998-12-01

    A multiple amputee more severe than a triple amputee is uncommon. There have been no reports on the rehabilitation outcome of a triple amputee, including hip disarticulation and transtibial amputation. The authors report the rehabilitation of a patient with left hip disarticulation, right trans-tibial amputation, and left trans-humeral amputation due to a train accident. He has successfully completed the rehabilitation programme and has become independent in prosthetic ambulation, activities of daily living, and driving.

  2. Differences in whole-body angular momentum between below-knee amputees and non-amputees across walking speeds.

    Science.gov (United States)

    Silverman, A K; Neptune, R R

    2011-02-01

    Unilateral, below-knee amputees have an increased risk of falling compared to non-amputees. The regulation of whole-body angular momentum is important for preventing falls, but little is known about how amputees regulate angular momentum during walking. This study analyzed three-dimensional, whole-body angular momentum at four walking speeds in 12 amputees and 10 non-amputees. The range of angular momentum in all planes significantly decreased with increasing walking speed for both groups. However, the range of frontal-plane angular momentum was greater in amputees compared to non-amputees at the first three walking speeds. This range was correlated with a reduced second vertical ground reaction force peak in both the intact and residual legs. In the sagittal plane, the amputee range of angular momentum in the first half of the residual leg gait cycle was significantly larger than in the non-amputees at the three highest speeds. In the second half of the gait cycle, the range of sagittal-plane angular momentum was significantly smaller in amputees compared to the non-amputees at all speeds. Correlation analyses suggested that the greater range of angular momentum in the first half of the amputee gait cycle is associated with reduced residual leg braking and that the smaller range of angular momentum in the second half of the gait cycle is associated with reduced residual leg propulsion. Thus, reducing residual leg braking appears to be a compensatory mechanism to help regulate sagittal-plane angular momentum over the gait cycle, but may lead to an increased risk of falling.

  3. An EMG Keyboard for Forearm Amputees

    Directory of Open Access Journals (Sweden)

    Wenwei Yu

    2003-01-01

    Full Text Available A high-efficiency, easy-to-use input device is not only important for data entry but also for human-computer interaction. To date, there has been little research on input devices with many degrees of freedom (DOF that can be used by the handicapped. This paper presents the development of an electromyography (EMG-based input device for forearm amputees. To overcome the difficulties in analysing EMG and realising high DOF from biosignals, the following were integrated: (1 an online learning method to cope with nonlinearity and the individual difference of EMG signals; (2 a smoothing algorithm to deal with noisy recognition results and transition states; and (3 a modified Huffman coding algorithm to generate the optimal code, taking expected error and input efficiency into consideration. Experiments showed the validity of the system and the possibility for development of a quiet, free-posture (no postural restriction input device with many DOF for users, including forearm amputees.

  4. Clinical rehabilitation of the amputee : A retrospective study

    NARCIS (Netherlands)

    Rommers, GM; Vos, LDW; Groothoff, JW; Eisma, WH

    1996-01-01

    The aim of this study was to determine the rehabilitation outcome of lower limb amputee patients after clinical rehabilitation. Altogether 183 amputee patients admitted for clinical rehabilitation in the years 1987-1991 were reviewed by retrospective analysis of medical record data. Three groups of

  5. Uphill and downhill walking in unilateral lower limb amputees

    NARCIS (Netherlands)

    Vrieling, A. H.; van Keeken, H. G.; Schoppen, T.; Otten, E.; Halbertsma, J. P. K.; Hof, A. L.; Postema, K.

    2008-01-01

    Objective: To study adjustment strategies in unilateral amputees in uphill and downhill walking. Design: observational cohort study. Subjects: Seven transfemoral, 12 transtibial unilateral amputees and 10 able-bodied subjects. Methods: In a motion analysis laboratory the subjects walked over a level

  6. Controlling propulsive forces in gait initiation in transfemoral amputees

    NARCIS (Netherlands)

    van Keeken, Helco G.; Vrieling, Aline H.; Hof, At L.; Halbertsma, Jan P. K.; Schoppen, Tanneke; Postema, Klaas; Otten, Bert

    2008-01-01

    During prosthetic gait initiation, transfemoral (TF) amputees control the spatial and temporal parameters that modulate the propulsive forces, the positions of the center of pressure (CoP), and the center of mass (CoM). Whether their sound leg or the prosthetic leg is leading, the TF amputees reach

  7. Increased cardiovascular disease mortality rates in traumatic lower limb amputees.

    Science.gov (United States)

    Modan, M; Peles, E; Halkin, H; Nitzan, H; Azaria, M; Gitel, S; Dolfin, D; Modan, B

    1998-11-15

    We evaluated the 24-year mortality rates of male traumatic lower limb amputees (n = 201) of the Israeli army, wounded between 1948 and 1974 compared with a cohort sample representing the general population (n = 1,832). Mortality rates were significantly higher (21.9% vs 12.1%, p amputees than in controls. Cardiovascular disease (CVD) mortality was the main cause for this difference. The prevalence of selected risk factors for CVD was determined in 101 surviving amputees (aged 50 to 65 years) and a sample of the controls (n = 96) matched by age and ethnic origin. Amputees had higher plasma insulin levels (during fasting and in response to oral glucose loading) and increased blood coagulation activity. No differences were found in rates of current symptoms of ischemic heart disease or of cerebrovascular disease, obesity, hypertension, altered plasma lipoprotein profile, impaired physical activity, smoking, or nutritional habits. Traumatic lower limb amputees had increased mortality rates due to CVD. Surviving amputees had hyperinsulinemia, increased coagulability, and increased sympathetic and parasympathetic responses (described previously). These established CVD risk factors may explain the excess mortality due to CVD in traumatic amputees.

  8. Prosthetic rehabilitation of the upper limb amputee

    Directory of Open Access Journals (Sweden)

    Bernard O′Keeffe

    2011-01-01

    Full Text Available The loss of all or part of the arm is a catastrophic event for a patient and a significant challenge to rehabilitation professionals and prosthetic engineers. The large, upper extremity amputee population in India has, historically, been poorly served, with most having no access to support or being provided with ineffective prostheses. In recent years, the arrival of organisations like Otto Bock has made high quality service standards and devices accessible to more amputees. This review attempts to provide surgeons and other medical professionals with an overview of the multidisciplinary, multistage rehabilitation process and the solution options available. With worldwide upper extremity prosthesis rejection rates at significant levels, the review also describes some of the factors which influence the outcome. This is particularly relevant in the Indian context where the service can involve high cost investments. It is the responsibility of all contributing professionals to guide vulnerable patients through the process and try to maximise the benefit that can be obtained within the resources available.

  9. Prosthetic options available for the diabetic lower limb amputee.

    Science.gov (United States)

    Chitragari, Gautham; Mahler, David B; Sumpio, Brandon J; Blume, Peter A; Sumpio, Bauer E

    2014-01-01

    Although the rate of lower limb amputation in patients with diabetes is decreasing, amputation still remains a major complication of diabetes. Prosthetics have been long used to help amputees ambulate. The last decade has seen many advances in prostheses with the enhanced understanding of the mechanics of ambulation and improved use of technology. This review describes the different types of prosthetic options available for below knee, ankle, and foot amputees, emphasizing the latest advances in prosthetic design.

  10. Insulin as a potential factor influencing blood pressure in amputees.

    Science.gov (United States)

    Rose, H G; Yalow, R S; Schweitzer, P; Schwartz, E

    1986-09-01

    War-injured, bilateral above-knee amputees are known to be at increased risk for cardiovascular mortality. To evaluate possible risk factors, we compared blood pressures and plasma glucose and insulin responses to orally administered glucose in 19 above-knee amputees from the Vietnam War (mean age, 36 +/- 1 years) with those of 12 age-matched unilateral below-elbow amputees. Body composition by densitometry and maximal oxygen consumption during arm or leg exercise were also determined. Nine of 19 leg amputees were hypertensive compared with one of 12 arm amputees. Their 3-hour average insulin responses were markedly increased (260 +/- 60 microU/ml) compared with those of normotensive leg (125 +/- 24 microU/ml) and arm amputees (101 +/- 20 microU/ml), and their mean body fat content (37.2%) also was elevated compared with that in both of these groups (23.2 and 22.6%, respectively). A unique finding was that both insulin response and body fat content were strongly and independently correlated with diastolic blood pressure (r = 0.55, p less than 0.01, and r = 0.62, p less than 0.01, respectively). We conclude that insulin may be a major factor in blood pressure regulation in the maturity-onset obesity that develops following traumatic leg amputation in young, healthy men.

  11. Neural activation differences in amputees during imitation of intact versus amputee movements

    Directory of Open Access Journals (Sweden)

    William F Cusack

    2012-06-01

    Full Text Available The mirror neuron system has been attributed with increased activation in motor-related cortical areas upon viewing of another’s actions. Recent work suggests that limb movements that are similar and dissimilar in appearance to that of the viewer equivalently activate the mirror neuron system. It is unclear if this result can be observed in the action encoding areas in amputees who use prosthetic devices. Intact subjects and upper extremity amputee prosthesis users were recruited to view video demonstrations of tools being used by an intact actor and a prosthetic device user. All subjects were asked to pantomime the movements seen in the video while recording electroencephalography. Intact subjects showed equivalent left parietofrontal activity during imitation after watching the intact or prosthetic arm. Likewise, when prosthesis users imitated prosthesis demonstrations, typical left parietofrontal activation was observed during planning. When prosthesis users imitated intact actors, a new pattern was revealed which showed greater bilateral parietal and occipital activity during movement planning (p<0.001. This change may be required for prosthesis users to imitate movements in which the limb states between the observed and the observer do not match. The finding that prosthesis users imitating other prosthesis users showed typical left parietofrontal activation suggests that these subjects engage normal planning related activity when they are able to imitate a limb matching their own. This result has significant implications on rehabilitation, as standard therapy involves training with an intact occupational therapist, which could necessitate atypical planning mechanisms in amputees when learning to use their prosthesis.

  12. Amputee Virtual Environment Support Space—A vision for virtual military amputee support

    Directory of Open Access Journals (Sweden)

    Ashley Fisher, MA

    2010-08-01

    Full Text Available The war in Iraq is the largest and longest sustained combat operation by the U.S. military since the Vietnam war. An estimated nearly 2 million U.S. military personnel have been deployed for Operation Iraqi Freedom and Operation Enduring Freedom [1]. Dr. Chuck Scoville, Col. Ret., Chief of Amputee Patient Care at Walter Reed Army Medical Center, stated that as of November 2009, 937 war fighters have suffered an amputation as a result of a battle injury. The successful recovery from a traumatic injury resulting in an amputation largely depends on care from clinical providers as well as peer support.

  13. Hand Grip Strength Vs. Sprint Effectiveness in Amputee Soccer Players

    Directory of Open Access Journals (Sweden)

    Wieczorek Marta

    2015-12-01

    Full Text Available Amputee soccer is one of the types of soccer designed for the disabled, especially those who have undergone amputations, as well as those with extremity dysfunction. The objective of the study was to find the relationship between hand grip strength and sprint time in amputee soccer players. Thirteen field amputee soccer players participated in the study. A SAEHAN hydraulic hand dynamometer manufactured by Jamar was used for hand grip strength measurements. The sprint running test was conducted over a distance of 30 m. The Fusion Smart Speed System was employed for running time measurements. No statistically significant relationships were found between hand grip strength of the left or right hand, and sprint times over 1, 5, 10, 15, 20, 25 and 30 m. Analysis of the running velocity curve of the subjects showed an interesting profile characterized by a 15 meter-long acceleration phase and a significant velocity increase over a distance of 20 – 25 m. The study suggests that there is no relationship between hand grip strength and sprint effectiveness in amputee soccer players. The specificity of locomotion with the use of elbow crutches among elite Polish amputee soccer players probably accounts for the profile of the sprint velocity curve. Extension of the acceleration phase in the sprint run and a velocity increase in the subsequent part of the run were observed.

  14. Improving Myoelectric Control for Amputees through Transcranial Direct Current Stimulation.

    Science.gov (United States)

    Pan, Lizhi; Zhang, Dingguo; Sheng, Xinjun; Zhu, Xiangyang

    2015-08-01

    Most prosthetic myoelectric control studies have shown good performance for unimpaired subjects. However, performance is generally unacceptable for amputees. The primary problem is the poor quality of electromyography (EMG) signals of amputees compared with healthy individuals. To improve clinical performance of myoelectric control, this study explored transcranial direct current stimulation (tDCS) to modulate brain activity and enhance EMG quality. We tested six unilateral transradial amputees by applying active and sham anodal tDCS separately on two different days. Surface EMG signals were acquired from the affected and intact sides for 11 hand and wrist motions in the pre-tDCS and post-tDCS sessions. Autoregression coefficients and linear discriminant analysis classifiers were used to process the EMG data for pattern recognition of the 11 motions. For the affected side, active anodal tDCS significantly reduced the average classification error rate (CER) by 10.1%, while sham tDCS had no such effect. For the intact side, the average CER did not change on the day of sham tDCS but increased on the day of active tDCS. These results demonstrated that tDCS could modulate brain function and improve EMG-based classification performance for amputees. It has great potential in dramatically reducing the length of learning process of amputees for effectively using myoelectrically controlled multifunctional prostheses.

  15. Suction socket suspension for below-knee amputees.

    Science.gov (United States)

    Roberts, R A

    1986-03-01

    In this study the current use of suction suspension for below-knee prostheses is examined by means of two questionnaire surveys. The experience of 56 below-knee (B-K) amputees wearing suction socket prostheses is evaluated comparing suction prostheses with previously worn limbs. A high degree of satisfaction was found, with amputees on the whole reporting improved skin condition, diminished pain, and increased activity levels compared to previous prosthetic history. The experience and opinions of 466 certified prosthetist members of the American Orthotist Prosthetist Association are examined in the second survey, including degree of contact, success, and evaluation of problems in using suction suspension for the B-K amputee. This survey indicated limited contact and familiarity with B-K suction suspension, with only 22% stating they had made this type of prosthesis. Prosthetists cited characteristics of the B-K residual limb as the chief deterrent to a successful fitting.

  16. Lower-limb amputee recovery response to an imposed error in mediolateral foot placement.

    Science.gov (United States)

    Segal, Ava D; Klute, Glenn K

    2014-09-22

    Despite walking with a wider step width, amputees remain 20% more likely to fall than non-amputees. Since mediolateral (ML) balance is critical for ambulation and contingent on ML foot placement, we used a ML disturbance to perturb walking balance and explore the influence of prosthetic foot stiffness on balance recovery. Ten transtibial amputees were fit with two commonly prescribed prosthetic feet with differing stiffness characteristics; 12 non-amputees also participated. A perturbation device that released an air burst just before heel strike imposed a repeatable medial or lateral disturbance in foot placement. After a medial disturbance, the first recovery step width was narrowed (pamputees (-41%) and more than twice as variable. The ML inclination angle remained reduced (-109%) for the prosthetic limb, while the sound limb and non-amputees approached undisturbed levels (pAmputees required five steps to return to undisturbed step width after a prosthetic medial disturbance versus two steps for the sound limb and for non-amputees. After a lateral disturbance, the first recovery step was widened for the prosthetic limb (+82%), sound limb (+75%), and wider than non-amputees (+51%; pAmputees also exhibited a similar upper torso response compared to the non-amputees for both disturbances. Prosthetic feet with different stiffness properties did not have a significant effect. In conclusion, amputee balance was particularly challenged by medial disturbances to the prosthetic limb implying a need for improved interventions that address these balance deficits.

  17. Over rough and smooth : Amputee gait on an irregular surface

    NARCIS (Netherlands)

    Curtze, C.; Hof, A.L.; Postema, K.; Otten, B.

    2011-01-01

    When negotiating irregular surfaces, the control of dynamic stability is challenged. In this study, we compared the adjustments in stepping behaviour and arm-swing of 18 unilateral transtibial amputees and 17 able-bodied participants when walking on flat and irregular surfaces. Experimental findings

  18. A new methodology to measure the running biomechanics of amputees.

    Science.gov (United States)

    Wilson, James Richard; Asfour, Shihab; Abdelrahman, Khaled Zakaria; Gailey, Robert

    2009-09-01

    We present a new methodology to measure the running biomechanics of amputees. This methodology combines the use of a spring-mass model and symmetry index, two standard techniques in biomechanics literature, but not yet used in concert to evaluate amputee biomechanics. The methodology was examined in the context of a pilot study to examine two transtibial amputee sprinters and showed biomechanically quantifiable changes for small adjustments in prosthetic prescription. Vertical ground reaction forces were measured in several trials for two transtibial amputees running at constant speed. A spring-mass model was used in conjunction with a symmetry index to observe the effect of varying prosthetic height and stiffness on running biomechanics. All spring-mass variables were significantly affected by changes in prosthetic prescription among the two subjects tested (p < 0.05). When prosthetic height was changed, both subjects showed significant differences, in Deltay(max), Deltal and contact time (t(c)) on the prosthetic limb and in k(vert) and k(leg) on the sound limb. The symmetry indices calculated for spring-mass variables were all significantly affected due to changes in prosthetic prescription for the male subject and all but the peak force (F(peak)) for the female subject. This methodology is a straight-forward tool for evaluating the effect of changes to prosthetic prescription.

  19. PROSTHETIC GAIT OF UNILATERAL TRANSFEMORAL AMPUTEES - A KINEMATIC STUDY

    NARCIS (Netherlands)

    JAEGERS, SMHJ; ARENDZEN, JH; DEJONGH, HJ

    1995-01-01

    Objective: The prosthetic gait of unilateral transfemoral amputees. Design: Case series. Setting: Laboratory of Gait Analysis (GIGA-system of K-lab) in the Department of Rehabilitation of a university hospital. Patients: Eleven men with transfemoral amputation (mean age 35.7 years) participated. The

  20. Variability and stability analysis of walking of transfemoral amputees

    NARCIS (Netherlands)

    Lamoth, Claudine C.; Ainsworth, Erik; Polomski, Wojtek; Houdijk, Han

    2010-01-01

    Variability and stability of walking of eight transfemoral amputees and eight healthy controls was studied under four conditions walking inside on a smooth terrain walking while performing a dual-task and walking outside on (ir)regular surfaces Trunk accelerations were recorded with a tri-axial acce

  1. The multiple meanings of 'disability' in interviews with amputees.

    Science.gov (United States)

    Heavey, Emily

    2013-01-01

    The link between having a lower-limb amputation and being disabled might seem self-evident. Indeed, the medical model of disability would suggest that lower-limb amputation causes disability, and that all lower-limb amputees are disabled people. Conversely, social models of disability would argue that limb loss does not determine disability, but that disabilities are rather caused by social structures and prejudices, while the interactional model suggests that there are both individual and social causes of disability. This paper draws on interviews with nine lower-limb amputees to address amputees' own accounts of disability, in order to determine how (if at all) they make links between being an amputee and being disabled. The analysis shows that participants draw on various models of disability, as well as their own lived experiences, to construct subjective and diverse definitions of disability. Three interlinking definitions of disability recurred across the data: disability as a measure of personal (in)abilities; disability as a stigmatizing mask; and disability as an official status. Overall, disability was constructed as a complex, context-dependent label, which could not be reduced to any singular concept.

  2. The Development of a Myoelectric Training Tool for Above-Elbow Amputees

    OpenAIRE

    2012-01-01

    The objective of above-elbow myoelectric prostheses is to reestablish the functionality of missing limbs and increase the quality of life of amputees. By using electromyography (EMG) electrodes attached to the surface of the skin, amputees are able to control motors in myoelectric prostheses by voluntarily contracting the muscles of their residual limb. This work describes the development of an inexpensive myoelectric training tool (MTT) designed to help upper limb amputees learn how to use m...

  3. Evaluation Of Gait Symmetry In Amputees Who Use Below Knee Prosthesis With Dynamic Foot

    Directory of Open Access Journals (Sweden)

    Yasin Yurt

    2012-06-01

    Full Text Available Purpose: To assess inter limb symmetry while walking in unilateral transtibial amputees which use dynamic foot. Method: Gait velocity, cadence, step length, stance percentages and ambulation index results of amputees (n=20 were recorded. Comparison was made with control group. (n=21 Results: Gait velocity, cadence and ambulation index results were greater for control group. Cases had longer stance time on their intact limb than amputated side. Stance time difference between limbs were higher for amputee group than control group. Conclusion: Amputees had higher stance percentage on their intact limb than sound limb with regard to healthy people.

  4. Left and right hand recognition in upper limb amputees.

    Science.gov (United States)

    Nico, Daniele; Daprati, Elena; Rigal, François; Parsons, Lawrence; Sirigu, Angela

    2004-01-01

    Previous research suggests a close similarity in brain activity between mental simulation of a movement and its real counterpart. To explore this similarity, we aimed to assess whether imagery is affected by the loss of a limb or of its motor skills. We examined the performance of 16 adult, upper limb amputees (and age-matched controls) in a left/right hand judgement task that implicitly requires motor imagery. The experimental group included subjects who had suffered the amputation of the dominant or the non-dominant limb. Although responding well above chance, amputees as a group were slower and less accurate than controls. Nevertheless, their response pattern was similar to that of controls, namely slower response times and more errors for stimuli depicting hands in unnatural orientations, i.e. postures difficult to reach with a real movement. Interestingly, for all stimuli, amputees' performance was strongly affected by the side of limb loss: subjects who underwent amputation of their preferred limb made more errors and required greater latencies to respond as compared with amputees of the non-dominant limb. In a further analysis we observed that the habit of wearing an aesthetic prosthesis significantly interfered with the ability to judge the corresponding hand. Our data lead to three main conclusions: (i) loss of a single limb per se does not prevent motor imagery but it significantly enhances its difficulty; (ii) these subjects apparently perform the hand recognition task using a strategy in which they initially mentally simulate movements of their dominant limb; (iii) wearing a prosthesis, devoid of any motor function, seems to interfere with motor imagery, consistent with the view that only 'tools' can be incorporated in a dynamic body schema.

  5. Biomechanical parameters of gait among transtibial amputees: a review

    Directory of Open Access Journals (Sweden)

    Alex Sandra Oliveira de Cerqueira Soares

    Full Text Available Rehabilitation for lower-limb amputees needs to focus on restoration of daily functions and independent locomotion. As gait is reestablished, reorganization of the motor pattern takes place in order to optimize the functions of the locomotor system. Biomechanics is a field of study that enables understanding of this reorganization. From such knowledge, appropriate strategies for recovering the autonomy of the means of locomotion can be established. Thus, this paper had the aim of reviewing the current status of the biomechanics of locomotion among unilateral transtibial amputees. To achieve this aim, papers written in English or Portuguese and published up to 2005 were selected from the Cochrane Library, PubMed, Scientific Electronic Library Online (SciELO, Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs and Dedalus databases. In cases of transtibial amputation, the absence of plantar flexors negatively affects locomotion. Increased absorption and energy generation by the muscles that control the hip joint of the amputated leg can be considered to be the main compensatory strategy developed by unilateral transtibial amputees during gait. Factors associated with the characteristics of the amputation, prosthesis and experimental protocol used directly influence the results.

  6. Balance control on a moving platform in unilateral lower limb amputees

    NARCIS (Netherlands)

    Vrieling, A. H.; van Keeken, H. G.; Schoppen, T.; Otten, E.; Hof, A. L.; Halbertsma, J. P. K.; Postema, K.

    2008-01-01

    Objective: To study balance control on a moving platform in lower limb amputees. Design: Observational cohort study. Participants: Unilateral transfemoral and transtibial amputees and able-bodied control subjects. Interventions: Balance control on a platform that moved in the anteroposterior directi

  7. Trans-femoral amputee pilots: criteria for return to the fighter cockpit.

    Science.gov (United States)

    Grossman, Alon; Goldstein, Liav; Heim, Michael; Barenboim, Erez; Dudkiewicz, Israel

    2005-04-01

    Proximal lower limb amputations (trans-femoral) usually leave amputees with significant functional disturbances. This article contains information regarding three pilots with trans-femoral amputations that returned swiftly to continue their aeronautical careers despite their disabilities. Adaptations are needed in the limb prostheses to enable the amputees to access the minimally spaced cockpit.

  8. Balance recovery after an evoked forward fall in unilateral transtibial amputees

    NARCIS (Netherlands)

    Curtze, Carolin; Hof, At L.; Otten, Bert; Postema, Klaas

    2010-01-01

    Falls are a common and potentially dangerous event, especially in amputees. In this study, we compared the mechanisms of balance recovery of 17 unilateral transtibial amputees and 17 matched able-bodied controls after being released from a forward-inclined orientation of 10%. Kinematic analysis reve

  9. Skin problems in lower limb amputees : an overview by case reports

    NARCIS (Netherlands)

    Meulenbelt, H.E.J.; Geertzen, J.H.B.; Dijkstra, Pieter; Jonkman, M.F.

    2007-01-01

    The stump in lower limb amputees is prone to skin problems because it is exposed to several unnatural conditions (shear and stress forces and increased humidity) when a prosthesis is used. This study reviews the literature on case reports of lower limb amputees with skin problems on the stump. In to

  10. Short-Term Physical and Mental Health Outcomes for Combat Amputee and Nonamputee Extremity Injury Patients

    Science.gov (United States)

    2012-01-01

    Amputees had significantly greater odds of certain mental health disorders including mood, sleep , pain, and postconcussion syndrome. However, ampu- tees...Second, amputees would have increased rates of mental health issues, particularly cognitive changes such as nonorganic sleep , pain, and postconcussion...Patients with brain/spinal injuries causing extremity paralysis were excluded. This research was approved by an institutional review board. Data

  11. Detection of the onset of gait initiation using kinematic sensors and EMG in transfemoral amputees

    NARCIS (Netherlands)

    Wentink, E.C.; Schut, V.G.H.; Prinsen, E.C.; Rietman, J.S.; Veltink, P.H.

    2013-01-01

    In this study we determined if detection of the onset of gait initiation in transfemoral amputees can be useful for voluntary control of upper leg prostheses. From six transfemoral amputees inertial sensor data and EMG were measured at the prosthetic leg during gait initiation. First, initial moveme

  12. Three-dimensional knee joint contact forces during walking in unilateral transtibial amputees.

    Science.gov (United States)

    Silverman, Anne K; Neptune, Richard R

    2014-08-22

    Individuals with unilateral transtibial amputations have greater prevalence of osteoarthritis in the intact knee joint relative to the residual leg and non-amputees, but the cause of this greater prevalence is unclear. The purpose of this study was to compare knee joint contact forces and the muscles contributing to these forces between amputees and non-amputees during walking using forward dynamics simulations. We predicted that the intact knee contact forces would be higher than those of the residual leg and non-amputees. In the axial and mediolateral directions, the intact and non-amputee legs had greater peak tibio-femoral contact forces and impulses relative to the residual leg. The peak axial contact force was greater in the intact leg relative to the non-amputee leg, but the stance phase impulse was greater in the non-amputee leg. The vasti and hamstrings muscles in early stance and gastrocnemius in late stance were the largest contributors to the joint contact forces in the non-amputee and intact legs. Through dynamic coupling, the soleus and gluteus medius also had large contributions, even though they do not span the knee joint. In the residual leg, the prosthesis had large contributions to the joint forces, similar to the soleus in the intact and non-amputee legs. These results identify the muscles that contribute to knee joint contact forces during transtibial amputee walking and suggest that the peak knee contact forces may be more important than the knee contact impulses in explaining the high prevalence of intact leg osteoarthritis.

  13. Advanced rehabilitation techniques for the multi-limb amputee.

    Science.gov (United States)

    Harvey, Zach T; Loomis, Gregory A; Mitsch, Sarah; Murphy, Ian C; Griffin, Sarah C; Potter, Benjamin K; Pasquina, Paul

    2012-01-01

    Advances in combat casualty care have contributed to unprecedented survival rates of battlefield injuries, challenging the field of rehabilitation to help injured service members achieve maximal functional recovery and independence. Nowhere is this better illustrated than in the care of the multiple-limb amputee. Specialized medical, surgical, and rehabilitative interventions are needed to optimize the care of this unique patient population. This article describes lessons learned at Walter Reed National Military Medical Center Bethesda in providing advanced therapy and prosthetics for combat casualties, but provides guidelines for all providers involved in the care of individuals with amputation.

  14. Real-time simultaneous myoelectric control by transradial amputees using linear and probability-weighted regression.

    Science.gov (United States)

    Smith, Lauren H; Kuiken, Todd A; Hargrove, Levi J

    2015-08-01

    Regression-based prosthesis control using surface electromyography (EMG) has demonstrated real-time simultaneous control of multiple degrees of freedom (DOFs) in transradial amputees. However, these systems have been limited to control of wrist DOFs. Use of intramuscular EMG has shown promise for both wrist and hand control in able-bodied subjects, but to date has not been evaluated in amputee subjects. The objective of this study was to evaluate two regression-based simultaneous control methods using intramuscular EMG in transradial amputees and compare their performance to able-bodied subjects. Two transradial amputees and sixteen able-bodied subjects used fine wire EMG recorded from six forearm muscles to control three wrist/hand DOFs: wrist rotation, wrist flexion/extension, and hand open/close. Both linear regression and probability-weighted regression systems were evaluated in a virtual Fitts' Law test. Though both amputee subjects initially produced worse performance metrics than the able-bodied subjects, the amputee subject who completed multiple experimental blocks of the Fitts' law task demonstrated substantial learning. This subject's performance was within the range of able-bodied subjects by the end of the experiment. Both amputee subjects also showed improved performance when using probability-weighted regression for targets requiring use of only one DOF, and mirrored statistically significant differences observed with able-bodied subjects. These results indicate that amputee subjects may require more learning to achieve similar performance metrics as able-bodied subjects. These results also demonstrate that comparative findings between linear and probability-weighted regression with able-bodied subjects reflect performance differences when used by the amputee population.

  15. Somatic and movement inductions phantom limb in non-amputees

    Science.gov (United States)

    Casas, D. M.; Gentiletti, G. G.; Braidot, A. A.

    2016-04-01

    The illusion of the mirror box is a tool for phantom limb pain treatment; this article proposes the induction of phantom limb syndrome on non-amputees upper limb, with a neurological trick of the mirror box. With two study situations: a) Somatic Induction is a test of the literature reports qualitatively, and novel proposal b) Motor Induction, which is an objective report by recording surface EEG. There are 3 cases proposed for Motor illusion, for which grasped movement is used: 1) Control: movement is made, 2) illusion: the mirror box is used, and 3) Imagination: no movement is executed; the subject only imagines its execution. Three different tasks are registered for each one of them (left hand, right hand, and both of them). In 64% of the subjects for somatic experience, a clear response to the illusion was observed. In the experience of motor illusion, cortical activation is detected in both hemispheres of the primary motor cortex during the illusion, where the hidden hand remains motionless. These preliminary findings in phantom limb on non-amputees can be a tool for neuro-rehabilitation and neuro-prosthesis control training.

  16. A powered prosthetic intervention for bilateral transfemoral amputees.

    Science.gov (United States)

    Lawson, Brian E; Ruhe, Brian; Shultz, Amanda; Goldfarb, Michael

    2015-04-01

    This paper presents the design and validation of a control system for a pair of powered knee and ankle prostheses to be used as a prosthetic intervention for bilateral transfemoral amputees. The control system leverages communication between the prostheses for enhanced awareness and stability, along with power generation at the knee and ankle joints to better restore biomechanical functionality in level ground walking. The control methodology employed is a combination of an impedance-based framework for weight-bearing portions of gait and a trajectory-based approach for the nonweight-bearing portions. The control system was implemented on a pair of self-contained powered knee and ankle prostheses, and the ability of the prostheses and control approach to provide walking functionality was assessed in a set of experimental trials with a bilateral transfemoral amputee subject. Specifically, experimental data from these trials indicate that the powered prostheses and bilateral control architecture provide gait kinematics that reproduce healthy gait kinematics to a greater extent than the subject's daily-use passive prostheses.

  17. Prescription options for the below knee amputee. A review.

    Science.gov (United States)

    Abrahamson, M A; Skinner, H B; Effeney, D J; Wilson, L A

    1985-02-01

    In 1973 a workshop sponsored by the National Academy of Sciences recommended that "efforts to develop prescription criteria for use of the numerous variants of the BK prosthesis should be intensified." This paper provides a review of the important considerations in the prescription of a below-knee prosthesis. It is intended that this information would assist the physician to make better informed decisions regarding the specific type of prosthesis for a particular patient. No attempt has been made to describe all prosthetic options since a majority of amputees are fit with only a few prescriptions. Thus, socket design, suspension, shank type, and foot specification may be optimized for individual patients through mutual agreement of the prosthetist and the knowledgeable physician. This paper will present some of the more difficult prescription solutions to the various fitting problems that are representative of our nation's amputee population. This is done with the knowledge that there may be other and equally successful solutions to these problems. Several illustrative examples are provided.

  18. Progressive thinning of visual motion area in lower limb amputees

    Directory of Open Access Journals (Sweden)

    Guangyao eJiang

    2016-03-01

    Full Text Available Accumulating evidence has indicated that amputation or deafferentation of a limb induces functional or structural reorganization in the visual areas. However, the extent of the visual areas involved after lower limb amputation remains uncertain. In this investigation, we studied 48 adult patients with unilateral lower limb amputation and 48 matched healthy controls using T1-weighted magnetic resonance imaging. Template-based regions of interest analysis was implemented to detect the changes of cortical thickness in the specific visual areas. Compared with normal controls, amputees exhibited significantly lower thickness in the V5/middle temporal (V5/MT+ visual area, as well as a trend of cortical thinning in the V3d. There was no significant difference in the other visual areas between the two groups. In addition, no significant difference of cortical thickness was found between patients with amputation at different levels. Across all amputees, correlation analyses revealed that the cortical thickness of the V5/MT+ was negatively correlated to the time since amputation. In conclusion, our findings indicate that the amputation of unilateral lower limb could induce changes in the motor-related visual cortex, and provide an update on the plasticity of the human brain after limb injury.

  19. The development and validation of a novel outcome measure to quantify mobility in the dysvascular lower extremity amputee: the amputee single item mobility measure

    Science.gov (United States)

    Norvell, Daniel C; Williams, Rhonda M; Turner, Aaron P; Czerniecki, Joseph M

    2016-01-01

    Objective: This study describes the development and psychometric evaluation of a novel patient-reported single-item mobility measure. Design: Prospective cohort study. Setting: Four Veteran’s Administration Medical Centers. Subjects: Individuals undergoing their first major unilateral lower extremity amputation; 198 met inclusion criteria; of these, 113 (57%) enrolled. Interventions: None. Main measures: The Amputee Single Item Mobility Measure, a single item measure with scores ranging from 0 to 6, was developed by an expert panel, and concurrently administered with the Locomotor Capabilities Index-5 (LCI-5) and other outcome measures at six weeks, four months, and 12 months post-amputation. Criterion and construct validity, responsiveness, and floor/ceiling effects were evaluated. Responsiveness was assessed using the standardized response mean. Results: The overall mean 12-month Amputee Single Item Mobility Measure score was 3.39 ±1.4. Scores for transmetatarsal, transtibial, and transfemoral amputees were 4.2 (±1.3), 3.2 (±1.5), and 2.9 (±1.1), respectively. Amputee Single Item Mobility Measure scores demonstrated “large” and statistically significant correlations with the LCI-5 scores at six weeks (r = 0.72), four months (r = 0.81), and 12 months (r = 0.86). At four months and 12 months, the correlation between Amputee Single Item Mobility Measure scores and hours of prosthetic use were r = 0.69 and r = 0.66, respectively, and between Amputee Single Item Mobility Measure scores and Trinity Amputation and Prosthesis Experience Scales functional restriction scores were r = 0.45 and r = 0.67, respectively. Amputee Single Item Mobility Measure scores increased significantly from six weeks to 12 months post-amputation. Minimal floor/ceiling effects were demonstrated. Conclusions: In the unilateral dysvascular amputee, the Amputee Single Item Mobility Measure has strong criterion and construct validity, excellent

  20. Physical, mental, and social predictors of functional outcome in unilateral lower-limb amputees

    NARCIS (Netherlands)

    Schoppen, Tanneke; Boonstra, Antje; Groothoff, JW; de Vries, J; Goeken, LN; Eisma, Willem

    2003-01-01

    Objective: To study the value of physical, mental, and social characteristics as predictors of functional outcome of elderly amputees. Design: Prospective, inception cohort study; comparisons with reference populations. Setting: Main hospitals, rehabilitation centers, nursing homes, patients' own re

  1. Prostheses, pain and sequelae of amputation, as seen by the amputee.

    Science.gov (United States)

    Chadderton, H C

    1978-04-01

    Results of a survey of 19 organizations belonging to World Veterans Federation indicate that major complains of amputees include; poor fitting, poor dissemination of knowledge to doctors and amputees regarding new prostheses, lack of opportunity for "input" from amputees at research level and inadequate measures to deal with phantom and stump pain. Suggested improvements by amputees; decrease in weight of prostheses, reduction in maintenance for swing and stance-phase control units development of recreational prostheses, more frequent checks through use of X-ray and film techniques, particularly during the "break-in" of a new appliance. Older veterans showed increasing concern in regard to development of consequential disabilities arising from amputation; premature arthritic changes in spine and remaining limb, circulatory problems and gastro-intestinal problems due to ingestion of drugs to control pain.

  2. Isometric hip muscle strength in posttraumatic below-knee amputees

    Directory of Open Access Journals (Sweden)

    Jandrić Slavica

    2007-01-01

    Full Text Available Background/Aim. Traumas and war injuries, next to chronic occlusive artery disease and diabetes mellitus-derived complications, are the most frequent cause of the lower limbs amputation. They affect mostly younger population that need a higher level of activities as compared with the elderly. Medical rehabilitation is very significant for the muscle performance improvement in this population providing their social reintegration. The aim of this study was to investigate the effect of below-knee amputation on the hip isometric muscle strength and effect of rehabilitation on improvement of hip muscle strength in below-knee amputees, secondary to war wounding. Methods. Forty below-knee amputees (after war wounding, average age 35.6±10.6 years, that were included in primary rehabilitation program with prosthetics, were examined. Objective parameters were used to evaluate therapeutical effects. Isometric muscle strength of hip flexors, extensors, abductors and adductors was measured by dynamometer and expressed in Newton (N at admission, control and discharge for each patient. Average length of the treatment was 51 ± 34.1 days. Results. For isometric hip flexors (t = - 1.99346, p < 0.05, extensors (t = -4.629073, p < 0.001, abductors (t = -4.9408, p < 0.001 and adductors (t = -2.00228, p < 0.05, muscle strength was significantly less on the amputated than on nonamputated side. The highest differences in muscle strength between amputated and nonamputated limbs were noted for hip abductors (26.6% and extensors (23.3%. There was significant improvement of mean values of strength for all examined hip muscles after rehabilitation and prosthetics for both legs in comparison to beginning of the therapy. The hip abductor on the amputated side was for 19.4% weaker after rehabilitation in comparison to the nonamputated limb. Conclusion. Decreases of isometric muscle strength in all examined hip muscles were observed, more in the amputated limb. Rehabilitation

  3. Real-time gait event detection for lower limb amputees using a single wearable sensor

    OpenAIRE

    Maqbool, HF; Husman, MAB; Awad, MI; Abouhossein, A; Mehryar, P; Iqbal, N.; Dehghani-Sanij, AA

    2016-01-01

    This paper presents a rule-based real-time gait event/phase detection system (R-GEDS) using a shank mounted inertial measurement unit (IMU) for lower limb amputees during the level ground walking. Development of the algorithm is based on the shank angular velocity in the sagittal plane and linear acceleration signal in the shank longitudinal direction. System performance was evaluated with four control subjects (CS) and one transfemoral amputee (TFA) and the results were validated with four F...

  4. Perspiration Thresholds and Secure Suspension for Lower Limb Amputees in Demanding Environments

    Science.gov (United States)

    2015-10-01

    care and innovative prostheses. FY15 Activities  Obtain & maintain HRPO/IRB approvals  Fabricate prosthetic components  Enroll lower limb amputee...AWARD NUMBER: W81XWH-14-1-0188 TITLE: Perspiration Thresholds and Secure Suspension for Lower Limb Amputees in Demanding Environments PRINCIPAL...COVERED 30Sep2014 – 29Sep2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-14-1-0188 Perspiration Thresholds and Secure Suspension for Lower Limb

  5. Characterization of evoked tactile sensation in forearm amputees with transcutaneous electrical nerve stimulation

    Science.gov (United States)

    Chai, Guohong; Sui, Xiaohong; Li, Si; He, Longwen; Lan, Ning

    2015-12-01

    Objective. The goal of this study is to characterize the phenomenon of evoked tactile sensation (ETS) on the stump skin of forearm amputees using transcutaneous electrical nerve stimulation (TENS). Approach. We identified the projected finger map (PFM) of ETS on the stump skin in 11 forearm amputees, and compared perceptual attributes of the ETS in nine forearm amputees and eight able-bodied subjects using TENS. The profile of perceptual thresholds at the most sensitive points (MSPs) in each finger-projected area was obtained by modulating current amplitude, pulse width, and frequency of the biphasic, rectangular current stimulus. The long-term stability of the PFM and the perceptual threshold of the ETS were monitored in five forearm amputees for a period of 11 months. Main results. Five finger-specific projection areas can be independently identified on the stump skin of forearm amputees with a relatively long residual stump length. The shape of the PFM was progressively similar to that of the hand with more distal amputation. Similar sensory modalities of touch, pressure, buzz, vibration, and numb below pain sensation could be evoked both in the PFM of the stump skin of amputees and in the normal skin of able-bodied subjects. Sensory thresholds in the normal skin of able-bodied subjects were generally lower than those in the stump skin of forearm amputees, however, both were linearly modulated by current amplitude and pulse width. The variation of the MSPs in the PFM was confined to a small elliptical area with 95% confidence. The perceptual thresholds of thumb-projected areas were found to vary less than 0.99 × 10-2 mA cm-2. Significance. The stable PFM and sensory thresholds of ETS are desirable for a non-invasive neural interface that can feed back finger-specific tactile information from the prosthetic hand to forearm amputees.

  6. Somatotopic reorganization of hand representation in bilateral arm amputees with or without special foot movement skill.

    Science.gov (United States)

    Yu, Xiao Jing; He, Hong Jian; Zhang, Qiao Wei; Zhao, Feng; Zee, Chi Shing; Zhang, Shi Zheng; Gong, Xiang Yang

    2014-02-10

    Bilateral arm amputees usually are excellent foot users. To explore the plasticity of the primary motor cortex in upper-extremities amputees and to determine if the acquisition of special foot movement skill is related with the bilateral hand amputation, we studied the primary motor cortex by using combined task and resting state functional magnetic resonance imaging (fMRI). We investigated 6 bilateral arm amputees with or without special foot movement skill. In the task fMRI study, we found that toe tapping of all the amputees activated the bilateral hand area, including cases without special foot skill. In addition, cases without special foot skill mainly activated the precentral gyrus, which differed from those with more adept foot motor skill who activated both the precentral and postcentral gyri. To further understand the plasticity of the hand area, the resting state functional connectivity was investigated between the foot and hand regions. One-tailed two-sample t-test suggested that the connections between two areas became significantly stronger in the amputee group. Our study demonstrates that hand region of the cortex does not remain 'silent' after bilateral arm amputation, but rather is recruited by other modalities such as adjacent or nonadjacent cortexes to process motor information in a functionally relevant manner. From the data presented, it seems that the bilateral arm amputees have a strong potential to develop new skills in their remaining extremities and practice may further enhance this potential.

  7. Step Frequency and Step Length of 200-m Sprint in Able-bodied and Amputee Sprinters.

    Science.gov (United States)

    Hobara, H; Sano, Y; Kobayashi, Y; Heldoorn, T A; Mochimaru, M

    2016-02-01

    The goal of this study was to examine the hypothesis that the difference in the 200-m sprint performance of amputee and able-bodied sprinters is due to a shorter step length rather than a lower step frequency. Men's elite-level 200-m races with a total of 16 able-bodied, 13 unilateral transtibial, 5 bilateral transtibial, and 16 unilateral transfemoral amputee sprinters were analyzed from publicly available internet broadcasts. For each run, the average forward velocity, step frequency, and step length over the entire 200-m distance were analyzed for each sprinter. The average forward velocity of able-bodied sprinters was faster than that of the other 3 groups, but there was no significant difference in average step frequency between able-bodied and transtibial amputee sprinters. However, the average step length of able-bodied sprinters was significantly longer than that of the transtibial amputee sprinters. In contrast, the step frequency and step length of transfemoral amputees were significantly lower and shorter than those of the other 3 groups. These results suggest that the differences in 200-m sprint performance between able-bodied and amputee sprinters are dependent on amputation level.

  8. Tactile display on the remaining hand for unilateral hand amputees

    Directory of Open Access Journals (Sweden)

    Li Tao

    2016-09-01

    Full Text Available Human rely profoundly on tactile feedback from fingertips to interact with the environment, whereas most hand prostheses used in clinics provide no tactile feedback. In this study we demonstrate the feasibility to use a tactile display glove that can be worn by a unilateral hand amputee on the remaining healthy hand to display tactile feedback from a hand prosthesis. The main benefit is that users could easily distinguish the feedback for each finger, even without training. The claimed advantage is supported by preliminary tests with healthy subjects. This approach may lead to the development of effective and affordable tactile display devices that provide tactile feedback for individual fingertip of hand prostheses.

  9. Bodies completed: on the physical rehabilitation of lower limb amputees.

    Science.gov (United States)

    Hoffman, Michal

    2013-05-01

    This ethnographic study, based on empirical work carried out in an Israeli rehabilitation hospital, discusses the physical rehabilitation of lower limb amputees, during which body normalcy is re-constructed. Throughout the process, physiotherapists serve as social agents who teach pragmatic and discursive practices to manage the body as well as the prosthesis in the re-cultivation of body techniques. The findings, portraying four spheres of meaning, show that the mere use of prosthesis is insufficient since it stigmatizes the body as absent a limb. To avoid such stigmatization, the staff teach compensatory and discursive skills which enable incorporation of the prosthesis in body techniques while referring to it as a biological leg. Constructed as a 'social organ', the device is gradually transformed from an extension to an integral part of the body. Disability and its remedies, thereby concealed, facilitate able-bodied performance. Paradoxically, the prosthesis, though meant to benefit patients, induces pain and discomfort, a fact that challenges the acceptance of its conventionality as a medical aid for amputees. Yet, physical rehabilitation by means of prosthetics remains one of the many medical practices in Israel that ensure a disability-free society, together with the promotion of rights to accessibility and anti-discrimination regulation. The study contributes to the theoretical debate regarding the relationship between the biological and the social in disability studies. The findings indicate the need to encompass the cultural and the corporeal when exploring disability. The ethnography of disability, I suggest, should be viewed as a juncture of socio-cultural perceptions of the body, embedded in its own corporeal constraints.

  10. Hyperbaric oxygenation accelerates prosthetic rehabilitation of lower limb amputees.

    Science.gov (United States)

    Igor, Simanic; Mirko, Teofilovski; Dalibor, Paspalj; Milutin, Radotic; Dusica, Djordjevic; Vladimir, Zivkovic; Vladimir, Jakovljevic

    2013-01-01

    The purpose of the study was to assess the effects of hyperbaric oxygen (HBO2) therapy on prosthetic rehabilitation of patients with unilateral lower limb amputation. Narang's scale,the Locomotor Capabilities Index and the two-minute walk test were used to assess functional abilities of amputees on the admission and on discharge from hospital. We also kept records of some clinical parameters whose improvement enables better mobility of patients: thigh and lower leg girth, strength of amputation stump, existence of amputation stump contracture, existence of some other complications on amputation stump, blood oxygenation and pulse palpation. Our results show that hyperbaric oxygenation accelerates prosthetic rehabilitation of lower limb amputees. HBO2-treated patients were discharged from the hospital faster than the controls (hospitalized for 133.2 +/- 54.87 days vs. 158.36 +/- 53.05 days), they had improved arterial Hb saturation (97.40 +/- 3.51% vs. 94.74 +/- 3.28 %) and pulse palpability (pulse palpable in 27 vs. 18 subjects), less complications of the amputation stump (complications present in 24 vs. 30 subjects), greater healthy leg thigh girth (50.75 +/- 3.96 cm vs. 48.90 +/- 2.59 cm), stronger amputation stump (mark 3.90 +/- 0.54 vs. 3.33 +/- 0.47) and better functional abilities as measured by adapted Narang's scale (category 3.43 +/- 1.30 vs. 4.10 +/- 1.12) and locomotor capabilities index (score 38.06 +/- 10.90 vs. 33.16 +/- 8.80). These findings highlight the increasing validity of this procedure after limb amputation, which should be confirmed by further research in multicenter studies involving a larger number of respondents.

  11. Muscle activation patterns during walking from transtibial amputees recorded within the residual limb-prosthetic interface

    Directory of Open Access Journals (Sweden)

    Huang Stephanie

    2012-08-01

    Full Text Available Abstract Background Powered lower limb prostheses could be more functional if they had access to feedforward control signals from the user’s nervous system. Myoelectric signals are one potential control source. The purpose of this study was to determine if muscle activation signals could be recorded from residual lower limb muscles within the prosthetic socket-limb interface during walking. Methods We recorded surface electromyography from three lower leg muscles (tibilias anterior, gastrocnemius medial head, gastrocnemius lateral head and four upper leg muscles (vastus lateralis, rectus femoris, biceps femoris, and gluteus medius of 12 unilateral transtibial amputee subjects and 12 non-amputee subjects during treadmill walking at 0.7, 1.0, 1.3, and 1.6 m/s. Muscle signals were recorded from the amputated leg of amputee subjects and the right leg of control subjects. For amputee subjects, lower leg muscle signals were recorded from within the limb-socket interface and from muscles above the knee. We quantified differences in the muscle activation profile between amputee and control groups during treadmill walking using cross-correlation analyses. We also assessed the step-to-step inter-subject variability of these profiles by calculating variance-to-signal ratios. Results We found that amputee subjects demonstrated reliable muscle recruitment signals from residual lower leg muscles recorded within the prosthetic socket during walking, which were locked to particular phases of the gait cycle. However, muscle activation profile variability was higher for amputee subjects than for control subjects. Conclusion Robotic lower limb prostheses could use myoelectric signals recorded from surface electrodes within the socket-limb interface to derive feedforward commands from the amputee’s nervous system.

  12. Normative Spatiotemporal Parameters During 100-m Sprints in Amputee Sprinters Using Running-Specific Prostheses.

    Science.gov (United States)

    Hobara, Hiroaki; Potthast, Wolfgang; Müller, Ralf; Kobayashi, Yoshiyuki; Heldoorn, Thijs A; Mochimaru, Masaaki

    2016-02-01

    The aim of this study was to develop a normative sample of step frequency and step length during maximal sprinting in amputee sprinters. We analyzed elite-level 100-m races of 255 amputees and 93 able-bodied sprinters, both men and women, from publicly-available Internet broadcasts. For each sprinter's run, the average forward velocity, step frequency, and step length over the 100-m distance were analyzed by using the official record and number of steps in each race. The average forward velocity was greatest in able-bodied sprinters (10.04 ± 0.17 m/s), followed by bilateral transtibial (8.77 ± 0.27 m/s), unilateral transtibial (8.65 ± 0.30 m/s), and transfemoral amputee sprinters (7.65 ± 0.38 m/s) in men. Differences in velocity among 4 groups were associated with step length (able-bodied vs transtibial amputees) or both step frequency and step length (able-bodied vs transfemoral amputees). Although we also found that the velocity was greatest in able-bodied sprinters (9.10 ± 0.14 m/s), followed by unilateral transtibial (7.08 ± 0.26 m/s), bilateral transtibial (7.06 ± 0.48 m/s), and transfemoral amputee sprinters (5.92 ± 0.33 m/s) in women, the differences in the velocity among the groups were associated with both step frequency and step length. Current results suggest that spatiotemporal parameters during a 100-m race of amputee sprinters is varied by amputation levels and sex.

  13. Robotic touch shifts perception of embodiment to a prosthesis in targeted reinnervation amputees.

    Science.gov (United States)

    Marasco, Paul D; Kim, Keehoon; Colgate, James Edward; Peshkin, Michael A; Kuiken, Todd A

    2011-03-01

    Existing prosthetic limbs do not provide amputees with cutaneous feedback. Tactile feedback is essential to intuitive control of a prosthetic limb and it is now clear that the sense of body self-identification is also linked to cutaneous touch. Here we have created an artificial sense of touch for a prosthetic limb by coupling a pressure sensor on the hand through a robotic stimulator to surgically redirected cutaneous sensory nerves (targeted reinnervation) that once served the lost limb. We hypothesize that providing physiologically relevant cutaneous touch feedback may help an amputee incorporate an artificial limb into his or her self image. To investigate this we used a robotic touch interface coupled with a prosthetic limb and tested it with two targeted reinnervation amputees in a series of experiments fashioned after the Rubber Hand Illusion. Results from both subjective (self-reported) and objective (physiological) measures of embodiment (questionnaires, psychophysical temporal order judgements and residual limb temperature measurements) indicate that returning physiologically appropriate cutaneous feedback from a prosthetic limb drives a perceptual shift towards embodiment of the device for these amputees. Measurements provide evidence that the illusion created is vivid. We suggest that this may help amputees to more effectively incorporate an artificial limb into their self image, providing the possibility that a prosthesis becomes not only a tool, but also an integrated body part.

  14. IMPORTANCE OF ILIOPSOAS AND ERECTOR SPINAE MUSCLES IN PREDICTING THE FUNCTIONAL COMPETENCE OF TRANSFEMORAL AMPUTEES

    Directory of Open Access Journals (Sweden)

    Lajja K Rishi

    2014-10-01

    Full Text Available Purpose: Muscle imbalance in transfemoral amputees impair physical mobility and activities of daily living. Aim of this study was to correlate the muscle imbalance with functional competence in transfemoral amputees. Methods: Thirty amputees were evaluated under inclusion criteria and randomly allocated into 2 groups. Group A received stretching(1 week followed by strengthening(3 weeks and in group B strengthening(3 weeks were followed by stretching(1 week . Phase I includes values after 1 week stretching program in group A and 3 weeks strengthening program in group B. Data were recorded at baseline, after phase I completion and end of treatment. Physical mobility was assessed by “Timed up and go” test. Results: Muscle imbalance and physical mobility improved significantly in both groups at the end of treatment. The correlation values of “Timed up and go” test with Iliopsoas and Erector spinae muscle showed significant improvement in both groups. Conclusion: Baseline measurements showed that Iliopsoas and Erector spinae muscles were tight whereas Gluteus maximus and Abdominal muscles were weak in transfemoral amputees. Functional mobility improved after correction of muscle imbalance. Stretching followed by strengthening gave more significant results than vice versa. Good posture in transfemoral amputee prevents muscle dysfunction and improves functional mobility.

  15. Concurrent multibody and Finite Element analysis of the lower-limb during amputee running.

    Science.gov (United States)

    Rigney, Stacey M; Simmons, Anne; Kark, Lauren

    2015-01-01

    Lower-limb amputee athletes use Carbon fiber Energy Storage and Return (ESAR) prostheses during high impact activities such as running. The advantage provided to amputee athletes due to the energy-storing properties of ESAR prostheses is as yet uncertain. Conventional energy analysis methods for prostheses rely upon multibody models with articulating joints. Alternatively, Finite Element (FE) analysis treats bodies as a deforming continuum and can therefore calculate the energy stored without using these rigid-body mechanics assumptions. This paper presents a concurrent multibody and FE model of the femur, tibia, socket and ESAR prosthesis of a transtibial amputee athlete during sprinting. Gait analysis spatial data was used to conduct an offline simulation of the affected leg's stance phase in COMSOL Multiphysics. The calculated peak elastic strain energy of the prosthesis was 80J, with an overall RMSE of simulated marker displacement of 4.19 mm. This concurrent model presents a novel method for analyzing in vivo ESAR prosthesis behavior.

  16. The Potency of Optical and Augmented Reality Mirror Boxes in Amputees and People with Intact Limbs

    Directory of Open Access Journals (Sweden)

    Kieran O'Neill

    2006-01-01

    Full Text Available Phantom limb pain is the distressing problem experienced by many amputees, defined as a painful sensation perceived in the area of the missing body part. Phantom limb pain can be very severe and disabling. It continues to be experienced by two thirds of amputees, eight years post-amputation. Augmented reality has the ability to change a person’s sensory experience. More applications of this technology are gradually being utilised for therapeutic purposes as augmented environments can be used both to distract the attention of patients from excruciatingly painful experiences and to promote cortical re-mapping at the site from where the pain arises. Using Augmented Reality, an environment has been created where upper limb amputees can both view and control motion of their phantom limb to help alleviate phantom limb pain.

  17. Comparison of below-knee amputee gait performed overground and on a motorized treadmill.

    Science.gov (United States)

    Button, Chris; Moyle, Stuart; Davids, Keith

    2010-04-01

    There has been no direct attempt to evaluate whether gait performed overground and on a treadmill is the same for lower limb amputees. A multiple case study approach was adopted to explore the degenerate movement behavior displayed by three male amputees. Participants walked overground at a self-selected preferred pace and when this speed was enforced on a treadmill (50 stride cycles per condition). The extremities of motion (i.e., maximum flexion) for the hip and knee joints differed between conditions (0.2-3.8 degrees). For two participants, the temporal asymmetry of gait was reduced on the treadmill. Initial data suggest that research on amputees simulating overground walking on a treadmill might need to be interpreted with some caution.

  18. Intracortical inhibition is modulated by phase of prosthetic rehabilitation in transtibial amputees

    Directory of Open Access Journals (Sweden)

    Brenton eHordacre

    2015-05-01

    Full Text Available Reorganisation of primary motor cortex (M1 is well described in long-term lower limb amputees. In contrast cortical reorganisation during the rehabilitation period after amputation is poorly understood. Thirteen transtibial amputees and thirteen gender matched control participants of similar age were recruited. Transcranial magnetic stimulation was used to assess corticomotor and intracortical excitability of M1 bilaterally. Neurophysiological assessments were conducted at admission, prosthetic casting, first walk and discharge. Gait variability at discharge was assessed as a functional measure. Compared to controls, amputees had reduced short-latency intracortical inhibition for the ipsilateral M1 at admission (p=0.01. Analysis across rehabilitation revealed short-latency intracortical inhibition was reduced for the contralateral M1 at first walk compared to discharge (p=0.003. For the ipsilateral M1 both short and long-latency intracortical inhibition were reduced at admission (p<0.05 and prosthetic casting (p<0.02. Analysis of the neurophysiology and gait function revealed several interesting relationships. For the contralateral M1, reduced inhibition at admission (p=0.04 and first walk (p=0.05 was associated with better gait function. For the ipsilateral M1, reduced inhibition at discharge (p=0.05 was associated with poor gait function. This study characterised intracortical excitability in rehabilitating amputees. A dichotomous relationship between reduced intracortical inhibition for each M1 and gait function was observed at different times. Intracortical inhibition may be an appropriate cortical biomarker of gait function in lower limb amputees during rehabilitation, but requires further investigation. Understanding M1 intracortical excitability of amputees undertaking prosthetic rehabilitation provides insight into brain reorganisation in the sub-acute post amputation period and may guide future studies seeking to improve rehabilitation

  19. Stepwise Rehabilitation of the Triple Amputee Combined With Dysfunction of the Sound Limb

    OpenAIRE

    Shin, Ji Cheol; Yang, Hye Eun; Yu, Su Jin; Kim, Na Young; Yoon, Seo Yeon

    2014-01-01

    To find a multiple amputee more severe than a triple amputee is not easy. This is a report of a 36-year-old patient with right knee disarticulation, left trans-femoral amputation and right elbow disarticulation due to peripheral ischemic necrosis, when he was applied vasopressor in septic shock condition. His left hand was also 2nd, 3rd, 4th, and 5th distal interphalangeal joint disarticulation status, and it was more difficult for him to do rehabilitation program, such as donning and doffing...

  20. Retractable Prosthesis for Transfemoral Amputees Using Series Elastic Actuators and Force Control

    OpenAIRE

    Galbally, Elena; Small, Frank; Zanco, Ivan

    2015-01-01

    We present a highly functional and cost-effective prosthesis for transfemoral amputees that uses series elastic actuators. These actuators allow for accurate force control, low impedance and large dynamic range. The design involves one active joint at the knee and a passive joint at the ankle. Additionally, the socket was designed using mirroring of compliances to ensure maximum comfort.

  1. Piezoelectric bimorphs' characteristics as in-socket sensors for transfemoral amputees.

    Science.gov (United States)

    El-Sayed, Amr M; Hamzaid, Nur Azah; Abu Osman, Noor Azuan

    2014-12-10

    Alternative sensory systems for the development of prosthetic knees are being increasingly highlighted nowadays, due to the rapid advancements in the field of lower limb prosthetics. This study presents the use of piezoelectric bimorphs as in-socket sensors for transfemoral amputees. An Instron machine was used in the calibration procedure and the corresponding output data were further analyzed to determine the static and dynamic characteristics of the piezoelectric bimorph. The piezoelectric bimorph showed appropriate static operating range, repeatability, hysteresis, and frequency response for application in lower prosthesis, with a force range of 0-100 N. To further validate this finding, an experiment was conducted with a single transfemoral amputee subject to measure the stump/socket pressure using the piezoelectric bimorph embedded inside the socket. The results showed that a maximum interface pressure of about 27 kPa occurred at the anterior proximal site compared to the anterior distal and posterior sites, consistent with values published in other studies. This paper highlighted the capacity of piezoelectric bimorphs to perform as in-socket sensors for transfemoral amputees. However, further experiments are recommended to be conducted with different amputees with different socket types.

  2. Piezoelectric Bimorphs’ Characteristics as In-Socket Sensors for Transfemoral Amputees

    Directory of Open Access Journals (Sweden)

    Amr M. El-Sayed

    2014-12-01

    Full Text Available Alternative sensory systems for the development of prosthetic knees are being increasingly highlighted nowadays, due to the rapid advancements in the field of lower limb prosthetics. This study presents the use of piezoelectric bimorphs as in-socket sensors for transfemoral amputees. An Instron machine was used in the calibration procedure and the corresponding output data were further analyzed to determine the static and dynamic characteristics of the piezoelectric bimorph. The piezoelectric bimorph showed appropriate static operating range, repeatability, hysteresis, and frequency response for application in lower prosthesis, with a force range of 0–100 N. To further validate this finding, an experiment was conducted with a single transfemoral amputee subject to measure the stump/socket pressure using the piezoelectric bimorph embedded inside the socket. The results showed that a maximum interface pressure of about 27 kPa occurred at the anterior proximal site compared to the anterior distal and posterior sites, consistent with values published in other studies. This paper highlighted the capacity of piezoelectric bimorphs to perform as in-socket sensors for transfemoral amputees. However, further experiments are recommended to be conducted with different amputees with different socket types.

  3. Study on Gait Efficiency and Energy Cost of Below Knee Amputees After Therapeutic Practices

    Directory of Open Access Journals (Sweden)

    Durbadal Biswas

    2011-04-01

    Full Text Available An earlier research advocated that a below knee amputee (BK with conventional trans-tibial prosthesis attains higher gait efficiency at lower energy cost with therapeutic practices of proper time and co-ordination in compare to normal subjects of similar physical parameters and quality of life. The present study focused on comparative analysis of energy cost and gait efficiency between a group of below knee amputees and a control group (normal subjects without amputation to indicate the consistency of the earlier findings. The subjects were selected with similar physical parameters and quality of life. Oxygen Uptake (VO2 and Heart Rate (HR were measured by Cosmed® k4 b2 analyzer system. Gait efficiency (p < 0.0001 was found higher with lower energy cost for BK amputees after therapeutic practices than control group. The therapeutic activities contributed to efficient gait pattern for amputees ensuring proper time and co-ordination with balance in consistence to the earlier research.

  4. [The reorganization of the schema and body image of the amputee].

    Science.gov (United States)

    Giorgi, Ines; Gobba, Omar; Manera, Marina

    2015-01-01

    The paper deals with the psychological problems related to the amputee's experience. The stages of the reorganization of the body image and the problems that may arise, are described. In this process the phantom limb syndrome represents an important paradigm for study and reflection.

  5. Effect of Stump Length on Postural Steadiness During Quiet Stance in Unilateral Trans-Tibial Amputee

    Directory of Open Access Journals (Sweden)

    P. Lenka

    2010-01-01

    Full Text Available Although force platform based Center of pressure (COP measures of postural steadiness have been used to test the diagnostic significance of various cerebellar and labyrinthine lesions, but very few literature are available on amputees. The aim of this work is to measure the effect of stump length of Trance-Tibial amputee on postural steadiness during quiet stance. The COP variation, which is the major determinant of stability, has been evaluated. Twenty transtibial amputee patients (age: 34±9.57 years participated in this study. Among them, ten patients were having stump length of (19.33±2.04 cm and ten patients were having stump length of (9.2±0.91 cm. Postural stability is evaluated considering following factors like, AP range, ML range, RMS distance, mean distance, sway velocity, sway area and mean power frequency. The result shows that the mean value of all the measure parameters are having higher values in case of patients having shorter stump length than there counterpart. Therefore, it is concluded that transtibial amputee with longer stump length has better postural steadiness.

  6. Early treatment of trans-tibial amputees: retrospective analysis of early fitting and elastic bandaging

    NARCIS (Netherlands)

    Velzen, van A.D.; Nederhand, M.J.; Emmelot, C.H.; IJzerman, M.J.

    2005-01-01

    This study investigates the effects of early fitting in trans-tibial amputees. The assumption is that compared to elastic bandaging, the use of a rigid dressing in early fitting will result in quicker wound healing and earlier ambulation. A retrospective file search was carried out in three differen

  7. Sciatic nerve block performed with nerve stimulation technique in an amputee a case study

    DEFF Research Database (Denmark)

    Heiring, C.; Kristensen, Billy

    2008-01-01

    We present a case of a sciatic nerve block performed with the nerve stimulation technique. This technique is normally not used in amputees because detection of a motor response to an electrical stimulation is impossible. In our patient the stimulation provoked a phantom sensation of movement...

  8. Mirror therapy in lower limb amputees. A look beyond primary motor cortex reorganization

    Energy Technology Data Exchange (ETDEWEB)

    Seidel, S.; Essmeister, M.; Sycha, T.; Auff, E. [Vienna Medical Univ. (Austria). Dept. of Neurology; Kasprian, G.; Furtner, J.; Schoepf, V.; Prayer, D. [Vienna Medical Univ. (Austria). Dept. of Neuroradiology

    2011-11-15

    Phantom pain in upper limb amputees is associated with the extent of reorganization in the primary sensorimotor cortex. Mirror visual feedback therapy has been shown to improve phantom pain. We investigated the extent of cortical reorganization in lower limb amputees and changes in neural activity induced by mirror therapy. Eight lower limb amputees underwent 12 sessions of MVFT and functional magnetic resonance imaging (fMRI) of the brain before the first and after the last MVFT session. FMRI sessions consisted of two runs in which subjects were instructed to perform repetitive movement of the healthy and phantom ankle. Before MVFT, the mean phantom pain intensity was 4.6 {+-} 3.1 on a visual analog scale and decreased to 1.8 {+-} 1.7 (p = 0.04). We did not observe a consistent pattern of cortical activation in primary sensorimotor areas during phantom limb movements. Following MVFT, increased activity was obtained in the right orbitofrontal cortex during phantom ankle movements. Comparison of cortical activity during movements of the phantom ankle and the intact ankle showed significantly higher activity in the left inferior frontal cortex (pars triangularis). These results question the known association between phantom pain and primary sensorimotor reorganization and propose reorganizational changes involving multiple cortical areas in lower limb amputees. Finally, reduction of phantom pain after mirror visual feedback therapy was associated with increased prefrontal cortical activity during phantom ankle movements. (orig.)

  9. Gait analysis of transfemoral amputee patients using prostheses with two different knee joints

    NARCIS (Netherlands)

    Boonstra, AM; Schrama, JM; Eisma, WH; Hof, AL; Fidler, EV

    1996-01-01

    Objective: To evaluate the gait of transfemoral amputee patients using a prosthesis with a 4-bar linkage knee joint with either a mechanical swing phase control (Otto Beck 3R20) or a pneumatic swing phase control (Tehlin knee). Design: Randomized cross-over trial. Setting: Rehabilitation Department

  10. Observation-based training for neuroprosthetic control of grasping by amputees.

    Science.gov (United States)

    Agashe, Harshavardhan A; Contreras-Vidal, Jose L

    2014-01-01

    Current brain-machine interfaces (BMIs) allow upper limb amputees to position robotic arms with a high degree of accuracy, but lack the ability to control hand pre-shaping for grasping different objects. We have previously shown that low frequency (0.1-1 Hz) time domain cortical activity recorded at the scalp via electroencephalography (EEG) encodes information about grasp pre-shaping. To transfer this technology to clinical populations such as amputees, the challenge lies in constructing BMI models in the absence of overt training hand movements. Here we show that it is possible to train BMI models using observed grasping movements performed by a robotic hand attached to amputees' residual limb. Three transradial amputees controlled the grasping motion of an attached robotic hand via their EEG, following the action-observation training phase. Over multiple sessions, subjects successfully grasped the presented object (a bottle or a credit card) in 53±16 % of trials, demonstrating the validity of the BMI models. Importantly, the validation of the BMI model was through closed-loop performance, which demonstrates generalization of the model to unseen data. These results suggest `mirror neuron system' properties captured by delta band EEG that allows neural representation for action observation to be used for action control in an EEG-based BMI system.

  11. Glasgow Coma Scores, Early Opioids, and Posttraumatic Stress Disorder Among Combat Amputees

    Science.gov (United States)

    2014-04-01

    Center, 2011). Patients with severe brain or spinal injury leading to paralysis were excluded. Of the 857 combat amputees injured through 2008, we...included postconcussion syndrome, pain, and sleep disorders. Data Analysis Sample sizes for analyses of data varied by the level of care at which

  12. Kinetic and Kinematic Differences in a Golf Swing in One and Both Lower Limb Amputees

    Directory of Open Access Journals (Sweden)

    Stastny Petr

    2015-12-01

    Full Text Available Amputee golfers need to cope with the absence of sole proprioception, a decreased range of swing motion and other factors which should be recognized for training purposes. The aim of this study was to determine the kinetic and kinematic differences in the golf swing in one leg and two legs amputees. The participants consisted of two males and one female at a professional or amateur level with a different degree of disability. Each participant was taped by 3D markers and performed five golf swings with the iron 6. The intraclass correlation coefficient (ICC did not vary between individuals in kinematics, however, it was low in kinetic variables of two leg amputees. The Kendal rank correlation showed a significant relationship between the level of amputation and a large number of kinetic and kinematic variables such as X factor, O factor, S factor and individual body angles. The fluency and similarity of the golf swing did not depend on the level of amputation. One lower limb amputation did not seem to increase movement variability contrary to two lower limb amputation. The most variable parameter was a weight-shift in all golfers. The takeaway and horizontal force angle depended on the level of amputation rather than individual technique, thus, their modification by training may be difficult. Estimation of golf swing „mistakes“ in amputees in respect to the leading arm in an early follow or late follow position appeared to be useless.

  13. Adjustments to amputation and an artificial limb in lower limb amputees

    NARCIS (Netherlands)

    Sinha, Richa; van den Heuvel, Wim J. A.; Arokiasamy, Perianayagam

    2014-01-01

    Background: Positive adjustments to amputation and an artificial limb play important roles in the rehabilitation process. Objectives: To study the different facets of adjustments to amputation and an artificial limb in lower limb amputees and to assess the possible role of different background and a

  14. Pain, functional status, social function and conditions of habitation in elderly unilaterally lower limb amputees

    Directory of Open Access Journals (Sweden)

    Đurović Aleksandar

    2007-01-01

    Full Text Available Background/Aim. Few authors are involved in home rehabilitation of amputees or their reintegration into the community. It has been remarked that there is a discontinuity between the phases of the amputee rehabilitation in Serbia. The aim of the study was to establish pain characteristics and functional status of amputees two months after the amputation and to determine their social function and the conditions of their habitation. Methods. This prospective observation study involved 38 elderly amputees with unilateral lower limb amputations. The patients were tested at the hospital on discharge and at their homes two months after the amputation. Pain intensity and functional status were measured by a visual analogue scale (VAS and by Functional Independence Measure (FIM. The patients’ social function was assessed using the Social Dysfunction Rating Scale (SDRS and conditions of their habitation by the self-created Scale of Conditions of Habitation (SCH. In statistic analysis we used the Student t test, χ2 test and Analysis of variance (ANOVA. Results. The majority of patients (63% underwent below knee amputation caused by diabetes (89%. A significant number of patients (84%, χ2 = 17.78; p < 0.01 was not visited by a physiotherapist nor an occupational therapist during two months at home. In this period, the majority of the amputees (68% had phantom pain or residual limb pain (21%. Two months after amputation the pain intensity was significantly lower (VAS = 4.07±2.19; 2.34±1.41; p < 0.001, and the functional status significantly better than on discharge (FIM = 75.13±16.52; 87.87±16.48; p < 0.001. The amputees had the average level of social dysfunction (SDRS = 62.00±11.68 and conditions of habitation (SCH = 7.81±1.97. Conclusion. A total 38 elderly amputees with unilateral lower limb amputations achieved significant functional improvement and reduction of pain, in spite of their social dysfunction, the absence of socio-medical support

  15. High density electromyography data of normally limbed and transradial amputee subjects for multifunction prosthetic control.

    Science.gov (United States)

    Daley, Heather; Englehart, Kevin; Hargrove, Levi; Kuruganti, Usha

    2012-06-01

    Pattern recognition based control of powered upper limb myoelectric prostheses offers a means of extracting more information from the available muscles than conventional methods. By identifying repeatable patterns of muscle activity across multiple muscle sites rather than relying on independent EMG signals it is possible to provide more natural, reliable control of myoelectric prostheses. The purposes of this study were to (1) determine if participants can perform distinctive muscle activation patterns associated with multiple wrist and hand movements reliably and (2) to show that high density EMG can be applied individually to determine the electrode location of a clinically acceptable number of electrodes (maximally eight) to classify multiple wrist and hand movements reliably in transradial amputees. Eight normally limbed subjects (five female, three male) and four transradial amputee subjects (two traumatic and congenital) subjects participated in this study, which examined the classification accuracies of a pattern recognition control system. It was found that tasks could be classified with high accuracy (85-98%) with normally limbed subjects (10-13 tasks) and with amputees (4-6) tasks. In healthy subjects, reducing the number of electrodes to eight did not affect accuracy significantly when those electrodes were optimally placed, but did reduce accuracy significantly when those electrodes were distributed evenly. In the amputee subjects, reducing the number of electrodes up to 4 did not affect classification accuracy or the number of tasks with high accuracy, independent of whether those remaining electrodes were evenly distributed or optimally placed. The findings in healthy subjects suggest that high density EMG testing is a useful tool to identify optimal electrode sites for pattern recognition control, but its use in amputees still has to be proven. Instead of just identifying the electrode sites where EMG activity is strong, clinicians will be able to

  16. Does obesity predict functional outcome in the dysvascular amputee?

    Science.gov (United States)

    Kalbaugh, Corey A; Taylor, Spence M; Kalbaugh, Brooke A; Halliday, Matthew; Daniel, Grace; Cass, Anna L; Blackhurst, Dawn W; Cull, David L; Langan, Eugene M; Carsten, Christopher G; York, John W; Snyder, Bruce A; Youkey, Jerry R

    2006-08-01

    Limited information is available concerning the effects of obesity on the functional outcomes of patients requiring major lower limb amputation because of peripheral arterial disease (PAD). The purpose of this study was to examine the predictive ability of body mass index (BMI) to determine functional outcome in the dysvascular amputee. To do this, 434 consecutive patients (mean age, 65.8 +/- 13.3, 59% male, 71.4% diabetic) undergoing major limb amputation (225 below-knee amputation, 27 through-knee amputation, 132 above-knee amputation, and 50 bilateral) as a complication of PAD from January 1998 through May 2004 were analyzed according to preoperative BMI. BMI was classified according to the four-group Center for Disease Control system: underweight, 0 to 18.4 kg/m2; normal, 18.5 to 24.9 kg/m2; overweight, 25 to 29.9 kg/m2; and obese, > or = 30 kg/m2. Outcome parameters measured included prosthetic usage, maintenance of ambulation, survival, and maintenance of independent living status. The chi2 test for association was used to examine prosthesis wear. Kaplan-Meier curves were constructed to assess maintenance of ambulation, survival, and maintenance of independent living status. Multivariate analysis using the multiple logistic regression model and a Cox proportional hazards model were used to predict variables independently associated with prosthetic use and ambulation, survival, and independence, respectively. Overall prosthetic usage and 36-month ambulation, survival, and independent living status for the entire cohort was 48.6 per cent, 42.8 per cent, 48.1 per cent, 72.3 per cent, and for patients with normal BMI was 41.5 per cent, 37.4 per cent, 45.6 per cent, and 69.5 per cent, respectively. There was no statistically significant difference in outcomes for overweight patients (59.2%, 50.7%, 52.5%, and 75%) or obese patients (51.8%, 46.2%, 49.7%, and 75%) when compared with normal patients. Although there were significantly poorer outcomes for underweight

  17. Redirection of cutaneous sensation from the hand to the chest skin of human amputees with targeted reinnervation

    OpenAIRE

    Kuiken, Todd A.; Marasco, Paul D.; Lock, Blair A.; Harden, R. Norman; Dewald, Julius P.A.

    2007-01-01

    Amputees cannot feel what they touch with their artificial hands, which severely limits usefulness of those hands. We have developed a technique that transfers remaining arm nerves to residual chest muscles after an amputation. This technique allows some sensory nerves from the amputated limb to reinnervate overlying chest skin. When this reinnervated skin is touched, the amputees perceive that they are being touched on their missing limb. We found that touch thresholds of the reinnervated ch...

  18. Lower-limb amputee ankle and hip kinetic response to an imposed error in mediolateral foot placement.

    Science.gov (United States)

    Segal, Ava D; Shofer, Jane B; Klute, Glenn K

    2015-11-26

    Maintaining balance while walking is challenging for lower limb amputees. The effect of prosthetic foot stiffness on recovery kinetics from an error in foot placement may inform prescription practice and lead to new interventions designed to improve balance. Ten unilateral transtibial amputees were fit with two prosthetic feet with different stiffness properties in random order. After a 3-week acclimation period, they returned to the lab for testing before switching feet. Twelve non-amputees also participated in a single data collection. While walking on an instrumented treadmill, we imposed a repeatable, unexpected medial or lateral disturbance in foot placement by releasing a burst of air at the ankle just before heel strike. Three-dimensional motion capture, ground reaction force and center of pressure (COP) data were collected for two steps prior, the disturbed step and three steps after the disturbance. During undisturbed walking, coronal ankle impulse was lower by 42% for amputees wearing a stiff compared to a compliant foot (p=0.017); however, across steps, both prosthetic recovery patterns were similar compared to the sound limb and non-amputees. Peak coronal hip moment was 15-20% lower for both foot types during undisturbed walking (pamputees. Amputee prosthetic COP excursion was unaffected by the disturbance (2.4% change) compared to the sound limb (59% change; pamputees (55% change; pamputees.

  19. Use of an Activity Monitor and GPS Device to Assess Community Activity and Participation in Transtibial Amputees

    Directory of Open Access Journals (Sweden)

    Brenton Hordacre

    2014-03-01

    Full Text Available This study characterized measures of community activity and participation of transtibial amputees based on combined data from separate accelerometer and GPS devices. The relationship between community activity and participation and standard clinical measures was assessed. Forty-seven participants were recruited (78% male, mean age 60.5 years. Participants wore the accelerometer and GPS devices for seven consecutive days. Data were linked to assess community activity (community based step counts and community participation (number of community visits. Community activity and participation were compared across amputee K-level groups. Forty-six participants completed the study. On average each participant completed 16,645 (standard deviation (SD 13,274 community steps and 16 (SD 10.9 community visits over seven days. There were differences between K-level groups for measures of community activity (F(2,45 = 9.4, p < 0.001 and participation (F(2,45 = 6.9, p = 0.002 with lower functioning K1/2 amputees demonstrating lower levels of community activity and participation than K3 and K4 amputees. There was no significant difference between K3 and K4 for community activity (p = 0.28 or participation (p = 0.43. This study demonstrated methodology to link accelerometer and GPS data to assess community activity and participation in a group of transtibial amputees. Differences in K-levels do not appear to accurately reflect actual community activity or participation in higher functioning transtibial amputees.

  20. Improving Functional Outcomes for Vascular Amputees Through Use of Mirror Therapy and Elimination of the Effects of Electromagnetic Fields.

    Science.gov (United States)

    Houston, Helen; Dickerson, Anne E

    2016-01-01

    The objective of this pilot study was to investigate the effectiveness of combining an amputee limb cover to eliminate the effects of electromagnetic fields (i.e., pain) and a Mirror Therapy exercise program to improve functional outcomes for vascular amputees. A cross-sectional repeated-measures design was used with 14 participants with either acute amputations or surgery at least 8 to 24 months previously. The 4-week intervention included the use of an amputee limb cover and mirror therapy exercises each day. The outcome measures were activities of daily living interference (e.g., self-care, walking, car transfer, low chair transfer, sleep), and well-being (e.g., satisfaction, mood, quality of life) at three times (pre- and posttreatment and maintenance). Participants with acute amputations made significant improvements in the areas of self-care, walking, car transfer, sleep, mood, and quality of life, while the subacute participants improved significantly in sleep and satisfaction. A reduction in the time required before prosthetic fitting decreased from 12 weeks to 8 weeks for acute amputees and an improvement in wearing tolerance from 0-2 to 8-12 hours for the subacute amputees were unexpected results suggesting the combined intervention may improves the extent to which amputees can increase participation in their activities of everyday living.

  1. Use of an activity monitor and GPS device to assess community activity and participation in transtibial amputees.

    Science.gov (United States)

    Hordacre, Brenton; Barr, Christopher; Crotty, Maria

    2014-03-25

    This study characterized measures of community activity and participation of transtibial amputees based on combined data from separate accelerometer and GPS devices. The relationship between community activity and participation and standard clinical measures was assessed. Forty-seven participants were recruited (78% male, mean age 60.5 years). Participants wore the accelerometer and GPS devices for seven consecutive days. Data were linked to assess community activity (community based step counts) and community participation (number of community visits). Community activity and participation were compared across amputee K-level groups. Forty-six participants completed the study. On average each participant completed 16,645 (standard deviation (SD) 13,274) community steps and 16 (SD 10.9) community visits over seven days. There were differences between K-level groups for measures of community activity (F(2,45) = 9.4, p participation (F(2,45) = 6.9, p = 0.002) with lower functioning K1/2 amputees demonstrating lower levels of community activity and participation than K3 and K4 amputees. There was no significant difference between K3 and K4 for community activity (p = 0.28) or participation (p = 0.43). This study demonstrated methodology to link accelerometer and GPS data to assess community activity and participation in a group of transtibial amputees. Differences in K-levels do not appear to accurately reflect actual community activity or participation in higher functioning transtibial amputees.

  2. An evaluation of the use made of cosmetic and functional prostheses by unilateral upper limb amputees.

    Science.gov (United States)

    Fraser, C M

    1998-12-01

    There is currently a distinction drawn between a prosthesis considered to be provided for purely cosmetic reasons and a functional prosthesis provided to enable the amputee to achieve basic hand function. Using video analysis the study reported in this paper demonstrates that for non-manipulative actions cosmetic prostheses are actively used in the performance of everyday tasks as frequently as functional prostheses. The study provides evidence for a cosmetic prosthesis to be presented to an amputee as a realistic initial prosthesis and not as the option of last resort if a functional prosthesis is rejected. It is also recommended that training is provided in the use of cosmetic prostheses in two-handed tasks.

  3. Clinical gait analysis for amputees: innovation wishlist and the perspectives offered by the outwalk protocol.

    Science.gov (United States)

    Cutti, Andrea Giovanni; Raggi, Michele; Andreoni, Giuseppe; Sacchetti, Rinaldo

    2015-01-01

    Clinical gait analysis (CGA) has shown potentials for the prosthetics field and has been found effective for scientific purposes and to design general rehabilitation models. However, intrinsic limitations of the "artificial" laboratory environment usually result in recording performances not representative patients' real-life gait. In order to promote the diffusion of CGA in the clinical decision-making process, a framework for developing novel, more ecological CGA applications is presented. Moreover, the Outwalk protocol, based on wearable sensors and developed within this framework guidelines, is described and validated for its inter-rater agreement on a population of transtibial amputees walking in a real-life scenario. Results show the possibility of drawing precise conclusions over different aspects of amputees' gait and prostheses' performance in every-day life conditions.

  4. Gait analysis and energy consumption of below-knee amputees wearing three different prosthetic feet.

    Science.gov (United States)

    Huang, G F; Chou, Y L; Su, F C

    2000-10-01

    This study scientifically measures the dynamic gait characteristics and energy consumption of 16 male below-knee amputees, eight vascular and eight traumatic, while wearing solid ankle cushion heel (SACH), single axis and multiple axis prosthetic feet via six-camera motion analysis, metabolic measurement cart and heavy-duty treadmill. Subjective results are additionally determined via questionnaire after testing. Motion analysis showed statistically significant differences at Pmultiple axis foot in the velocity, cadence, stride length and single limb stance. Significant differences were found in energy consumption between the traumatic and vascular groups, and significant changes in walking under different speeds and different inclines. Results provide quantitative and qualitative information about the dynamic performance of the various feet, which can be helpful in prescribing the optimal prosthetic foot for individual amputees.

  5. An intent recognition strategy for transfemoral amputee ambulation across different locomotion modes.

    Science.gov (United States)

    Young, Aaron J; Simon, Ann; Hargrove, Levi J

    2013-01-01

    Powered lower limb prostheses, capable of multiple locomotion modes, are being developed for transfemoral amputees. Current devices do not seamlessly transition between modes such as level walking, stairs and slopes. The purpose of this study was to develop an intent recognition system and test its performance across five different modes. A Dynamic Bayesian Network (DBN) was used for classification of neural and mechanical signals while four amputees completed a circuit containing level-walking, ramp ascent, ramp descent, stair ascent and stair descent. Our results indicate that transitional and steady-state stair steps had a high recognition rate (>99%), while ramp steps were significantly more difficult to classify (pamputees to naturally transition between locomotion modes on powered prostheses.

  6. Configuring a powered knee and ankle prosthesis for transfemoral amputees within five specific ambulation modes.

    Directory of Open Access Journals (Sweden)

    Ann M Simon

    Full Text Available Lower limb prostheses that can generate net positive mechanical work may restore more ambulation modes to amputees. However, configuration of these devices imposes an additional burden on clinicians relative to conventional prostheses; devices for transfemoral amputees that require configuration of both a knee and an ankle joint are especially challenging. In this paper, we present an approach to configuring such powered devices. We developed modified intrinsic control strategies--which mimic the behavior of biological joints, depend on instantaneous loads within the prosthesis, or set impedance based on values from previous states, as well as a set of starting configuration parameters. We developed tables that include a list of desired clinical gait kinematics and the parameter modifications necessary to alter them. Our approach was implemented for a powered knee and ankle prosthesis in five ambulation modes (level-ground walking, ramp ascent/descent, and stair ascent/descent. The strategies and set of starting configuration parameters were developed using data from three individuals with unilateral transfemoral amputations who had previous experience using the device; this approach was then tested on three novice unilateral transfemoral amputees. Only 17% of the total number of parameters (i.e., 24 of the 140 had to be independently adjusted for each novice user to achieve all five ambulation modes and the initial accommodation period (i.e., time to configure the device for all modes was reduced by 56%, to 5 hours or less. This approach and subsequent reduction in configuration time may help translate powered prostheses into a viable clinical option where amputees can more quickly appreciate the benefits such devices can provide.

  7. Configuring a powered knee and ankle prosthesis for transfemoral amputees within five specific ambulation modes.

    Science.gov (United States)

    Simon, Ann M; Ingraham, Kimberly A; Fey, Nicholas P; Finucane, Suzanne B; Lipschutz, Robert D; Young, Aaron J; Hargrove, Levi J

    2014-01-01

    Lower limb prostheses that can generate net positive mechanical work may restore more ambulation modes to amputees. However, configuration of these devices imposes an additional burden on clinicians relative to conventional prostheses; devices for transfemoral amputees that require configuration of both a knee and an ankle joint are especially challenging. In this paper, we present an approach to configuring such powered devices. We developed modified intrinsic control strategies--which mimic the behavior of biological joints, depend on instantaneous loads within the prosthesis, or set impedance based on values from previous states, as well as a set of starting configuration parameters. We developed tables that include a list of desired clinical gait kinematics and the parameter modifications necessary to alter them. Our approach was implemented for a powered knee and ankle prosthesis in five ambulation modes (level-ground walking, ramp ascent/descent, and stair ascent/descent). The strategies and set of starting configuration parameters were developed using data from three individuals with unilateral transfemoral amputations who had previous experience using the device; this approach was then tested on three novice unilateral transfemoral amputees. Only 17% of the total number of parameters (i.e., 24 of the 140) had to be independently adjusted for each novice user to achieve all five ambulation modes and the initial accommodation period (i.e., time to configure the device for all modes) was reduced by 56%, to 5 hours or less. This approach and subsequent reduction in configuration time may help translate powered prostheses into a viable clinical option where amputees can more quickly appreciate the benefits such devices can provide.

  8. Piezoelectric Bimorphs' Characteristics as In-Socket Sensors for Transfemoral Amputees

    OpenAIRE

    El-Sayed, Amr M.; Nur Azah Hamzaid; Noor Azuan Abu Osman

    2014-01-01

    Alternative sensory systems for the development of prosthetic knees are being increasingly highlighted nowadays, due to the rapid advancements in the field of lower limb prosthetics. This study presents the use of piezoelectric bimorphs as in-socket sensors for transfemoral amputees. An Instron machine was used in the calibration procedure and the corresponding output data were further analyzed to determine the static and dynamic characteristics of the piezoelectric bimorph. The piezoelectric...

  9. The effects of suction and pin/lock suspension systems on transtibial amputees' gait performance.

    Directory of Open Access Journals (Sweden)

    Hossein Gholizadeh

    Full Text Available BACKGROUND: The suction sockets that are commonly prescribed for transtibial amputees are believed to provide a better suspension than the pin/lock systems. Nevertheless, their effect on amputees' gait performance has not yet been fully investigated. The main intention of this study was to understand the potential effects of the Seal-in (suction and the Dermo (pin/lock suspension systems on amputees' gait performance. METHODOLOGY/PRINCIPAL FINDINGS: Ten unilateral transtibial amputees participated in this prospective study, and two prostheses were fabricated for each of them. A three-dimensional motion analysis system was used to evaluate the temporal-spatial, kinematics and kinetics variables during normal walking. We also asked the participants to complete some part of Prosthesis Evaluation Questionnaire (PEQ regarding their satisfaction and problems with both systems. The results revealed that there was more symmetry in temporal-spatial parameters between the prosthetic and sound limbs using the suction system. However, the difference between two systems was not significant (p<0.05. Evaluation of kinetic data and the subjects' feedback showed that the participants had more confidence using the suction socket and the sockets were more fit for walking. Nevertheless, the participants had more complaints with this system due to the difficulty in donning and doffing. CONCLUSION: It can be concluded that even though the suction socket could create better suspension, fit, and gait performance, overall satisfaction was higher with the pin/lock system due to easy donning and doffing of the prosthesis. TRIAL REGISTRATION: irct.ir IRCT2014012816395N1.

  10. A prosthesis-specific multi-link segment model of lower-limb amputee sprinting.

    Science.gov (United States)

    Rigney, Stacey M; Simmons, Anne; Kark, Lauren

    2016-10-03

    Lower-limb amputees commonly utilize non-articulating energy storage and return (ESAR) prostheses for high impact activities such as sprinting. Despite these prostheses lacking an articulating ankle joint, amputee gait analysis conventionally features a two-link segment model of the prosthetic foot. This paper investigated the effects of the selected link segment model׳s marker-set and geometry on a unilateral amputee sprinter׳s calculated lower-limb kinematics, kinetics and energetics. A total of five lower-limb models of the Ottobock(®) 1E90 Sprinter were developed, including two conventional shank-foot models that each used a different version of the Plug-in-Gait (PiG) marker-set to test the effect of prosthesis ankle marker location. Two Hybrid prosthesis-specific models were then developed, also using the PiG marker-sets, with the anatomical shank and foot replaced by prosthesis-specific geometry separated into two segments. Finally, a Multi-link segment (MLS) model was developed, consisting of six segments for the prosthesis as defined by a custom marker-set. All full-body musculoskeletal models were tested using four trials of experimental marker trajectories within OpenSim 3.2 (Stanford, California, USA) to find the affected and unaffected hip, knee and ankle kinematics, kinetics and energetics. The geometry of the selected lower-limb prosthesis model was found to significantly affect all variables on the affected leg (p variables on the affected leg, and none of the unaffected leg variables. The results indicate that the omission of prosthesis-specific spatial, inertial and elastic properties from full-body models significantly affects the calculated amputee gait characteristics, and we therefore recommend the implementation of a MLS model.

  11. Return to Duty Rate of Amputee Soldiers in the Current Conflicts in Afghanistan and Iraq

    Science.gov (United States)

    2010-06-01

    6 If an amputee soldier wishes to remain on active duty, he or she must demonstrate a higher level of function with a prosthesis and have the...at American Orthopaedic Foot and Ankle Society Annual Meeting, Vancouver, BC, Canada, July 15–18, 2009. The opinions or assertions contained herein are...and knee disarticulation), transtibial, and Syme (includes foot proximal to the metatarsals). Rank/pay grades were grouped into three categories

  12. Compensatory changes accompanying chronic forced use of the nondominant hand by unilateral amputees.

    Science.gov (United States)

    Philip, Benjamin A; Frey, Scott H

    2014-03-05

    Amputation of the dominant hand forces patients to use the nondominant hand exclusively, including for tasks (e.g., writing and drawing) that were formerly the sole domain of the dominant hand. The behavioral and neurological effects of this chronic forced use of the nondominant hand remain largely unknown. Yet, these effects may shed light on the potential to compensate for degradation or loss of dominant hand function, as well as the mechanisms that support motor learning under conditions of very long-term training. We used a novel precision drawing task and fMRI to investigate 8 adult human amputees with chronic (mean 33 years) unilateral dominant (right) hand absence, and right-handed matched controls (8 for fMRI, 19 for behavior). Amputees' precision drawing performances with their left hands reached levels of smoothness (associated with left hemisphere control), acceleration time (associated with right hemisphere control), and speed equivalent to controls' right hands, whereas accuracy maintained a level comparable with controls' left hands. This compensation is supported by an experience-dependent shift from heavy reliance on the dorsodorsal parietofrontal pathway (feedback control) to the ventrodorsal pathway and prefrontal regions involved in the cognitive control of goal-directed actions. Relative to controls, amputees also showed increased activity within the former cortical sensorimotor hand territory in the left (ipsilateral) hemisphere. These data demonstrate that, with chronic and exclusive forced use, the speed and quality of nondominant hand precision endpoint control in drawing can achieve levels nearly comparable with the dominant hand.

  13. Secure Microprocessor-Controlled Prosthetic Leg for Elderly Amputees: Preliminary Results

    Directory of Open Access Journals (Sweden)

    S. Krut

    2011-01-01

    Full Text Available We introduce a new prosthetic leg design, adapted to elderly trans-femoral amputees. Technical progress in prosthesis design mainly concerns active individuals. An important number of elderly amputees are not very mobile, tire easily, present reduced muscle strength, and have difficulties managing their balance. Therefore, the needs and characteristics of this specific population are very different from those of younger ones and the prosthetic solutions are not adapted. Our artificial knee has been designed to fulfill the specific requirements of this population in terms of capabilities, transfer assistance, security, intuitiveness, simplicity of use, and types of physical activity to be performed. We particularly focused our efforts on ensuring safe and secure stand-to-sit transfers. We developed an approach to control the different states of the prosthetic joint (blocked, free, resistant, associated with different physical activities. Amputee posture and motion are observed through a single multi-axis force sensor embedded in the prosthesis. The patient behaves naturally, while the controller analyses his movements in order to detect his intention to sit down. The detection algorithm is based on a reference pattern, calibrated individually, to which the sensor data are compared, and submitted to a set of tests allowing the discrimination of the intention to sit down from other activities. Preliminary validation of the system has been performed in order to verify the applicability of the prosthesis to different tasks: walking, standing, sitting down, standing up, picking up an object from a chair, slope and stair climbing.

  14. Phantom movements from physiologically inappropriate muscles: A case study with a high transhumeral amputee.

    Science.gov (United States)

    Gade, Julie; Hugosdottir, Rosa; Kamavuako, Ernest N

    2015-08-01

    Individuals with high-level amputation have a great need for functional prostheses because of their vast functional deficits. Conventional techniques are considered inappropriate for high-level amputees due to the lack of physiologically appropriate muscles. This study investigates how accurate phantom movements (PMs) can be classified from physiologically inappropriate muscles. The study involves a case study of a 42-year-old transhumeral amputee. Suitable PMs and best electrode configuration were identified using the sequential forward selection method and brute-force technique. Using linear discriminant analysis, the best PMs (elbow extension/flexion, wrist supination/pronation) and rest were classified with error ranging from 3% to 0.18% when using 3 to 8 EMG channels respectively. A completion rate of 93 % was obtained during a targeted achievement control test in a virtual reality environment. This case indicates that a proximal transhumeral amputee can generate muscle activation patterns related to distinct PMs; and these PMs can be decoded from physiologically inappropriate muscles.

  15. The development of a myoelectric training tool for above-elbow amputees.

    Science.gov (United States)

    Dawson, Michael R; Fahimi, Farbod; Carey, Jason P

    2012-01-01

    The objective of above-elbow myoelectric prostheses is to reestablish the functionality of missing limbs and increase the quality of life of amputees. By using electromyography (EMG) electrodes attached to the surface of the skin, amputees are able to control motors in myoelectric prostheses by voluntarily contracting the muscles of their residual limb. This work describes the development of an inexpensive myoelectric training tool (MTT) designed to help upper limb amputees learn how to use myoelectric technology in advance of receiving their actual myoelectric prosthesis. The training tool consists of a physical and simulated robotic arm, signal acquisition hardware, controller software, and a graphical user interface. The MTT improves over earlier training systems by allowing a targeted muscle reinnervation (TMR) patient to control up to two degrees of freedom simultaneously. The training tool has also been designed to function as a research prototype for novel myoelectric controllers. A preliminary experiment was performed in order to evaluate the effectiveness of the MTT as a learning tool and to identify any issues with the system. Five able-bodied participants performed a motor-learning task using the EMG controlled robotic arm with the goal of moving five balls from one box to another as quickly as possible. The results indicate that the subjects improved their skill in myoelectric control over the course of the trials. A usability survey was administered to the subjects after their trials. Results from the survey showed that the shoulder degree of freedom was the most difficult to control.

  16. Mechanisms of Gait Asymmetry Due to Push-Off Deficiency in Unilateral Amputees.

    Science.gov (United States)

    Adamczyk, Peter Gabriel; Kuo, Arthur D

    2015-09-01

    Unilateral lower-limb amputees exhibit asymmetry in many gait features, such as ground force, step time, step length, and joint mechanics. Although these asymmetries result from weak prosthetic-side push-off, there is no proven mechanistic explanation of how that impairment propagates to the rest of the body. We used a simple dynamic walking model to explore possible consequences of a unilateral impairment similar to that of a transtibial amputee. The model compensates for reduced push-off work from one leg by performing more work elsewhere, for example during the middle of stance by either or both legs. The model predicts several gait abnormalities, including slower forward velocity of the body center-of-mass during intact-side stance, greater energy dissipation in the intact side, and more positive work overall. We tested these predictions with data from unilateral transtibial amputees (N = 11) and nonamputee control subjects (N = 10) walking on an instrumented treadmill. We observed several predicted asymmetries, including forward velocity during stance phases and energy dissipation from the two limbs, as well as greater work overall. Secondary adaptations, such as to reduce discomfort, may exacerbate asymmetry, but these simple principles suggest that some asymmetry may be unavoidable in cases of unilateral limb loss.

  17. Anthropometric profile and physical performance characteristic of the Brazilian amputee football (soccer team

    Directory of Open Access Journals (Sweden)

    Mário A. M. Simim

    2013-09-01

    Full Text Available Amputee football is a variation of conventional soccer in which athletes with lower limb amputation and one athelete with upper limb amputation (the goalkeeper participate. The objective of this study was to investigate the anthropometric and physical characteristics of amputee football athletes and to verify differences between heart rate peak (HRpeak and equations for predicting maximum heart rate (HRmax. Twelve amputee soccer players from the Brazilian team participated in this study. The body mass, height and body composition were measured. The physical tests used were: the 20 m running test, the T-square test and the Yo Yo intermitent recovery test - level 1 (YYIRT1. The percentage of fat was significantly different between midfielders and defenders. No significant differences were found between positions in the physical tests. The HRpeak was significantly lower than all of HRmax prediction equations tested. We conclude that the indicators of physical performance did not differ significantly between the different tactics roles of players, and that, after intermittent maximum effort, the cardiac response was lower when compared with the investigated HRmax prediction equations.

  18. Pediatric unilateral below-elbow amputees: retrospective analysis of 34 patients given multiple prosthetic options.

    Science.gov (United States)

    Crandall, Robin C; Tomhave, Wendy

    2002-01-01

    Thirty-four unilateral below-elbow amputees from the Shriners Hospitals for Children/Twin Cities were retrospectively analyzed in long-term follow-up. All of these patients were provided with a variety of prosthetic options, including a "passive" cosmetic upper extremity device. Most of the patients were also fitted with conventional prostheses using a body-powered voluntary closing terminal device (97%) as well as myoelectric prostheses (82%). These patients were considered consistent prosthetic users by the clinic team. The average follow-up was 14 years, with many of the patients being followed up throughout their entire childhood. All patients were sent questionnaires, and the authors carried out patient interviews and chart review. Final analysis indicated that 15 patients (44%) selected a simple cosmetic "passive hand" as their prosthesis of choice. In long-term follow-up 14 patients (41%) continued as multiple users. Fourteen patients (41%) selected the conventional prosthesis using a voluntary closing terminal device as the prosthesis of choice. Only five patients (15%) selected the myoelectric device as their primary prosthesis. The authors conclude that successful unilateral pediatric amputees may choose multiple prostheses on the basis of function and that frequently the most functional prosthesis selected in the long term is the simplest in design. The authors believe strongly that unilateral pediatric amputees should be offered a variety of prosthetic options to help with normal activities of daily living.

  19. A Robotic Model of Transfemoral Amputee Locomotion for Design Optimization of Knee Controllers

    Directory of Open Access Journals (Sweden)

    Mohsen Akbari Shandiz

    2013-03-01

    Full Text Available A two‐dimensional, seven link, nine degrees of freedom biped model was developed to investigate the dynamic characteristics of normal and transfemoral amputee locomotion during the entire gait cycle. The equations of motion were derived using the Lagrange method and the stance foot‐ground contact was simulated using a five‐point penetration model. The joint driving torques were obtained using forward dynamic optimization of the normal human gait and applied to the intact joints of the amputee. Three types of motion controllers; frictional, elastic and hydraulic were considered for the prosthetic joints of the amputee and their design parameters were optimized to achieve the closest kinematics to that of the normal gait. It was found that, if optimally designed, all three passive controllers could reasonably reproduce a normal kinematical pattern in the swing phase. However, the stance phase kinematics could only be replicated by the hydraulic and elastic controllers; the performance of the latter was highly sensitive to the design parameters. It was concluded that an appropriately designed hydraulic motion controller can provide reasonably normal kinematics and reliable stability for stance knee flexion prostheses.

  20. Spatiotemporal Variables of Able-bodied and Amputee Sprinters in Men's 100-m Sprint.

    Science.gov (United States)

    Hobara, H; Kobayashi, Y; Mochimaru, M

    2015-06-01

    The difference in world records set by able-bodied sprinters and amputee sprinters in the men's 100-m sprint is still approximately 1 s (as of 28 March 2014). Theoretically, forward velocity in a 100-m sprint is the product of step frequency and step length. The goal of this study was to examine the hypothesis that differences in the sprint performance of able-bodied and amputee sprinters would be due to a shorter step length rather than lower step frequency. Men's elite-level 100-m races with a total of 36 able-bodied, 25 unilateral and 17 bilateral amputee sprinters were analyzed from the publicly available internet broadcasts of 11 races. For each run of each sprinter, the average forward velocity, step frequency and step length over the whole 100-m distance were analyzed. The average forward velocity of able-bodied sprinters was faster than that of the other 2 groups, but there was no significant difference in average step frequency among the 3 groups. However, the average step length of able-bodied sprinters was significantly longer than that of the other 2 groups. These results suggest that the differences in sprint performance between 2 groups would be due to a shorter step length rather than lower step frequency.

  1. Ethnicity and spatiotemporal parameters of bilateral and unilateral transtibial amputees in a 100-m sprint.

    Science.gov (United States)

    Hobara, Hiroaki; Hashizume, Satoru; Kobayashi, Yoshiyuki; Usami, Yuko; Mochimaru, Masaaki

    2016-01-01

    Similar to able-bodied sprinters, most of the medals for the 100-m sprint in past Paralympic Games and IPC Athletics World Championships were dominated by West African (WA) and Caucasian (CC) amputee sprinters, not Asian (AS) sprinters. Although these results indicate differences in sprint performance due to ethnicity, little is known about the ethnicity and spatiotemporal parameters of the 100-m sprint for amputee sprinters. The purpose of this study was to investigate the differences in the spatiotemporal parameters of WA, CC and AS sprinters with bilateral and unilateral transtibial amputations during a 100-m sprint. We analyzed 6 WA, 28 CC, and 10 AS amputee sprinters from publicly available Internet broadcasts. For each sprinter's run, the average speed, average step length, and step frequency were calculated by using the number of steps in conjunction with the official race time. No significant differences were found in the spatiotemporal parameters of the 100-m sprint for the WA and CC groups. On the other hand, the average speed of the AS group was significantly lower because of its shorter step length during the 100-m sprint. The results suggest that WA and CC sprinters would perform similarly during a 100-m sprint, but AS sprinters would not.

  2. Vibrotactile stimulation promotes embodiment of an alien hand in amputees with phantom sensations.

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    D'Alonzo, Marco; Clemente, Francesco; Cipriani, Christian

    2015-05-01

    Tactile feedback is essential to intuitive control and to promote the sense of self-attribution of a prosthetic limb. Recent findings showed that amputees can be tricked to experience this embodiment, when synchronous and modality-matched stimuli are delivered to biological afferent structures and to an alien rubber hand. Hence, it was suggested to exploit this effect by coupling touch sensors in a prosthesis to an array of haptic tactile stimulators in the prosthetic socket. However, this approach is not clinically viable due to physical limits of current haptic devices. To address this issue we have proposed modality-mismatched stimulation and demonstrated that this promotes self-attribution of an alien hand on normally limbed subjects. In this work we investigated whether similar effects could be induced in transradial amputees with referred phantom sensations in a series of experiments fashioned after the Rubber Hand Illusion using vibrotactile stimulators. Results from three independent measures of embodiment demonstrated that vibrotactile sensory substitution elicits body-ownership of a rubber hand in transradial amputees. These results open up promising possibilities in this field; indeed miniature, safe and inexpensive vibrators could be fitted into commercially available prostheses and sockets to induce the illusion every time the prosthesis manipulates an object.

  3. Powered ankle-foot prosthesis for the improvement of amputee ambulation.

    Science.gov (United States)

    Au, Samuel K; Herr, Hugh; Weber, Jeff; Martinez-Villalpando, Ernesto C

    2007-01-01

    This paper presents the mechanical design, control scheme, and clinical evaluation of a novel, motorized ankle-foot prosthesis, called MIT Powered Ankle-Foot Prosthesis. Unlike a conventional passive-elastic ankle-foot prosthesis, this prosthesis can provide active mechanical power during the stance period of walking. The basic architecture of the prosthesis is a unidirectional spring, configured in parallel with a force-controllable actuator with series elasticity. With this architecture, the anklefoot prosthesis matches the size and weight of the human ankle, and is also capable of delivering high mechanical power and torque observed in normal human walking. We also propose a biomimetic control scheme that allows the prosthesis to mimic the normal human ankle behavior during walking. To evaluate the performance of the prosthesis, we measured the rate of oxygen consumption of three unilateral transtibial amputees walking at self-selected speeds to estimate the metabolic walking economy. We find that the powered prosthesis improves amputee metabolic economy from 7% to 20% compared to the conventional passive-elastic prostheses (Flex-Foot Ceterus and Freedom Innovations Sierra), even though the powered system is twofold heavier than the conventional devices. This result highlights the benefit of performing net positive work at the ankle joint to amputee ambulation and also suggests a new direction for further advancement of an ankle-foot prosthesis.

  4. Brain responses to acupuncture stimulation in the prosthetic hand of an amputee patient.

    Science.gov (United States)

    Lee, In-Seon; Jung, Won-Mo; Lee, Ye-Seul; Wallraven, Christian; Chae, Younbyoung

    2015-10-01

    This report describes the brain responses to acupuncture in an upper limb amputee patient. A 62-year-old male had previously undergone a lower left arm amputation following an electrical accident. Using functional MRI, we investigated brain responses to acupuncture stimulation in the aforementioned amputee under three conditions: (a) intact hand, (b) prosthetic hand (used by the patient), and (c) fake fabric hand. The patient described greater de qi sensation when he received acupuncture stimulation in his prosthetic hand compared to a fake hand, with both stimulations performed in a similar manner. We found enhanced brain activation in the insula and sensorimotor cortex in response to acupuncture stimulation in the amputee's prosthetic hand, while there was only minimal activation in the visual cortex in response to acupuncture stimulation in a fake hand. The enhanced brain responses to acupuncture stimulation of the patient's prosthetic hand might be derived from cortical reorganisation, as he has been using his prosthetic hand for over 40 years. Our findings suggest the possible use of acupuncture stimulation in a prosthetic hand as an enhanced sensory feedback mechanism, which may represent a new treatment approach for phantom limb pain.

  5. P300-amplitudes in upper limb amputees with and without phantom limb pain in a visual oddball paradigm.

    Science.gov (United States)

    Karl, Anke; Diers, Martin; Flor, Herta

    2004-07-01

    The aim of the study was to investigate to what extent cortical hyper-reactivity to visual stimuli is present in upper limb amputees. Five amputees with phantom limb pain (PLP), five amputees without PLP (Non-PLP) and 10 healthy controls (HC) were investigated using a visual oddball paradigm. Two hundred visual stimuli were presented with target stimuli occurring at a probability of 25% and standard stimuli at a probability of 75%. Event-related potentials were recorded from nine scalp positions (F3, F4, Fz, C3, C4, Cz, P3, P4, Pz). The PLP-patients had significantly higher P300-amplitudes to both types of stimuli compared to the non-PLP-patients. The HC were not significantly different from both amputee groups. P300-amplitude to targets at frontal sites in the hemisphere contralateral to the amputation was higher in the PLP patients. P300-latencies to target stimuli differed only at frontal sites with PLP-patients showing significantly longer latencies than non-PLP-patients. To standard stimuli, however, they showed significantly shorter latencies at central and parietal scalp positions. The HC had significantly shorter latencies than both amputee groups. The size of the P300-amplitude was positively correlated with the intensity of PLP. These findings suggest a higher magnitude of non-specific cortical excitability in amputees with PLP and a reduced excitability in amputees without PLP. This extends previous findings of differences in cortical excitability in PLP and non-PLP patients in the sensorimotor domain.

  6. Co-contraction patterns of trans-tibial amputee ankle and knee musculature during gait

    Directory of Open Access Journals (Sweden)

    Seyedali Mahyo

    2012-05-01

    Full Text Available Abstract Background Myoelectric control of upper extremity powered prostheses has been used clinically for many years, however this approach has not been fully developed for lower extremity prosthetic devices. With the advent of powered lower extremity prosthetic components, the potential role of myoelectric control systems is of increasing importance. An understanding of muscle activation patterns and their relationship to functional ambulation is a vital step in the future development of myoelectric control. Unusual knee muscle co-contractions have been reported in both limbs of trans-tibial amputees. It is currently unknown what differences exist in co-contraction between trans-tibial amputees and controls. This study compares the activation and co-contraction patterns of the ankle and knee musculature of trans-tibial amputees (intact and residual limbs, and able-bodied control subjects during three speeds of gait. It was hypothesized that residual limbs would have greater ankle muscle co-contraction than intact and able-bodied control limbs and that knee muscle co-contraction would be different among all limbs. Lastly it was hypothesized that the extent of muscle co-contraction would increase with walking speed. Methods Nine unilateral traumatic trans-tibial amputees and five matched controls participated. Surface electromyography recorded activation from the Tibialis Anterior, Medial Gastrocnemius, Vastus Lateralis and Biceps Femoris of the residual, intact and control limbs. A series of filters were applied to the signal to obtain a linear envelope of the activation patterns. A co-contraction area (ratio of the integrated agonist and antagonist activity was calculated during specific phases of gait. Results Co-contraction of the ankle muscles was greater in the residual limb than in the intact and control limbs during all phases of gait. Knee muscle co-contraction was greater in the residual limb than in the control limb during all phases

  7. The capability of fiber Bragg grating sensors to measure amputees' trans-tibial stump/socket interface pressures.

    Science.gov (United States)

    Al-Fakih, Ebrahim A; Osman, Noor Azuan Abu; Eshraghi, Arezoo; Adikan, Faisal Rafiq Mahamd

    2013-08-12

    This study presents the first investigation into the capability of fiber Bragg grating (FBG) sensors to measure interface pressure between the stump and the prosthetic sockets of a trans-tibial amputee. FBG element(s) were recoated with and embedded in a thin layer of epoxy material to form a sensing pad, which was in turn embedded in a silicone polymer material to form a pressure sensor. The sensor was tested in real time by inserting a heavy-duty balloon into the socket and inflating it by using an air compressor. This test was conducted to examine the sensitivity and repeatability of the sensor when subjected to pressure from the stump of the trans-tibial amputee and to mimic the actual environment of the amputee's Patellar Tendon (PT) bar. The sensor exhibited a sensitivity of 127 pm/N and a maximum FSO hysteresis of around ~0.09 in real-time operation. Very good reliability was achieved when the sensor was utilized for in situ measurements. This study may lead to smart FBG-based amputee stump/socket structures for pressure monitoring in amputee socket systems, which will result in better-designed prosthetic sockets that ensure improved patient satisfaction.

  8. EMG-based simultaneous and proportional estimation of wrist/hand kinematics in uni-lateral trans-radial amputees.

    Science.gov (United States)

    Jiang, Ning; Vest-Nielsen, Johnny L G; Muceli, Silvia; Farina, Dario

    2012-06-28

    We propose a method for estimating wrist kinematics during dynamic wrist contractions from multi-channel surface electromyography (EMG). The algorithm extracts features from the surface EMG and uses dedicated multi-layer perceptron networks to estimate individual joint angles of the 3 degrees of freedom (DoFs) of the wrist. The method was designed with the aim of proportional and simultaneous control of multiple DoFs of active prostheses by unilateral amputees. Therefore, the proposed approach was tested in both unilateral transradial amputees and in intact-limbed control subjects. It was shown that the joint angles at the 3 DoFs of amputees can be estimated from surface EMG recordings , during mirrored bi-lateral contractions that simultaneously and proportionally articulated the 3 DoFs. The estimation accuracies of amputee subjects with long stumps were 62.5% ± 8.50% across all 3 DoFs, while accuracies of the intact-limbed control subjects were 72.0% ± 8.29%. The estimation results from intact-limbed subjects were consistent with earlier studies. The results from the current study demonstrated the feasibility of the proposed myoelectric control approach to provide a more intuitive myoelectric control strategy for unilateral transradial amputees.

  9. EMG-based simultaneous and proportional estimation of wrist/hand kinematics in uni-lateral trans-radial amputees

    Directory of Open Access Journals (Sweden)

    Jiang Ning

    2012-06-01

    Full Text Available Abstract We propose a method for estimating wrist kinematics during dynamic wrist contractions from multi-channel surface electromyography (EMG. The algorithm extracts features from the surface EMG and uses dedicated multi-layer perceptron networks to estimate individual joint angles of the 3 degrees of freedom (DoFs of the wrist. The method was designed with the aim of proportional and simultaneous control of multiple DoFs of active prostheses by unilateral amputees. Therefore, the proposed approach was tested in both unilateral transradial amputees and in intact-limbed control subjects. It was shown that the joint angles at the 3 DoFs of amputees can be estimated from surface EMG recordings , during mirrored bi-lateral contractions that simultaneously and proportionally articulated the 3 DoFs. The estimation accuracies of amputee subjects with long stumps were 62.5% ± 8.50% across all 3 DoFs, while accuracies of the intact-limbed control subjects were 72.0% ± 8.29%. The estimation results from intact-limbed subjects were consistent with earlier studies. The results from the current study demonstrated the feasibility of the proposed myoelectric control approach to provide a more intuitive myoelectric control strategy for unilateral transradial amputees.

  10. Gait in male trans-tibial amputees: a comparative study with healthy subjects in relation to walking speed.

    Science.gov (United States)

    Hermodsson, Y; Ekdahl, C; Persson, B M; Roxendal, G

    1994-08-01

    Walking speed, stance duration and ground reaction forces were studied with the use of a stable force platform (Kistler) in 24 male transtibial amputees and 12 healthy subjects matched for sex and age. The aim of the study was to compare the gait performance of two groups with unilateral trans-tibial amputations for either vascular disease or trauma and also to compare the results of the two groups with the results of a group of healthy subjects. Multiple linear regression analysis was used to compare the stance duration and the ground reaction forces in relation to walking speed. The vascular and traumatic amputees had significantly reduced walking speeds compared with the healthy subjects, 0.85 +/- 0.2 m/s and 0.99 +/- 0.2 m/s. respectively, as compared to 1.42 +/- 0.2 m/s. By comparing the vascular and traumatic amputees with the healthy subjects in relation to walking speed, it was shown that the gait performance of the vascular amputee differed from that of the traumatic amputee, a difference that was not caused by the reduced walking speed. The active forces during push off on both the healthy (p = 0.02) and the prosthetic leg (p = 0.003) in the trauma group were not found in the vascular group. This disparity could be an effect of the systemic disease. It may be argued that the results of this study contribute to the understanding of the reduced walking ability of the vascular amputee and should be borne in mind when planning rehabilitation.

  11. Gait symmetry and regularity in transfemoral amputees assessed by trunk accelerations

    Directory of Open Access Journals (Sweden)

    Rocchi Laura

    2010-01-01

    Full Text Available Abstract Background The aim of this study was to evaluate a method based on a single accelerometer for the assessment of gait symmetry and regularity in subjects wearing lower limb prostheses. Methods Ten transfemoral amputees and ten healthy control subjects were studied. For the purpose of this study, subjects wore a triaxial accelerometer on their thorax, and foot insoles. Subjects were asked to walk straight ahead for 70 m at their natural speed, and at a lower and faster speed. Indices of step and stride regularity (Ad1 and Ad2, respectively were obtained by the autocorrelation coefficients computed from the three acceleration components. Step and stride durations were calculated from the plantar pressure data and were used to compute two reference indices (SI1 and SI2 for step and stride regularity. Results Regression analysis showed that both Ad1 well correlates with SI1 (R2 up to 0.74, and Ad2 well correlates with SI2 (R2 up to 0.52. A ROC analysis showed that Ad1 and Ad2 has generally a good sensitivity and specificity in classifying amputee's walking trial, as having a normal or a pathologic step or stride regularity as defined by means of the reference indices SI1 and SI2. In particular, the antero-posterior component of Ad1 and the vertical component of Ad2 had a sensitivity of 90.6% and 87.2%, and a specificity of 92.3% and 81.8%, respectively. Conclusions The use of a simple accelerometer, whose components can be analyzed by the autocorrelation function method, is adequate for the assessment of gait symmetry and regularity in transfemoral amputees.

  12. The energy cost for the step-to-step transition in amputee walking.

    Science.gov (United States)

    Houdijk, Han; Pollmann, Eveline; Groenewold, Marlies; Wiggerts, Han; Polomski, Wojtek

    2009-07-01

    The purpose of this study was to investigate whether the increased energy cost of amputee gait could be accounted for by an increase in the mechanical work dissipated during the step-to-step transition in walking. Eleven transtibial amputees (AMP) and 11 age-matched controls (CO) walked at both comfortable (CWS) and fixed (FWS, 1.3m/s) walking speed, while external mechanical work of each separate leg and metabolic energy consumption were measured. At FWS the metabolic energy consumption (E(met)) was significantly higher in AMP compared to CO (3.34 Jkg(-1)s(-1) vs. 2.73 Jkg(-1)s(-1)). At CWS, no difference in energy consumption was found (3.56 Jkg(-1)s(-1) vs. 3.58 Jkg(-1)s(-1)) but CWS was significantly lower in AMP compared to CO (1.35 ms(-1) vs. 1.52 ms(-1)). In conjunction with the higher E(met) at FWS, the negative work generated by the intact leading leg for the step-to-step transition in double support was significantly higher for AMP than CO at FWS. A moderate though significant correlation was found between negative mechanical power generated during the step-to-step transition and metabolic power (CWS: r=-0.56, p=0.007; FWS: r=-0.50, p=0.019). Despite the difference in negative work during the step-to-step transition, the total absolute mechanical work over a stride did not differ between groups. This could possibly be attributed to exchange of internal positive and negative work during single support, which remains unnoticed in the external work calculations. It was concluded that the increased mechanical work for the step-to-step transition from prosthetic to intact limb contributes to the increased metabolic energy cost of amputee walking.

  13. [Comparative study of the volume difference vs. healthy limb, morphological and population description in transfemoral amputees].

    Science.gov (United States)

    Mendoza-Cruz, Felipe; Rodríguez-Reyes, Gerardo; Galván Duque-Gastélum, Carlos; Alvarez-Camacho, Michelín

    2014-07-01

    Knowledge of the general characteristics and physical condition that keeps the transfemoral amputation stump to select and adapt appropriate type of prosthesis to restore a walking pattern amputee patient acceptable and useful design parameters set to propose new prosthetic systems. In this paper, the degree of difference between the volumes of the limb stump and healthy as well as morphological features occurred more frequently in the stumps of transfemoral amputees who were treated at the Laboratory of Orthotics and Prosthetics (LOP), Instituto Nacional de Rehabilitación (INR) in 2008. It captured all patients with unilateral transfemoral amputation left and right, over 18 years old, both sexes, use of hearing candidates were evaluated clinically and took three measurements of the circumferences at different wavelengths and the limb stump healthy, were calculated volumes of both sides using the mathematical model of the truncated cone and analyzed in three groups according to the level of amputation (proximal, middle and distal third). We obtained 49 patients, 39 men and 10 women, the difference stump volume compared to healthy limb volume per group were: 44.9% proximal third, middle third and distal 26.5%, 21.1%, the frequency of diagnostic data showed a stump right transfemoral amputees, due to metabolic, without use of prostheses, the most common morphological features indicate that the stump has a conical shape and size distal third, whose tissue is semi-flaccid consistency, the scar is not adhered to deep planes and shows a negative tinel, the mattress soft tissue is 2.15 ± 1.3 cm and physically presents a force level 4 in the clinical rating scale Daniels. The data are consistent with other studies comparing the percentage of the volume change with the percentages of reduced diameters transfemoral stump muscle, likewise agrees most amputees incidence of diabetes mellitus with other studies, cataloging it eat first cause amputation. The general description

  14. Virtual Constraint Control of a Powered Prosthetic Leg: From Simulation to Experiments with Transfemoral Amputees

    Science.gov (United States)

    Lenzi, Tommaso; Hargrove, Levi J.; Sensinger, Jonathon W.

    2014-01-01

    Recent powered (or robotic) prosthetic legs independently control different joints and time periods of the gait cycle, resulting in control parameters and switching rules that can be difficult to tune by clinicians. This challenge might be addressed by a unifying control model used by recent bipedal robots, in which virtual constraints define joint patterns as functions of a monotonic variable that continuously represents the gait cycle phase. In the first application of virtual constraints to amputee locomotion, this paper derives exact and approximate control laws for a partial feedback linearization to enforce virtual constraints on a prosthetic leg. We then encode a human-inspired invariance property called effective shape into virtual constraints for the stance period. After simulating the robustness of the partial feedback linearization to clinically meaningful conditions, we experimentally implement this control strategy on a powered transfemoral leg. We report the results of three amputee subjects walking overground and at variable cadences on a treadmill, demonstrating the clinical viability of this novel control approach. PMID:25558185

  15. Two-dimensional myoelectric control of a robotic arm for upper limb amputees

    Science.gov (United States)

    López Celani, Natalia M.; Soria, Carlos M.; Orosco, Eugenio C.; di Sciascio, Fernando A.; Valentinuzzi, Max E.

    2007-11-01

    Rehabilitation engineering and medicine have become integral and significant parts of health care services, particularly and unfortunately in the last three or four decades, because of wars, terrorism and large number of car accidents. Amputees show a high rate of rejection to wear prosthetic devices, often because of lack of an adequate period of adaptation. A robotic arm may appear as a good preliminary stage. To test the hypothesis, myoelectric signals from two upper limb amputees and from four normal volunteers were fed, via adequate electronic conditioning and using MATLAB, to an industrial robotic arm. Proportional strength control was used for two degrees of freedom (x-y plane) by means of eight signal features of control (four traditional statistics plus energy, integral of the absolute value, Willison's amplitude, waveform length and envelope) for comparison purposes, and selecting the best of them as final reference. Patients easily accepted the system and learned in short time how to operate it. Results were encouraging so that valuable training, before prosthesis is implanted, appears as good feedback; besides, these patients can be hired as specialized operators in semi-automatized industry.

  16. Real-time gait event detection for transfemoral amputees during ramp ascending and descending.

    Science.gov (United States)

    Maqbool, H F; Husman, M A B; Awad, M I; Abouhossein, A; Dehghani-Sanij, A A

    2015-01-01

    Events and phases detection of the human gait are vital for controlling prosthesis, orthosis and functional electrical stimulation (FES) systems. Wearable sensors are inexpensive, portable and have fast processing capability. They are frequently used to assess spatio-temporal, kinematic and kinetic parameters of the human gait which in turn provide more details about the human voluntary control and ampute-eprosthesis interaction. This paper presents a reliable real-time gait event detection algorithm based on simple heuristics approach, applicable to signals from tri-axial gyroscope for lower limb amputees during ramp ascending and descending. Experimental validation is done by comparing the results of gyroscope signal with footswitches. For healthy subjects, the mean difference between events detected by gyroscope and footswitches is 14 ms and 10.5 ms for initial contact (IC) whereas for toe off (TO) it is -5 ms and -25 ms for ramp up and down respectively. For transfemoral amputee, the error is slightly higher either due to the placement of footswitches underneath the foot or the lack of proper knee flexion and ankle plantarflexion/dorsiflexion during ramp up and down. Finally, repeatability tests showed promising results.

  17. Influence of malalignment on socket reaction moments during gait in amputees with transtibial prostheses.

    Science.gov (United States)

    Boone, David A; Kobayashi, Toshiki; Chou, Teri G; Arabian, Adam K; Coleman, Kim L; Orendurff, Michael S; Zhang, Ming

    2013-04-01

    Alignment - the process and measured orientation of the prosthetic socket relative to the foot - is important for proper function of a transtibial prosthesis. Prosthetic alignment is performed by prosthetists using visual gait observation and amputees' feedback. The aim of this study was to investigate the effect of transtibial prosthesis malalignment on the moments measured at the base of the socket: the socket reaction moments. Eleven subjects with transtibial amputation were recruited from the community. An instrumented prosthesis alignment component was used to measure socket reaction moments during ambulation under 17 alignment conditions, including nominally aligned using conventional clinical methods, and angle perturbations of 3° and 6° (flexion, extension, abduction, and adduction) and translation perturbations of 5mm and 10mm (anterior, posterior, lateral, and medial) referenced from the nominal alignment. Coronal alignment perturbations caused systematic changes in the coronal socket reaction moments. All angle and translation perturbations revealed statistically significant differences on coronal socket reaction moments compared to the nominal alignment at 30% and 75% of stance phase (Psocket reaction moments was not as responsive as that of the coronal perturbations. The sagittal angle and translation perturbations of the socket led to statistically significant changes in minimum moment, maximum moment, and moments at 45% of stance phase in the sagittal plane. Therefore, malalignment affected the socket reaction moments in amputees with transtibial prostheses.

  18. The development of a rapid prototyping prosthetic socket coated with a resin layer for transtibial amputees.

    Science.gov (United States)

    Hsu, L H; Huang, G F; Lu, C T; Hong, D Y; Liu, S H

    2010-03-01

    This article proposes a type of transtibial socket composed of an inner layer fabricated by a rapid prototyping (RP) machine and an outer layer coated with unsaturated polyester resin. This work integrates contemporary technologies including a handheld scanner and CAD systems, to design a thin primary socket shape and then manufactures the socket using a fused deposition-modeling machine. To prevent breakage caused by the layer-based forming process and to reinforce flexural strength, the current research coats the preliminary RP socket with a layer of unsaturated polyester resin. After shaping the proximal brim of the resin-reinforced RP socket to match the specific stump, this study assembles and aligns a shank and a prosthetic foot to form a prosthesis set. After completing a trial safety walk wearing the prosthesis, which is satisfactory to the amputee and a registered prosthetist, this research measures interface pressures between the stump and the resin-reinforced RP socket. Experiment results demonstrate that the resin-reinforced RP socket is applicable for transtibial amputees. In addition to strengthening the FDM socket and producing consistent socket fit, this study also demonstrates a feasible procedure that employs current technologies to design and manufacture transtibial sockets without plaster moulds.

  19. Control Capabilities of Myoelectric Robotic Prostheses by Hand Amputees: A Scientific Research and Market Overview.

    Science.gov (United States)

    Atzori, Manfredo; Müller, Henning

    2015-01-01

    Hand amputation can dramatically affect the capabilities of a person. Cortical reorganization occurs in the brain, but the motor and somatosensorial cortex can interact with the remnant muscles of the missing hand even many years after the amputation, leading to the possibility to restore the capabilities of hand amputees through myoelectric prostheses. Myoelectric hand prostheses with many degrees of freedom are commercially available and recent advances in rehabilitation robotics suggest that their natural control can be performed in real life. The first commercial products exploiting pattern recognition to recognize the movements have recently been released, however the most common control systems are still usually unnatural and must be learned through long training. Dexterous and naturally controlled robotic prostheses can become reality in the everyday life of amputees but the path still requires many steps. This mini-review aims to improve the situation by giving an overview of the advancements in the commercial and scientific domains in order to outline the current and future chances in this field and to foster the integration between market and scientific research.

  20. Stepwise rehabilitation of the triple amputee combined with dysfunction of the sound limb.

    Science.gov (United States)

    Shin, Ji Cheol; Yang, Hye Eun; Yu, Su Jin; Kim, Na Young; Yoon, Seo Yeon

    2014-02-01

    To find a multiple amputee more severe than a triple amputee is not easy. This is a report of a 36-year-old patient with right knee disarticulation, left trans-femoral amputation and right elbow disarticulation due to peripheral ischemic necrosis, when he was applied vasopressor in septic shock condition. His left hand was also 2nd, 3rd, 4th, and 5th distal interphalangeal joint disarticulation status, and it was more difficult for him to do rehabilitation program, such as donning and doffing the prostheses. For more efficient rehabilitation training program, we first focused on upper extremities function, since we believed that he might need a walking aid for gait training later. After 13 weeks of rehabilitation program, he has become sit to stand and walk short distance independently with an anterior walker. Although he still needs some assistance with activities of daily living, his Functional Independence Measure score improved from 48 to 90 during the course of 13 weeks.

  1. Control Capabilities of Myoelectric Robotic Prostheses by Hand Amputees: A Scientific Research and Market Overview

    Directory of Open Access Journals (Sweden)

    Manfredo eAtzori

    2015-11-01

    Full Text Available Hand amputation can dramatically affect the capabilities of a person. Cortical reorganization occurs in the brain, but the motor and somatosensorial cortex can interact with the remnant muscles of the missing hand even many years after the amputation, leading to the possibility to restore the capabilities of hand amputees through myoelectric prostheses. Myoelectric hand prostheses with many degrees of freedom are commercially available and recent advances in rehabilitation robotics suggest that their natural control can be performed in real life. The first commercial products exploiting pattern recognition to recognize the movements have recently been released, however the most common control systems are still usually unnatural and must be learned through long training. Dexterous and naturally controlled robotic prostheses can become reality in the everyday life of amputees but the path still requires many steps. This mini-review aims to improve the situation by giving an overview of the advancements in the commercial and scientific domains in order to outline the current and future chances in this field and to foster the integration between market and scientific research.

  2. Adaptation to altered balance conditions in unilateral amputees due to atherosclerosis: a randomized controlled study

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    Bretz Éva

    2011-05-01

    Full Text Available Abstract Background Amputation impairs the ability to balance. We examined adaptation strategies in balance following dysvascularity-induced unilateral tibial amputation in skilled prosthetic users (SPU and first fitted amputees (FFA (N = 28. Methods Excursions of center of pressure (COP were determined during 20 s quiet standing using a stabilometry system with eyes-open on both legs or on the non-affected leg(s. Main measures: COP trajectories and time functions; distribution of reaction forces between the two legs; inclination angles obtained through second order regression analysis using stabilogram data. Results FFA vs SPU demonstrated 27.8% greater postural sway in bilateral stance (p = 0.0004. Postural sway area was smaller in FFA standing on the non-affected leg compared with SPU (p = 0.028. The slope of the regression line indicating postural stability was nearly identical in FFA and SPU and the direction of regression line was opposite for the left and right leg amputees. Conclusion Of the two adaptation strategies in balance, the first appears before amputation due to pain and fatigue in the affected leg. This strategy appears in the form of reduced postural sway while standing on the non-affected leg. The second adaptation occurs during rehabilitation and regular use of the prosthesis resulting in normal weightbearing associated with reduced postural sway on two legs and return to the normal postural stability on one leg.

  3. A prosthetic knee using magnetorhelogical fluid damper for above-knee amputees

    Science.gov (United States)

    Park, Jinhyuk; Choi, Seung-Bok

    2015-04-01

    A prosthetic knee for above-knee (AK) amputees is categorized into two types; namely a passive and an active type. The passive prosthetic knee is generally made by elastic materials such as carbon fiber reinforced composite material, titanium and etc. The passive prosthetic knee easy to walk. But, it has disadvantages such that a knee joint motion is not similar to ordinary people. On the other hand, the active prosthetic knee can control the knee joint angle effectively because of mechanical actuator and microprocessor. The actuator should generate large damping force to support the weight of human body. But, generating the large torque using small actuator is difficult. To solve this problem, a semi-active type prosthetic knee has been researched. This paper proposes a semi-active prosthetic knee using a flow mode magneto-rheological (MR) damper for AK amputees. The proposed semi-active type prosthetic knee consists of the flow mode MR damper, hinge and prosthetic knee body. In order to support weight of human body, the required energy of MR damper is smaller than actuator of active prosthetic leg. And it can control the knee joint angle by inducing the magnetic field during the stance phase.

  4. Assessment of Gait Symmetry in Transfemoral Amputees Using C-Leg Compared With 3R60 Prosthetic Knees

    DEFF Research Database (Denmark)

    Petersen, Andreas Overbeck; Comins, Jonathan David; Alkjaer, T

    2010-01-01

    The objective of the study was to investigate gait symmetry in transfemoral amputees using a hydraulic- and a microprocessor-controlled knee prosthesis. An A-B design with repeated measurements was chosen, and the measurements were carried out at a prosthetics/orthotics rehabilitation center. Nine...

  5. Sports Adaptations for Unilateral and Bilateral Upper-Limb Amputees: Archery/Badminton/Baseball/Softball/Bowling/Golf/Table Tennis.

    Science.gov (United States)

    Cowart, Jim

    1979-01-01

    The booklet discusses sports adaptations for unilateral and bilateral upper limb amputees. Designs for adapted equipment are illustrated and information on adaptations are described for archery (including an archery release aid and a stationary bow holder); badminton (serving tray); baseball/softball (adaptations for catching, throwing, and…

  6. Sport prostheses and prosthetic adaptations for the upper and lower limb amputees : an overview of peer reviewed literature

    NARCIS (Netherlands)

    Bragaru, Mihai; Dekker, Rienk; Geertzen, Jan H. B.

    2012-01-01

    Background: Sport prostheses are used by both upper- and lower-limb amputees while participating in sports and other physical activities. Although the number of these devices has increased over the past decade, no overview of the peer reviewed literature describing them has been published previously

  7. Altered kinetic strategy for the control of swing limb elevation over obstacles in unilateral below-knee amputee gait.

    Science.gov (United States)

    Hill, S W; Patla, A E; Ishac, M G; Adkin, A L; Supan, T J; Barth, D G

    1999-05-01

    Our goal was to document the kinetic strategies for obstacle avoidance in below-knee amputees. Kinematic data were collected as unilateral below-knee traumatic amputees stepped over obstacles of various heights in the walking path. Inverse dynamics were employed to calculate power profiles and work during the limb-elevation and limb-lowering phases. Limb elevation was achieved by employing a different strategy of intra-limb interaction for elevation of the prosthetic limb than for the sound limb, which was similar to that seen in healthy adult non-amputees. As obstacle height increased, prosthetic side knee flexion was increased by modulating the work done at the hip, and not the knee, as seen on the sound side. Although the strength of the muscles about the residual knee was preserved, the range of motion of that knee had previously been found to be somewhat limited. Perhaps more importantly, potential instability of the interface between the stump and the prosthetic socket, and associated discomfort at the stump could explain the altered limb-elevation strategy. Interestingly, the limb-lowering strategy seen in the sound limb and in non-amputees already features modulation of rotational and translational work at the hip, so an alternate strategy was not required. Thus, following a major insult to the sensory and neuromuscular system, the CNS is able to update the internal model of the locomotor apparatus as the individual uses the new limb in a variety of movements, and modify control strategies as appropriate.

  8. Transradial Amputee Gesture Classification Using an Optimal Number of sEMG Sensors: An Approach Using ICA Clustering.

    Science.gov (United States)

    Naik, Ganesh R; Al-Timemy, Ali H; Nguyen, Hung T

    2016-08-01

    Surface electromyography (sEMG)-based pattern recognition studies have been widely used to improve the classification accuracy of upper limb gestures. Information extracted from multiple sensors of the sEMG recording sites can be used as inputs to control powered upper limb prostheses. However, usage of multiple EMG sensors on the prosthetic hand is not practical and makes it difficult for amputees due to electrode shift/movement, and often amputees feel discomfort in wearing sEMG sensor array. Instead, using fewer numbers of sensors would greatly improve the controllability of prosthetic devices and it would add dexterity and flexibility in their operation. In this paper, we propose a novel myoelectric control technique for identification of various gestures using the minimum number of sensors based on independent component analysis (ICA) and Icasso clustering. The proposed method is a model-based approach where a combination of source separation and Icasso clustering was utilized to improve the classification performance of independent finger movements for transradial amputee subjects. Two sEMG sensor combinations were investigated based on the muscle morphology and Icasso clustering and compared to Sequential Forward Selection (SFS) and greedy search algorithm. The performance of the proposed method has been validated with five transradial amputees, which reports a higher classification accuracy ( > 95%). The outcome of this study encourages possible extension of the proposed approach to real time prosthetic applications.

  9. Increasing ankle push-off work with a powered prosthesis does not necessarily reduce metabolic rate for transtibial amputees.

    Science.gov (United States)

    Quesada, Roberto E; Caputo, Joshua M; Collins, Steven H

    2016-10-03

    Amputees using passive ankle-foot prostheses tend to expend more metabolic energy during walking than non-amputees, and reducing this cost has been a central motivation for the development of active ankle-foot prostheses. Increased push-off work at the end of stance has been proposed as a way to reduce metabolic energy use, but the effects of push-off work have not been tested in isolation. In this experiment, participants with unilateral transtibial amputation (N=6) walked on a treadmill at a constant speed while wearing a powered prosthesis emulator. The prosthesis delivered different levels of ankle push-off work across conditions, ranging from the value for passive prostheses to double the value for non-amputee walking, while all other prosthesis mechanics were held constant. Participants completed six acclimation sessions prior to a data collection in which metabolic rate, kinematics, kinetics, muscle activity and user satisfaction were recorded. Metabolic rate was not affected by net prosthesis work rate (p=0.5; R(2)=0.007). Metabolic rate, gait mechanics and muscle activity varied widely across participants, but no participant had lower metabolic rate with higher levels of push-off work. User satisfaction was affected by push-off work (p=0.002), with participants preferring values of ankle push-off slightly higher than in non-amputee walking, possibly indicating other benefits. Restoring or augmenting ankle push-off work is not sufficient to improve energy economy for lower-limb amputees. Additional necessary conditions might include alternate timing or control, individualized tuning, or particular subject characteristics.

  10. Energy Cost and Gait Efficiency of Below-Knee Amputee and Normal Subject with Similar Physical Parameters & Quality of Life: A Comparative Case Study

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    Durbadal Biswas

    2010-10-01

    Full Text Available The study focused on the comparative analysis of energy cost and gait efficiency between a below knee (BK amputee and a reference subject (without amputation. It also attempted to indicate the specific feature responsible for a controlled gait with optimum energy cost for BK amputees. Selection criteria of the subjects were similar physical parameters and quality of life studied with WHOQOL-100 quality of life assessment. A Cosmed® k4 b2 Respiratory Analyzer system was used for the measurement of Oxygen Uptake (VO2, Energy Expenditure per minute (EE and Heart Rate (HR. Gait efficiency (p < 0.0002 was found higher for BK amputee than normal subject. The therapeutic activities and mainly walking rhythm contributed to improve the mobility & balance. This ensures the optimum time & co-ordination of movements and hence improves the gait efficiency for the BK amputee. Comparison with control group was performed to validate the data.

  11. Classification of motor intent in transradial amputees using sonomyography and spatio-temporal image analysis

    Science.gov (United States)

    Hariharan, Harishwaran; Aklaghi, Nima; Baker, Clayton A.; Rangwala, Huzefa; Kosecka, Jana; Sikdar, Siddhartha

    2016-04-01

    In spite of major advances in biomechanical design of upper extremity prosthetics, these devices continue to lack intuitive control. Conventional myoelectric control strategies typically utilize electromyography (EMG) signal amplitude sensed from forearm muscles. EMG has limited specificity in resolving deep muscle activity and poor signal-to-noise ratio. We have been investigating alternative control strategies that rely on real-time ultrasound imaging that can overcome many of the limitations of EMG. In this work, we present an ultrasound image sequence classification method that utilizes spatiotemporal features to describe muscle activity and classify motor intent. Ultrasound images of the forearm muscles were obtained from able-bodied subjects and a trans-radial amputee while they attempted different hand movements. A grid-based approach is used to test the feasibility of using spatio-temporal features by classifying hand motions performed by the subjects. Using the leave-one-out cross validation on image sequences acquired from able-bodied subjects, we observe that the grid-based approach is able to discern four hand motions with 95.31% accuracy. In case of the trans-radial amputee, we are able to discern three hand motions with 80% accuracy. In a second set of experiments, we study classification accuracy by extracting spatio-temporal sub-sequences the depict activity due to the motion of local anatomical interfaces. Short time and space limited cuboidal sequences are initially extracted and assigned an optical flow behavior label, based on a response function. The image space is clustered based on the location of cuboids and features calculated from the cuboids in each cluster. Using sequences of known motions, we extract feature vectors that describe said motion. A K-nearest neighbor classifier is designed for classification experiments. Using the leave-one-out cross validation on image sequences for an amputee subject, we demonstrate that the classifier is

  12. Central representation of phantom limb phenomenon in amputees studied with single photon emission computerized tomography.

    Science.gov (United States)

    Liaw, M Y; You, D L; Cheng, P T; Kao, P F; Wong, A M

    1998-01-01

    To explore the possible mechanisms of phantom limb discomfort after amputation, three amputees with phantom limb pain were studied. This study examined the change of regional cerebral blood flow using technetium-99m hexamethylpropyleneamine oxime-single photon emission computerized tomography, which was arranged at the time of severe phantom limb discomfort and after the discomfort subsided or was completely relieved. Nine representative transverse slices parallel to the orbitomeatal line were selected for quantification. The cortical ribbon (2-cm thickness) was equally subdivided into 12 symmetrical pairs of sector regions of interest in each slice. The irregularly shaped regions of interest were drawn manually around the right thalamus and basal ganglion and then mirrored to the left thalamus and basal ganglion. The contralateral to ipsilateral ratio of regional cerebral blood flow for each area was calculated. The intensity of phantom limb pain was evaluated on a 0 to 10 visual analog scale. In Cases 1 and 2, the contralateral to ipsilateral regional cerebral blood flow ratios of multiple areas of the frontal, temporal, or parietal lobes were increased at the time of more severe phantom limb pain, and the ratios were normalized or even decreased when the phantom limb pain subsided. In Case 3, increased contralateral to ipsilateral regional cerebral blood flow ratios were also found over the frontal, temporal, and parietal lobe. However, most of the increased regional cerebral blood flow ratios of regions of interest in the first study persisted in the follow-up study. Also, the regional cerebral blood flow ratios of greater number of regions of interest of the same gyrus and new gyrus were increased. There was no significant right-left difference of regional cerebral blood flow over bilateral thalami and basal ganglia in all three cases. The results suggested that phantom limb pain might be associated with cortical activation involving the frontal, temporal, or

  13. Specificities of prosthetic and orthotic rehabilitation in amputees with head injury

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    Teofilovski Mirko

    2011-01-01

    Full Text Available Background/Aim. The prosthetic-orthotic rehabilitation (POR of amputees with head injury within the polytrauma presents a specific entity. The number of traumas caused by the traffic and the low-intensity war conflicts, increases constantly. The aim of our study was to examine the influence of complications on the POR duration and outcome in polytrauma amputees with head injury (PTAHI recording complications at the beginning and during the POR. Methods. The study was carried out on the patients divided into two groups of 35 polytrauma male patients each of corresponding age with unilateral transfemoral amputation caused by the war injury. The experimental group consisted of the amputees with head injury. Standard clinical techniques and procedures, as well as special functional evaluation techniques were used. Results. The PATHI started POR with a greater number of complications (average rate 7.29 vs 5.11 per patient; W = 928.000: Z = 3.730: p = 0.000. There was a highly significant positive correlation between this number and the Barthel Score value change (Fx, H, p < 0.01, and negative significant correlation considering prosthetic use and functional capacity test values (Fx, H p < 0.05. On admision, the amount of complications defined for the value 4 of POR outcome was significantly higher than values 2 and 3, respectively (H = 8.948; df = 2; p = 0.011. The PTAHI developed significantly more frequently complications during rehabilitation (X2 = 1.061; df = 1; p < 0.01. The proportion of the examinees with the value 4 who developed complications during rehabilitations was significantly higher than those with value 2 (Fp = 3.406; df1 = 2; df2 = 67; p = 0.038. The rehabilitation of the PTAHI lasted significantly longer (average 259.09 vs 183.63 days; W = 923.500; Z = -3.748; p = 0.000. Conclusion. The PTAHI including head injuries started prostheticorthotic rehabilitation with more prosthetic complications and their psychological status was worse

  14. To Compare the Effect of Pre and Post Weight Bearing Anxiety, Depression in Conventional and Modular Prosthesis on Unilateral Transtibial Amputees

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    R. Raja

    2014-01-01

    Full Text Available Aims and Objectives: To compare the effect of anxiety and depression on unilateral trans tibial amputees those who are using conventional and modular patellar tendon bearing (PTB prosthesis with stump exercises. Material and Methods: A sample of 40 persons with below knee amputation who were trained to wear prosthesis were studied with an experimental comparative study design. Patients who were admitted at Kempegowda Institute of Medical Sciences and Research Centre, Bangalore, K. S. Hegde Medical Academy and Research Centre Mangalore, (N=150 who underwent unilateral transtibial, transfemoral and other amputations between August 2009 - December 2011. To find out peri and postoperative prosthetic fitting, anxiety and depression level of transtibial amputees who wear conventional and modular PTB prosthesis. 3 years of experimental comparative study reveals that the outcome measures of peri and post-operative anxiety and depression level while using conventional PTB prosthesis with stump exercises and modular PTB prosthesis with stump exercises on unilateral transtibial amputees. Results: The unilateral transtibial amputees who were trained with modular prosthesis along with stump exercises group patients anxiety and depression levels are reduced as compared to the unilateral transtibial amputees who were trained with conventional PTB prosthesis along with stump exercises. There is no significant difference seen in both the groups while giving stump exercises alone. Conclusion: The unilateral transtibial amputees who were trained with modular prosthesis along with stump exercises group, patient’s anxiety and depression levels are reduced drastically.

  15. Relation of Stump Length with Various Gait Parameters in Trans-tibial Amputee

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    Koyel Majumdar

    2008-07-01

    Full Text Available The purpose of this paper is evaluating the impact of stump length of unilateral below knee amputees (BKA on different gait parameters. Nine unilateral BKA were chosen and divided into three groups comprising patients with short, medium, and long stump length. Each of them underwent gait analysis test by Computer Dynography (CDG system to measure the gait parameters. It was found that the ground reaction force is higher in the patients with medium stump length whereas the velocity, step length both for the prosthetic and sound limb and cadence were high in longer stump length. Statistical analysis shows a significant difference (p<0.05 between the gait parameters of BKA with medium and longer stump length. The patients with longer stump length were more efficient than medium and short stump patients as they consumed comparatively lesser energy while walking with self-selected velocity and conventional (Solid ankle cushioned heel SACH foot.

  16. The Importance of Technical Devices in the Self-care of Upper Limbs Amputees.

    Science.gov (United States)

    Mészáros, Gabriella; Vén, Ildikó

    2015-01-01

    The National Institute of Medical Rehabilitation (NIMR) is engaged in the rehabilitation of posttraumatic patients, including also attending traumatic cases with amputated upper limbs. The lack of upper limbs is a great obstacle in essential functioning for the injured, and that is why we give high priority to planning, constructing and individually adopting appliances for aiding everyday life. Special literature gives distinguished attention to operative techniques and the possibilities of prosthetic devices, but no professional articles present any special devices needed for discharging everyday vital functions. The purpose of this lecture is to present the results of our follow-up examination aimed at upper limbs amputees reeducated since 1994 at the NIMR (9 patients). Case studies conclude that the prosthetic care plays a surprisingly small part in the self-sufficiency of the injured. Claims to individual appliances are already more considerable but these cannot be obtained in normal commerce because of unprofitable production in view of users so few in number.

  17. Multiple Neuromas Cause Painful "Jumping Stump" in a Transfemoral Amputee: A Case Report.

    Science.gov (United States)

    Buntragulpoontawee, Montana; Pattamapaspong, Nuttaya; Tongprasert, Siam

    2016-09-01

    Painful "jumping stump" is an uncommon but very disturbing complication postamputation. This condition is one of the movement disorder entities resulting from peripheral nerve pathology, often known as "peripherally induced movement disorders." Previously case reports have been written about painful and nonpainful incidence of "jumping stump"; however, only the earliest "jumping stump" article in 1852 suspected that neuromas might influence the involuntary movement. In this study, we describe a 38-year-old man with bilateral transfemoral amputee who suffered from painful "jumping stump" with multiple neuromas confirmed by imaging. He was treated successfully by ultrasound-guided phenol injection into the sciatic neuroma stalks. The pathophysiology of jumping stump and its possible association with neuroma are briefly discussed.

  18. Dismounted complex blast injuries: patterns of injuries and resource utilization associated with the multiple extremity amputee.

    Science.gov (United States)

    Fleming, Mark; Waterman, Scott; Dunne, James; D'Alleyrand, Jean-Claude; Andersen, Romney C

    2012-01-01

    The objective of this report is to analyze the resource utilization and injury patterns of complex dismounted blast injuries. A retrospective review of U.S. service members injured in combat between 2007 and 2010 was conducted. Data analyzed included age, injury mechanism, amputated limbs, number and type of associated injuries, blood products utilized, intensive care unit length of stay (ILOS), hospital length of stay (HLOS) and the Injury Severity Score (ISS). Patients were stratified based on the number of amputations. Sixty-three patients comprised the multiple extremity amputation (MEA) group. Ninety-eight percent sustained injuries from an improvised explosive device (IED) and 96% were dismounted. The ISS, number of surgical encounters, blood products utilized and ILOS were all clinically significantly different than controls. Care of multiple extremity amputees involves the utilization of significant resources. This knowledge may better help surgeons and administrators allocate assets at hospitals, both military and civilian, who care for this complex and challenging patient population.

  19. Real-time gait event detection for lower limb amputees using a single wearable sensor.

    Science.gov (United States)

    Maqbool, H F; Husman, M A B; Awad, M I; Abouhossein, A; Mehryar, P; Iqbal, N; Dehghani-Sanij, A A

    2016-08-01

    This paper presents a rule-based real-time gait event/phase detection system (R-GEDS) using a shank mounted inertial measurement unit (IMU) for lower limb amputees during the level ground walking. Development of the algorithm is based on the shank angular velocity in the sagittal plane and linear acceleration signal in the shank longitudinal direction. System performance was evaluated with four control subjects (CS) and one transfemoral amputee (TFA) and the results were validated with four FlexiForce footswitches (FSW). The results showed a data latency for initial contact (IC) and toe off (TO) within a range of ± 40 ms for both CS and TFA. A delay of about 3.7 ± 62 ms for a foot-flat start (FFS) and an early detection of -9.4 ± 66 ms for heel-off (HO) was found for CS. Prosthetic side showed an early detection of -105 ± 95 ms for FFS whereas intact side showed a delay of 141 ±73 ms for HO. The difference in the kinematics of the TFA and CS is one of the potential reasons for high variations in the time difference. Overall, detection accuracy was 99.78% for all the events in both groups. Based on the validated results, the proposed system can be used to accurately detect the temporal gait events in real-time that leads to the detection of gait phase system and therefore, can be utilized in gait analysis applications and the control of lower limb prostheses.

  20. Energy consumption during prosthetic walking and physical fitness in older hip disarticulation amputees

    Directory of Open Access Journals (Sweden)

    Takaaki Chin, MD

    2012-12-01

    Full Text Available The objective of this study is to investigate energy consumption during prosthetic walking and physical fitness in older hip disarticulation (HD subjects and to examine the ambulatory outcome in a community setting. The subjects were seven unilateral HD amputees with an average age of 67.7 +/– 3.9 yr. Energy consumption was measured during prosthetic walking at each individual’s comfortable walking speed (CWS by means of a portable telemetric system. An incremental exercise test was performed to evaluate fitness. The average CWS for the subjects was 30.5 +/– 9.6 m/min. The average oxygen consumption rate at each CWS was 18.3 +/– 2.4 mL/kg/min, and the average oxygen cost was 0.639 +/– 0.165 mL/kg/m. The maximum oxygen uptake during exercise as a proportion of predicted maximum oxygen uptake (%VO2max for the subjects was 57.2 +/– 11.1. Five subjects continued prosthetic walking on return to their communities. Two subjects abandoned prosthetic walking. The %VO2max for the five who continued prosthetic walking after discharge ranged from 55.8 to 72.0. The subjects who abandoned prosthetic walking had lower %VO2max of 43.3 and 44.2. Energy consumption during prosthetic walking at CWS seemed not to be excessive. Older HD amputees in good physical condition were able to successfully walk with a prosthesis in a community setting. A lower level of fitness appears to make community walking prohibitive.

  1. The role of the environment in eliciting phantom-like sensations in non-amputees

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    Elizabeth eLewis

    2013-01-01

    Full Text Available Following the amputation of a limb, many amputees report that they can still vividly perceive its presence despite conscious knowledge that it is not physically there. However, our ability to probe the mental representation of this experience is limited by the intractable and often distressing pain associated with amputation. Here, we present a method for eliciting phantom-like experiences in non-amputees using a variation of the rubber hand illusion in which a finger has been removed from the rubber hand. An interpretative phenomenological analysis revealed that the structure of this experience shares a wide range of sensory attributes with subjective reports of phantom limb experience. For example, when the space where the ring finger should have been on the rubber hand was stroked, 93% of participants (i.e., 28/30 reported the vivid presence of a finger that they could not see and a total of 57% (16/28 of participants who felt that the finger was present reported one or more additional sensory qualities such as tingling or numbness (25%; 7/28 and alteration in the perceived size of the finger (50%; 14/28. These experiences indicate the adaptability of body experience and share some characteristics of the way that phantom limbs are described. Participants attributed changes to the shape and size of their ‘missing’ finger to the way in which the experimenter mimed stroking in the area occupied by the missing finger. This alteration of body perception is similar to the phenomenon of telescoping experienced by people with phantom limbs and suggests that our sense of embodiment not only depends on internal body representations but on perceptual information coming from peripersonal space.

  2. Body image and self-esteem in lower-limb amputees.

    Directory of Open Access Journals (Sweden)

    Lukas A Holzer

    Full Text Available BACKGROUND: Limb amputation is often an inevitable procedure in the advanced condition of various diseases and poses a dramatic impact on a patient's life. The aim of the present study is to analyze the impact of lower-limb amputations on aesthetic factors such as body image and self-esteem as well as quality of life (QoL. METHODS: 298 patients (149 uni- or bilateral lower-limb amputees and 149 controls were included in this cross-sectional study in three centers. Demographic data was collected and patients received a 118-item questionnaire including the Multidimensional Body-Self Relations Questionnaire (MBSRQ, the Rosenberg Self-esteem (RSE scale and the SF-36 Health Survey (QoL. ANOVA and student's t-test were used for statistical analysis. RESULTS: Unilateral lower-limb amputees showed a significant lower MBSRQ score of 3.07±0.54 compared with 3.41±0.34 in controls (p<0.001 and a lower score in the RSE compared to controls (21.63±4.72 vs. 21.46±5.86. However, differences were not statistically significant (p = 0.36. Patients with phantom pain sensation had a significantly reduced RSE (p = 0.01. The SF-36 health survey was significantly lower in patients with lower-limb amputation compared to controls (42.17±14.47 vs. 64.05±12.39 (p<0.001. CONCLUSION: This study showed that lower-limb amputations significantly influence patients' body image and QoL. Self-esteem seems to be an independent aspect, which is not affected by lower-limb amputation. However, self-esteem is influenced significantly by phantom pain sensation.

  3. Effect of swim speed on leg-to-arm coordination in unilateral arm amputee front crawl swimmers.

    Science.gov (United States)

    Osborough, Conor; Daly, Daniel; Payton, Carl

    2015-01-01

    The aim of this study was to examine the effect of swimming speed on leg-to-arm coordination in competitive unilateral arm amputee front crawl swimmers. Thirteen well-trained swimmers were videotaped underwater during three 25-m front crawl trials (400 m, 100 m and 50 m pace). The number, duration and timing of leg kicks in relation to arm stroke phases were identified by video analysis. Within the group, a six-beat kick was predominantly used (n = 10) although some swimmers used a four-beat (n = 2) or eight-beat kick (n = 1). Swimming speed had no significant effect on the relative duration of arm stroke and leg kick phases. At all speeds, arm stroke phases were significantly different (P amputee swimmers functionally adapt their motor organisation to swim front crawl.

  4. Center of pressure and total force analyses for amputees walking with a backpack load over four surfaces.

    Science.gov (United States)

    Sinitski, Emily H; Herbert-Copley, Andrew G; Lemaire, Edward D; Doyle, Sean S; Besemann, Markus; Dudek, Nancy L

    2016-01-01

    Understanding how load carriage affects walking is important for people with a lower extremity amputation who may use different strategies to accommodate to the additional weight. Nine unilateral traumatic transtibial amputees (K4-level) walked over four surfaces (level-ground, uneven ground, incline, decline) with and without a 24.5 kg backpack. Center of pressure (COP) and total force were analyzed from F-Scan insole pressure sensor data. COP parameters were greater on the intact limb than on the prosthetic limb, which was likely a compensation for the loss of ankle control. Double support time (DST) was greater when walking with a backpack. Although longer DST is often considered a strategy to enhance stability and/or reduce loading forces, changes in DST were only moderately correlated with changes in peak force. High functioning transtibial amputees were able to accommodate to a standard backpack load and to maintain COP progression, even when walking over different surfaces.

  5. Influence of Prosthetic Sagittal Alignment on Trans-Tibial Amputee Gait and Compensating Pattern:A Case Study

    Institute of Scientific and Technical Information of China (English)

    JIA Xiaohong; WANG Rencheng; ZHANG Ming; LI Xiaobing

    2008-01-01

    This study relates the gait asymmetry,residual limb comfort,and energy cost dunng walking and identifies a compensating pattem for the trans-tibial amputees when the prostheses are misaligned.One male subject with a trans-tibial amputation volunteered for the study.The knee joint moments at the prosthetic side,the phase symmetry index,and the interface pressures were discussed under three sagittalal ignment settings.The results show that the subject changes the knee joint moment,gait symmetry,and interface pressure with a misaligned prosthesis to improve his comfort and movement dudng walking.A high-quality liner reduces the gait sensitivity to misalignment and enhances the amputee's ability to compensate for misalignment.Since different people have different compensation pattems,more cases will be studied in future work.

  6. Neck of femur fracture fixation in a bilateral amputee: an uncommon condition requiring an improvised fracture table positioning technique.

    Science.gov (United States)

    Berg, Andrew James; Bhatia, Chandra

    2014-02-21

    While neck of femur fractures are common it is rare to see this injury in a bilateral leg amputee. Special consideration needs to be given to the management of these patients. We report the case of a 58-year-old man with bilateral leg amputation who presented to the emergency department with left hip pain following a fall. A fracture of the left neck of femur with extension into the femoral shaft was diagnosed. Internal fixation was planned with a dynamic hip screw. Standard fracture table setup, which allows for traction of the fractured limb and positioning of the contralateral limb such that anteroposterior and lateral X-rays can be obtained, was not possible in this case due to the amputations. We highlight considerations that need to be made in positioning a bilateral amputee for neck of femur fracture fixation and also highlight an improvised technique that can be utilised by other surgeons.

  7. Classification of Phantom Finger, Hand, Wrist, and Elbow Voluntary Gestures in Transhumeral Amputees With sEMG.

    Science.gov (United States)

    Jarrasse, Nathanael; Nicol, Caroline; Touillet, Amelie; Richer, Florian; Martinet, Noel; Paysant, Jean; de Graaf, Jozina Bernardina

    2017-01-01

    Decoding finger and hand movements from sEMG electrodes placed on the forearm of transradial amputees has been commonly studied by many research groups. A few recent studies have shown an interesting phenomenon: simple correlations between distal phantom finger, hand and wrist voluntary movements and muscle activity in the residual upper arm in transhumeral amputees, i.e., of muscle groups that, prior to amputation, had no physical effect on the concerned hand and wrist joints. In this study, we are going further into the exploration of this phenomenon by setting up an evaluation study of phantom finger, hand, wrist and elbow (if present) movement classification based on the analysis of surface electromyographic (sEMG) signals measured by multiple electrodes placed on the residual upper arm of five transhumeral amputees with a controllable phantom limb who did not undergo any reinnervation surgery. We showed that with a state-of-the-art classification architecture, it is possible to correctly classify phantom limb activity (up to 14 movements) with a rather important average success (over 80% if considering basic sets of six hand, wrist and elbow movements) and to use this pattern recognition output to give online control of a device (here a graphical interface) to these transhumeral amputees. Beyond changing the way the phantom limb condition is apprehended by both patients and clinicians, such results could pave the road towards a new control approach for transhumeral amputated patients with a voluntary controllable phantom limb. This could ease and extend their control abilities of functional upper limb prosthetics with multiple active joints without undergoing muscular reinnervation surgery.

  8. Stability and selectivity of a chronic, multi-contact cuff electrode for sensory stimulation in human amputees

    Science.gov (United States)

    Tan, Daniel W.; Schiefer, Matthew A.; Keith, Michael W.; Anderson, J. Robert; Tyler, Dustin J.

    2015-04-01

    Objective. Stability and selectivity are important when restoring long-term, functional sensory feedback in individuals with limb-loss. Our objective is to demonstrate a chronic, clinical neural stimulation system for providing selective sensory response in two upper-limb amputees. Approach. Multi-contact cuff electrodes were implanted in the median, ulnar, and radial nerves of the upper-limb. Main results. Nerve stimulation produced a selective sensory response on 19 of 20 contacts and 16 of 16 contacts in subjects 1 and 2, respectively. Stimulation elicited multiple, distinct percept areas on the phantom and residual limb. Consistent threshold, impedance, and percept areas have demonstrated that the neural interface is stable for the duration of this on-going, chronic study. Significance. We have achieved selective nerve response from multi-contact cuff electrodes by demonstrating characteristic percept areas and thresholds for each contact. Selective sensory response remains consistent in two upper-limb amputees for 1 and 2 years, the longest multi-contact sensory feedback system to date. Our approach demonstrates selectivity and stability can be achieved through an extraneural interface, which can provide sensory feedback to amputees.

  9. Physiological Cost Index and Comfort Walking Speed in Two Level Lower Limb Amputees Having No Vascular Disease

    Science.gov (United States)

    Vllasolli, Teuta Osmani; Orovcanec, Nikola; Zafirova, Beti; Krasniqi, Blerim; Murtezani, Ardiana; Krasniqi, Valbona; Rama, Bukurije

    2015-01-01

    Background: The Physiological Cost Index (PCI) was introduced by MacGregor to estimate the energy cost in walking of healthy people, also it has been reported for persons with lower limb amputation, walking with prosthesis. Objective: To assess energy cost and walking speed in two level lower limb amputation: transfemoral and transtibial amputation and to determine if the age and prosthetic walking supported with walking aids have impact on energy cost and walking speed. Methods: A prospective cross sectional study was performed in two level lower limb amputees with no vascular disease who were rehabilitated at the Department of Prosthetics and Orthotics at the University Clinical Center of Kosovo. The Physiological Cost Index (PCI) was assessed by five minutes of continuous indoor walking at Comfort Walking Speed (CWS). Results: Eighty three lower limb amputees were recruited. It is shown relevant impact of level of amputation in PCI (t=6.8, pamputation. Conclusions: Walking with transfemoral prosthesis or using walking aids during prosthetic ambulation is matched with higher cost of energy and slower walking speed. Advanced age was shown with high impact on PCI and CWS in both groups of amputees. PMID:25870485

  10. Mechanical work performed by individual limbs of transfemoral amputees during step-to-step transitions: Effect of walking velocity.

    Science.gov (United States)

    Bonnet, Xavier; Villa, Coralie; Fodé, Pascale; Lavaste, Francois; Pillet, Hélène

    2014-01-01

    The greater metabolic demand during the gait of people with a transfemoral amputation limits their autonomy and walking velocity. Major modifications of the kinematic and kinetic patterns of transfemoral amputee gait quantified using gait analysis may explain their greater energy cost. Donelan et al. proposed a method called the individual limb method to explore the relationships between the gait biomechanics and metabolic cost. In the present study, we applied this method to quantify mechanical work performed by the affected and intact limbs of transfemoral amputees. We compared a cohort of six active unilateral transfemoral amputees to a control group of six asymptomatic subjects. Compared to the control group, we found that there was significantly less mechanical work produced by the affected leg and significantly more work performed by the unaffected leg during the step-to-step transition. We also found that this mechanical work increased with walking velocity; the increase was less pronounced for the affected leg and substantial for the unaffected leg. Finally, we observed that the lesser work produced by the affected leg was linked to the increase in the hip flexion moment during the late stance phase, which is necessary for initiating knee flexion in the affected leg. It is possible to quantify the mechanical work performed during gait by people with a transfemoral amputation, using the individual limb method and conventional gait laboratory equipment. The method provides information that is useful for prosthetic fitting and rehabilitation.

  11. Changes in force production and stroke parameters of trained able-bodied and unilateral arm-amputee female swimmers during a 30 s tethered front-crawl swim.

    Science.gov (United States)

    Lee, Casey Jane; Sanders, Ross H; Payton, Carl J

    2014-01-01

    This study examined changes in the propulsive force and stroke parameters of arm-amputee and able-bodied swimmers during tethered swimming. Eighteen well-trained female swimmers (nine unilateral arm amputees and nine able-bodied) were videotaped performing maximal-effort 30 s front-crawl swims, while attached to a load cell mounted on a pool wall. Tether force, stroke rate, stroke phase durations and inter-arm angle were quantified. The able-bodied group produced significantly higher mean and maximum tether forces than the amputee group. The mean of the intra-cyclic force peaks was very similar for both groups. Mean and maximum tether force had significant negative associations with 100 m swim time, for both groups. Both groups exhibited a similar fatigue index (relative decrease in tether force) during the test, but the amputees had a significantly greater stroke rate decline. A significant positive association between stroke rate decline and fatigue index was obtained for the able-bodied group only. Inter-arm angle and relative phase durations did not change significantly during the test for either group, except the recovery phase duration of the arm amputees, which decreased significantly. This study's results can contribute to the development of a more evidence-based classification system for swimmers with a disability.

  12. ENERGY-COST DURING AMBULATION IN TRANSFEMORAL AMPUTEES - A KNEE-JOINT WITH A MECHANICAL SWING PHASE-CONTROL VS A KNEE-JOINT WITH A PNEUMATIC SWING PHASE-CONTROL

    NARCIS (Netherlands)

    BOONSTRA, AM; SCHRAMA, J; FIDLER, [No Value; EISMA, WH

    1995-01-01

    The aim of the study was (i) to evaluate the preference of transfemoral amputees for a 4-bar linked knee joint with either a mechanical swing phase control or a pneumatic swing phase control, and (ii) to compare the energy expenditure in transfemoral amputees using a prosthesis with a mechanical swi

  13. Estimating urea volume in amputees on peritoneal dialysis by modified anthropometric formulas.

    Science.gov (United States)

    Tzamaloukas, A H; Murata, G H

    1996-01-01

    Body composition determines body water content (the fraction body water/body weight). With developing obesity, body weight and body water increase, but body water content decreases. The anthropometric formulas for urea volume (body water) for Kt/V computations in nonamputated peritoneal dialysis subjects reflect this fundamental rule of body composition. However, the use of uncorrected anthropometric formulas in amputees provides body water content estimates inconsistent with the estimates of body composition obtained from nutritional assessment. Corrected estimates of urea volume can be obtained in three steps: (1) The non-amputated weight at the same body composition is computed by dividing the weight at the urea kinetic study (postamputation) by (1-the fractional weight loss from the amputation); (2) body water and body water content at this nonamputated weight are obtained from the appropriate anthropometric formula; (3) at the time of the urea kinetic study, post-amputation, body water is equal to the estimate of body water content obtained from step 2 times the body weight at the urea kinetic study. The corrected estimates of urea volume provide body water content values agreeing with the estimates from nutritional assessment.

  14. Autobiographical memory and psychological distress in a sample of upper-limb amputees.

    Directory of Open Access Journals (Sweden)

    Martina Luchetti

    Full Text Available Amputation is a traumatic and life-changing event that can take years to adjust to. The present study (a examines psychological adjustment in a specific trauma-exposed sample, (b compares the phenomenology (e.g., vividness of amputation-related memories to more recent memories, and (c tests whether memory phenomenology is associated with psychological distress. A total of 24 upper-limb amputees recalled two autobiographical memories--an amputation-related memory and a recent memory--and rated the phenomenological qualities of each memory, including Vividness, Coherence, Emotional Intensity, Visual Perspective, and Distancing. Participants also completed self-rated measures of psychological distress and personality. The sample was generally well adjusted; participants showed no relevant symptoms of anxiety and depression, and personality scores were similar to the general population. There were no significant differences in phenomenology between the two types of memories recalled. Even though amputation-related memories were, on average, almost 20 years older than the recent memories, they retained their intense phenomenology. Despite the intensity of the memory, none of the phenomenological dimensions were associated with psychological distress. It is worth to further define which dimensions of phenomenology characterize memories of traumatic events, and their association with individuals' psychological reactions.

  15. Glasgow Coma Scale scores, early opioids, and 4-year psychological outcomes among combat amputees

    Directory of Open Access Journals (Sweden)

    Ted Melcer, PhD

    2014-09-01

    Full Text Available Morphine and fentanyl are frequently used for analgesia after trauma, but there is debate over the advantages and disadvantages of these opioids. Among combat amputees, intravenous (IV morphine (vs IV fentanyl after injury was associated with reduced likelihood of posttraumatic stress disorder (PTSD. The previous results were based on military health diagnoses over 2 yr postinjury. The present study followed psychological diagnoses of patients with amputation for 4 yr using military and Department of Veterans Affairs health data. In-­theater combat casualty records (n = 145 documented Glasgow Coma Scale (GCS scores and/or morphine, fentanyl, or no opioid treatment within hours of injury. We found that (1 GCS scores were not significantly associated with PTSD; (2 longitudinal modeling using four (yearly time points showed significantly reduced odds of PTSD for patients treated with morphine (vs fentanyl across years (adjusted odds ratio = 0.40; 95% confidence interval = 0.17–0.94; (3 reduced PTSD prevalence for morphine (vs IV fentanyl; morphine = 25%, fentanyl = 59%, p < 0.05 was significant, specifically among patients with traumatic brain injury during the first 2 yr postinjury; and (4 PTSD prevalence, but not other disorders (e.g., mood, increased between year 1 (PTSD = 18% and years 2 through 4 postinjury (PTSD range = 30%–32%.

  16. Inpatient rehabilitation challenges in a quadrimembral amputee after bilateral hand transplantation.

    Science.gov (United States)

    Lee, Jerome; Garcia, Angela M; Lee, W P Andrew; Munin, Michael C

    2011-08-01

    Bilateral forearm and hand transplantation poses unique challenges especially in the setting of bilateral lower limb amputations. A 57-yr-old man with bilateral transradial amputations and bilateral transtibial amputations after remote streptococcal sepsis was admitted for inpatient rehabilitation because of severe debilitation after forearm/hand transplantations. He required 6 wks of bed rest to allow the healing of the allografts but developed profound deconditioning. Because of weight-bearing precautions and other complications such as femoral neurapraxia, he required the use of body weight-support apparatus to ambulate with lower limb prostheses, keeping weight off the allografts. He progressed to walking 600 ft using a platform-wheeled walker at a modified independent level, to climbing four stairs with minimal assistance, and to being able to toss a small football using his right hand, indicating improved flexor function in this hand. Tacrolimus levels were maintained without clinical evidence of acute rejection. Through an individualized therapy regimen, careful monitoring of the allografts and dedicated support staff, rehabilitation training of a previous quadrimembral amputee after bilateral hand transplantations can be successful.

  17. Motion Intention Analysis-Based Coordinated Control for Amputee-Prosthesis Interaction

    Directory of Open Access Journals (Sweden)

    Fei Wang

    2010-01-01

    Full Text Available To study amputee-prosthesis (AP interaction, a novel reconfigurable biped robot was designed and fabricated. In homogeneous configuration, two identical artificial legs (ALs were used to simulate the symmetrical lower limbs of a healthy person. Linear inverted pendulum model combining with ZMP stability criterion was used to generate the gait trajectories of ALs. To acquire interjoint coordination for healthy gait, rate gyroscopes were mounted on CoGs of thigh and shank of both legs. By employing principal component analysis, the measured angular velocities were processed and the motion synergy was obtained in the final. Then, one of two ALs was replaced by a bionic leg (BL, and the biped robot was changed into heterogeneous configuration to simulate the AP coupling system. To realize symmetrical stable walking, master/slave coordinated control strategy is proposed. According to information acquired by gyroscopes, BL recognized the motion intention of AL and reconstructed its kinematic variables based on interjoint coordination. By employing iterative learning control, gait tracking of BL to AL was archived. Real environment robot walking experiments validated the correctness and effectiveness of the proposed scheme.

  18. Amputation effects on the underlying complexity within transtibial amputee ankle motion

    Energy Technology Data Exchange (ETDEWEB)

    Wurdeman, Shane R., E-mail: shanewurdeman@gmail.com [Nebraska Biomechanics Core Facility, University of Nebraska at Omaha, Omaha, Nebraska 68182 (United States); Advanced Prosthetics Center, Omaha, Nebraska 68134 (United States); Myers, Sara A. [Nebraska Biomechanics Core Facility, University of Nebraska at Omaha, Omaha, Nebraska 68182 (United States); Stergiou, Nicholas [Nebraska Biomechanics Core Facility, University of Nebraska at Omaha, Omaha, Nebraska 68182 (United States); College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska 68198 (United States)

    2014-03-15

    The presence of chaos in walking is considered to provide a stable, yet adaptable means for locomotion. This study examined whether lower limb amputation and subsequent prosthetic rehabilitation resulted in a loss of complexity in amputee gait. Twenty-eight individuals with transtibial amputation participated in a 6 week, randomized cross-over design study in which they underwent a 3 week adaptation period to two separate prostheses. One prosthesis was deemed “more appropriate” and the other “less appropriate” based on matching/mismatching activity levels of the person and the prosthesis. Subjects performed a treadmill walking trial at self-selected walking speed at multiple points of the adaptation period, while kinematics of the ankle were recorded. Bilateral sagittal plane ankle motion was analyzed for underlying complexity through the pseudoperiodic surrogation analysis technique. Results revealed the presence of underlying deterministic structure in both prostheses and both the prosthetic and sound leg ankle (discriminant measure largest Lyapunov exponent). Results also revealed that the prosthetic ankle may be more likely to suffer loss of complexity than the sound ankle, and a “more appropriate” prosthesis may be better suited to help restore a healthy complexity of movement within the prosthetic ankle motion compared to a “less appropriate” prosthesis (discriminant measure sample entropy). Results from sample entropy results are less likely to be affected by the intracycle periodic dynamics as compared to the largest Lyapunov exponent. Adaptation does not seem to influence complexity in the system for experienced prosthesis users.

  19. Clinical evaluation of two prosthetic suspension systems in a bilateral transtibial amputee.

    Science.gov (United States)

    Gholizadeh, Hossein; Abu Osman, Noor Azuan; Kamyab, Mojtaba; Eshraghi, Arezoo; Lúvíksdóttir, Asa Gulaug; Wan Abas, Wan Abu Bakar

    2012-10-01

    The effects of Seal-In X5 and Dermo liner (Össur) on suspension and patient's comfort in lower limb amputees are unclear. In this report, we consider the case of a 51-yr-old woman with bilateral transtibial amputation whose lower limbs were amputated because of peripheral vascular disease. The subject had bony and painful residual limbs, especially at the distal ends. Two prostheses that used Seal-In X5 liners and a pair of prostheses with Dermo liners were fabricated, and the subject wore each for a period of 2 wks. Once the 2 wks had passed, the pistoning within the socket was assessed and the patient was questioned as to her satisfaction with both liners. This study revealed that Seal-In X5 liner decreased the residual limb pain experienced by the patient and that 1-2 mm less pistoning occurred within the socket compared with the Dermo liner. However, the patient needed to put in extra effort for donning and doffing the prosthesis. Despite this, it is clear that the Seal-In X5 liner offers a viable alternative for individuals with transtibial amputations who do not have enough soft tissue around the bone, especially at the end of the residual limb.

  20. Gait Training Interventions for Lower Extremity Amputees: A Systematic Literature Review.

    Science.gov (United States)

    Highsmith, M Jason; Andrews, Casey R; Millman, Claire; Fuller, Ashley; Kahle, Jason T; Klenow, Tyler D; Lewis, Katherine L; Bradley, Rachel C; Orriola, John J

    2016-09-01

    Lower extremity (LE) amputation patients who use prostheses have gait asymmetries and altered limb loading and movement strategies when ambulating. Subsequent secondary conditions are believed to be associated with gait deviations and lead to long-term complications that impact function and quality of life as a result. The purpose of this study was to systematically review the literature to determine the strength of evidence supporting gait training interventions and to formulate evidence statements to guide practice and research related to therapeutic gait training for lower extremity amputees. A systematic review of three databases was conducted followed by evaluation of evidence and synthesis of empirical evidence statements (EES). Eighteen manuscripts were included in the review, which covered two areas of gait training interventions: 1) overground and 2) treadmill-based. Eight EESs were synthesized. Four addressed overground gait training, one covered treadmill training, and three statements addressed both forms of therapy. Due to the gait asymmetries, altered biomechanics, and related secondary consequences associated with LE amputation, gait training interventions are needed along with study of their efficacy. Overground training with verbal or other auditory, manual, and psychological awareness interventions was found to be effective at improving gait. Similarly, treadmill-based training was found to be effective: 1) as a supplement to overground training; 2) independently when augmented with visual feedback and/or body weight support; or 3) as part of a home exercise plan. Gait training approaches studied improved multiple areas of gait, including sagittal and coronal biomechanics, spatiotemporal measures, and distance walked.

  1. Technology Efficacy in Active Prosthetic Knees for Transfemoral Amputees: A Quantitative Evaluation

    Directory of Open Access Journals (Sweden)

    Amr M. El-Sayed

    2014-01-01

    Full Text Available Several studies have presented technological ensembles of active knee systems for transfemoral prosthesis. Other studies have examined the amputees’ gait performance while wearing a specific active prosthesis. This paper combined both insights, that is, a technical examination of the components used, with an evaluation of how these improved the gait of respective users. This study aims to offer a quantitative understanding of the potential enhancement derived from strategic integration of core elements in developing an effective device. The study systematically discussed the current technology in active transfemoral prosthesis with respect to its functional walking performance amongst above-knee amputee users, to evaluate the system’s efficacy in producing close-to-normal user performance. The performances of its actuator, sensory system, and control technique that are incorporated in each reported system were evaluated separately and numerical comparisons were conducted based on the percentage of amputees’ gait deviation from normal gait profile points. The results identified particular components that contributed closest to normal gait parameters. However, the conclusion is limitedly extendable due to the small number of studies. Thus, more clinical validation of the active prosthetic knee technology is needed to better understand the extent of contribution of each component to the most functional development.

  2. Loading applied on prosthetic knee of transfemoral amputee: comparison of inverse dynamics and direct measurements.

    Science.gov (United States)

    Dumas, R; Cheze, L; Frossard, L

    2009-11-01

    Inverse dynamics is the most comprehensive method that gives access to the net joint forces and moments during walking. However it is based on assumptions (i.e., rigid segments linked by ideal joints) and it is known to be sensitive to the input data (e.g., kinematic derivatives, positions of joint centres and centre of pressure, inertial parameters). Alternatively, transducers can be used to measure directly the load applied on the residuum of transfemoral amputees. So, the purpose of this study was to compare the forces and moments applied on a prosthetic knee measured directly with the ones calculated by three inverse dynamics computations--corresponding to 3 and 2 segments, and "ground reaction vector technique"--during the gait of one patient. The maximum RMSEs between the estimated and directly measured forces (i.e., 56 N) and moment (i.e., 5 N m) were relatively small. However the dynamic outcomes of the prosthetic components (i.e., absorption of the foot, friction and limit stop of the knee) were only partially assessed with inverse dynamic methods.

  3. Factors that predict walking ability with a prosthesis in lower limb amputees

    Directory of Open Access Journals (Sweden)

    Knežević Aleksandar

    2016-01-01

    Full Text Available Introduction. Identification of predictive factors for walking ability with a prosthesis, after lower limb amputation, is very important in order to define patient’s potentials and realistic rehabilitation goals, however challenging they are. Objective. The objective of this study was to investigate whether variables determined at the beginning of rehabilitation process are able to predict walking ability at the end of the treatment using support vector machines (SVMs. Methods. This research was designed as a retrospective clinical case series. The outcome was defined as three-leveled ambulation ability. SVMs were used for predicting model forming. Results. The study included 263 patients, average age 60.82 Ѓ} 9.27 years. In creating SVM models, eleven variables were included: age, gender, cause of amputation, amputation level, period from amputation to prosthetic rehabilitation, Functional Comorbidity Index (FCI, presence of diabetes, presence of a partner, restriction concerning hip or knee extension, residual limb hip extensor strength, and mobility at admission. Six SVM models were created with four, five, six, eight, 10, and 11 variables, respectively. Genetic algorithm was used as an optimization procedure in order to select the best variables for predicting the level of walking ability. The accuracy of these models ranged from 72.5% to 82.5%. Conclusion. By using SVM model with four variables (age, FCI, level of amputation, and mobility at admission we are able to predict the level of ambulation with a prosthesis in lower limb amputees with high accuracy.

  4. Amputation effects on the underlying complexity within transtibial amputee ankle motion

    Science.gov (United States)

    Wurdeman, Shane R.; Myers, Sara A.; Stergiou, Nicholas

    2014-03-01

    The presence of chaos in walking is considered to provide a stable, yet adaptable means for locomotion. This study examined whether lower limb amputation and subsequent prosthetic rehabilitation resulted in a loss of complexity in amputee gait. Twenty-eight individuals with transtibial amputation participated in a 6 week, randomized cross-over design study in which they underwent a 3 week adaptation period to two separate prostheses. One prosthesis was deemed "more appropriate" and the other "less appropriate" based on matching/mismatching activity levels of the person and the prosthesis. Subjects performed a treadmill walking trial at self-selected walking speed at multiple points of the adaptation period, while kinematics of the ankle were recorded. Bilateral sagittal plane ankle motion was analyzed for underlying complexity through the pseudoperiodic surrogation analysis technique. Results revealed the presence of underlying deterministic structure in both prostheses and both the prosthetic and sound leg ankle (discriminant measure largest Lyapunov exponent). Results also revealed that the prosthetic ankle may be more likely to suffer loss of complexity than the sound ankle, and a "more appropriate" prosthesis may be better suited to help restore a healthy complexity of movement within the prosthetic ankle motion compared to a "less appropriate" prosthesis (discriminant measure sample entropy). Results from sample entropy results are less likely to be affected by the intracycle periodic dynamics as compared to the largest Lyapunov exponent. Adaptation does not seem to influence complexity in the system for experienced prosthesis users.

  5. Use of prostheses and footwear in 110 inner-city partial-foot amputees.

    Science.gov (United States)

    Sobel, E; Japour, C J; Giorgini, R J; Levitz, S J; Richardson, H L

    2001-01-01

    The number of partial-foot amputations performed is increasing, and many recommendations have been made regarding the use of prostheses and footwear designed to prevent higher-level amputations in this population. The present study investigated the use of prostheses and shoe inserts and the types of footwear worn by partial-foot amputees in the inner city to determine whether previous recommendations are being followed as well as whether new prosthetic styles are being used. The study surveyed 110 patients (73 men and 37 women) with a mean age of 58.6 years (range, 21 to 86 years) with partial-foot amputations of all levels. The results showed that about one-half of all patients wore a shoe-insert orthosis. Although 54% wore some form of special footwear to accommodate and protect the residual foot, no patient in this study wore a shoe with a rocker-bottom sole. Only one patient with a transmetatarsal amputation used a brace and only one patient in the entire study wore a modern cosmetic foot prosthesis.

  6. Phantom hand and wrist movements in upper limb amputees are slow but naturally controlled movements.

    Science.gov (United States)

    De Graaf, J B; Jarrassé, N; Nicol, C; Touillet, A; Coyle, T; Maynard, L; Martinet, N; Paysant, J

    2016-01-15

    After limb amputation, patients often wake up with a vivid perception of the presence of the missing limb, called "phantom limb". Phantom limbs have mostly been studied with respect to pain sensation. But patients can experience many other phantom sensations, including voluntary movements. The goal of the present study was to quantify phantom movement kinematics and relate these to intact limb kinematics and to the time elapsed since amputation. Six upper arm and two forearm amputees with various delays since amputation (6months to 32years) performed phantom finger, hand and wrist movements at self-chosen comfortable velocities. The kinematics of the phantom movements was indirectly obtained via the intact limb that synchronously mimicked the phantom limb movements, using a Cyberglove® for measuring finger movements and an inertial measurement unit for wrist movements. Results show that the execution of phantom movements is perceived as "natural" but effortful. The types of phantom movements that can be performed are variable between the patients but they could all perform thumb flexion/extension and global hand opening/closure. Finger extension movements appeared to be 24% faster than finger flexion movements. Neither the number of types of phantom movements that can be executed nor the kinematic characteristics were related to the elapsed time since amputation, highlighting the persistence of post-amputation neural adaptation. We hypothesize that the perceived slowness of phantom movements is related to altered proprioceptive feedback that cannot be recalibrated by lack of visual feedback during phantom movement execution.

  7. Autobiographical memory and psychological distress in a sample of upper-limb amputees.

    Science.gov (United States)

    Luchetti, Martina; Montebarocci, Ornella; Rossi, Nicolino; Cutti, Andrea G; Sutin, Angelina R

    2014-01-01

    Amputation is a traumatic and life-changing event that can take years to adjust to. The present study (a) examines psychological adjustment in a specific trauma-exposed sample, (b) compares the phenomenology (e.g., vividness) of amputation-related memories to more recent memories, and (c) tests whether memory phenomenology is associated with psychological distress. A total of 24 upper-limb amputees recalled two autobiographical memories--an amputation-related memory and a recent memory--and rated the phenomenological qualities of each memory, including Vividness, Coherence, Emotional Intensity, Visual Perspective, and Distancing. Participants also completed self-rated measures of psychological distress and personality. The sample was generally well adjusted; participants showed no relevant symptoms of anxiety and depression, and personality scores were similar to the general population. There were no significant differences in phenomenology between the two types of memories recalled. Even though amputation-related memories were, on average, almost 20 years older than the recent memories, they retained their intense phenomenology. Despite the intensity of the memory, none of the phenomenological dimensions were associated with psychological distress. It is worth to further define which dimensions of phenomenology characterize memories of traumatic events, and their association with individuals' psychological reactions.

  8. Optimization of prosthetic foot stiffness to reduce metabolic cost and intact knee loading during below-knee amputee walking: a theoretical study.

    Science.gov (United States)

    Fey, Nicholas P; Klute, Glenn K; Neptune, Richard R

    2012-11-01

    Unilateral below-knee amputees develop abnormal gait characteristics that include bilateral asymmetries and an elevated metabolic cost relative to non-amputees. In addition, long-term prosthesis use has been linked to an increased prevalence of joint pain and osteoarthritis in the intact leg knee. To improve amputee mobility, prosthetic feet that utilize elastic energy storage and return (ESAR) have been designed, which perform important biomechanical functions such as providing body support and forward propulsion. However, the prescription of appropriate design characteristics (e.g., stiffness) is not well-defined since its influence on foot function and important in vivo biomechanical quantities such as metabolic cost and joint loading remain unclear. The design of feet that improve these quantities could provide considerable advancements in amputee care. Therefore, the purpose of this study was to couple design optimization with dynamic simulations of amputee walking to identify the optimal foot stiffness that minimizes metabolic cost and intact knee joint loading. A musculoskeletal model and distributed stiffness ESAR prosthetic foot model were developed to generate muscle-actuated forward dynamics simulations of amputee walking. Dynamic optimization was used to solve for the optimal muscle excitation patterns and foot stiffness profile that produced simulations that tracked experimental amputee walking data while minimizing metabolic cost and intact leg internal knee contact forces. Muscle and foot function were evaluated by calculating their contributions to the important walking subtasks of body support, forward propulsion and leg swing. The analyses showed that altering a nominal prosthetic foot stiffness distribution by stiffening the toe and mid-foot while making the ankle and heel less stiff improved ESAR foot performance by offloading the intact knee during early to mid-stance of the intact leg and reducing metabolic cost. The optimal design also

  9. Mechanical energetic contributions from individual muscles and elastic prosthetic feet during symmetric unilateral transtibial amputee walking: a theoretical study.

    Science.gov (United States)

    Zmitrewicz, Robert J; Neptune, Richard R; Sasaki, Kotaro

    2007-01-01

    Energy storage and return (ESAR) foot-ankle prostheses have been developed in an effort to improve gait performance in lower-limb amputees. However, little is known about their effectiveness in providing the body segment mechanical energetics normally provided by the ankle muscles. The objective of this theoretical study was to use muscle-actuated forward dynamics simulations of unilateral transtibial amputee and non-amputee walking to identify the contributions of ESAR prostheses to trunk support, forward propulsion and leg swing initiation and how individual muscles must compensate in order to produce a normal, symmetric gait pattern. The simulation analysis revealed the ESAR prosthesis provided the necessary trunk support, but it could not provide the net trunk forward propulsion normally provided by the plantar flexors and leg swing initiation normally provided by the biarticular gastrocnemius. To compensate, the residual leg gluteus maximus and rectus femoris delivered increased energy to the trunk for forward propulsion in early stance and late stance into pre-swing, respectively, while the residual iliopsoas delivered increased energy to the leg in pre- and early swing to help initiate swing. In the intact leg, the soleus, gluteus maximus and rectus femoris delivered increased energy to the trunk for forward propulsion in the first half of stance, while the iliopsoas increased the leg energy it delivered in pre- and early swing. Thus, the energy stored and released by the ESAR prosthesis combined with these muscle compensations was able to produce a normal, symmetric gait pattern, although various neuromuscular and musculoskeletal constraints may make such a pattern non-optimal.

  10. Prediction of Above-elbow Motions in Amputees, based on Electromyographic(EMG Signals, Using Nonlinear Autoregressive Exogenous (NARX Model

    Directory of Open Access Journals (Sweden)

    Ali Akbar Akbari

    2014-08-01

    Full Text Available Introduction In order to improve the quality of life of amputees, biomechatronic researchers and biomedical engineers have been trying to use a combination of various techniques to provide suitable rehabilitation systems. Diverse biomedical signals, acquired from a specialized organ or cell system, e.g., the nervous system, are the driving force for the whole system. Electromyography(EMG, as an experimental technique,is concerned with the development, recording, and analysis of myoelectric signals. EMG-based research is making progress in the development of simple, robust, user-friendly, and efficient interface devices for the amputees. Materials and Methods Prediction of muscular activity and motion patterns is a common, practical problem in prosthetic organs. Recurrent neural network (RNN models are not only applicable for the prediction of time series, but are also commonly used for the control of dynamical systems. The prediction can be assimilated to identification of a dynamic process. An architectural approach of RNN with embedded memory is Nonlinear Autoregressive Exogenous (NARX model, which seems to be suitable for dynamic system applications. Results Performance of NARX model is verified for several chaotic time series, which are applied as input for the neural network. The results showed that NARX has the potential to capture the model of nonlinear dynamic systems. The R-value and MSE are  and  , respectively. Conclusion  EMG signals of deltoid and pectoralis major muscles are the inputs of the NARX  network. It is possible to obtain EMG signals of muscles in other arm motions to predict the lost functions of the absent arm in above-elbow amputees, using NARX model.

  11. Balance control enhancement using sub-sensory stimulation and visual-auditory biofeedback strategies for amputee subjects.

    Science.gov (United States)

    Lee, Ming-Yih; Lin, Chih-Feng; Soon, Kok-Soon

    2007-12-01

    Sub-sensory electrical or mechanical stimulation can enhance the sensitivity of the human somatosensory system to improve the balance control capabilities of elderly. In addition, clinical studies suggest that visual-auditory biofeedback can improve sensory compensation for the elderly. This study hypothesizes that the static balance and gait performance of single leg quiet standing and treadmill walking could be improved for providing proprioceptive neuromuscular facilitation using sub-sensory stimulation and visual-auditory biofeedback in amputee subjects. To test this, a computerized foot pressure biofeedback sensory compensation system using sub-threshold low-level electrical stimulation combined with visual-auditory biofeedback was developed. Seven unilateral trans-tibial amputees who wore prostheses over 2 years were recruited. The subjects performed multiple single leg quiet standing trials with sub-sensory electrical stimulation applied at the quadriceps muscle during half of the trials. Static balance performance was characterized by using a Zebris motion analysis system to measure the sway distance and duration of the centre of mass on the second sacral (S2) of the subjects. In addition, multiple treadmill ambulatory trials with or without visual-auditory biofeedback was performed. Dynamic gait performance was characterized with a Zebris instrumented insole to measure the temporal responses of foot pressure sensors. Experimental results showed an improvement in three balance performance indices (Holding Time Index, HTI, Maximum Sway Distance Index, MSDI, and Average Sway Distance Index, ASDI) during single leg quiet standing by applying sub-sensory stimulation. The improvement ratio of these balance performance indices across subjects for single leg quiet standing tests resulted in 132.34% in HTI, 44.61% in MSDI, and 61.45% in ASDI. With visual-auditory biofeedback as a cue for heel contact and toe push-off condition during treadmill ambulation, the

  12. Neural correlates of the rubber hand illusion in amputees: a report of two cases.

    Science.gov (United States)

    Schmalzl, Laura; Kalckert, Andreas; Ragnö, Christina; Ehrsson, H Henrik

    2014-08-01

    One of the current challenges in the field of advanced prosthetics is the development of artificial limbs that provide the user with detailed sensory feedback. Sensory feedback from our limbs is not only important for proprioceptive awareness and motor control, but also essential for providing us with a feeling of ownership or simply put, the sensation that our limbs actually belong to ourselves. The strong link between sensory feedback and ownership has been repeatedly demonstrated with the so-called rubber hand illusion (RHI), during which individuals are induced with the illusory sensation that an artificial hand is their own. In healthy participants, this occurs via integration of visual and tactile signals, which is primarily supported by multisensory regions in premotor and intraparietal cortices. Here, we describe a functional magnetic resonance imaging (fMRI) study with two upper limb amputees, showing for the first time that the same brain regions underlie ownership sensations of an artificial hand in this population. Albeit preliminary, these findings are interesting from both a theoretical as well as a clinical point of view. From a theoretical perspective, they imply that even years after the amputation, a few seconds of synchronous visuotactile stimulation are sufficient to activate hand-centered multisensory integration mechanisms. From a clinical perspective, they show that a very basic sensation of touch from an artificial hand can be obtained by simple but precisely targeted stimulation of the stump, and suggest that a similar mechanism implemented in prosthetic hands would greatly facilitate ownership sensations and in turn, acceptance of the prosthesis.

  13. Psychophysical Evaluation of the Capability for Phantom Limb Movement in Forearm Amputees.

    Science.gov (United States)

    Kawashima, Noritaka; Mita, Tomoki

    2016-01-01

    A phantom limb is the sensation that an amputated limb is still attached to the body and is moving together with other body parts. Phantom limb phenomenon is often described on the basis of the patient's subjective sense, for example as represented using a visual analog scale (VAS). The aim of this study was to propose a novel quantification method for behavioral aspect of phantom limb by psychophysics. Twelve unilateral forearm amputees were asked to perform phantom wrist motion with various motion frequencies (60, 80, 100, 120, 140, 160, 180, 200, 220, 240% of preferred speed). The attainment of phantom limb motion in each session was rated by the VAS ranging from 0 (hard) to 10 (easy). The relationship between the VAS and motion frequency was mathematically fitted by quadric function, and the value of shift and the degree of steepness were obtained as evaluation variables for the phantom limb movement. In order to test whether the proposed method can reasonably quantify the characteristics of phantom limb motion, we compared the variables among three different phantom limb movement conditions: (1) unilateral (phantom only), (2) bimanual, and (3) bimanual wrist movement with mirror reflection-induced visual feedback (MVF). While VAS rating showed a larger extent of inter- and intra-subject variability, the relationship of the VAS in response to motion frequency could be fitted by quadric curve, and the obtained parameters based on quadric function well characterize task-dependent changes in phantom limb movement. The present results suggest the potential usefulness of psychophysical evaluation as a validate assessment tool of phantom limb condition.

  14. Psychophysical Evaluation of the Capability for Phantom Limb Movement in Forearm Amputees.

    Directory of Open Access Journals (Sweden)

    Noritaka Kawashima

    Full Text Available A phantom limb is the sensation that an amputated limb is still attached to the body and is moving together with other body parts. Phantom limb phenomenon is often described on the basis of the patient's subjective sense, for example as represented using a visual analog scale (VAS. The aim of this study was to propose a novel quantification method for behavioral aspect of phantom limb by psychophysics. Twelve unilateral forearm amputees were asked to perform phantom wrist motion with various motion frequencies (60, 80, 100, 120, 140, 160, 180, 200, 220, 240% of preferred speed. The attainment of phantom limb motion in each session was rated by the VAS ranging from 0 (hard to 10 (easy. The relationship between the VAS and motion frequency was mathematically fitted by quadric function, and the value of shift and the degree of steepness were obtained as evaluation variables for the phantom limb movement. In order to test whether the proposed method can reasonably quantify the characteristics of phantom limb motion, we compared the variables among three different phantom limb movement conditions: (1 unilateral (phantom only, (2 bimanual, and (3 bimanual wrist movement with mirror reflection-induced visual feedback (MVF. While VAS rating showed a larger extent of inter- and intra-subject variability, the relationship of the VAS in response to motion frequency could be fitted by quadric curve, and the obtained parameters based on quadric function well characterize task-dependent changes in phantom limb movement. The present results suggest the potential usefulness of psychophysical evaluation as a validate assessment tool of phantom limb condition.

  15. Gait Training Interventions for Lower Extremity Amputees: A Systematic Literature Review

    Science.gov (United States)

    Highsmith, M. Jason; Andrews, Casey R.; Millman, Claire; Fuller, Ashley; Kahle, Jason T.; Klenow, Tyler D.; Lewis, Katherine L.; Bradley, Rachel C.; Orriola, John J.

    2016-01-01

    Lower extremity (LE) amputation patients who use prostheses have gait asymmetries and altered limb loading and movement strategies when ambulating. Subsequent secondary conditions are believed to be associated with gait deviations and lead to long-term complications that impact function and quality of life as a result. The purpose of this study was to systematically review the literature to determine the strength of evidence supporting gait training interventions and to formulate evidence statements to guide practice and research related to therapeutic gait training for lower extremity amputees. A systematic review of three databases was conducted followed by evaluation of evidence and synthesis of empirical evidence statements (EES). Eighteen manuscripts were included in the review, which covered two areas of gait training interventions: 1) overground and 2) treadmill-based. Eight EESs were synthesized. Four addressed overground gait training, one covered treadmill training, and three statements addressed both forms of therapy. Due to the gait asymmetries, altered biomechanics, and related secondary consequences associated with LE amputation, gait training interventions are needed along with study of their efficacy. Overground training with verbal or other auditory, manual, and psychological awareness interventions was found to be effective at improving gait. Similarly, treadmill-based training was found to be effective: 1) as a supplement to overground training; 2) independently when augmented with visual feedback and/or body weight support; or 3) as part of a home exercise plan. Gait training approaches studied improved multiple areas of gait, including sagittal and coronal biomechanics, spatiotemporal measures, and distance walked. PMID:28066520

  16. Microchannel-based regenerative scaffold for chronic peripheral nerve interfacing in amputees.

    Science.gov (United States)

    Srinivasan, Akhil; Tahilramani, Mayank; Bentley, John T; Gore, Russell K; Millard, Daniel C; Mukhatyar, Vivek J; Joseph, Anish; Haque, Adel S; Stanley, Garrett B; English, Arthur W; Bellamkonda, Ravi V

    2015-02-01

    Neurally controlled prosthetics that cosmetically and functionally mimic amputated limbs remain a clinical need because state of the art neural prosthetics only provide a fraction of a natural limb's functionality. Here, we report on the fabrication and capability of polydimethylsiloxane (PDMS) and epoxy-based SU-8 photoresist microchannel scaffolds to serve as viable constructs for peripheral nerve interfacing through in vitro and in vivo studies in a sciatic nerve amputee model where the nerve lacks distal reinnervation targets. These studies showed microchannels with 100 μm × 100 μm cross-sectional areas support and direct the regeneration/migration of axons, Schwann cells, and fibroblasts through the microchannels with space available for future maturation of the axons. Investigation of the nerve in the distal segment, past the scaffold, showed a high degree of organization, adoption of the microchannel architecture forming 'microchannel fascicles', reformation of endoneurial tubes and axon myelination, and a lack of aberrant and unorganized growth that might be characteristic of neuroma formation. Separate chronic terminal in vivo electrophysiology studies utilizing the microchannel scaffolds with permanently integrated microwire electrodes were conducted to evaluate interfacing capabilities. In all devices a variety of spontaneous, sensory evoked and electrically evoked single and multi-unit action potentials were recorded after five months of implantation. Together, these findings suggest that microchannel scaffolds are well suited for chronic implantation and peripheral nerve interfacing to promote organized nerve regeneration that lends itself well to stable interfaces. Thus this study establishes the basis for the advanced fabrication of large-electrode count, wireless microchannel devices that are an important step towards highly functional, bi-directional peripheral nerve interfaces.

  17. Effect of prosthetic alignment changes on socket reaction moment impulse during walking in transtibial amputees.

    Science.gov (United States)

    Kobayashi, Toshiki; Orendurff, Michael S; Arabian, Adam K; Rosenbaum-Chou, Teri G; Boone, David A

    2014-04-11

    The alignment of a lower limb prosthesis affects the way load is transferred to the residual limb through the socket, and this load is critically important for the comfort and function of the prosthesis. Both magnitude and duration of the moment are important factors that may affect the residual limb health. Moment impulse is a well-accepted measurement that incorporates both factors via moment-time integrals. The aim of this study was to investigate the effect of alignment changes on the socket reaction moment impulse in transtibial prostheses. Ten amputees with transtibial prostheses participated in this study. The socket reaction moment impulse was measured at a self-selected walking speed using a Smart Pyramid in 25 alignment conditions, including a nominal alignment (clinically aligned by a prosthetist), as well as angle malalignments of 2°, 4° and 6° (abduction, adduction, extension and flexion) and translation malalignments of 5 mm, 10 mm and 15 mm (lateral, medial, anterior and posterior). The socket reaction moment impulse of the nominal alignment was compared for each condition. The relationship between the alignment and the socket reaction moment impulse was clearly observed in the coronal angle, coronal translation and sagittal translation alignment changes. However, this relationship was not evident in the sagittal angle alignment changes. The results of this study suggested that the socket reaction moment impulse could potentially serve as a valuable parameter to assist the alignment tuning process for transtibial prostheses. Further study is needed to investigate the influence of the socket reaction moment impulse on the residual limb health.

  18. Load on osseointegrated fixation of a transfemoral amputee during a fall: Determination of the time and duration of descent.

    Science.gov (United States)

    Frossard, Laurent Alain

    2010-12-01

    Mitigation of fall-related injuries for populations of transfemoral amputees fitted with a socket or an osseointegrated fixation is challenging. Wearing a protective device fitted within the prosthesis might be a possible solution, provided that issues with automated fall detection and time of deployment of the protective mechanism are solved. The first objective of this study was to give some examples of the times and durations of descent during a real forward fall of a transfemoral amputee that occurred inadvertently while attending a gait measurement session to assess the load applied on the residuum. The second objective was to present five semi-automated methods of detection of the time of descent using the load data. The load was measured directly at 200 Hz using a six-channel transducer. The average time and duration of descent were 242 ± 42 ms (145-310 ms) and 619 ± 42 ms (550-715 ms), respectively. This study demonstrated that the transition between walking and falling was characterized by times of descent that occurred sequentially. The sensitivity and specificity of an automated algorithm might be improved by combining several methods of detection based on the deviation of the loads measured from their own trends and from a template previously established.

  19. Understanding dynamic stability from pelvis accelerometer data and the relationship to balance and mobility in transtibial amputees.

    Science.gov (United States)

    Howcroft, Jennifer; Lemaire, Edward D; Kofman, Jonathan; Kendell, Cynthia

    2015-03-01

    This study investigated whether pelvis acceleration-derived parameters can differentiate between dynamic stability states for transtibial amputees during level (LG) and uneven ground (UG) walking. Correlations between these parameters and clinical balance and mobility measures were also investigated. A convenience sample of eleven individuals with unilateral transtibial amputation walked on LG and simulated UG while pelvis acceleration data were collected at 100Hz. Descriptive statistics, Fast Fourier Transform, ratio of even to odd harmonics, and maximum Lyapunov exponent measures were derived from acceleration data. Of the 26 pelvis acceleration measures, seven had a significant difference (p≤0.05) between LG and UG walking conditions. Seven distinct, stability-relevant measures appeared in at least one of the six regression models that correlated accelerometer-derived measures to Berg Balance Scale (BBS), Community Balance and Mobility Scale (CBMS), and Prosthesis Evaluation Questionnaire (PEQ) scores, explaining up to 100% of the variability in these measures. Of these seven measures, medial-lateral acceleration range was the most frequent model variable, appearing in four models. Anterior-posterior acceleration standard deviation and stride time appeared in three models. Pelvis acceleration-derived parameters were able to differentiate between LG and UG walking for transtibial amputees. UG walking provided the most relevant data for balance and mobility assessment. These results could translate to point of patient contact assessments using a wearable system such as a smartbelt or accelerometer-equipped smartphone.

  20. An unusual cause of S1 radicular pain presenting as early phantom pain in a transfemoral amputee: a case report.

    Science.gov (United States)

    Smuck, Matthew; Christensen, Sara; Lee, Stan S; Sagher, Oren

    2008-01-01

    Recent epidemiologic studies have shown back pain to be a significant cause of pain in lower-limb amputees, but only a handful of cases have reported sciatica in amputees. The symptoms are usually described as a phantom pain or neuropathic pain in the residual limb that is often refractory to conventional treatments. These symptoms typically occur with back pain and are distinct from the patient's usual symptoms. Interestingly, back pain is not a universal finding. We present a patient with presumed phantom limb pain subsequently discovered to be caused by an S1 radiculopathy. This patient's supposed phantom pain persisted despite multiple medication trials. Initial work-up revealed a sciatic neuroma at the stump. Treatments targeting this neuroma were unsuccessful. Further evaluation found that a sacroiliac joint screw placed to stabilize a pelvic fracture had intruded into the S1 neuroforamen. A diagnostic S1 nerve block temporarily relieved the patient's pain, and the screw was removed. Pain persisted and a spinal cord stimulator was placed resulting in improvement of his pain. Because conventional diagnostic tests are limited, including physical exam and electromyography, a fluoroscopically guided selective spinal nerve block proved to be a useful diagnostic tool in this patient.

  1. Contribution of each leg to the control of unperturbed bipedal stance in lower limb amputees: new insights using entropy.

    Directory of Open Access Journals (Sweden)

    Petra Hlavackova

    Full Text Available The present study was designed to assess the relative contribution of each leg to unperturbed bipedal posture in lower limb amputees. To achieve this goal, eight unilateral traumatic trans-femoral amputees (TFA were asked to stand as still as possible on a plantar pressure data acquisition system with their eyes closed. Four dependent variables were computed to describe the subject's postural behavior: (1 body weight distribution, (2 amplitude, (3 velocity and (4 regularity of centre of foot pressure (CoP trajectories under the amputated (A leg and the non-amputated (NA leg. Results showed a larger body weight distribution applied to the NA leg than to the A leg and a more regular CoP profiles (lower sample entropy values with greater amplitude and velocity under the NA leg than under the A leg. Taken together, these findings suggest that the NA leg and the A leg do not equally contribute to the control of unperturbed bipedal posture in TFA. The observation that TFA do actively control unperturbed bipedal posture with their NA leg could be viewed as an adaptive process to the loss of the lower leg afferents and efferents because of the unilateral lower-limb amputation. From a methodological point of view, these results demonstrate the suitability of computing bilateral CoP trajectories regularity for the assessment of lateralized postural control under pathological conditions.

  2. Effects of Shoe Heel Height on Loading and Muscle Activity for Trans-Tibial Amputees During Standing

    Institute of Scientific and Technical Information of China (English)

    JIA Xiaohong; WANG Rencheng; Winson Lee

    2009-01-01

    This study accesses the effects of shoe heel heights on loading, muscle activity, and plantar foot pressure of trans-tibial amputees during standing. Five male subjects with unilateral trans-tibial amputation volunteered to participate in this study. Three pairs of shoes with zero, 20 mm, and 40 mm heel heights were used. The loading line of the prosthetic side, the plantar foot pressure, and the surface electromyography (EMG) of 10 muscles were simultaneously recorded. With increasing shoe heel heights during standing, the loading line of the prosthetic side shifted from the anterior to the posterior side of the knee center, the peak pressure was increased in the medial forefoot region, and the peak pressure was reduced in the heel region. The EMG of the medial and lateral gastrocnemius of the sound leg almost doubled and that of the rectus fomris, vastus lateralis, and vastus medialis of the prosthetic side increased to different extents with in-creasing heel heights from zero to 40 mm. These results show a high correlation with human physical be-havior. Changing of the heel heights for trans-tibial amputees during standing actually had similar effects to altering the prosthetic sagittal alignment. The results suggest that an alignment change is necessary to ac-commodate heel height changes and that prosthesis users should be cautious when choosing shoes.

  3. Artificial redirection of sensation from prosthetic fingers to the phantom hand map on transradial amputees: vibrotactile versus mechanotactile sensory feedback.

    Science.gov (United States)

    Antfolk, Christian; D'Alonzo, Marco; Controzzi, Marco; Lundborg, Göran; Rosén, Birgitta; Sebelius, Fredrik; Cipriani, Christian

    2013-01-01

    This work assesses the ability of transradial amputees to discriminate multi-site tactile stimuli in sensory discrimination tasks. It compares different sensory feedback modalities using an artificial hand prosthesis in: 1) a modality matched paradigm where pressure recorded on the five fingertips of the hand was fed back as pressure stimulation on five target points on the residual limb; and 2) a modality mismatched paradigm where the pressures were transformed into mechanical vibrations and fed back. Eight transradial amputees took part in the study and were divided in two groups based on the integrity of their phantom map; group A had a complete phantom map on the residual limb whereas group B had an incomplete or nonexisting map. The ability in localizing stimuli was compared with that of 10 healthy subjects using the vibration feedback and 11 healthy subjects using the pressure feedback (in a previous study), on their forearms, in similar experiments. Results demonstrate that pressure stimulation surpassed vibrotactile stimulation in multi-site sensory feedback discrimination. Furthermore, we demonstrate that subjects with a detailed phantom map had the best discrimination performance and even surpassed healthy participants for both feedback paradigms whereas group B had the worst performance overall. Finally, we show that placement of feedback devices on a complete phantom map improves multi-site sensory feedback discrimination, independently of the feedback modality.

  4. An assistive device designed to convey independent donning of a shuttle lock trans-tibial prosthesis for a multiple limb amputee.

    Science.gov (United States)

    Tamir, E; Heim, M; Oppenheim, U; Siev-Ner, I

    2003-04-01

    This contribution describes a simple device designed to convey independent donning of a shuttle lock trans-tibial prosthesis for a multiple limb amputee. The device is made of a post with a shuttle lock mechanism at one end and a plate covered by rubber at the other end. This device enables correct positioning of the silicone liner and independent attachment to the prosthesis.

  5. Use of an instrumented treadmill for real-time gait symmetry evaluation and feedback in normal and trans-tibial amputee subjects.

    Science.gov (United States)

    Dingwell, J B; Davis, B L; Frazier, D M

    1996-08-01

    The purpose of this research was to evaluate a newly developed system for assessing and providing feedback of gait symmetry information in real time to subjects walking on a motorised treadmill (the CCF Treadmill). The advantages of the system are that it allows the rapid collection and comparison of temporal and kinetic parameters of gait for multiple successive strides, at a constant known speed, without forcing subjects to target their footsteps. Gait asymmetries of six normal (mean age 42.7 years) and six unilateral transtibial amputee subjects (mean age 41.7, and average 6.0 years using a prosthesis) were quantified. The amputee group was the reevaluated after receiving five minutes of training with each of three different types of real-time visual feedback (RTVF). Asymmetries in the measured parameters before feedback were 4.6 times greater in the amputee population than in the normal group, and were consistent with the finding of previous authors. Significant decreases in gait asymmetry were demonstrated for all forms of feedback after amputees received feedback training. Results, however, indicated that gait asymmetries for different variables are not necessarily related, and that more work needs to be done to identify those variables for which attaining a more symmetrical gait pattern is most beneficial. Further work also needs to be done to determine the long term effects of such RTVF training. The CCF Treadmill and RTVF were shown to be potentially useful tools both for defining rehabilitation targets and for quantifying patients' progress towards those goals.

  6. Evaluation of problems and needs of veteran lower-limb amputees in the San Francisco Bay Area during the period 1977-1980.

    Science.gov (United States)

    Hoaglund, F T; Jergesen, H E; Wilson, L; Lamoreux, L W; Roberts, R

    1983-07-01

    From 1977 through 1980, 251 veterans from the San Francisco Bay Area received permanent lower-extremity prostheses at the two local Veterans Administration hospitals. For a survey, 213 of the 251 were contacted and 179 of them (84%) responded to written or telephone questionnaires concerning their prosthetic problems and complaints and their recommendations regarding prosthetic care. Seventy-four percent of the patients were traumatic amputees and 23 percent were dysvascular amputees. Eighty-six percent of the traumatic amputees said they wore their limbs all day, compared with only 51 percent of the dysvascular group. Seventy-one percent of traumatic and 43 percent of dysvascular amputees engaged in some form of recreational activity. There was a high incidence of complaints of pain in the residual limb: 55 percent among the dysvascular group and 44 percent among the traumatic group. Half of the patients had socket problems. Fifty-four of the 178 patients received a physical examination, a prosthetic evaluation, and a gait analysis. Among this group, 59 percent of the below-knee prostheses and 78 percent of the above-knee prostheses had inadequate socket fitting. Improper shaping of socket margins was the most frequently observed deficiency. Moreover, 41 percent of below-knee and 22 percent of above-knee amputees had mechanical skin irritation or skin breakdown in the examined residual limbs. Faulty suspension and alignment in addition to improper socket fit and construction contributed to this problem. Excessive stiffness of SACH foot heel cushions was the most common prosthetic foot problem and contributed to gait abnormalities.

  7. Evaluation of a temporary prosthetic insert in the rehabilitation of elderly ischaemic below-knee amputees: a pilot study.

    Science.gov (United States)

    Hallam, F M; Jull, G A

    1988-01-01

    The physiotherapy management of elderly, ischaemic below knee amputees is often compromised by delayed and/or complicated wound healing. Such patients are often unable to ambulate on a prosthesis for prolonged periods. Problems concommitant with immobilization such as weakness, contractures, and decreased morale tend to arise. This pilot study investigated the efficacy of incorporating a shaped Dunlopillo insert into a temporary prosthetic socket to allow the at risk group to ambulate as soon as the sutures were removed regardless of the state of wound healing. Two parameters were evaluated, namely wound healing and stump maturation. A total of eighteen subjects were observed in a control and an experimental group. Both wound healing (p < 0.05) and stump maturation (p < 0.05) were significantly enhanced by the inclusion of a Dunlopillo insert.

  8. A realistic implementation of ultrasound imaging as a human-machine interface for upper-limb amputees

    Directory of Open Access Journals (Sweden)

    David eSierra González

    2013-10-01

    Full Text Available In the past years, especially with the advent of multi-fingered hand prostheses, the rehabilitation robotics community has tried to improve the use of human-machine interfaces to reliably control mechanical artifacts with many degrees of freedom. Ideally, the control schema should be intuitive and reliable, and the calibration (training short and flexible.This work focuses on medical ultrasound imaging as such an interface. Medical ultrasound imaging is rich in information, fast, widespread, relatively cheap and provides high temporal/spatial resolution; moreover, it is harmless. We already showed that a linear relationship exists between ultrasound image features of the human forearm and the hand kinematic configuration; here we demonstrate that such a relationship also exists between similar features and fingertip forces. An experiment with 10 participants shows that a very fast data collection, namely of zero and maximum forces only and using no force sensors, suffices to train a system that predicts intermediate force values spanning a range of about 20N per finger with average errors in the range 10-15%.This training approach, in which the ground truth is limited to an 'on-off' visual stimulus, constitutes a realistic scenario and we claim that it could be equally used by intact subjects and amputees. The linearity of the relationship between images and forces is furthermore exploited to build an incremental learning system that works online and can be retrained on demand by the human subject. We expect this system to be able in principle to reconstruct an amputee's imaginary limb, and act as a sensible improvement of, e.g., mirror therapy, in the treatment of phantom-limb pain.

  9. Estimation of forces at the interface between an artificial limb and an implant directly fixed into the femur in above-knee amputees.

    Science.gov (United States)

    Stephenson, Paul; Seedhom, Bahaa B

    2002-01-01

    This article describes the method used for estimating the forces and moments, acting during locomotion, at the interface between an artificial leg and an implant directly fixed into the femur, in above-knee amputees. Twelve transfemoral amputees completed a predefined gait assessment during which kinetic (ground reaction loads and torque) and kinematic (limb orientation) gait data were recorded. A developed mathematical model enabled the ground reaction forces to be translated to the level of amputation. It is assumed that the loads calculated at the stump-socket interface would approximate those experienced by the proposed implant. The longitudinal force and the moment in the sagittal plane were the two most significant loads at the stump. These data were essential to obtain to facilitate the analysis of stress arising at the implant-bone interface that has been subsequently undertaken.

  10. Bilogy Machine Initiative: Developing Innovative Novel Methods to Improve Neuro-rehabilitation for Amputees and Treatment for Patients at Remote Sites with Acute Brain Injury

    Science.gov (United States)

    2010-09-01

    average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data...presentation of earlier work on upper extremity amputees for a Society for Neuroscience meeting. We conducted an international search and successfully...VAMP-MIST inducible blockers of transmitter release developed by the Svoboda lab, and the ivermectin -sensitive CI-channel developed by the Lester

  11. Dynamic input to determine hip joint moments, power and work on the prosthetic limb of transfemoral amputees: ground reaction vs knee reaction

    OpenAIRE

    FROSSARD, Laurent; Cheze, Laurence; Dumas, Raphaël

    2011-01-01

    Background: Calculation of lower limb kinetics is limited by floor-mounted force-plates. Objectives: Comparison of hip joint moments, power and mechanical work on the prosthetic limb of a transfemoral amputee calculated by inverse dynamics using either the ground reactions (force-plates) or knee reactions (transducer). Study design: Comparative analysis. Methods: Kinematics, ground reaction and knee reaction data were collected using a motion analysis system, two forceplates, and a multi-axia...

  12. Assessing the Relative Contributions of Active Ankle and Knee Assistance to the Walking Mechanics of Transfemoral Amputees Using a Powered Prosthesis.

    Science.gov (United States)

    Ingraham, Kimberly A; Fey, Nicholas P; Simon, Ann M; Hargrove, Levi J

    2016-01-01

    Powered knee-ankle prostheses are capable of providing net-positive mechanical energy to amputees. Yet, there are limitless ways to deliver this energy throughout the gait cycle. It remains largely unknown how different combinations of active knee and ankle assistance affect the walking mechanics of transfemoral amputees. This study assessed the relative contributions of stance phase knee swing initiation, increasing ankle stiffness and powered plantarflexion as three unilateral transfemoral amputees walked overground at their self-selected walking speed. Five combinations of knee and ankle conditions were evaluated regarding the kinematics and kinetics of the amputated and intact legs using repeated measures analyses of variance. We found eliminating active knee swing initiation or powered plantarflexion was linked to increased compensations of the ipsilateral hip joint during the subsequent swing phase. The elimination of knee swing initiation or powered plantarflexion also led to reduced braking ground reaction forces of the amputated and intact legs, and influenced both sagittal and frontal plane loading of the intact knee joint. Gradually increasing prosthetic ankle stiffness influenced the shape of the prosthetic ankle plantarflexion moment, more closely mirroring the intact ankle moment. Increasing ankle stiffness also corresponded to increased prosthetic ankle power generation (despite a similar maximum stiffness value across conditions) and increased braking ground reaction forces of the amputated leg. These findings further our understanding of how to deliver assistance with powered knee-ankle prostheses and the compensations that occur when specific aspects of assistance are added/removed.

  13. Heterotopic ossification in combat amputees from Afghanistan and Iraq wars: Five case histories and results from a small series of patients

    Directory of Open Access Journals (Sweden)

    Ted Melcer, PhD

    2011-01-01

    Full Text Available Heterotopic ossification (HO is excess bone growth in soft tissues that frequently occurs in the residual limbs of combat amputees injured in Operation Iraqi Freedom and Operation Enduring Freedom, or Iraq and Afghanistan wars, respectively. HO can interfere with prosthetic use and walking and delay patient rehabilitation. This article describes symptomatic and/or radiographic evidence of HO in a patient series of combat amputees rehabilitating at a military amputee care clinic (27 patients/33 limbs. We conducted a retrospective review of patient records and physician interviews to document evidence of HO symptoms in these limbs (e.g., pain during prosthetic use, skin breakdown. Results showed HO-related symptoms in 10 of the 33 residual limbs. Radiographs were available for 25 of the 33 limbs, and a physician identified at least moderate HO in 15 of the radiographs. However, 5 of the 15 patients who showed at least moderate radiographic HO did not report adverse symptoms. Five individual patient histories described HO onset, symptoms, treatments, and outcomes. These case histories illustrated how HO location relative to pressure-sensitive/pressure-tolerant areas of the residual limb may determine whether patients experienced symptoms. These histories revealed the uncommon but novel finding of potential benefits of HO for prosthetic suspension.

  14. Assessing the Relative Contributions of Active Ankle and Knee Assistance to the Walking Mechanics of Transfemoral Amputees Using a Powered Prosthesis.

    Directory of Open Access Journals (Sweden)

    Kimberly A Ingraham

    Full Text Available Powered knee-ankle prostheses are capable of providing net-positive mechanical energy to amputees. Yet, there are limitless ways to deliver this energy throughout the gait cycle. It remains largely unknown how different combinations of active knee and ankle assistance affect the walking mechanics of transfemoral amputees. This study assessed the relative contributions of stance phase knee swing initiation, increasing ankle stiffness and powered plantarflexion as three unilateral transfemoral amputees walked overground at their self-selected walking speed. Five combinations of knee and ankle conditions were evaluated regarding the kinematics and kinetics of the amputated and intact legs using repeated measures analyses of variance. We found eliminating active knee swing initiation or powered plantarflexion was linked to increased compensations of the ipsilateral hip joint during the subsequent swing phase. The elimination of knee swing initiation or powered plantarflexion also led to reduced braking ground reaction forces of the amputated and intact legs, and influenced both sagittal and frontal plane loading of the intact knee joint. Gradually increasing prosthetic ankle stiffness influenced the shape of the prosthetic ankle plantarflexion moment, more closely mirroring the intact ankle moment. Increasing ankle stiffness also corresponded to increased prosthetic ankle power generation (despite a similar maximum stiffness value across conditions and increased braking ground reaction forces of the amputated leg. These findings further our understanding of how to deliver assistance with powered knee-ankle prostheses and the compensations that occur when specific aspects of assistance are added/removed.

  15. Assessing the Relative Contributions of Active Ankle and Knee Assistance to the Walking Mechanics of Transfemoral Amputees Using a Powered Prosthesis

    Science.gov (United States)

    Simon, Ann M.; Hargrove, Levi J.

    2016-01-01

    Powered knee-ankle prostheses are capable of providing net-positive mechanical energy to amputees. Yet, there are limitless ways to deliver this energy throughout the gait cycle. It remains largely unknown how different combinations of active knee and ankle assistance affect the walking mechanics of transfemoral amputees. This study assessed the relative contributions of stance phase knee swing initiation, increasing ankle stiffness and powered plantarflexion as three unilateral transfemoral amputees walked overground at their self-selected walking speed. Five combinations of knee and ankle conditions were evaluated regarding the kinematics and kinetics of the amputated and intact legs using repeated measures analyses of variance. We found eliminating active knee swing initiation or powered plantarflexion was linked to increased compensations of the ipsilateral hip joint during the subsequent swing phase. The elimination of knee swing initiation or powered plantarflexion also led to reduced braking ground reaction forces of the amputated and intact legs, and influenced both sagittal and frontal plane loading of the intact knee joint. Gradually increasing prosthetic ankle stiffness influenced the shape of the prosthetic ankle plantarflexion moment, more closely mirroring the intact ankle moment. Increasing ankle stiffness also corresponded to increased prosthetic ankle power generation (despite a similar maximum stiffness value across conditions) and increased braking ground reaction forces of the amputated leg. These findings further our understanding of how to deliver assistance with powered knee-ankle prostheses and the compensations that occur when specific aspects of assistance are added/removed. PMID:26807889

  16. Energy flow analysis of amputee walking shows a proximally-directed transfer of energy in intact limbs, compared to a distally-directed transfer in prosthetic limbs at push-off.

    Science.gov (United States)

    Weinert-Aplin, R A; Howard, D; Twiste, M; Jarvis, H L; Bennett, A N; Baker, R J

    2017-01-01

    Reduced capacity and increased metabolic cost of walking occurs in amputees, despite advances in prosthetic componentry. Joint powers can quantify deficiencies in prosthetic gait, but do not reveal how energy is exchanged between limb segments. This study aimed to quantify these energy exchanges during amputee walking. Optical motion and forceplate data collected during walking at a self-selected speed for cohorts of 10 controls, 10 unilateral trans-tibial, 10 unilateral trans-femoral and 10 bilateral trans-femoral amputees were used to determine the energy exchanges between lower limb segments. At push-off, consistent thigh and shank segment powers were observed between amputee groups (1.12W/kg vs. 1.05W/kg for intact limbs and 0.97W/kg vs. 0.99W/kg for prosthetic limbs), and reduced prosthetic ankle power, particularly in trans-femoral amputees (3.12W/kg vs. 0.87W/kg). Proximally-directed energy exchange was observed in the intact limbs of amputees and controls, while prosthetic limbs displayed distally-directed energy exchanges at the knee and hip. This study used energy flow analysis to show a reversal in the direction in which energy is exchanged between prosthetic limb segments at push-off. This reversal was required to provide sufficient energy to propel the limb segments and is likely a direct result of the lack of push-off power at the prosthetic ankle, particularly in trans-femoral amputees, and leads to their increased metabolic cost of walking.

  17. Toward attenuating the impact of arm positions on electromyography pattern-recognition based motion classification in transradial amputees

    Directory of Open Access Journals (Sweden)

    Geng Yanjuan

    2012-10-01

    Full Text Available Abstract Background Electromyography (EMG pattern-recognition based control strategies for multifunctional myoelectric prosthesis systems have been studied commonly in a controlled laboratory setting. Before these myoelectric prosthesis systems are clinically viable, it will be necessary to assess the effect of some disparities between the ideal laboratory setting and practical use on the control performance. One important obstacle is the impact of arm position variation that causes the changes of EMG pattern when performing identical motions in different arm positions. This study aimed to investigate the impacts of arm position variation on EMG pattern-recognition based motion classification in upper-limb amputees and the solutions for reducing these impacts. Methods With five unilateral transradial (TR amputees, the EMG signals and tri-axial accelerometer mechanomyography (ACC-MMG signals were simultaneously collected from both amputated and intact arms when performing six classes of arm and hand movements in each of five arm positions that were considered in the study. The effect of the arm position changes was estimated in terms of motion classification error and compared between amputated and intact arms. Then the performance of three proposed methods in attenuating the impact of arm positions was evaluated. Results With EMG signals, the average intra-position and inter-position classification errors across all five arm positions and five subjects were around 7.3% and 29.9% from amputated arms, respectively, about 1.0% and 10% low in comparison with those from intact arms. While ACC-MMG signals could yield a similar intra-position classification error (9.9% as EMG, they had much higher inter-position classification error with an average value of 81.1% over the arm positions and the subjects. When the EMG data from all five arm positions were involved in the training set, the average classification error reached a value of around 10.8% for

  18. A Multi-Class Proportional Myocontrol Algorithm for Upper Limb Prosthesis Control: Validation in Real-Life Scenarios on Amputees.

    Science.gov (United States)

    Amsuess, Sebastian; Goebel, Peter; Graimann, Bernhard; Farina, Dario

    2015-09-01

    Functional replacement of upper limbs by means of dexterous prosthetic devices remains a technological challenge. While the mechanical design of prosthetic hands has advanced rapidly, the human-machine interfacing and the control strategies needed for the activation of multiple degrees of freedom are not reliable enough for restoring hand function successfully. Machine learning methods capable of inferring the user intent from EMG signals generated by the activation of the remnant muscles are regarded as a promising solution to this problem. However, the lack of robustness of the current methods impedes their routine clinical application. In this study, we propose a novel algorithm for controlling multiple degrees of freedom sequentially, inherently proportionally and with high robustness, allowing a good level of prosthetic hand function. The control algorithm is based on the spatial linear combinations of amplitude-related EMG signal features. The weighting coefficients in this combination are derived from the optimization criterion of the common spatial patterns filters which allow for maximal discriminability between movements. An important component of the study is the validation of the method which was performed on both able-bodied and amputee subjects who used physical prostheses with customized sockets and performed three standardized functional tests mimicking daily-life activities of varying difficulty. Moreover, the new method was compared in the same conditions with one clinical/industrial and one academic state-of-the-art method. The novel algorithm outperformed significantly the state-of-the-art techniques in both subject groups for tests that required the activation of more than one degree of freedom. Because of the evaluation in real time control on both able-bodied subjects and final users (amputees) wearing physical prostheses, the results obtained allow for the direct extrapolation of the benefits of the proposed method for the end users. In

  19. The biomechanical effects of the inclusion of a torque absorber on trans-femoral amputee gait, a pilot study.

    Science.gov (United States)

    Van der Linden, M L; Twiste, N; Rithalia, S V S

    2002-04-01

    This paper reports on a pilot study investigating the effects on the gait of two transfemoral amputees of to the inclusion of a torque absorber (TA) and its location relative to the knee unit. Both subjects carried out gait tests with a prosthesis with no TA with, a TA proximal to the knee unit and with a TA distal to the knee unit. Three-dimensional gait analysis was carried out to establish the kinematic and kinetic gait parameters of both the prosthetic and sound side. It was found that the TA did not significantly affect the sagittal kinetic and kinematic parameters of the sound or the prosthetic side. However, for one subject the axial rotation of the socket relative to the foot was significantly greater with the TA. It was concluded that by using the methodology of this pilot study, it is possible to investigate the rotations in the transverse plane within the prosthetic limb and pelvis. Further, including a TA may reduce the relative motion between the stump and the socket and therefore may decrease skin breakdown due to diminished shear forces.

  20. The Evaluation of Daily Life Activities after Application of an Osseointegrated Prosthesis Fixation in a Bilateral Transfemoral Amputee

    Science.gov (United States)

    Schalk, Stephanie A.F.; Jonkergouw, Niels; van der Meer, Fred; Swaan, Willem M.; Aschoff, Horst-H.; van der Wurff, Peter

    2015-01-01

    Abstract Individuals with a transfemoral amputation (TFA) may experience limitations in daily life due to reduced mobility and prosthesis-related problems. An osseointegrated prosthesis fixation (OPF) procedure in amputees might contribute to a solution for patients with short stumps or socket-related problems. To date, no study has specifically described the application of an OPF procedure in individuals with a TFA. This study evaluated the level of daily life activities of a 21-year old service member with a bilateral TFA and cerebral trauma. Due to a short stump length and coordination problems, an OPF procedure was deemed the most suitable option. The result of this procedure and the rehabilitation program showed an increased mobility and satisfaction as obtained by the assessment of life habits questionnaire (LIFE-H) and lower extremity functional scale. The participant was able to walk short distances and the Genium knee provided a stance position. Stair ambulation is impossible because of inadequate muscle capacity. In this specific case we conclude that the quality of life improved through the use of an OPF. However, OPF might not be the appropriate device for every individual with TFA, due to varying bone compositions, co-morbidities, and limited clinical experience and unknown long-term effects. PMID:26356693

  1. Amputee Mobility Predictor-Bilateral: A performance-based measure of mobility for people with bilateral lower-limb loss

    Directory of Open Access Journals (Sweden)

    Michele A. Raya, PhD, PT, SCS, ATC

    2013-10-01

    Full Text Available The Amputee Mobility Predictor (AMP is an outcome measure designed to assess mobility and functional capabilities for people with unilateral lower-limb amputation. No comparable measure exists for those with bilateral lower-limb amputation (BLLA. The purpose of this study was to examine the utility of the AMP-Bilateral (AMP-B to measure the ability to perform functional tasks related to participation in advanced skill activities in those with BLLA and to determine whether AMP-B scores correlated with 6-minute walk test (6MWT performance. Twenty-six male servicemembers (SMs completed the study: 12 with bilateral transtibial amputation (BTTA, 7 with bilateral transfemoral amputation (BTFA, and 7 with combination transtibial and transfemoral amputation (TTA/TFA. Significant differences existed between the AMP-B scores (p < 0.001, AMP scores (p < 0.001, and 6MWT distance (p < 0.05 for SMs with BTTA and TTA/TFA and SMs with BTTA and BTFA but not between those with BTFA and TTA/TFA. Scoring of five AMP items was modified because they necessitate at least one intact knee joint to generate the necessary torque requirements to perform the activity without upper-limb assistance. Minor modifications in scoring of the AMP do not alter total score and allow clinicians to determine the mobility and functional capabilities of SMs with BTFA and TFA/TTA.

  2. Intuitive, online, simultaneous, and proportional myoelectric control over two degrees-of-freedom in upper limb amputees.

    Science.gov (United States)

    Jiang, Ning; Rehbaum, Hubertus; Vujaklija, Ivan; Graimann, Bernhard; Farina, Dario

    2014-05-01

    We propose an approach for online simultaneous and proportional myoelectric control of two degrees-of-freedom (DoF) of the wrist, using surface electromyographic signals. The method is based on the nonnegative matrix factorization (NMF) of the wrist muscle activation to extract low-dimensional control signals translated by the user into kinematic variables. This procedure does not need a training set of signals for which the kinematics is known (labeled dataset) and is thus unsupervised (although it requires an initial calibration without labeled signals). The estimated control signals using NMF are used to directly control two DoFs of wrist. The method was tested on seven subjects with upper limb deficiency and on seven able-bodied subjects. The subjects performed online control of a virtual object with two DoFs to achieve goal-oriented tasks. The performance of the two subject groups, measured as the task completion rate, task completion time, and execution efficiency, was not statistically different. The approach was compared, and demonstrated to be superior to the online control by the industrial state-of-the-art approach. These results show that this new approach, which has several advantages over the previous myoelectric prosthetic control systems, has the potential of providing intuitive and dexterous control of artificial limbs for amputees.

  3. Techniques for Interface Stress Measurements within Prosthetic Sockets of Transtibial Amputees: A Review of the Past 50 Years of Research.

    Science.gov (United States)

    Al-Fakih, Ebrahim A; Abu Osman, Noor Azuan; Mahmad Adikan, Faisal Rafiq

    2016-07-20

    The distribution of interface stresses between the residual limb and prosthetic socket of a transtibial amputee has been considered as a direct indicator of the socket quality fit and comfort. Therefore, researchers have been very interested in quantifying these interface stresses in order to evaluate the extent of any potential damage caused by the socket to the residual limb tissues. During the past 50 years a variety of measurement techniques have been employed in an effort to identify sites of excessive stresses which may lead to skin breakdown, compare stress distributions in various socket designs, and evaluate interface cushioning and suspension systems, among others. The outcomes of such measurement techniques have contributed to improving the design and fitting of transtibial sockets. This article aims to review the operating principles, advantages, and disadvantages of conventional and emerging techniques used for interface stress measurements inside transtibial sockets. It also reviews and discusses the evolution of different socket concepts and interface stress investigations conducted in the past five decades, providing valuable insights into the latest trends in socket designs and the crucial considerations for effective stress measurement tools that lead to a functional prosthetic socket.

  4. Techniques for Interface Stress Measurements within Prosthetic Sockets of Transtibial Amputees: A Review of the Past 50 Years of Research

    Directory of Open Access Journals (Sweden)

    Ebrahim A. Al-Fakih

    2016-07-01

    Full Text Available The distribution of interface stresses between the residual limb and prosthetic socket of a transtibial amputee has been considered as a direct indicator of the socket quality fit and comfort. Therefore, researchers have been very interested in quantifying these interface stresses in order to evaluate the extent of any potential damage caused by the socket to the residual limb tissues. During the past 50 years a variety of measurement techniques have been employed in an effort to identify sites of excessive stresses which may lead to skin breakdown, compare stress distributions in various socket designs, and evaluate interface cushioning and suspension systems, among others. The outcomes of such measurement techniques have contributed to improving the design and fitting of transtibial sockets. This article aims to review the operating principles, advantages, and disadvantages of conventional and emerging techniques used for interface stress measurements inside transtibial sockets. It also reviews and discusses the evolution of different socket concepts and interface stress investigations conducted in the past five decades, providing valuable insights into the latest trends in socket designs and the crucial considerations for effective stress measurement tools that lead to a functional prosthetic socket.

  5. Socket Interface Pressure and Amputee Reported Outcomes for Comfortable and Uncomfortable Conditions of Patellar Tendon Bearing Socket: A Pilot Study.

    Science.gov (United States)

    Safari, Mohammad Reza; Tafti, Nahid; Aminian, Gholamreza

    2015-01-01

    The objectives of the current study were to compare intra-socket pressure differences between comfortable and uncomfortable socket conditions, and the usefulness of subject perception of satisfaction, activity limitations, and socket comfort in distinguishing between these two socket conditions. Five unilateral trans-tibial amputees took part in the study. They answered the Socket Comfort Score (SCS) and Trinity Amputation and Prosthetic Experience Scale (TAPES) questionnaires before the interface pressure (in standing and walking) was measured for the uncomfortable socket condition at five regions of the residual limb. Participants were then provided with a comfortable socket and wore it for two weeks. Participants who were satisfied with the socket fit after two weeks repeated the SCS and TAPES questionnaires and interface pressure measurements. The differences between the test results of the two conditions were not statistically significant, except for the interface pressure at the popliteal region during the early stance phase, TAPES socket fit subscale, and the SCS. Due to large variability of the data and the lack of statistical significance, no firm conclusion can be made on the possible relationship between the interface pressure values and the patient-reported outcomes of the two socket conditions. A larger sample size and longer acclimation period are required to locate significant differences.

  6. Hands-Off and Hands-On Casting Consistency of Amputee below Knee Sockets Using Magnetic Resonance Imaging

    Science.gov (United States)

    Rowe, Philip

    2013-01-01

    Residual limb shape capturing (Casting) consistency has a great influence on the quality of socket fit. Magnetic Resonance Imaging was used to establish a reliable reference grid for intercast and intracast shape and volume consistency of two common casting methods, Hands-off and Hands-on. Residual limbs were cast for twelve people with a unilateral below knee amputation and scanned twice for each casting concept. Subsequently, all four volume images of each amputee were semiautomatically segmented and registered to a common coordinate system using the tibia and then the shape and volume differences were calculated. The results show that both casting methods have intra cast volume consistency and there is no significant volume difference between the two methods. Inter- and intracast mean volume differences were not clinically significant based on the volume of one sock criteria. Neither the Hands-off nor the Hands-on method resulted in a consistent residual limb shape as the coefficient of variation of shape differences was high. The resultant shape of the residual limb in the Hands-off casting was variable but the differences were not clinically significant. For the Hands-on casting, shape differences were equal to the maximum acceptable limit for a poor socket fit. PMID:24348164

  7. Efficacy of proprioceptive neuromuscular facilitation techniques versus traditional prosthetic training for improving ambulatory function in transtibial amputees

    Directory of Open Access Journals (Sweden)

    Pallavi Sahay, MPT

    2014-06-01

    Full Text Available The objective of this randomized controlled trial was to evaluate the efficacy of proprioceptive neuromuscular facilitation (PNF techniques in comparison to traditional prosthetic training (TPT in improving ambulatory function in transtibial amputees. Thirty study participants (19 men and 11 women with unilateral transtibial amputation participated in the study. They were randomly allocated to either the traditional training group (i.e., TPT (n = 15 or the PNF training group (n = 15. The treatment in the TPT group consisted of weight-bearing, weight-shifting, balance, and gait exercises for 30 minutes daily for 10 treatment sessions. In the PNF group, the same activities were performed by employing PNF principles and techniques. The outcome measures were gait parameters (e.g., stride width, step length, and stride length and the Locomotor Capabilities Index (LCI. The between-group comparisons at the end of the trial showed that the PNF group showed significant improvement in gait parameters and in the LCI, compared to the TPT group (p < 0.05. The results of the study suggested that prosthetic training based on proprioceptive feedback is more effective than the traditional prosthetic programme in improving ambulatory function.

  8. BIOENERGETIC DIFFERENCES DURING WALKING AND RUNNING IN TRANSFEMORAL AMPUTEE RUNNERS USING ARTICULATING AND NON-ARTICULATING KNEE PROSTHESES

    Science.gov (United States)

    Highsmith, M. Jason; Kahle, Jason T.; Miro, Rebecca M.; Mengelkoch, Larry J.

    2016-01-01

    Transfemoral amputation (TFA) patients require considerably more energy to walk and run than non-amputees. The purpose of this study was to examine potential bioenergetic differences (oxygen uptake (VO2), heart rate (HR), and ratings of perceived exertion (RPE)) for TFA patients utilizing a conventional running prosthesis with an articulating knee mechanism versus a running prosthesis with a non-articulating knee joint. Four trained TFA runners (n = 4) were accommodated to and tested with both conditions. VO2 and HR were significantly lower (p ≤ 0.05) in five of eight fixed walking and running speeds for the prosthesis with an articulating knee mechanism. TFA demonstrated a trend for lower RPE at six of eight walking speeds using the prosthesis with the articulated knee condition. A trend was observed for self-selected walking speed, self-selected running speed, and maximal speed to be faster for TFA subjects using the prosthesis with the articulated knee condition. Finally, all four TFA participants subjectively preferred running with the prosthesis with the articulated knee condition. These findings suggest that, for trained TFA runners, a running prosthesis with an articulating knee prosthesis reduces ambulatory energy costs and enhances subjective perceptive measures compared to using a non-articulating knee prosthesis. PMID:28066524

  9. Hands-Off and Hands-On Casting Consistency of Amputee below Knee Sockets Using Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Safari

    2013-01-01

    Full Text Available Residual limb shape capturing (Casting consistency has a great influence on the quality of socket fit. Magnetic Resonance Imaging was used to establish a reliable reference grid for intercast and intracast shape and volume consistency of two common casting methods, Hands-off and Hands-on. Residual limbs were cast for twelve people with a unilateral below knee amputation and scanned twice for each casting concept. Subsequently, all four volume images of each amputee were semiautomatically segmented and registered to a common coordinate system using the tibia and then the shape and volume differences were calculated. The results show that both casting methods have intra cast volume consistency and there is no significant volume difference between the two methods. Inter- and intracast mean volume differences were not clinically significant based on the volume of one sock criteria. Neither the Hands-off nor the Hands-on method resulted in a consistent residual limb shape as the coefficient of variation of shape differences was high. The resultant shape of the residual limb in the Hands-off casting was variable but the differences were not clinically significant. For the Hands-on casting, shape differences were equal to the maximum acceptable limit for a poor socket fit.

  10. Prosthetic ankle push-off work reduces metabolic rate but not collision work in non-amputee walking

    Science.gov (United States)

    Caputo, Joshua M.; Collins, Steven H.

    2014-12-01

    Individuals with unilateral below-knee amputation expend more energy than non-amputees during walking and exhibit reduced push-off work and increased hip work in the affected limb. Simple dynamic models of walking suggest a possible solution, predicting that increasing prosthetic ankle push-off should decrease leading limb collision, thereby reducing overall energy requirements. We conducted a rigorous experimental test of this idea wherein ankle-foot prosthesis push-off work was incrementally varied in isolation from one-half to two-times normal levels while subjects with simulated amputation walked on a treadmill at 1.25 m.s-1. Increased prosthesis push-off significantly reduced metabolic energy expenditure, with a 14% reduction at maximum prosthesis work. In contrast to model predictions, however, collision losses were unchanged, while hip work during swing initiation was decreased. This suggests that powered ankle push-off reduces walking effort primarily through other mechanisms, such as assisting leg swing, which would be better understood using more complete neuromuscular models.

  11. Compensatory mechanism involving the knee joint of the intact limb during gait in unilateral below-knee amputees.

    Science.gov (United States)

    Beyaert, C; Grumillier, C; Martinet, N; Paysant, J; André, J-M

    2008-08-01

    This study evaluated the asymmetry of knee kinetics during uncomfortable gait induced by prosthesis misalignment to further demonstrate the compensatory function of the knee joint of the intact limb during gait. Three-dimensional gait analysis including knee kinematics and kinetics at the beginning of stance phase was conducted in 15 healthy subjects and 17 unilateral trans-tibial amputees (TTA) walking at self-selected speed in three conditions of prosthetic alignment: initial alignment (IA); initial alignment altered either by 6 degrees of internal rotation (IR) or by 6 degrees of external rotation (ER) applied on the pylon. Patients reported best comfort of gait in IA condition and discomfort mainly in IR condition. Maximum knee flexion and knee total work at power phases K0-K2 were significantly higher in intact limbs compared to prosthetic and control limbs. In intact limbs, these variables had significantly higher values (+10-35%, pknee kinetics of the prosthetic limb, which suggests a protective mechanism. Knee kinetics of the intact limb did alter, which suggests a compensatory mechanism.

  12. Post-amputation pain is associated with the recall of an impaired body representation in dreams-results from a nation-wide survey on limb amputees.

    Science.gov (United States)

    Bekrater-Bodmann, Robin; Schredl, Michael; Diers, Martin; Reinhard, Iris; Foell, Jens; Trojan, Jörg; Fuchs, Xaver; Flor, Herta

    2015-01-01

    The experience of post-amputation pain such as phantom limb pain (PLP) and residual limb pain (RLP), is a common consequence of limb amputation, and its presence has negative effects on a person's well-being. The continuity hypothesis of dreams suggests that the presence of such aversive experiences in the waking state should be reflected in dream content, with the recalled body representation reflecting a cognitive proxy of negative impact. In the present study, we epidemiologically assessed the presence of post-amputation pain and other amputation-related information as well as recalled body representation in dreams in a sample of 3,234 unilateral limb amputees. Data on the site and time of amputation, residual limb length, prosthesis use, lifetime prevalence of mental disorders, presence of post-amputation pain, and presence of non-painful phantom phenomena were included in logistic regression analyses using recalled body representation in dreams (impaired, intact, no memory) as dependent variable. The effects of age, sex, and frequency of dream recall were controlled for. About 22% of the subjects indicated that they were not able to remember their body representation in dreams, another 24% of the amputees recalled themselves as always intact, and only a minority of less than 3% recalled themselves as always impaired. Almost 35% of the amputees dreamed of themselves in a mixed fashion. We found that lower-limb amputation as well as the presence of PLP and RLP was positively associated with the recall of an impaired body representation in dreams. The presence of non-painful phantom phenomena, however, had no influence. These results complement previous findings and indicate complex interactions of physical body appearance and mental body representation, probably modulated by distress in the waking state. The findings are discussed against the background of alterations in cognitive processes after amputation and hypotheses suggesting an innate body model.

  13. Leg Amputees Pattern Recognition with BP Neural Network%BP神经网络大腿截肢者运动模式识别

    Institute of Scientific and Technical Information of China (English)

    刘磊; 杨鹏; 刘作军; 耿艳利

    2014-01-01

    在假肢运动优化控制的研究中,针对动力型假肢控制方面存在的运动模式识别准确性差的问题,搭建人体下肢运动信息系统获取下肢髋关节角速度信号和加速度信号。建立基于BP神经网络的大腿截肢者运动识别模型。研究了建模过程中输入输出数据预处理、网络结构设计、训练模式选择等问题。改进模型能有效识别平地行走、上楼、下楼、上坡和下坡5种运动模式,正确识别率达到了90.4%,已具备一定的实用性。%Lower limb amputation significantly affects the quality of the leg amputee's daily life. Recent advance-ments in electromechanical actuators have propelled the recent development of powered artificial legs. Accurately rec-ognizing the leg amputee's locomotion intent is required in order to realize the smooth and seamless control of prosthet-ic legs. The approach infers amputee's intents of upslope, downgrade, stairs ascent, stairs descent or level-ground walking without the need for instrumentation of the sound-side leg. Specifically, the intent recognizer utilizes the fea-tures extracted from accelerometer and gyroscope. The preprocessing of input and output data, design of network structure, training mode selection and other aspects were analyzed. This paper demonstrates via experiments the ef-fectiveness of the approach.

  14. Recommended number of strides for automatic assessment of gait symmetry and regularity in above-knee amputees by means of accelerometry and autocorrelation analysis

    Directory of Open Access Journals (Sweden)

    Tura Andrea

    2012-02-01

    Full Text Available Abstract Background Symmetry and regularity of gait are essential outcomes of gait retraining programs, especially in lower-limb amputees. This study aims presenting an algorithm to automatically compute symmetry and regularity indices, and assessing the minimum number of strides for appropriate evaluation of gait symmetry and regularity through autocorrelation of acceleration signals. Methods Ten transfemoral amputees (AMP and ten control subjects (CTRL were studied. Subjects wore an accelerometer and were asked to walk for 70 m at their natural speed (twice. Reference values of step and stride regularity indices (Ad1 and Ad2 were obtained by autocorrelation analysis of the vertical and antero-posterior acceleration signals, excluding initial and final strides. The Ad1 and Ad2 coefficients were then computed at different stages by analyzing increasing portions of the signals (considering both the signals cleaned by initial and final strides, and the whole signals. At each stage, the difference between Ad1 and Ad2 values and the corresponding reference values were compared with the minimum detectable difference, MDD, of the index. If that difference was less than MDD, it was assumed that the portion of signal used in the analysis was of sufficient length to allow reliable estimation of the autocorrelation coefficient. Results All Ad1 and Ad2 indices were lower in AMP than in CTRL (P Conclusions Without the need to identify and eliminate the phases of gait initiation and termination, twenty strides can provide a reasonable amount of information to reliably estimate gait regularity in transfemoral amputees.

  15. Contributions of knee swing initiation and ankle plantar flexion to the walking mechanics of amputees using a powered prosthesis.

    Science.gov (United States)

    Ingraham, Kimberly A; Fey, Nicholas P; Simon, Ann M; Hargrove, Levi J

    2014-01-01

    Recently developed powered prostheses are capable of producing near-physiological joint torque at the knee and/or ankle joints. Based on previous studies of biological joint impedance and the mechanics of able-bodied gait, an impedance-based controller has been developed for a powered knee and ankle prosthesis that integrates knee swing initiation and powered plantar flexion in late stance with increasing ankle stiffness throughout stance. In this study, five prosthesis configuration conditions were tested to investigate the individual contributions of each sub-strategy to the overall walking mechanics of four unilateral transfemoral amputees as they completed a clinical 10-m walk test using a powered knee and ankle prosthesis. The baseline condition featured constant ankle stiffness and no swing initiation or powered plantar flexion. The four remaining conditions featured knee swing initiation alone (SI) or in combination with powered plantar flexion (SI+PF), increasing ankle stiffness (SI+IK), or both (SI+PF+IK). Self-selected walking speed did not significantly change between conditions, although subjects tended to walk the slowest in the baseline condition compared to conditions with swing initiation. The addition of powered plantar flexion resulted in significantly higher ankle power generation in late stance irrespective of ankle stiffness. The inclusion of swing initiation resulted in a significantly more flexed knee at toe off and a significantly higher average extensor knee torque following toe off. Identifying individual contributions of intrinsic control strategies to prosthesis biomechanics could help inform the refinement of impedance-based prosthesis controllers and simplify future designs of prostheses and lower-limb assistive devices alike.

  16. Gait Measures and Dynamic Weight bearing in Young and Elder Trans-tibal Amputee using PTB Prosthesis with SACH foot

    Directory of Open Access Journals (Sweden)

    Prasanna K. Lenka

    2008-12-01

    Full Text Available Objective: to investigate the changes associated with age in gait characteristics and dynamic weight bearing pattern of sound and prosthetic limb of persons with unilateral amputation. Participant: two groups of seven young (24±3.8 years and seven elderly unilateral amputee (71±6 years were selected for this study. Setting: both groups walked at their self selected speed over a 20 second duration plane surface walk way in trans-tibial prosthesis with PTB socket and SACH foot. The raw data of force and EMG sensors of gait analyzer were filtered, processed and analyzed with help of ‘matlab 7.0. A blue tooth enabled heart rate telemetry system was used for calculating gait efficiency in terms of physiological cost index (PCI. Results: significant differences were found in stride duration, (p=0.003, step duration sound limb (p<0.002, stance duration sound limb (p=0.002, stance duration prosthetic limb (p=0.006 and cadence (p=0.001<0.05, however no difference was found in EMG pattern of vastus lateralis between the two groups. The dynamic weight distribution showed more normalized load on anterior parts of heel and minimum load at calcaneal max in elderly group. The results of vertical ground reaction force found the prosthetic side of elderly group takes more weight than young group during loading response. In comparison, PCI was observed to be greater in case of elderly group. Conclusion: most of difference between two groups could be explained by speed variations and biomechanical limitation of ankle joint due to natural aging process.

  17. Comparison of different microprocessor controlled knee joints on the energy consumption during walking in trans-femoral amputees: intelligent knee prosthesis (IP) versus C-leg.

    Science.gov (United States)

    Chin, Takaaki; Machida, Katsuhiro; Sawamura, Seishi; Shiba, Ryouichi; Oyabu, Hiroko; Nagakura, Yuji; Takase, Izumi; Nakagawa, Akio

    2006-04-01

    The purpose of this study was to investigate the characteristic differences between the IP and C-Leg by making a comparative study of energy consumption and walking speeds in trans-femoral amputees. The subjects consisted of four persons with traumatic trans-femoral amputations aged 17 - 33 years who had been using the IP and were active in society. Fourteen able-bodied persons served as controls. First the energy consumption at walking speeds of 30, 50, 70, and 90 m/min was measured when using the IP. Then the knee joint was switched to the C-Leg. The same energy consumption measurement was taken once the subjects were accustomed to using the C-Leg. The most metabolically efficient walking speed was also determined. At a walking speed of 30 m/min using the IP and C-Leg, the oxygen rate (ml/kg/ min) was, on average, 42.5% and 33.3% higher (Pmicroprocessor controlled knee joints appeared to be valid alternative for improving walking performance of trans-femoral amputees.

  18. A 3D mathematical model to predict spinal joint and hip joint force for trans-tibial amputees with different SACH foot pylon adjustments.

    Science.gov (United States)

    Yu, Chung-huang; Hung, Yu-Cheng; Lin, Yang-Hua; Chen, Guan-Xun; Wei, Shun-Hwa; Huang, Chang-Hung; Chen, Chen-Sheng

    2014-09-01

    A solid-ankle cushioned heel (SACH) foot is a non-joint foot without natural ankle function. Trans-tibial amputees may occur toe scuffing in the late swing phase due to a lack of active dorsiflexion. To address this problem, clinical guidelines suggests shortening the pylon to produce a smooth gait. However, this causes a leg length discrepancy, induces asymmetry in the hip joint, and causes an overload of L5/S1 joint force. Therefore, this study aimed to investigate the influence of different prosthesis pylons on the hip joint and L5/S1 joint forces. Ten subjects were recruited using leg length for normalisation. Four different pylon reductions (0%, 1%, 2%, and 3%) were used for gait analysis. A Vicon system and force plates were used to collect kinematic data and ground reaction force, respectively. The software package MATLAB was used to create a mathematical model for evaluating the symmetry and force of the hip joint and the low back force of the L5/S1 joint. The model was validated by the correlation coefficient (CC=0.947) and root mean square (RMS=0.028 BW). The model estimated that the 1% group had a symmetrical hip joint force and a lower L5/S1 joint force in the vertical direction. This study indicates that a 1% pylon shortening on a SACH prosthesis is appropriate for a trans-tibial amputee.

  19. The Conventional Non-Articulated SACH or a Multiaxial Prosthetic Foot for Hypomobile Transtibial Amputees? A Clinical Comparison on Mobility, Balance, and Quality of Life

    Directory of Open Access Journals (Sweden)

    Francesco Paradisi

    2015-01-01

    Full Text Available The effects of a non-articulated SACH and a multiaxial foot-ankle mechanism on the performance of low-activity users are of great interest for practitioners in amputee rehabilitation. The aim of this study is to compare these two prosthetic feet and assess possible improvements introduced by the increased degrees of freedom provided by the multiaxial foot. For this purpose, a group of 20 hypomobile transtibial amputees (TTAs had their usual SACH replaced with a multiaxial foot. Participants’ functional mobility, involving ambulatory skills in overground level walking, ramps, and stairs, was evaluated by performing Six-Minute Walking Test (6MWT, Locomotor Capability Index-5 (LCI-5, Hill Assessment Index (HAI, and Stair Assessment Index (SAI. Balance performances were assessed using Berg Balance Scale (BBS and analysing upper body accelerations during gait. Moreover, the Prosthesis Evaluation Questionnaire (PEQ was performed to indicate the prosthesis-related quality of life. Results showed that participants walked faster using the multiaxial foot (p<0.05 maintaining the same upright gait stability. Significant improvements with the multiaxial foot were also observed in BBS, LCI-5, and SAI times and 4 of 9 subscales of the PEQ. Our findings demonstrate that a multiaxial foot represents a considerable alternative solution with respect to the conventional SACH in the prosthetic prescription for hypomobile TTAs.

  20. Walking Ability of Amputees with Unilateral Transfemoral Prosthesis%单侧大腿截肢者步行能力研究

    Institute of Scientific and Technical Information of China (English)

    刁子龙; 曹学军; 杨平; 蔡丽飞

    2015-01-01

    Objective To investigate the characteristics of walking ability of the amputees with unilateral transfemoral prosthesis. Meth-ods 16 unilateral transfemoral amputees (patients) and 16 healthy adults (controls) were tested with 6-minute walking test indoor, 1000 m walking outdoor on various terrain, balance test and energy expenditure test. Results The speed, frequency and stride length were significant-ly less in the patients than in the controls (P0.05). There were significant differences in time and energy expenditure of outdoor 1000 m walk test between two groups (P0.05)。室外1000 m步行测试完成时间和能量消耗存在显著性差异(P0.05),但室内6 min步行距离与室外1000 m完成时间存在显著性差异(P<0.05)。结论单侧大腿截肢者步态缺乏效率,能量消耗大,平衡功能尚可。不同类型假肢膝关节可能对患者步行能力发生影响。

  1. The Conventional Non-Articulated SACH or a Multiaxial Prosthetic Foot for Hypomobile Transtibial Amputees? A Clinical Comparison on Mobility, Balance, and Quality of Life.

    Science.gov (United States)

    Paradisi, Francesco; Delussu, Anna Sofia; Brunelli, Stefano; Iosa, Marco; Pellegrini, Roberto; Zenardi, Daniele; Traballesi, Marco

    2015-01-01

    The effects of a non-articulated SACH and a multiaxial foot-ankle mechanism on the performance of low-activity users are of great interest for practitioners in amputee rehabilitation. The aim of this study is to compare these two prosthetic feet and assess possible improvements introduced by the increased degrees of freedom provided by the multiaxial foot. For this purpose, a group of 20 hypomobile transtibial amputees (TTAs) had their usual SACH replaced with a multiaxial foot. Participants' functional mobility, involving ambulatory skills in overground level walking, ramps, and stairs, was evaluated by performing Six-Minute Walking Test (6 MWT), Locomotor Capability Index-5 (LCI-5), Hill Assessment Index (HAI), and Stair Assessment Index (SAI). Balance performances were assessed using Berg Balance Scale (BBS) and analysing upper body accelerations during gait. Moreover, the Prosthesis Evaluation Questionnaire (PEQ) was performed to indicate the prosthesis-related quality of life. Results showed that participants walked faster using the multiaxial foot (p foot were also observed in BBS, LCI-5, and SAI times and 4 of 9 subscales of the PEQ. Our findings demonstrate that a multiaxial foot represents a considerable alternative solution with respect to the conventional SACH in the prosthetic prescription for hypomobile TTAs.

  2. Capability enhancement and amputee care in Operation Iraqi Freedom: The role of a rehabilitation and prosthetics assistance team in reconstruction operations.

    Science.gov (United States)

    Scherer, Matthew

    2009-05-01

    Defining the role of the U.S. Army Rehabilitation and Prosthetic Assistance Team in reconstruction operations was a key component of this first of its kind Army Medical Department (AMEDD) mission in a combat theater of operations. In the tradition of civil-military operations, a five-man team trained 11 Iraqi rehabilitation and prosthetic providers on best clinical, technical, and business practices to manage the nation's growing amputee population. The team instructed, assisted, and supervised Iraqi clinicians in the delivery of prosthetic and rehabilitation services to 124 patients over 350 patient clinical visits. After a successful transition from Multi-National Force-Iraq oversight to the Iraqi Ministry of Defense (MoD), the premier prosthetics and rehabilitation clinic in Iraq now provides services to patients from current and past conflicts, including civilians and pediatric patients.

  3. 截肢者日常生活用假手的仿生设计方法%Bionics Design of Artificial Hands for Amputees

    Institute of Scientific and Technical Information of China (English)

    王人成; 王爱明; 刘启栋

    2011-01-01

    This paper discusses the bionics design methods of artificial hands for amputees from aspects of appearance and material, function and structure, control and operation methods. Putting forward some cases of artificial hand with unidirection and multi-degree of freedom, the factors of artificial hands bionics design are analyzed.%本文从外观式样与材料、功能与结构,以及控制与操纵方式三个角度讨论了截肢者日常生活用假手的仿生设计方法.通过对单自由度和多指多自由度典型假手实例进行分析,分析了假手仿生设计需要重点考虑的几个因素.

  4. Fixed and self-paced treadmill walking for able-bodied and transtibial amputees in a multi-terrain virtual environment.

    Science.gov (United States)

    Sinitski, Emily H; Lemaire, Edward D; Baddour, Natalie; Besemann, Markus; Dudek, Nancy L; Hebert, Jacqueline S

    2015-02-01

    A self-paced treadmill automatically adjusts speed in real-time to match the user's walking speed, potentially enabling more natural gait than fixed-speed treadmills. This research examined walking speed changes for able-bodied and transtibial amputee populations on a self-paced treadmill in a multi-terrain virtual environment and examined gait differences between fixed and self-paced treadmill speed conditions. Twelve able-bodied (AB) individuals and 12 individuals with unilateral transtibial amputation (TT) walked in a park-like virtual environment with level, slopes, and simulated uneven terrain scenarios. Temporal-spatial and range-of-motion parameters were analyzed. Within the self-paced condition, all participants significantly varied walking speed (pmultiple movement scenarios in order to elicit more natural gait across various terrain. Fixed-speed treadmills may induce gait compensations to maintain the fixed speed.

  5. Inter-individual difference in the effect of mirror reflection-induced visual feedback on phantom limb awareness in forearm amputees.

    Directory of Open Access Journals (Sweden)

    Noritaka Kawashima

    Full Text Available OBJECTIVE: To test whether the phantom limb awareness could be altered by observing mirror reflection-induced visual feedback (MVF in unilateral forearm amputees. METHODS: Ten unilateral forearm amputees were asked to perform bilateral (intact and phantom synchronous wrist motions with and without MVF. During wrist motion, electromyographic activities in the extensor digitorum longus (EDL and flexor carpi radialis muscles (FCR were recorded with bipolar electrodes. Degree of wrist range of motion (ROM was also recorded by electrogoniometry attached to the wrist joint of intact side. Subjects were asked to answer the degree of attainment of phantom limb motion using a visual analog scale (VAS: ranging from 0 (hard to 10 (easy. RESULTS: VAS and ROM were significantly increased by utilizing MVF, and the extent of an enhancement of the VAS and wrist ROM was positively correlated (r = 0.72, p<0.05. Although FCR EMG activity also showed significant enhancement by MVF, this was not correlated with the changes of VAS and ROM. Interestingly, while we found negative correlation between EDL EMG activity and wrist ROM, MVF generally affected to be increasing both EDL EMG and ROM. CONCLUSIONS: Although there was larger extent of variability in the effect of MVF on phantom limb awareness, MVF has a potential to enhance phantom limb awareness, in case those who has a difficulty for the phantom limb motion. The present result suggests that the motor command to the missing limb can be re-activated by an appropriate therapeutic strategy such as mirror therapy.

  6. Evaluation of the gait performance of above-knee amputees while walking with 3R20 and 3R15 knee joints

    Directory of Open Access Journals (Sweden)

    AliReza Taheri

    2012-01-01

    Full Text Available Background: The performance of the subjects with above-knee amputation is noticeably poorer than normal subjects. Various types of components have been designed to compensate their performance. Among various prosthetic components, the knee joint has great influence on the function. Two types of knee joints (3R15, 3R20 have been used broadly for above-knee prostheses. However, there is not enough research to highlight the influence of these joints on the gait performance of the subjects. Therefore, an aim of this research was to investigate the performance of the above-knee amputees while walking with 3R15 and 3R20 knee joints. Materials and Methods: 7 above-knee amputees were recruited in this research study. They were asked to walk with a comfortable speed to investigate the gait function of the subjects with 3 cameras 3D motion analysis system (Kinematrix system. The difference between the performances of the subjects with these joints was compared by use of paired t-test. Results: The results of this study showed that, the performances of the subjects with 3R20 were better than that with 3R15. The walking speed of the subjects with 3R20 was 66.7 m/min compared to 30.4 m/min (P-value = 0.045. Moreover; the symmetry of walking with 3R20 was more than that with 3R15, based on the spatio- temporal gait parameters values (P-value <0.05. Conclusion: The difference between the performances of the subjects with 3R20 and 3R15 knee joints was related to the walking speed, which improved while walking with 3R20 joint.

  7. Walking Ability of Bilateral Transtibial Amputees Assisted with Prostheses%双小腿截肢者假肢辅助下行走能力的评价1

    Institute of Scientific and Technical Information of China (English)

    马鑫鑫; 曹学军; 杨平; 蔡丽飞; 刁子龙

    2014-01-01

    目的:比较双小腿截肢者穿戴假肢的行走能力与正常人的差别,制定双小腿截肢者穿戴假肢行走能力参考指标。方法选择11例双小腿截肢者作为截肢组,12名健康成年人作为对照组,分别进行室内步态分析测试、室外行走1 km所用时间及能量消耗测试、静态站立平衡能力测试。结果室内步态分析测试中,截肢组自我感觉最舒适平均速度为1.07 m/s,对照组为1.29 m/s。当受试者以自我感觉最舒适的速度行走时,截肢组部分步态时空参数与对照组存在显著性差异(P0.05)。结论双小腿截肢者与正常人的行走能力存在差异,对截肢者行走能力定量的评价能够为截肢者的康复提供更准确的参考。%Objective To compare the walking ability between bilateral transtibial amputees and normal controls, and develope refer-ence indexes of bilateral transtibial amptees' walking ability while wearing prostheses. Methods 11 bilateral transtibial amputees served as amputation group, 12 normal subjects served as controls. The indoor gait characteristics, outdoor time cost and energy consumption, and stat-ic balance of both groups were evaluated. Results After the indoor gait analysis, the average self-selected-speed of the amputees was 1.07 m/s, while the self-selected-speed of the normal people was 1.29 m/s. When the subjects walked with their self-selected-speed, there were significant differences in some of the gait spatial and temporal parameters between 2 groups (P0.05). Conclusion The walking ability of the bilateral transtibial amputees wearing prosthe-ses is different from normal people. Quantitative evaluation of walking ability can provide more accurate reference for the rehabilitation of amputees.

  8. EVALUTION OF EFFECTIVENESS OF BALANCE TRAINING IN CONVENTIONAL PROSTHESIS VERSUS ULTRAMODERN PROSTHESIS IN UNILATERAL TRANSTIBIAL AMPUTEE BY USING FLAMINGO BALANCE TEST

    Directory of Open Access Journals (Sweden)

    Suresh

    2014-08-01

    Full Text Available AIM: To estimate the effectiveness of balance training on unilateral transtibal amputee with conventional prosthesis and ultramodern prosthesis. To compare the Effectiveness of balance training in conventional prosthesis versus ultramodern prosthesis in unilateral transtibial amputee by using Flamingo balance test. MATERIALS AND METHODS: After obtaining informed consent from the patients, we studied a total of 40 patients, aged between 30- 60 yrs, where they were randomly allocated into two groups. 20 patients in Group A with conventional prosthesis and 20 patients with ultramodern prosthesis in group B were subjected to 3 weeks of structured exercise programme after initial assessment of balance with Flamingo’s balance test and ten metre walk test. These tests were repeated in repeated in both the groups after the exercise programme and the results were tabulated and analysed. RESULTS: The mean age of population in group A was 50.55± 7.20 and in group B was 48.55±5.58, with age group ranging from 30 – 60 yrs. In group A the pre and post interventions mean values in Flamingo’s balance test were 15.55±2.58 and 13.05±3.05 respectively. In group B the pre and post intervention mean values were 12.35±1.26 and 8.3±0.86 respectively. In group A the pre and post interventions mean values in ten metre walk test are 45.00±3.62 and 35.00±6.39 respectively. In group B the pre and post intervention mean value are 40.00±4.29 and 26.70±2.95 respectively. The mean difference of balance using Flamingo Balance test during pre and post intervention in both the groups were compared using independent ‘t‘ test, which showed (t of 4.971 vs 6.805 in Groups A and B respectively; p=000*. The mean difference of balance in both the groups for ten metre walk test were t of 3.979 vs 5.650 in Groups A and B respectively (; p= 000*. CONCLUSION: In both groups there are statistically significant improvements in scores flamingo balance test and 10mt. walk

  9. Design of a stumble pre-warning system for lowerlimb amputees%假肢穿戴者跌倒预警系统设计

    Institute of Scientific and Technical Information of China (English)

    陈国兴; 刘作军; 陈玲玲; 杨鹏

    2015-01-01

    The stumble of lower limb amputees was divided into two major categories of tripping and slipping,the potential data sources may be used as stumble pre-warning of amputees was extracted, then the invalid data were excluded with the reference of human body kinematics.Followed by the de-sign of the structure of the stumble pre-warning system,using the principle of support vector ma-chine,and combined with the valid data collected,the corresponding discriminant was concluded,then applying it to the stumble pre-warning system.This method can outgoing warning signals before stumble,making the powered prosthesis have enough time to complete protection action.In addition, tripping and slipping experiments were conducted,and the results showed that the warning accuracy can reach 97% by applying this system.%将假肢穿戴者主要跌倒情形分为绊倒与滑倒两大类,对可能作为假肢穿戴者跌倒预警的潜在数据源进行提取,参考人体运动学,排除掉不能作为预警的数据源,设计了跌倒预警系统的结构,运用支持向量机的原理,并结合采集到的有效数据,训练得出相对应的判别式,将其嵌入跌倒预警系统中。该方法可以保证在患者跌倒之前发出警告信号,使得动力型假肢有足够时间完成保护动作。分别进行绊倒与滑倒实验,结果表明应用此系统的平均预警正确率可达97%。

  10. Validação da versão para a língua portuguesa do questionário de Medida Funcional para Amputados (Functional Measure for Amputees Questionnaire Brazilian-Portuguese validation of the Functional Measure for Amputees Questionnaire

    Directory of Open Access Journals (Sweden)

    Eneida Ritsuko Ono Kageyama

    2008-01-01

    Full Text Available O objetivo deste estudo foi traduzir e adaptar culturalmente o Functional Measure for Amputees Questionnaire (FMA para a população brasileira e analisar sua validade e eficácia quando aplicado em pacientes amputados de membro inferior. O procedimento seguiu as etapas de tradução, retro-tradução, análise das versões português e inglês por um comitê multidisciplinar, e pré-teste. O questionário traduzido foi aplicado em 44 pacientes (39 homens e 5 mulheres com amputação em nível transtibial (N=27 e transfemoral (N=17, com idade média de 47,5±17,2 anos. No estudo da confiabilidade, em média, os coeficientes Kappa foram superiores a 0,80; e 25% deles foram iguais a 1,0, indicando haver excelente concordância inter e intra-entrevistadores. Na análise da consistência interna, o valor do coeficiente para a questão sobre o Índice de Capacidade Locomotora foi igual a 0,79, demonstrando haver consistência no bloco de questões relacionadas à mobilidade. A adaptação transcultural foi satisfatória; algumas modificações foram necessárias, porém sem implicar mudança na estrutura ou no conteúdo do questionário original. Os resultados sugerem que a versão brasileira do FMA, MFA - questionário de Medida Funcional para Amputados pode ser um instrumento confiável para medir o resultado funcional de pacientes brasileiros reabilitados após amputação de membro inferior.The aim of this study was to translate into Brazilian-Portuguese and culturally adapt the Functional Measure for Amputees Questionnaire (FMA, also testing its reliability and validity for assessing lower-limb amputees functional capacity. The FMA was translated, back-translated, evaluated by a multidisciplinary committee, and pre-tested. The final version was submitted to field test on a group made up of 44 subjects (39 men and 5 women with transtibial (N= 27 and transfemoral (N=17 amputation level. The inter- and intra-examiner test showed high reliability

  11. Development of a prosthesis shoulder mechanism for upper limb amputees: application of an original design methodology to optimize functionality and wearability.

    Science.gov (United States)

    Troncossi, Marco; Borghi, Corrado; Chiossi, Marco; Davalli, Angelo; Parenti-Castelli, Vincenzo

    2009-05-01

    The application of a design methodology for the determination of the optimal prosthesis architecture for a given upper limb amputee is presented in this paper along with the discussion of its results. In particular, a novel procedure was used to provide the main guidelines for the design of an actuated shoulder articulation for externally powered prostheses. The topology and the geometry of the new articulation were determined as the optimal compromise between wearability (for the ease of use and the patient's comfort) and functionality of the device (in terms of mobility, velocity, payload, etc.). This choice was based on kinematic and kinetostatic analyses of different upper limb prosthesis models and on purpose-built indices that were set up to evaluate the models from different viewpoints. Only 12 of the 31 simulated prostheses proved a sufficient level of functionality: among these, the optimal solution was an articulation having two actuated revolute joints with orthogonal axes for the elevation of the upper arm in any vertical plane and a frictional joint for the passive adjustment of the humeral intra-extra rotation. A prototype of the mechanism is at the clinical test stage.

  12. The Evaluation of Daily Life Activities after Application of an Osseointegrated Prosthesis Fixation in a Bilateral Transfemoral Amputee: A Case Study.

    Science.gov (United States)

    Schalk, Stephanie A F; Jonkergouw, Niels; van der Meer, Fred; Swaan, Willem M; Aschoff, Horst-H; van der Wurff, Peter

    2015-09-01

    Individuals with a transfemoral amputation (TFA) may experience limitations in daily life due to reduced mobility and prosthesis-related problems. An osseointegrated prosthesis fixation (OPF) procedure in amputees might contribute to a solution for patients with short stumps or socket-related problems. To date, no study has specifically described the application of an OPF procedure in individuals with a TFA. This study evaluated the level of daily life activities of a 21-year old service member with a bilateral TFA and cerebral trauma. Due to a short stump length and coordination problems, an OPF procedure was deemed the most suitable option.The result of this procedure and the rehabilitation program showed an increased mobility and satisfaction as obtained by the assessment of life habits questionnaire (LIFE-H) and lower extremity functional scale. The participant was able to walk short distances and the Genium knee provided a stance position. Stair ambulation is impossible because of inadequate muscle capacity.In this specific case we conclude that the quality of life improved through the use of an OPF. However, OPF might not be the appropriate device for every individual with TFA, due to varying bone compositions, co-morbidities, and limited clinical experience and unknown long-term effects.

  13. Postoperative transcutaneous oxygen measurement in the prediction of delayed wound healing and prosthetic fitting among amputees during rehabilitation. A pilot study.

    Science.gov (United States)

    Yablon, S A; Novick, E S; Jain, S S; Inhoffer, M; Graves, D E

    1995-01-01

    Postoperative assessment of amputation wound healing remains largely subjective in nature, being based on the physician's clinical judgement. These considerations significantly impact on the rehabilitation course, as premature prosthetic fitting may result in wound breakdown. Alternatively, delayed healing may result in prolonged hospital length of stay. Few attempts have been made to correlate objective parameters of limb perfusion with amputation wound healing or prosthetic fitting outcome during the rehabilitation phase of treatment. A pilot study was conducted, in which the transcutaneous oxygen monitor, a noninvasive device measuring transcutaneous partial pressure of oxygen (tcpO2), was applied to the stumps of 11 consecutive above-or below-knee amputees admitted for rehabilitation after amputation. All patients were tested within 1 wk of admission and 45 days of amputation. The treatment team was blinded as to the test results. A direct correlation was observed between wound healing outcome and tcpO2 results (Fisher's exact test [FET], P = 0.03), and no patient with a tcpO2 of rpbi], = -0.835; P = 0.01), delayed prosthetic fitting (rpbi = 0.742; p = 0.01), and poorer wound healing at admission (rpbi = 0.932; P = 0.001). Postoperative tcpO2 measurement may have use in objectively identifying patients at greater risk of delayed wound healing and prosthetic fitting, although further study is warranted.

  14. 下肢截肢者穿戴假肢行走能力的评价%Evaluation for Walking Ability of Lower Limb Amputees with Prostheses:A Literature Analysis

    Institute of Scientific and Technical Information of China (English)

    魏艳琴; 曹学军; 杨平; 蔡丽飞

    2016-01-01

    Objective To systematically review the evaluation tools for walking ability of lower limb amputees wearing prostheses. Methods A computer-based search of PubMed, Wanfang Data and CNKI.net was performed for articles related to the evaluation of walking ability of lower limb amputees wearing prostheses published from January, 1995 to December, 2015. Results and Conclusion A total of 20 papers were selected, including 18 foreign literatures and 2 Chinese articles. There were many evaluation tools for walking ability of lower limb amputees wearing prostheses, and should be chosen according to the actual situation.%目的:对下肢截肢者穿戴假肢行走能力的评价方法进行文献研究。方法以“下肢、截肢、结果评价、行走、步态”为中文关键词,以“lower limb*、amput*、outcome assessment、walk*、gait”为英文关键词,检索PubMed、万方数据库和中国知网1995年1月~2015年12月的相关文章。纳入与下肢截肢者穿戴假肢行走能力评价相关的文章。结果和结论共筛选出20篇相关文献,包括外文文献18篇,中文文献2篇。对下肢截肢者假肢辅助下行走能力的评价方法有很多,各有侧重,应当根据实际需要同时采用多种方法进行评价。

  15. The nursing care of an amputee patient for choledochotomy combined with choledochoscope calculus removed treatment%左下肢截肢后胆总管切开联合胆道镜取石术的护理

    Institute of Scientific and Technical Information of China (English)

    宋江华

    2013-01-01

      胆总管结石在肝胆外科是一种常见病,可对于截肢后合并胆总管结石的病人来说是极少见的。文章介绍了一例左下肢截肢后胆总管切开联合胆道镜取石术的护理过程,术前做好心理护理和各项准备工作,术后严密观察生命体征和并发症,尤其做好引流管和 T 管拔管的护理,并给予恰当的饮食指导。%  The common bile duct calculi is a common disease in the liver and galbladder surgery, but amputees patient with common bile duct calculi is rare. The paper presents the nursing care of an amputee patient for choledochotomy combined with choledochoscope calculus removed treatment. Psychological care and al the preparatory work are carried out before the surgery. Vital signs and complications are closely observed after the surgery, especialy the nursing care of drainage tube and T extubation and the appropriate dietary guidance.

  16. Phantom limb pain in amputees: epidemiological investigation of 108 cases in Wenchuan Earthquake%5·12汶川地震绵竹灾区幻肢痛发生情况调查

    Institute of Scientific and Technical Information of China (English)

    杜海龙; 何纯青; 赵正恩; 许猛; 张立海; 柳现飞; 唐佩福

    2011-01-01

    目的 观察汶川地震伤员截肢后幻肢痛的流行病学特征,分析创伤性截肢术后幻肢痛发生的相关危险因素.方法 2008年8月~2010年5月期间,对四川省绵竹市5·12地震截肢伤员进行针对幻肢痛发生情况的现况调查,此后每3月一次电话随访直至术后2年.结果 本文调查了绵竹市147例截肢伤员,获得连续完整资料108例,幻肢痛的2年患病率是86例(79.6%),22例(20.4%)在截肢后2年内从未发生过幻肢痛.取截肢术后8个时间点(每3个月一次,共2年),计算幻肢痛发病率依次为:61.1%、62.9%、68.5%、70.4%、69.4%、66.7%、62.0%、62.0%.女性幻肢痛发病率(88.7%),明显高于男性(67.4%,P<0.05).结论 幻肢痛在四川地震截肢伤员当中有较高的发病率,女性比男性更容易发生幻肢痛.%Objective To investigate the epidemiological characteristics of phantom limb pain (PLP) in amputees due to earthquake trauma and risk factors thereof. Methods All amputees aged 8~80 found in Mianzhu City, Sichuan Province, 512 cases in total who were hurt during the Wenchuan Earthquake, 42 males and 64 females, underwent in-home survey on PLP and then telephone or outpatient department follow-up once 3 months was conducted for 2 years. Results Continuous and complete data were obtained from 108 cases with an effective rate of 73.5%. Eight-six of the 108 amputees ever suffered from PLP with a prevalence rate of 79.6%. And the prevalence rates of PLP at the 8 different time points during the 2 years of follow-up were 61.1%, 62.9%, 68.5%, 70.4%, 69.4%, 66.7%,62.0%, and 62.0% respectively. Fifty-five out of the 62 females (88.7%) suffered from PLP, with a prevalence rate of 88.7%, significantly higher than that among the males (67.4%, 31/46, P=0.037).Seventy-nine of the 86 PLP patients (91.9%)visited hospitals, 35 cases (40.7%) with PLP as the main complaint. There was not significant difference in the PLP prevalence rate between

  17. 自制残肢伤口固定套在截肢患者中的应用%Application of homemade stump wound fixed sets for amputees

    Institute of Scientific and Technical Information of China (English)

    唐翠; 许月萍; 王刚

    2014-01-01

    目的:利用自制残肢伤口固定套固定残肢伤口,探讨其临床应用效果。方法选择急诊行截肢手术的肢体毁损伤患者68例,随机分为观察组35例,术后利用自制残肢伤口固定套固定;对照组33例采用敷料外U型石膏固定。比较两组患者术后伤口引流量、局部肿胀程度、残肢皮肤压疮、伤口感染、邻近关节活动功能情况。结果观察组感染率为5.71%,皮肤压疮坏死率为8.57%,肿胀发生率为28.57%,均低于对照组(18.18%,15.15%,54.55%),差异有统计学意义(χ2值分别为3.810,3.340,4.790;P<0.05)。观察组患者术后伤口引流量为(46.80±12.35) ml,邻近关节活动度为(145.68±13.20)°,对照组分别为(89.81±10.61)ml,(112.46±9.21)°,两组比较差异有统计学意义(t值分别为24.721,11.330;P<0.05)。结论利用自制残肢伤口固定套固定残肢伤口,能减少伤口术后出血,促进肿胀消退,减少皮肤压疮,有利于早期邻近关节功能锻炼。%Objective To discuss the clinical effect of homemade stump wound fixed sets for amputees. Methods From January 2010 to November 2013 we treated sixty eight cases of patients with smashed wound, who received emergency amputation surgery.We randomly selected thirty five cases of using homemade stump wound fixed sets as experimental group, and chosenthirty three cases of using the U-shaped plaster dressingmethodto dress outside wound as control group, comparing two groups with postoperative wound drainage, local swelling, stump skin pressure sores, wound infection, joint function close to the situation. Results In the experimental group, the infection rate was 5.71%, skin necrosis rate 8.57%, incidence of swelling 28.57%,while those rate in the control group were 18.18%,15.15% and 54.55% respectively, the differences were statistically signifcant (χ2 =3

  18. Uso da prótese e retorno ao trabalho em amputados por acidentes de transporte Use of prosthesis and return to work by amputees involved in traffic accidents

    Directory of Open Access Journals (Sweden)

    Lílian de Fátima Dornelas

    2010-01-01

    Full Text Available OBJETIVO: Verificar o uso de prótese de membro inferior e o retorno ao trabalho em amputados por acidentes de transporte (AT. MÉTODO: Estudo de série de casos por meio de uma entrevista, com amputados por AT, cadastrados no período de dezembro de 2002 a dezembro de 2004, após a alta da reabilitação na AACD/MG. A amostra foi composta por 26 amputados, 22 homens e quatro mulheres, com média de idade de 37,7 anos. Quinze amputações eram transfemorais e 11 transtibiais. Dezoito (69,2% pessoas tinham grau de instrução fundamental. RESULTADOS: Todos os amputados receberam a prótese e 16 (61,5% deles, relataram utilizá-la para passeio. Todos os indivíduos permaneceram afastados do trabalho após o acidente, sendo que 16 (66,7% afastaram pelo INSS, seis (25% aposentaram por invalidez e dois (8,3% por idade. Cinco das pessoas afastadas pelo INSS retornaram ao trabalho e três aposentadas por invalidez e uma por idade, declararam que praticam atividade para suplementar à aposentadoria. CONCLUSÃO: O uso da prótese é comumente para passeio e é baixa a taxa de retorno ao trabalho após a reabilitação.. O baixo nível de instrução e qualificação podem ter sido responsáveis por estes resultados.OBJECTIVE: To detect the use of a prosthetic leg and the return to work in amputees by traffic accidents (TA. METHOD: A case series by means of an interview with AT amputees who were registered between December 2002 and December 2004, after discharge from rehabilitation at the AACD/MG. The sample consisted of 26 amputees, 22 men and four women, mean age of 37.7 years. Fifteen amputations were above the knee and 11 below the knee. Eighteen (69.2% people had completed elementary education. RESULTS: All amputees received prostheses and 16 (61.5% of them reported using it for walking. All subjects remained off work after the accident, and 16 (66.7% remained off work by utilizing the INSS, six (25% retired due to disability and two (8.3% retired

  19. 全骨盆切除者使用不同代步工具的能量消耗%Energy Expenditure of A Hemicorporectomy Amputee Moving with Different Mobility Devices

    Institute of Scientific and Technical Information of China (English)

    杨平; 蔡丽飞; 马鑫鑫; 曹学军

    2014-01-01

    Objective To compare the energy expenditure of a hemicorporectomy amputee moving with different mobility devices. Methods A middle-aged male hemicorporectomy amputee was measured with cardiopulmonary exercise test when moving with 4 kinds of transport:socket, cart, wheelchair, and prosthesis. Results The patient moved the slowest with prosthesis, fastest with wheelchair. The heart rate was the highest with prosthesis and lowest with cart. The absolute oxygen consumption, the relative volume of oxygen consumption and metabolic (Mets) were the most when hand walking with socket, and lowest with cart. Conclusion Hand walking with socket costs the larg-est energy when walking, and the rest are prosthesis, wheelchair, and cart.%目的:比较全骨盆切除者使用不同代步工具的能量消耗。方法对1例中年男性全骨盆切除者使用4种代步工具(接受腔、代步车、轮椅、假肢)时,进行运动心肺功能测试。结果患者使用假肢的移动速度最慢,轮椅最快;使用假肢的心率最高,代步车最低;使用接受腔进行手支撑行走的绝对耗氧量、相对耗氧量和代谢当量均最大,代步车最小。结论使用接受腔进行手支撑行走的能量消耗最大,其次分别为假肢、轮椅、代步车。

  20. 上肢经肱骨截肢神经功能重建研究%A Pilot Study of Nerve Function Reinnervation on a Transhumeral Amputee

    Institute of Scientific and Technical Information of China (English)

    黄剑平; 李文庆; 杨琳; 朱明星; 朱小弟; 李楚炎; 杨子健; 李光林

    2016-01-01

    表面肌电信号是一种安全、非侵入的电生理信息,作为实现直觉控制多功能肌电假肢系统的信息源而被广泛应用。由于经肱骨截肢者截肢的程度较高,残留的肢体肌肉少,缺乏足够的肌电信息源,无法实现多功能肌电假肢的直觉控制。目前现有技术是通过采用靶向肌肉神经功能重建的方法重建缺失肌电信息源。但目前国内尚未有关于截肢者残端神经功能重建方法的相关研究。因此,文章提出一种新型的神经吻合技术——目标神经功能替代术:采用靶向肌肉神经功能重建术与目标神经功能替代术相结合的方法,首次在国内对经肱骨截肢者成功实施了神经功能重建手术,成功建立了经肱骨截肢者神经功能重建模型,重建了因截肢而丧失的肌电信息。并采用高密度肌电技术对术前和术后的手-腕-肘部动作进行肌电信号采集,通过动作分类识别的准确率验证了该手术后肌电信息源重建的可靠性。这些结果初步验证了该方法可以为经肱骨截肢者残肢重建缺失肢体神经功能,并为直觉控制多功能肌电假肢提供潜在的信息源。%Surface electromyography (sEMG) is a safe and non-invasive electrophysiological signal that has been widely used to provide intuitive control for myoelectric prostheses. Intuitively controlling a prosthetic device is a major challenge for transhumeral amputees (TAs) since they have insufficient residual muscles that could rarely produce enough sEMG signals. To resolve this challenge, targeted muscle reinnervation (TMR) technique which reinnervates the missing muscular has been developed in some previous studies. However, there is no relevant research on the reconstruction of nerve function for TAs in China. In this study, a new surgical method that integrates the TMR technique with targeted nerve function replacement (TNFR) for nerve function regeneration is presented

  1. Study on Compensation Mechanism of Below-Knee Amputee when Climbing Ladder Based on Surface Electromyography Comparison%基于表面肌电信号对比分析的膝下假肢爬梯补偿机制研究

    Institute of Scientific and Technical Information of China (English)

    付艳; 李世其; 陈振国

    2012-01-01

    sEMG is one of the important variables to describe the muscle level. This paper compared the sEMG signals in time and frequency domain from right/left erector spinal and right/left rectus femora of 6 able-bodied people and 6 below-knee amputees and analyzed how differently each muscle of below-knee amputees and able-bodied people functions during ladder climbing. As the results indicate, both MF and iEMG of the amputees' rectus femoris are significantly lower than those of healthy part (P<0.001,n=87)as well as those of able-bodied people. And MF and iEMG of the below-knee amputees' erector spinae are bigger than that of the able-bodied (P<0.001,n=87). It can be concluded that the below-knee amputees' erector spinals are weaker than other body parts during ladder climbing. The torso and healthy leg provide compensations for the weakness.%表面肌电信号是测试肌力大小的重要指标之一.本文通过对6名健体者(健康人组)和6名膝下假肢者(残疾人组)爬梯活动中左右竖脊肌和左右股直肌的表面肌电的时域和频域分析,对比两组被试在爬梯过程中的这四块主要活动肌群肌力的差异.结果,无论是中值频率(MF)还是积分肌电值(iEMG),残疾人被试在假肢一侧的股直肌指标值都要显著小于其健体一侧(P<0.05,n=87),也小于健康被试的股直肌.残疾被试的竖脊肌显著大于健康被试(P<0.001,n=87).研究表明,爬梯过程中,残疾人假肢一侧的股直肌持久力和爆发力均弱于其他身体部位,腰部及健体一侧提供能力补偿.

  2. A study of body image,prosthesis satisfaction and quality of life of the amputees from 5·12 Wenchuan earthquake%五一二汶川地震截肢伤员身体意象、假肢满意度及生活质量的研究

    Institute of Scientific and Technical Information of China (English)

    李奎成; 李曾慧平; 陈正宏; 王扬春; 丘开亿; 刘德明; 黎景波; 何爱群

    2008-01-01

    目的 了解地震截肢伤员的生活质量(QOL)、身体意象、假肢满意度及其相互关系,找出存在的问题以利于进行针对性干预.方法 选择五一二汶川地震下肢截肢伤员21例,采用健康状况调查简表(SF-36)评定QOL,采用截肢者身体意象评估表(ABIS)评估身体意象,选用自制假肢满意度问卷调查假肢满意程度.结果 SF-36总分为(41.90±15.00),ABIS得分为(64.58 ±10.60),假肢满意度得分为(59.52±11.06).ABIS得分女性高于男性(P<0.05);SF-36评分与假肢满意程度呈正相关(P<0.05),与身体意象评分呈负相关(P<0.05);身体意象与SF-36总分及其中活力、精神健康项评分呈负相关(P<0.05);假肢满意程度与患者教育程度呈正相关(P<0.01),与SF-36总分及精神健康项评分呈正相关(P<0.05).结论 身体意象紊乱以及对假肢的满意度在一定程度上影响r地震截肢伤员的QOL,应加以干预,使其正确认识假肢和身体意象,提高QOL.%Objective To explore body image(BI),prosthesis satisfaction and quality of life(QOL)of amputees from Wenchuan earthquake and the relationship among them to provide evidence for the intervention.Methods A total of 21 amputees accepted a survey regarding QOL,BI,and satisfaction with prosthesis.The scale of SF-36 was used to assess QOL.Amputees Bodily Image Scale(ABIS)was;used to assess BI.A self-design questionnaire wag used to evaluate the prosthesis satisfaction of amputees.Results The scores of SF-36,ABIS,and prosthesis satisfaction wag 41.90 ±15.00,64.58 ±10.60,and 59.52±11.06,respectively.The ABIS scores in women(65.07 ±12.10)were hisher than that in men(63.20 ±5.0)(P<0.05).There was a positive correlation between score of QOL and prosthesis satisfaction,but a negative correlation between QOL and BI.The negative correlations were also observed between BI and Vitality,BI and mental health.Prosthesis satisfaction had positive correla tions with education level.QOL and mental

  3. Análise do impacto mecânico nas próteses de um sujeito bi-amputado durante a marcha Mechanic impact analysis in the prostheses of a bilateral lower-limb amputee during the gait

    Directory of Open Access Journals (Sweden)

    Thessaly Puel de Oliveira

    2011-03-01

    Full Text Available Observa-se o aumento do uso da acelerometria (medida de impactos na aplicação clínica, especialmente para estudos da marcha acoplando-se os acelerômetros na tíbia. Entretanto, não se tem observado estudos sobre os efeitos dessas vibrações no sistema locomotor de usuários de prótese do membro inferior. O objetivo deste estudo foi medir a quantidade de impacto durante a marcha de um sujeito amputado bilateral transtibial. As coletas foram realizadas durante a marcha do sujeito caminhando a 4 km/h em uma distância de 8 metros com dois acelerômetros piezoelétricos uniaxiais fixados em dois locais distintos da prótese: inicialmente nos encaixes das próteses e posteriormente fixou-se nas hastes metálicas. Utilizou-se estatística descritiva exploratória com Anova One-Way e Post Hoc de Tukey. Constatou-se diferenças significativas com o teste Anova One-Way entre as 10 aquisições em cada local de fixação do acelerômetro. Através do Post Hoc de Tukey observou-se maiores picos de aceleração no encaixe esquerdo (p LATELY We can experience the increasing use of accelerometers (Shock measurements in clinical applications, especially in gait studies attaching the accelerometers in the subjects tibia to impact appraisal. However, there are few studies about the effect of those vibrations in the locomotor system of lower limb prosthetic users. The objective of this study was to measure the amount of vibration during the gait in two different spots in both prostheses of bilateral below-knee amputee. For the acquisition we use a gait speed of 4km/h through 8 meters walk with two uniaxial piezoelectric accelerometers set at two different sites of the prostheses. First, the accelerometers were fixed in both prostheses sockets and later they were fixed in the prostheses pylons. We used descriptive statistics exploratory Anova one-way and post hoc Tukey. The One-way Anova test showed significant differences comparing the accelerometer

  4. 地震儿童截肢伤员血清酶学检查指标初步分析%Preliminary analysis of serum enzymes indicators in childhood amputees due to earthquake resulting trauma

    Institute of Scientific and Technical Information of China (English)

    蒋欣; 刘利君; 李卉

    2014-01-01

    目的 回顾分析地震中儿童截肢伤员的血清酶学检查结果,并讨论其临床意义.方法 从2008年四川汶川和2013年四川芦山两次特大地震150例地震创伤患儿中,选择血清酶学检查结果完整的、以肢体外伤为主的患儿45例,分为3组:截肢组6例、骨筋膜室切开减压组5例、普通创伤组34例.统计各组患儿的血清酶学检查数据,配对后进行统计分析.以同期随机选取的10例非地震创伤的骨科患儿作为对照;以20例成人地震截肢伤员作为对照.结果 各组地震创伤患儿损伤严重度评分(ISS)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、羟丁酸脱氢酶(HBDH)等血清酶学指标比较差异均有统计学意义(FISS=15.474,P<0.001;FASTT=10.770,P<0.001;FALT=12.799,P<0.001;FCK=12.848,P<0.001;FLDH=13.126,P<0.001;FHBDH=13.186,P<0.001),以截肢组患儿升高最为明显;且儿童截肢组AST、LDH、HBDA明显高于成人截肢组,而ALT、CK略为升高.血清酶学指标对病情及预后的正确判断有很大的帮助.同时在统计中还发现,CK是一个对急性重症创伤患者特别是伴随严重软组织损伤患者病情进行评估的极其敏感的生化检查指标,在各组病例中增高极为显著,CK可从非地震创伤组的(129±62) U/L升高到地震截肢组的(44208±39 788) U/L,超过300多倍,增高极为显著,其中有的患者最高值竟达到117 513 U/L,超过840倍.而一旦及时进行了截肢手术或骨筋膜室切开减压等治疗处理后,患儿的CK值又会迅速下降,直至正常.结论 完善而连续的血清生化检查在急性重度创伤儿童的治疗过程中极为必要,对临床医生正确判断病情并确定治疗方案有着非常重要的临床意义.%Objective To retrospectively analyze the serum enzymes in childhood amputees as a result of earthquake,and to discuss their clinical significance.Methods From 150 children amputees who

  5. Caracterização nutricional de jogadores de elite de futebol de amputados Caracterización nutricional de jugadores de elite de futbol de amputados Nutritional characterization of elite amputee soccer players

    Directory of Open Access Journals (Sweden)

    Ainá Innocencio da Silva Gomes

    2005-02-01

    amputados no es conocido por el público en general. Este deporte requiere un aumento en la demanda metabólica y, com la amputación de miembros inferiores, el gasto energético de la caminata y la corrida puede aumentar considerablemente. Luego, el aspecto nutricional tiene un papel importante en el desempeño deportivo y en la calidad de vida de estos atletas. El objetivo del presente estudio fué evaluar el estado nutricional de cuatro jugadores de futbol de amputados, con edades entre los 21 y 33 años, participantes de la Seleción Brasilera de Futbol de Amputados. El consumo alimenticio fué evaluado a través del registro alimenticio de 6 dias para energia, macronutrientes, fibras alimentarias y micronutrientes. La avaliación antropométrica consistió en las medidas de estatura, peso, pliuegues cutáneos y circunferencias que permitieron evaluar el estado nutricional. Los análisis bioquímicos realizados fueron: hemoglobina, hematocrito, ferritina y transferrina para verificar el estado nutricional de hierro; urea, albúmina y creatinina para caracterizar el perfil protéico y el colesterol total y fracciones de triglicerídeos para evaluar el perfil lipídico. Los resultados mostraron que los atletas presentaban grandes variaciones en cuanto al consumo energético (2179 a 4294 kcal y de macronutrientes. Los atletas presentaron consumo lipídico de 25 a 30% do VET, protéico de 1,8 a 3,9 g/kg/dia y un bajo percentual de carbohidratos (48 a 54% de VET y baja ingesta de vitamina E. La evaluación bioquímica demostró que no existía anemia ferropénica, con las reservas protéicas adecuadas y el perfil lipídico dentro de la faja de normalidad. Se concluye que los futbolistas amputados necesitan de orientacion nutricional, para corregir hábitos alimenticios observados en el periodo pre-competitivo y para propiciar un mejor desempeño atletico.Although soccer is a popular sport in Brazil, the amputee soccer is not known by the public in general. This sport

  6. Influence of Technology Advancement on Disabled Sports---Taking Transtibial Amputee Sprinting as an Example%科技进步在残疾人竞技运动中的作用--以膝下截肢短跑运动为例

    Institute of Scientific and Technical Information of China (English)

    冯毅; 文安; 刘宇

    2014-01-01

    The prosthetic legs that transtibial amputees wore in sprinting underwent a history from customary prostheses ,sport prostheses to sprint prostheses .Today ,sprint prostheses are all made of carbon fibre and are increasing transtibial amputees’ performance in sprinting .In this article ,mechanical properties of carbon fibre prostheses ,evolution of sprinting prosthesis and development of transtibial amputee sprinting events are discussed ,and we forecast the per-formance in transtibial amputees’ sprinting in the future .This will exemplify the key influence of technology advancement on the development of disabled sports .%膝下截肢残疾人短跑运动经过近40年的发展历程,运动员所佩戴的小腿假肢经历了由日常假肢向运动型假肢、短跑专用假肢分化和发展的过程,这同时也是膝下截肢短跑运动不断快速发展的过程。分析了短跑专用假肢的演化历史、碳纤维假肢的性能,以及膝下截肢短跑运动的发展历史与现状,探讨假肢技术的进步对于膝下截肢短跑运动员成绩提高所起的重要作用;并对膝下截肢短跑运动和假肢技术的发展前景进行展望,以此为例,阐述科技进步在残疾人竞技运动中的重要作用。

  7. Clinical evaluation and treatment of stumps in amputees injured in Wenchuan earthquake%地震后截肢患者残肢的临床评定和康复治疗

    Institute of Scientific and Technical Information of China (English)

    武继祥; 刘宏亮; 周贤丽; 刘青山; 汪琴; 尹清; 余洪俊; 吴宗耀

    2008-01-01

    Objective To analyze the feature and cause of stumps of amputees after Wenchuan earthquake,and study the effects of rehabilitation treatment for stumps.Methods Fifty-two cases with stump limbs post-amputation were evaluated,including stump skin status,stump shape,stump length,stump swelling,range of motion (ROM)of joint and strength of stump,and were treated with physical therapy,stump moulding and kinesiotherapy.Results The incidences of stump ulcer,stump swelling,conical stump,short stump and limitation of ROM of joint in all 52 cases were 76%,73%,34%,40%and 42%respectively.After rehabilitation treatment stump ulcers healed,stump swelling eliminated;stump shape,ROM of joint and muscle strength improved obviously.All poor stumps could be fit with the prosthetic limb and get good function.Conclusion The incidences of poor stump limb post·amputation after earthquake were high.Rehabilitation treatment can improve the stump condition.Early comprehensive rehabilitative intervention after amputation is important for fitting the prosthetic limb tO the stump.%目的 分析地震致截肢患者残肢的特点和原因、观察康复治疗的效果.方法 从残端皮肤情况、残肢形态、残肢长度、残肢肿胀、残肢关节活动度和残肢肌力等方面对52条残肢进行评定,并进行物理治疗、残肢塑形和运动治疗.结果 52条残肢中,残端有溃疡或窦道、残肢肿胀、圆锥形残肢和短残肢分别占76%、73%、34%和40%,残肢关节活动受限者占42%,所有患者残肢肌力明显减退.经康复治疗后,残肢无肿胀、溃疡或窦道完全愈合,残肢形状、关节活动度和肌力明显改善,已达到假肢装配条件,均装配假肢,并获得良好的功能.结论 地震后截肢不良残肢发生率高,综合康复治疗能明显改善残肢条件,早期康复治疗对促进患者康复,安装假肢具有重要意义.

  8. Bionic Running for Unilateral Transtibial Military Amputees

    Science.gov (United States)

    2010-01-01

    effectiveness during real time control. One simplification to state estimation algorithms is to measure the amputee’s electromyographic (EMG) signals ...directly. Studies suggest there is a correlation between the amputee’s EMG signals and the desired actuator function (Ferris, 2006; Novacheck, 1998...However, the dominant factor in the effectiveness of myoelectric -based control is the system’s ability to reliably acquire and process an

  9. Amputees and sports: a systematic review.

    Science.gov (United States)

    Bragaru, Mihail; Dekker, Rienk; Geertzen, Jan H B; Dijkstra, Pieter U

    2011-09-01

    Amputation of a limb may have a negative impact on the psychological and physical well-being, mobility and social life of individuals with limb amputations. Participation in sports and/or regular physical activity has a positive effect on the above mentioned areas in able-bodied individuals. Data concerning participation in sports or regular physical activity together with its benefits and risks for individuals with limb amputations are scarce. No systematic review exists that addresses a wide range of outcomes such as biomechanics, cardiopulmonary function, psychology, sport participation and sport injuries. Therefore, the aim of this article is to systematically review the literature about individuals with limb amputations and sport participation. MEDLINE (PubMed), EMBASE, CINAHL® and SportDiscus® were searched without time or language restrictions using free text words and MeSH terms. The last search date was 31 March 2010. Books, internet sites and references of included papers were checked for papers relevant to the topic under review. Papers were included if the research topic concerned sports and a minimum of ten individuals with limb amputations were part of the study population. Papers were excluded if they included individuals with amputations of body parts other than upper or lower limbs or more distal than the wrist or ankle, or if they consisted of case reports, narrative reviews, books, notes or letters to the editor. Title, abstract and full-text assessments were performed by two independent observers following a list of preset criteria. Of the 3689 papers originally identified, 47 were included in the review. Most of the included studies were older than 10 years and had cross-sectional designs. Study participants were generally younger and often had more traumatic amputations than the general population of individuals with limb amputations. Heterogeneity in population characteristics, intervention types and main outcomes made data pooling impossible. In general, sports were associated with a beneficial effect on the cardiopulmonary system, psychological well-being, social reintegration and physical functioning. Younger individuals with unilateral transtibial amputations achieve better athletic performance and encounter fewer problems when participating in sports compared with older individuals with bilateral transfemoral amputations. Regardless of their amputation level, individuals with limb amputations participate in a wide range of recreational activities. The majority of them were not aware of the sport facilities in their area and were not informed about available recreational activities. Sport prosthetic devices were used mostly by competitive athletes. For football, the injury rate and pattern of the players with an amputation were similar to those of able-bodied players. Individuals with limb amputations appear to benefit both physically and psychologically from participation in sports and/or regular physical activity. Therefore, sports should be included in rehabilitation programmes, and individuals with limb amputations should be encouraged to pursue a physically active life following hospital discharge.

  10. Amputees and sports : a systematic review

    NARCIS (Netherlands)

    Bragaru, M.; Dekker, R.; Geertzen, J.H.B.; Dijkstra, P.U.

    2011-01-01

    Amputation of a limb may have a negative impact on the psychological and physical well-being, mobility and social life of individuals with limb amputations. Participation in sports and/or regular physical activity has a positive effect on the above mentioned areas in able-bodied individuals. Data co

  11. 神经断端肌肉内埋入法治疗汶川地震截肢伤员痛性神经瘤%Treatment of painful stump neuroma by resection and nerve stump implantation into muscle in twelve Wenchuan earthquake amputees

    Institute of Scientific and Technical Information of China (English)

    何纯青; 赵正恩; 许猛; 张立海; 柳现飞; 唐佩福

    2011-01-01

    目的:探讨神经断端肌肉内埋入法治疗地震伤截肢残端痛性神经瘤的临床疗效.方法:应用神经断端肌肉内埋入法治疗汶川地震伤截肢伤员痛性神经瘤12例27处,观察术后症状、体征及患肢功能改变情况.结果:12例全部获随访12~26个月,平均16个月.随访时患者主诉肢体残端疼痛和触电感消失;局部无压痛、叩击痛和Tinel征,残端软组织内未触及硬性结节或包块;患肢功能较术前明显改善.结论:采用神经断端肌肉内埋入法治疗地震伤截肢残端痛性神经瘤,可减轻痛苦,疗效确切.%Objective To investigate the clinical efficacy of a painful stump neuroma treatment by resection and nerve stump implantation into muscle in treating Wenchuan earthquake amputees. Methods In 12 Wenchuan earthquake amputees (27 painful neuromas), painful neuroma underwent resection and implantation into the nearby muscle. Changes of symptoms and limb function were observed. Results All the cases were followed up for 12 -26 months with an average of 16 months. It was shown that limb stump pain and “electric -shock” sensation disappeared without any local tenderness, percussion tenderness or Tinel sign. The soft tissue nodule or mass of limb stump disappeared. Limb function improved, compared with preoperative evaluation. Conclusions Pesection and nerve stump implantation into muscle is a feasible and effective method for treatment of painful stump neuroma after amputation.

  12. Vliv nastavení protézy a protetického chodidla na posturální chování u osob po transtibiální amputaci The influence of prostheses and prosthetic foot alignment on postural behavior in transtibial amputees

    Directory of Open Access Journals (Sweden)

    Miroslav Janura

    2007-01-01

    prosthetic component in transtibial amputees is determinative for postural stability and bipedal locomotion to a great extent. The aim of this study was to qualify the influence of variation in prostheses and prosthetic foot alignment in transtibial amputees on postural behaviour. Postural behaviour was analyzed in a group of 13 males (age 56 ± 13 years with five different prostheses and prosthetic foot lignment. The results of the study show that change in prostheses alignment has an influence on muscle activity and on selected posturographic parameters. As the kinesiologically most optimal we have identified the extension of the prostheses by 1 cm with regard to normal prosthesis alignment.

  13. Dočasná symetrie zdravých a protetických končetin během chůze osoby s transtibiální amputací s různým protetickým zařazením Temporal symmetry of sound and prosthetic limbs during transtibial amputee gait with various prosthetic alignment

    Directory of Open Access Journals (Sweden)

    Miroslav Janura

    2007-01-01

    reduced. In the course of the biomechanical investigation of gait in subjects with various afflictions, the symmetry of lower limb loading is also the object of research. A certain number of biomechanical studies are focussed on the kinematic and dynamic variables of the gait cycle in subjects with transtibial amputation (Bateni & Olney, 2002; Thomas et al., 2000; Perry, 2004. An interesting problem is the evaluation of gait symmetry between a transtibial amputee and groups of healthy persons (Winter & Sienko, 1988; Dingwell, Davis, & Frazier, 1996. Miff et al. (2005 compared temporal symmetries in a healthy group with the values in a transtibial amputee group during gait initiation and termination. Nolan et al. (2003 took an interest in changes in gait symmetry influenced by gait speed in transtibial and transfemoral amputees in comparison with a healthy group. The interlimb gait symmetry of transtibial amputees wearing two different prosthetic feet in the early rehabilitation stage was investigated by Marinakis (2004. Full symmetry in one's gait is not always desirable. The human system, with its major structural asymmetries in the neuromuscular skeletal system (one limb has been amputated cannot perform optimally when the gait is symmetrical (Winter & Sienko, 1988. Non symmetrical gait performance, with constraints of its residual system and the mechanics of its prosthesis, is better in this case. For persons who have undergone amputation, asymmetrical gait may be the instrument which protects the stump of the disabled limb. We can say that gait asymmetry would be a relevant measure for investigating the gait characteristics of amputees and establishing their propensity for future joint pain and degeneration (Nolan et al., 2003. For amputee gait, the choice of a suitable prosthesis is very important. The influence of a prosthetic foot on gait variables in a group of these subjects was observed by Gitter et al. (1991. Efficiency of performance of the gait cycle is also

  14. Consumer Guide for Amputees: A Guide to Lower Limb Prosthetics

    Science.gov (United States)

    ... and share Favorites Del.icio.us Digg Facebook Google Bookmarks Technorati Yahoo MyWeb by C. Michael Schuch, ... or gaining clearance for easier entrance into a car. The rotation unit allows this woman with a ...

  15. Psycho-physiological training approach for amputee rehabilitation.

    Science.gov (United States)

    Dhal, Chandan; Wahi, Akshat

    2015-01-01

    Electromyography (EMG) signals are very noisy and difficult to acquire. Conventional techniques involve amplification and filtering through analog circuits, which makes the system very unstable. The surface EMG signals lie in the frequency range of 6Hz to 600Hz, and the dominant range is between the ranges from 20Hz to 150Hz. 1 Our project aimed to analyze an EMG signal effectively over its complete frequency range. To remove these defects, we designed what we think is an easy, effective, and reliable signal processing technique. We did spectrum analysis, so as to perform all the processing such as amplification, filtering, and thresholding on an Arduino Uno board, hence removing the need for analog amplifiers and filtering circuits, which have stability issues. The conversion of time domain to frequency domain of any signal gives a detailed data of the signal set. Our main aim is to use this useful data for an alternative methodology for rehabilitation called a psychophysiological approach to rehabilitation in prosthesis, which can reduce the cost of the myoelectric arm, as well as increase its efficiency. This method allows the user to gain control over their muscle sets in a less stressful environment. Further, we also have described how our approach is viable and can benefit the rehabilitation process. We used our DSP EMG signals to play an online game and showed how this approach can be used in rehabilitation.

  16. Proprioception in Above-the-Knee Amputees with Artificial Limbs

    Directory of Open Access Journals (Sweden)

    E. P. Latanioti

    2013-01-01

    Full Text Available Purpose. To evaluate the lower limb proprioceptive sensation in patients with femoral amputation who received an artificial joint. Materials and Methods. 22 patients (18 men, 4 women, 24–65 years old (mean: 42, who had undergone above-the-knee joint amputation and underwent evaluation of proprioception using joint reposition in a predetermined angle of 15° knee flexion. The measurements were applied using a conventional goniometer to both amputated and healthy knees. The last ones were used as internal control. All patients performed an active knee flexion from hyperextension to 15° in a closed kinetic chain in order to evaluate proprioceptive sensation of the knee joint using the joint position sense (JPS method during specific controllable circumstances very close to normal gait. Results. JPS at 15° flexion for the amputated knee was calculated to be equal to 13.91 (SD = ±4.74, and for the healthy side it was equal to 14.15 (SD = ±2.61. No statistically significant differences were detected between the amputated and the healthy limb (. Conclusions. The proprioceptive information of the stumps did not appear to be affected significantly after thigh amputation and application of artificial prosthesis when JPS at 15° was evaluated. It seems that these patients compensate the loss of the knee sensory receptors via alternative mechanisms.

  17. Proprioception in Above-the-Knee Amputees with Artificial Limbs

    OpenAIRE

    Latanioti, E. P.; Angoules, A. G.; Boutsikari, E. C.

    2013-01-01

    Purpose. To evaluate the lower limb proprioceptive sensation in patients with femoral amputation who received an artificial joint. Materials and Methods. 22 patients (18 men, 4 women), 24–65 years old (mean: 42), who had undergone above-the-knee joint amputation and underwent evaluation of proprioception using joint reposition in a predetermined angle of 15° knee flexion. The measurements were applied using a conventional goniometer to both amputated and healthy knees. The last ones were u...

  18. [Amputee rehabilitation: taking charge, functional assessment and goal setting].

    Science.gov (United States)

    Damiani, Carlo

    2015-01-01

    Patients with lower limb amputations need the help of a multi-professional care team. There is no single professional who encompasses the skills required by patients who generally present multiple pathologies: skills in the care of wounds which are often dehiscent, knowledge of prosthetics, considering the fast evolving technologies in the field, psychological skills, essential to help the patient face their somatic conditions and resultant changes in body image. The physiatrist manages a care team which must prioritise treatments and intervention methods, and define practicable objectives in both the short and long term. The article details the basic principles to be followed for each patient so as to not overlook any of the aspects which combine to create a process which is neither simple nor quick, and focuses on the first parts of the treatment, from admittance until the choice of the temporary prosthesis.

  19. Isometric hip muscle strength in posttraumatic below-knee amputees

    OpenAIRE

    Jandrić Slavica

    2007-01-01

    Background/Aim. Traumas and war injuries, next to chronic occlusive artery disease and diabetes mellitus-derived complications, are the most frequent cause of the lower limbs amputation. They affect mostly younger population that need a higher level of activities as compared with the elderly. Medical rehabilitation is very significant for the muscle performance improvement in this population providing their social reintegration. The aim of this study was to investigate the effect of below-kne...

  20. Surgical apgar score predicts early complication in transfemoral amputees

    DEFF Research Database (Denmark)

    Wied, Christian; Foss, Nicolai B; Kristensen, Morten T

    2016-01-01

    AIM: To assess whether the surgical apgar score (SAS) is a prognostic tool capable of identifying patients at risk of major complications following lower extremity amputations surgery. METHODS: This was a single-center, retrospective observational cohort study conducted between January 2013...

  1. Characterization of amputee gait using a biomechanical approach

    OpenAIRE

    2016-01-01

    Esta tese propõe uma abordagem biomecânica para a caracterização da marcha de amputado de membro inferior, como um caso particular da marcha humana. O estudo foi dividido em duas partes. Na primeira parte, uma análise de marcha completa é executada a partir de experimentos realizados em sujeitos amputados e não amputados. Foram medidas diferentes variáveis cinemáticas e cinéticas, detectando assimetrias entre os membros amputados. Foi realizada uma avaliação quantitativa de simetria nos...

  2. The amputee patient: complications of its process of rehabilitation

    OpenAIRE

    Ospina, Jackeline; Serrano, Fernando

    2010-01-01

    This article is centered in the presentation of the complications that can be given in the stump of an amputated patient, considering the context of the phases and the stages of the rehabilitation process through which it must pass this type of patient. Also, the boarding of this subject is framed specially in one of the main causes of amputation in the world and in a country like Colombia that for years has been submerged in a special situation of violence. It also defines different strategi...

  3. Prosthetic reconstruction to restore function in transcarpal amputees.

    Science.gov (United States)

    Salminger, S; Roche, A D; Hruby, L A; Sturma, A; Riedl, O; Bergmeister, K D; Aszmann, O C

    2016-03-01

    Mutilated hands at the distal level may pose a challenge for reconstruction. Biological treatment options may require multiple surgical interventions and a long rehabilitation course with little hope of good functional outcome. Standard hand prostheses are also not an ideal solution, as they are too long and cumbersome for partial hand injuries. This paper outlines the functional outcomes of prosthetic reconstruction with devices customized for the transcarpal amputation levels. The functional outcome was evaluated with the Action Research Arm Test (ARAT), Southampton Hand Assessment Procedure (SHAP), and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Functional evaluation was performed at least 12 months after final fitting. Psychological assessment was performed with the Short Form-36. The three patients achieved a mean ARAT score of 35.67 ± 0.58. The average SHAP score was 74 ± 7.81. The average DASH score was found to be 16.11 ± 12.03. The reconstructed hand achieved a score of 75.27 ± 8.16% in SHAP and 62.57 ± 1.02% in ARAT in relation to the healthy hand. All patients exhibited average physical and mental component summary scales in the Short Form-36. The majority of transcarpal amputations are seen in manual laborers due to work-related trauma. Returning to work is the main goal in such young and otherwise-healthy patients. As shown with this study, prosthetic fitting results in quick and reliable functional reconstruction. Therefore, this treatment should be considered as an option during the initial decision-making process of reconstructing difficult traumatic injuries of the hand.

  4. Midterm Health and Personnel Outcomes of Recent Combat Amputees

    Science.gov (United States)

    2010-03-01

    998.5b-998.59 Osteomyelitis: 730.Ub-730.99 Cellulitis : 682.Ub-682.99 Chronic infection of amputation stump: 997.62 Infectioii/inflajiimatory due to...Syndrome Anemia Postoperative Infection Osteomyelitis Cellulitis Heterotopic Ossification Amputation Slump Complications Chronic Infection of Amputation...Infectiims Postoperative Infecüon Osteomyelilis Cellulitis Chronic Infection , Amputation Slump Infection /Inflammatory Due to Device Septicemia Stump

  5. Improved Training Method for Rapid Rehabilitation of Amputees

    Science.gov (United States)

    2015-05-01

    transtibial or transfemoral amputation at the Naval Medical Center San Diego. The training was a secondary rehabilitation program, implemented after...indicate that task-specific training is an effective rehabilitation method to reduce falls in warfighters with lower limb amputations . 15. SUBJECT...are at risk for diminished quality of life. The goal of this research effort was to rehabilitate warfighters with a lower extremity amputation to

  6. Perception of socket alignment perturbations in amputees with transtibial prostheses

    OpenAIRE

    David A. Boone, PhD; Toshiki Kobayashi, PhD; Teri G . Chou, PhD; Adam K. Arabian, PhD; Kim L. Coleman, MS; Michael S. Orendurff, PhD; Ming Zhang, Ph

    2012-01-01

    A person with amputation’s subjective perception is the only tool available to describe fit and comfort to a prosthetist. However, few studies have investigated the effect of alignment on this perception. The aim of this article is to determine whether people with amputation could perceive the alignment perturbations of their prostheses and effectively communicate them. A randomized controlled perturbation of angular (3 and 6 degrees) and translational (5 and 10 mm) alignments in the sagittal...

  7. Geriatric rehabilitation of lower limb amputees: a multicenter study.

    NARCIS (Netherlands)

    Eijk, M.S. van; Linde, H. van der; Buijck, B.I.; Zuidema, S.U.; Koopmans, R.T.C.M.

    2012-01-01

    PURPOSE: The aim of this study was to determine factors independently associated with successful rehabilitation of patients with lower limb amputation in skilled nursing facilities (SNFs). METHODS: All patients admitted to one of the 11 participating SNFs were eligible. Multidisciplinary teams colle

  8. Geriatric rehabilitation of lower limb amputees : a multicenter study

    NARCIS (Netherlands)

    Eijk, Monica Spruit-van; van der Linde, Harmen; Buijck, Bianca I; Zuidema, Sytse U; Koopmans, Raymond T C M

    2012-01-01

    PURPOSE: The aim of this study was to determine factors independently associated with successful rehabilitation of patients with lower limb amputation in skilled nursing facilities (SNFs). METHODS: All patients admitted to one of the 11 participating SNFs were eligible. Multidisciplinary teams colle

  9. Robotic leg control with EMG decoding in an amputee with nerve transfers.

    Science.gov (United States)

    Hargrove, Levi J; Simon, Ann M; Young, Aaron J; Lipschutz, Robert D; Finucane, Suzanne B; Smith, Douglas G; Kuiken, Todd A

    2013-09-26

    The clinical application of robotic technology to powered prosthetic knees and ankles is limited by the lack of a robust control strategy. We found that the use of electromyographic (EMG) signals from natively innervated and surgically reinnervated residual thigh muscles in a patient who had undergone knee amputation improved control of a robotic leg prosthesis. EMG signals were decoded with a pattern-recognition algorithm and combined with data from sensors on the prosthesis to interpret the patient's intended movements. This provided robust and intuitive control of ambulation--with seamless transitions between walking on level ground, stairs, and ramps--and of the ability to reposition the leg while the patient was seated.

  10. An electromyographic study of the hip muscles of transfemoral amputees in walking.

    Science.gov (United States)

    Jaegers, S M; Arendzen, J H; de Jongh, H J

    1996-07-01

    The aim of this study was to obtain insight into the electromyographic activity of the hip muscles after transfemoral amputation and to determine whether the cleaved hip muscles are still functional in locomotion. The electromyographic activity of the superficial hip muscles of both legs was studied in 11 men who had a unilateral transfemoral amputation. The intact muscles at the intact and amputated side showed the same sequence of activity as did those in healthy subjects, but during a longer period of time. The activity of the cleaved muscles with intact muscle fibers (gluteus maximus, tensor fasciae latae) was dependent on whether the iliotibial tract was reanchored. If the iliotibial tract was fixed, the same activity was found in the muscles of the patients as in those of healthy subjects. The activity of the cleaved, once biarticular, muscles (sartorius, rectus femoris, hamstring muscles, gracilis) was dependent on whether the muscles were reanchored and on the level of amputation. If the cleaved muscles were reanchored correctly, the muscles remained functional in locomotion in patients with an amputation in the distal half of the femur. In patients with high amputation levels, these muscles were almost continuously active; they probably play a role in fixing the socket.

  11. Safety of Osseointegrated Implants for Transfemoral Amputees: A Two-Center Prospective Cohort Study

    NARCIS (Netherlands)

    Muderis, M. Al; Khemka, A.; Lord, S.J.; Meent, H. van de; Frolke, J.P.M.

    2016-01-01

    BACKGROUND: Osseointegrated implants are an alternative for prosthetic attachment for individuals unable to wear a socket following an amputation. The concept of an integrated metal implant communicating with the external environment raises substantial concern about the risk of ascending infection.

  12. An electromyographic study of the hip muscles of transfemoral amputees in walking

    NARCIS (Netherlands)

    Jaegers, SMHJ; Arendzen, JH; deJongh, HJ

    1996-01-01

    The aim of this study was to obtain insight into the electromyographic activity of the hip muscles after transfemoral amputation and to determine whether the cleaved hip muscles are still functional in locomotion, The electromyographic activity of the superficial hip muscles of both legs was studied

  13. Comparison of muscle activity patterns of transfemoral amputees and control subjects during walking

    NARCIS (Netherlands)

    Wentink, Eva C.; Prinsen, Eric C.; Rietman, Johan S.; Veltink, Peter H.

    2013-01-01

    Background Only few studies have looked at electromyography (EMG) during prosthetic gait. Differences in EMG between normal and prosthetic gait for stance and swing phase were never separately analyzed. These differences can give valuable information if and how muscle activity changes in prosthetic

  14. Algorithm for the prediction of the reactive forces developed in the socket of transfemoral amputees

    OpenAIRE

    JUAN FERNANDO RAMÍREZ; EMMANUEL JARAMILLO MUÑOZ; JAIME ANDRÉS VÉLEZ

    2012-01-01

    Se presenta un algoritmo en Matlab 2010a basado en un modelo matemático para predecir los momentos y las fuerzas de reacción en un punto particular del socket vinculado al miembro inferior de un amputado transfemoral. El modelo tiene en cuenta las inercias desarrolladas durante el ciclo de la marcha. Se realiza una validación del modelo comparando los resultados con los datos obtenidos en un laboratorio de análisis de la marcha y se encuentra una buena correspondencia con los datos experiment...

  15. ALGORITHM FOR THE PREDICTION OF THE REACTIVE FORCES DEVELOPED IN THE SOCKET OF TRANSFEMORAL AMPUTEES

    Directory of Open Access Journals (Sweden)

    JUAN FERNANDO RAMÍREZ

    2012-01-01

    Full Text Available Se presenta un algoritmo en Matlab 2010a basado en un modelo matemático para predecir los momentos y las fuerzas de reacción en un punto particular del socket vinculado al miembro inferior de un amputado transfemoral. El modelo tiene en cuenta las inercias desarrolladas durante el ciclo de la marcha. Se realiza una validación del modelo comparando los resultados con los datos obtenidos en un laboratorio de análisis de la marcha y se encuentra una buena correspondencia con los datos experimentales en las fases de apoyo y balanceo.

  16. How do walking, standing, and resting influence transtibial amputee residual limb fluid volume?

    Directory of Open Access Journals (Sweden)

    Joan E. Sanders, PhD

    2014-08-01

    Full Text Available The purpose of this research was to determine how fluid volume changes in the residual limbs of people with transtibial amputation were affected by activity during test sessions with equal durations of resting, standing, and walking. Residual limb extracellular fluid volume was measured using biompedance analysis in 24 participants. Results showed that all subjects lost fluid volume during standing with equal weight-bearing, averaging a loss rate of –0.4%/min and a mean loss over the 25 min test session of 2.6% (standard deviation [SD] 1.1. Sixteen subjects gained limb fluid volume during walking (mean gain of 1.0% [SD 2.5], and fifteen gained fluid volume during rest (mean gain of 1.0% [SD 2.2]. Walking explained only 39.3% of the total session fluid volume change. There was a strong correlation between walk and rest fluid volume changes (−0.81. Subjects with peripheral arterial disease experienced relatively high fluid volume gains during sitting but minimal changes or losses during sit-to-stand and stand-to-sit transitioning. Healthy female subjects experienced high fluid volume changes during transitioning from sit-to-stand and stand-to-sit. The differences in fluid volume response among subjects suggest that volume accommodation technologies should be matched to the activity-dependent fluid transport characteristics of the individual prosthesis user.

  17. Nursing before operating on amputee%截肢病人手术前的护理

    Institute of Scientific and Technical Information of China (English)

    吴坤

    2004-01-01

    @@ 截肢是一种严重的破坏性手术.术后肢体的残缺、生活能力的下降,会导致病人出现严重的心理反应,如自卑感、悲观失望,甚至有厌世轻生等不良心态,导致疾病恢复缓慢.所以要消除病人的不良心态,促进伤口愈合,就需要护士为病人做全面、细致的术前护理,使病人能配合治疗及护理,消除心理顾虑.

  18. Adaptation and prosthesis effects on stride-to-stride fluctuations in amputee gait.

    Directory of Open Access Journals (Sweden)

    Shane R Wurdeman

    Full Text Available Twenty-four individuals with transtibial amputation were recruited to a randomized, crossover design study to examine stride-to-stride fluctuations of lower limb joint flexion/extension time series using the largest Lyapunov exponent (λ. Each individual wore a "more appropriate" and a "less appropriate" prosthesis design based on the subject's previous functional classification for a three week adaptation period. Results showed decreased λ for the sound ankle compared to the prosthetic ankle (F1,23 = 13.897, p = 0.001 and a decreased λ for the "more appropriate" prosthesis (F1,23 = 4.849, p = 0.038. There was also a significant effect for the time point in the adaptation period (F2,46 = 3.164, p = 0.050. Through the adaptation period, a freezing and subsequent freeing of dynamic degrees of freedom was seen as the λ at the ankle decreased at the midpoint of the adaptation period compared to the initial prosthesis fitting (p = 0.032, but then increased at the end compared to the midpoint (p = 0.042. No differences were seen between the initial fitting and the end of the adaptation for λ (p = 0.577. It is concluded that the λ may be a feasible clinical tool for measuring prosthesis functionality and adaptation to a new prosthesis is a process through which the motor control develops mastery of redundant degrees of freedom present in the system.

  19. Validity of DynaPort GaitMonitor for assessment of spatiotemporal parameters in amputee gait

    NARCIS (Netherlands)

    Houdijk, Han; Appelman, Franka M; Van Velzen, Judith M; Van der Woude, Lucas H V; Van Bennekom, Coen A M

    2008-01-01

    Accelerometry can be used to objectively assess the walking ability of people with a lower-limb prosthesis inside and outside the laboratory setting. In this study, the validity of the DynaPort GaitMonitor software (McRoberts, The Hague, the Netherlands) for assessing spatiotemporal parameters of am

  20. Studying Upper-Limb Amputee Prosthesis Use to Inform Device Design

    Science.gov (United States)

    2015-10-01

    processing pipelines that match standards in the field of biomechanics . This system and the associated pre and post processing techniques will provide much...These scripts have been written to match the guidelines of the international society of biomechanics (ISB) 8. Collection and setup of materials for the...adam.spiers@yale.edu Nearest person month worked: 12 Contribution to Project: Postdoc researcher responsible for running at-home and in-lab studies

  1. Adjustments to amputation and artificial limb, and quality of life in lower limb amputees

    NARCIS (Netherlands)

    Sinha, Richa

    2013-01-01

    Amputatie van ledematen heeft een grote impact op het individu, niet alleen bij de vervalsing van het lichaamsbeeld, maar ook van invloed op hun sociale en psychologische functioneren. Prothese is de enige manier waarop deze mensen kunnen onafhankelijk zijn, deel te nemen aan de samenleving, en herv

  2. Adjustments to amputation and artificial limb, and quality of life in lower limb amputees

    OpenAIRE

    Sinha, Richa

    2013-01-01

    Amputatie van ledematen heeft een grote impact op het individu, niet alleen bij de vervalsing van het lichaamsbeeld, maar ook van invloed op hun sociale en psychologische functioneren. Prothese is de enige manier waarop deze mensen kunnen onafhankelijk zijn, deel te nemen aan de samenleving, en hervatten hun werk. Er zijn verschillende factoren, die het gebruik van prothese door geamputeerden kan ook van invloed zijn en op hun beurt van invloed op hun kwaliteit van leven (QoL). De onderzoeksv...

  3. Motor control and learning with lower-limb myoelectric control in amputees.

    Science.gov (United States)

    Alcaide-Aguirre, Ramses E; Morgenroth, David C; Ferris, Daniel P

    2013-01-01

    Advances in robotic technology have recently enabled the development of powered lower-limb prosthetic limbs. A major hurdle in developing commercially successful powered prostheses is the control interface. Myoelectric signals are one way for prosthetic users to provide feedforward volitional control of prosthesis mechanics. The goal of this study was to assess motor learning in people with lower-limb amputation using proportional myoelectric control from residual-limb muscles. We examined individuals with transtibial amputation and nondisabled controls performing tracking tasks of a virtual object. We assessed how quickly the individuals with amputation improved their performance and whether years since amputation correlated with performance. At the beginning of training, subjects with amputation performed much worse than control subjects. By the end of a short training period, tracking error did not significantly differ between subjects with amputation and nondisabled subjects. Initial but not final performance correlated significantly with time since amputation. This study demonstrates that although subjects with amputation may initially have poor volitional control of their residual lower-limb muscles, training can substantially improve their volitional control. These findings are encouraging for the future use of proportional myoelectric control of powered lower-limb prostheses.

  4. Motor control and learning with lower-limb myoelectric control in amputees

    OpenAIRE

    2013-01-01

    Advances in robotic technology have recently enabled the development of powered lower-limb prosthetic limbs. A major hurdle in developing commercially successful powered prostheses is the control interface. Myoelectric signals are one way for prosthetic users to provide feedforward volitional control of prosthesis mechanics. The goal of this study was to assess motor learning in people with lower-limb amputation using proportional myoelectric control from residual-limb muscles. We examined in...

  5. Glasgow Coma Scale Scores, Early Opioids, and 4-year Psychological Outcomes among Combat Amputees

    Science.gov (United States)

    2014-01-01

    probably to avoid worsening low blood pressure following severe injury [10–14]. The no opioids group (vs fentanyl) also had a relatively low...fractures of the skull), and 850.00–854.10 ( intracranial injury, including concussion, contusion, laceration, and hemor- rhage) [36]. These TBI...lowest Akaike information criterion [40]. Finally, longitudinal analyses (The GEN- MOD procedure, SAS Institute Inc) compared changes in prevalence of

  6. The traumatic lower extremity amputee: surgical challenges and advances in prosthetics.

    Science.gov (United States)

    Cannada, Lisa K; Vaidya, Rahul; Covey, Dana C; Hanna, Kathryn; Dougherty, Paul

    2013-01-01

    The mangled lower extremity is a challenging injury to treat. Orthopaedic surgeons treating patients with these severe injuries must have a clear understanding of contemporary advantages and disadvantages of limb salvage versus amputation. It is helpful to review the acute management of mangled extremity injuries in the civilian and military populations, to be familiar with current postoperative protocols, and to recognize recent advances in prosthetic devices.

  7. Development of Osseointegrated Implants for Soldier Amputees Following Orthopaedic Extremity Trauma

    Science.gov (United States)

    2008-08-01

    male and female cadaveric femurs. Morphometric variations of the periosteal surface of long bones have been identified with changing age, gender and...femurs have been scanned, reconstructed using MIMICS (Materialise USA), periosteal and endeosteal analysis has been performed using custom written code...investigation was to determine if a broad spectrum CerageninTM (CSA - 13) antimicrobial could prevent pin track infections in a percutaneous tibial

  8. Neglected foreign body in contralateral limb in a traumatic transfemoral amputee-radiographs can be misleading

    Directory of Open Access Journals (Sweden)

    Jaiswal Atin

    2013-02-01

    Full Text Available 【Abstract】Missed or neglected foreign bodies are not infrequent in surgical practice. This case report high-lights the fact that thorough clinical examination and de-tailed evaluation of trauma patients are very necessary so that any associated injuries or foreign bodies will not be missed and any unforeseen clinical or medico-legal compli-cations can be prevented. We present a case of a 35-year-old male patient who had traumatic transfemoral amputa-tion of the right lower limb with a clean laceration (size 2 cmx1 cm over the medial aspect of the left thigh. Radio-graphs suggested a single radioopaque foreign body which proved misleading, as during surgical removal multiple radi-olucent and radiopaque foreign bodies were discovered. Postoperative ultrasound was performed and showed no retained foreign bodies. A secondary closure of the right thigh amputation was done and patient was discharged. At the last follow-up, 9 months after injury, the patient had no complaints, and both the amputation stump and the wound over the left thigh were healthy. Thus in the cases of re-tained foreign bodies, in addition to thorough clinical ex-amination and radiography, ultrasonograpy should be supplemented. And if required, use of CT scan as well as MRI should be also considered. Key words: Foreign bodies; Radiography; Diagnos-tic errors; Ultrasonography

  9. Neglected foreign body in contralateral limb in a traumatic transfemoral amputee-radiographs can be misleading

    Institute of Scientific and Technical Information of China (English)

    Atin Jaiswal; Masood Habib; Yashwant Singh Tanwar

    2013-01-01

    Missed or neglected foreign bodies are not infrequent in surgical practice.This case report highlights the fact that thorough clinical examination and detailed evaluation of trauma patients are very necessary so that any associated injuries or foreign bodies will not be missed and any unforeseen clinical or medico-legal complications can be prevented.We present a case of a 35-year-old male patient who had traumatic transfemoral amputation of the right lower limb with a clean laceration (size 2 cmx 1 cm) over the medial aspect of the left thigh.Radiographs suggested a single radioopaque foreign body which proved misleading,as during surgical removal multiple radiolucent and radiopaque foreign bodies were discovered.Postoperative ultrasound was performed and showed no retained foreign bodies.A secondary closure of the right thigh amputation was done and patient was discharged.At the last follow-up,9 months after injury,the patient had no complaints,and both the amputation stump and the wound over the left thigh were healthy.Thus in the cases of retained foreign bodies,in addition to thorough clinical examination and radiography,ultrasonograpy should be supplemented.And if required,use of CT scan as well as MRI should be also considered.

  10. Neglected foreign body in contralateral limb in a traumatic transfemoral amputee---radiographs can be misleading.

    Science.gov (United States)

    Jaiswal, Atin; Habib, Masood; Tanwar, Yashwant-Singh

    2013-01-01

    Missed or neglected foreign bodies are not infrequent in surgical practice. This case report highlights the fact that thorough clinical examination and detailed evaluation of trauma patients are very necessary so that any associated injuries or foreign bodies will not be missed and any unforeseen clinical or medico-legal complications can be prevented. We present a case of a 35-year- old male patient who had traumatic transfemoral amputation of the right lower limb with a clean laceration (size 2 cm multiply 1 cm) over the medial aspect of the left thigh. Radiographs suggested a single radioopaque foreign body which proved misleading, as during surgical removal multiple radiolucent and radiopaque foreign bodies were discovered. Postoperative ultrasound was performed and showed no retained foreign bodies. A secondary closure of the right thigh amputation was done and patient was discharged. At the last follow-up, 9 months after injury, the patient had no complaints, and both the amputation stump and the wound over the left thigh were healthy. Thus in the cases of retained foreign bodies, in addition to thorough clinical examination and radiography, ultrasonograpy should be supplemented. And if required, use of CT scan as well as MRI should be also considered.

  11. Phantom pain and phantom sensations in upper limb amputees : an epidemiological study

    NARCIS (Netherlands)

    Kooijman, CM; Dijkstra, PU; Geertzen, JHB; Elzinga, A; van der Schans, CP

    2000-01-01

    Phantom pain in subjects with an amputated limb is a well-known problem. However, estimates of the prevalence of phantom pain differ considerably in the literature. Various factors associated with phantom pain have been described including pain before the amputation, gender, dominance, and time elap

  12. Skin problems of the stump and hand function in lower limb amputees : A historic cohort study

    NARCIS (Netherlands)

    Baars, E. C. T.; Dijkstra, P. U.; Geertzen, J. H. B.

    2008-01-01

    The aim of this study was to investigate the relationship between liner-related skin problems of the stump in patients with a lower limb amputation and impaired hand function. Sixty patients who were treated in a rehabilitation hospital from 1998-2006 were included in an historic cohort study. Data

  13. A Study of the Amputee Experience of Viewing Self in the Mirror

    Science.gov (United States)

    Freysteinson, Wyona; Thomas, Lisa; Sebastian-Deutsch, Amy; Douglas, Denika; Melton, Danielle; Celia, Tania; Reeves, Kristin; Bowyer, Patricia

    2017-01-01

    Abstract Purpose To describe the trajectory of viewing self in a mirror after an ampu-tation and participants’ perceptions of what health care professionals should know about mirrors. Design Hermeneutic phenomenology Methods Focus groups were conducted to collect the research data. Findings The mirror experience had three key moments: decision, seeing, and consent. The trajectory of viewing self in a mirror had four key themes: mirror shock, mirror anguish, recognizing self, and acceptance: a new normal. Participants’ recommendations for introducing the mirror after an amputation and using a mirror to avoid skin breakdown and infection, and correct gait and balance are described. Conclusions This study provides a unique viewpoint into the world of those who have suffered amputation of a limb. Clinical Relevance Rehabilitation nurses and other health care professionals are encouraged through these participants to consider the effect and value of mirrors when caring for those who have had an amputation. PMID:26879100

  14. The mobility scale for lower limb amputees : The SIGAM/WAP mobility scale

    NARCIS (Netherlands)

    Rommers, G. M.; Ryall, N. H.; Kap, A.; De Laat, F.; Van Der Linde, H.

    2008-01-01

    Purpose. To translate the SIGAM mobility scale into the Dutch language and to test and validate its properties in everyday practice. Method. The SIGAM mobility scale as published by Ryall et al. was translated into the Dutch language with the local used verbs for prosthetic use. The translated Dutch

  15. Mobile Gait Analysis System for Lower Limb Amputee High-Level Activity Rehabilitation

    Science.gov (United States)

    2012-09-01

    and transverse plane, respectively, in the case of the lower leg or robotic lower leg. Initially, the intermediate reference frame is aligned with...conducted without use of the health information. 13. Documents to be submitted for review: Scientific Review Current Curriculum vitae for each...collection forms/CRFs Other documents to be submitted for review, as applicable to this study: Assent Document(s) Medical Monitor Curriculum vitae

  16. Computer aided design of prosthetic sockets for below-knee amputees.

    Science.gov (United States)

    Saunders, C G; Foort, J; Bannon, M; Lean, D; Panych, L

    1985-04-01

    A computer-aided sculpting system for use in prosthetics is described. The prosthetist's sculpting tools now consist of a computer, a graphics terminal, a mouse and an on-screen moveable cursor. Accompanied by the system software, these tools allow systematic modification of a primitive socket using techniques analogous to those used by a prosthetist working with rasps and plaster.

  17. Rehabilitation of below-knee amputees: factors influencing outcome and costs in three programmes.

    Science.gov (United States)

    Durance, J P; Warren, W K; Kerbel, D B; Stroud, T W

    1989-01-01

    The components of three different rehabilitation programmes were analysed to determine the factors that influence functional outcomes and prosthetic costs. Age and additional health problems showed little relationship to inpatient activity level while the physical health status score had a significant relationship. The level of expectation in the rehabilitation programmes for walking independently with canes or without aids at discharge was shown to have a strong influence on the activity level attained and the length of rehabilitation stay. The style of socket did not appear to affect fitting success but had some effect on the efficiency of the prosthetic fitting process and the length of stay.

  18. Resuscitation and blood utilization guidelines for the multiply injured, multiple amputee.

    Science.gov (United States)

    Alfieri, Keith A; Elster, Eric A; Dunne, James

    2012-01-01

    Given the current tempo of overseas contingency operations, military orthopaedic surgeons are increasingly performing their duties in an austere environment. At Level 1 trauma centers and combat support hospitals, resources tend to be more abundant than in less "metropolitan'' locations. Combat casualty care has reinforced the idea of a multidisciplinary team approach to severely injured trauma patients. During mass casualty situations, as seen recently in Haiti and in the wake of Hurricane Katrina, all members of the trauma team may need to perform duties on the periphery of their comfort zone. Early involvement of orthopaedic surgeons in damage control surgery, as well as resuscitation, are critical to the survival of patients with high amputations, multiple amputations, open pelvic injuries, and mangled extremities common in high-energy penetrating and blast-induced trauma. This article introduces the concept of Damage Control Resuscitation to the orthopaedic surgeon, and also presents a treatment guideline for use as appropriate.

  19. Mobile Gait Analysis System for Lower Limb Amputee High-Level Activity Rehabilitation

    Science.gov (United States)

    2013-09-01

    The direction of gravity can be used, along with trigonometry , to determine the pitch and roll orientations of the IMU. We are interested in the...18(1S) 93. 15. Hofstad CJ, van der Linde H, Nienhuis B, Eng M, Weerdesteyn V, Duysens J, Geurts AC. High Failure Rates When Avoiding Obstacles ...pest, respectively, is calculated using the direction of gravity from the accelerometer signals, basic trigonometry and sequential rotations. The

  20. Controlling horizontal deceleration during gait termination in transfemoral amputees : Measurements and simulations

    NARCIS (Netherlands)

    van Keeken, Helco G.; Vrieling, Aline H.; Hof, At L.; Postema, Klaas; Otten, Bert

    2013-01-01

    In this study we investigated how leading limb angles combined with active ankle moments of a sound ankle or passive stiffness of a prosthetic ankle, influence the center of mass (CoM) velocity during the single limb support phase in gait termination. Also, we studied how the trailing limb velocity

  1. Risk Factors Associated with Diagnoses of Heterotopic Ossification in Recent Combat Amputees

    Science.gov (United States)

    2009-07-22

    infection 20/69 (29%) 82/313 (26%) Osteomyelitis 22/69 (32%) 62/313 (20%)* Cellulitis 18/69 (26%) 51/313 (16%) Amputation stump...several complications: osteomyelitis, infections , deep vessel thrombosis, and pulmonary embolism. Conclusions: The present study extended previous...complications13-23, such as infections , phantom limb syndrome, deep vessel thrombosis, and pulmonary embolism have not received systematic study as possible

  2. Dynamic balance control in transfemoral amputees: Individual contribution of the prosthesis side

    NARCIS (Netherlands)

    Nederhand, M.J.; Asseldonk, van E.H.F.; Kooij, van der H.

    2006-01-01

    1. Summary/conclusions This study explores the use of a new developed method to assess the individual contribution of both legs to postural control. The results imply that the contribution of the prosthetic leg in balance control is not a mere reflection of the weight distribution. 2. Introduction

  3. Control of lateral balance in walking - Experimental findings in normal subjects and above-knee amputees

    NARCIS (Netherlands)

    Hof, At L.; van Bockel, Renske M.; Schoppen, Tanneke; Postema, Klaas

    2007-01-01

    In walking the human body is never in balance. Most of the time the trunk is supported by one leg and the centre of mass (CoM) 'falls' to the contralateral side. In dynamical situations the velocity of the CoM should be acknowledged as well in the 'extrapolated centre of mass (XcoM). Centre of press

  4. Strength, Pain, Function in OIF/OEF Amputees: A Nurse-Managed Program

    Science.gov (United States)

    2014-03-25

    Nursing Competencies and Practice: Patient outcomes Quality and safety Translate research into practice/evidence-based practice Clinical...for the warrior Care for all entrusted to our care Nursing Competencies and Practice: Patient outcomes Quality and safety Translate research...second chair rise test) were dependent on the soldier having the prosthesis for the amputated limb which typically occurred by week 7 of the study. The

  5. Successful use of autogenous bone graft for the treatment of a radius-ulna nonunion in an amputee dog

    Directory of Open Access Journals (Sweden)

    B.W. Minto

    2015-08-01

    Full Text Available Fracture nonunions represent important complications in orthopedic surgeries. Nonunion repairs or bone defects are surgically challenging. Our aim was to describe a nonunion case, which was repaired with rapid bone recovery. An 8-month-old male mixed breed dog that has been previously operated was presented to the Veterinary Medical Teaching Hospital of São Paulo State University, with a right radius-ulna nonunion and an amputated contralateral forelimb. A cancellous bone graft was collected from a partially amputated limb, in order to correct the nonunion, and used in association with a locking plate. After four weeks, the bone graft had been incorporated into the original bone. Clinical union with good weight bearing was achieved after eight weeks.

  6. Rehabilitation evaluation and treatment in an amputee%截肢患者的康复评定与治疗

    Institute of Scientific and Technical Information of China (English)

    李放

    2003-01-01

    目的 :对 1例截肢患者进行病例讨论,以明确康复评定、康复计划及康复目标. 方法 :康复干预前后进行康复团队讨论. 结果 :患者为经股骨( transfemoral, TF)下位截肢,处于假肢前期,存在髋关节挛缩、肌肉萎缩和幻肢痛.经 2周治疗后,患者的运动功能和实用功能均改善.已佩带长腿假肢.讨论内容涵盖了一般评定、截肢特征、康复计划、具体方法和目标等. 结论 :通过团队合作,可以完善截肢的康复任务.

  7. Testing and training for amputee's up limb%上肢功能测试与训练

    Institute of Scientific and Technical Information of China (English)

    斯扬; 胡天培

    2002-01-01

    提高假肢控制准确率是多自由度假手应用过程中的难题,现提出用于残肢者配装三自 由度假手的康复测试和训练方法.临床实验表明,受试者配装三自由度假手后,控制动作的 准确率由训练前的 16% 提高到 100%(测试 100次 ).达到实用的要求 .

  8. Fitting a bilateral transhumeral amputee with utensil prostheses and their functional assessment 10 years later: a case report.

    Science.gov (United States)

    Hung, Jen Wen; Wu, Yee Hwa

    2005-11-01

    Traumatic transhumeral amputations resulting from electric burn injury are uncommon and present a significant rehabilitation challenge. Compensating for loss of fine, coordinated function of the upper extremities with prostheses is difficult medically, technologically, psychologically, and socially. We followed up a patient with traumatic bilateral transhumeral amputation who was fitted with specially designed bilateral low-temperature utensil prostheses for 10 years. A bilateral utensil prosthesis consists of 2 thermoplastic sockets, an elastic harness, 2 utensil holders, and several different utensils. The characteristics of utensil prostheses are low cost, quick fabrication, and responsiveness to a patient's needs. Ten years after the patient's first prosthesis fitting, he still used these specially designed prostheses. By using these devices and his feet, the patient has regained independence in most activities of daily living and gained a new working skill.

  9. What Is the Magnitude and Long-term Economic Cost of Care of the British Military Afghanistan Amputee Cohort?

    OpenAIRE

    Edwards, D. S.; Phillip, Rhodri D.; Bosanquet, Nick; Anthony M J Bull; Clasper, Jon C.

    2015-01-01

    Background Personal protection equipment, improved early medical care, and rapid extraction of the casualty have resulted in more injured service members who served in Afghanistan surviving after severe military trauma. Many of those who survive the initial trauma are faced with complex wounds such as multiple amputations. Although costs of care can be high, they have not been well quantified before. This is required to budget for the needs of the injured beyond their service in the armed for...

  10. A Comparison of Health Outcomes for Combat Amputee and Limb Salvage Patients Injured in Iraq and Afghanistan Wars

    Science.gov (United States)

    2013-01-01

    clinics.28 Study Population and Patient Identification Patients who died of wounds and those with brain or spinal injuries causing extremity paralysis were...test as appropriate) were aEA versus LA, bEA versus LS, and cLA versus LS. Other psychological disorders included pain, sleep , and cognitive disorders

  11. Assessment of transfemoral amputees using C-Leg and Power Knee for ascending and descending inclines and steps

    Directory of Open Access Journals (Sweden)

    Erik J. Wolf, PhD

    2012-08-01

    Full Text Available Adding active power to a prosthetic knee unit may improve function and reduce the potential for overuse injuries in persons with transfemoral amputation (TFA. Servicemembers who have sustained a TFA are often young and motivated to perform at high functional levels. The goal of this article is to compare the biomechanics of ramp and stair descent and ascent for participants using the C-Leg and the Power Knee (PK. Subjects were asked to ascend and descend an instrumented staircase and 12 degree ramp at their comfortable pace while equipped with retroreflective markers. Temporal-spatial and kinetic data were collected. Knee power generated by the nondisabled limb during stair ascent for subjects wearing the C-Leg was significantly greater than for those wearing the PK. Knee power generated by prosthetic knee units was significantly greater for subjects while wearing the PK. Although the PK reduced the power required from the nondisabled knee during stair climbing, it does not appear to be superior to the C-Leg for other tasks. Adding power to a prosthetic knee may reduce wear on the nondisabled limb; however, there are still limitations that require improvement.

  12. Osseocutaneous integration of an intraosseous transcutaneous amputation prosthesis implant used for reconstruction of a transhumeral amputee: case report.

    Science.gov (United States)

    Kang, Norbert V; Pendegrass, Catherine; Marks, Linda; Blunn, Gordon

    2010-07-01

    Exoprosthetic replacement with an artificial limb is the main option for reconstruction after traumatic amputation of an upper limb. Direct skeletal attachment using an osseointegrated implant improves the ease of fixation of the exoprosthesis to the amputation stump. We now report the use of an intraosseous transcutaneous amputation prosthesis that is designed to achieve osseocutaneous integration. Osseocutaneous integration differs from osseointegration because the aim is to create a stable interface among the implant, the bone, and the soft tissues. This reduces the risk of soft tissue infection and troublesome discharge, which are problems encountered with current osseointegrated implants that focus largely on the bone-implant interface. We describe our experience with an intraosseous transcutaneous amputation prosthesis in a case of transhumeral amputation with 2 years of follow-up.

  13. Dynamic Balance Control (DBC) in lower leg amputee subjects; contribution of the regulatory activity of the prosthesis side

    NARCIS (Netherlands)

    Nederhand, M.J.; Asseldonk, van E.H.F.; Kooij, van der H.; Rietman, J.S.

    2012-01-01

    Background Regaining effective postural control after lower limb amputation requires complex adaptation strategies in both the prosthesis side and the non-amputated side. The objective in this study is to determine the individual contribution of the ankle torques generated by both legs in balance co

  14. Finite element analysis for the evaluation of the structural behaviour, of a prosthesis for trans-tibial amputees.

    Science.gov (United States)

    Omasta, Milan; Paloušek, David; Návrat, Tomáš; Rosický, Jiří

    2012-01-01

    The finite element analysis (FEA) has been identified as a useful tool for the stress and strain behaviour determination in lower limb prosthetics. The residual limb and prosthetic socket interface was the main subject of interest in previous studies. This paper focuses on the finite element analysis for the evaluation of structural behaviour of the Sure-flex™ prosthetic foot and other load-bearing components. A prosthetic socket was not included in the FEA. An approach for the finite element modelling including foot analysis, reverse engineering and material property testing was used. The foot analysis incorporated ground reaction forces measurement, motion analysis and strain gauge analysis. For the material model determination, non-destructive laboratory testing and its FE simulation was used. A new, realistic way of load application is presented along with a detailed investigation of stress distribution in the load-bearing components of the prosthesis. A novel approach for numerical and experimental agreement determination was introduced. This showed differences in the strain on the pylon between the experimental and the numerical model within 30% for the anteroposterior bending and up to 25% for the compression. The highest von Mises stresses were found on the foot-pylon connecting component at toe off. Peak stress of 216MPa occurred on the posterior adjusting screw and maximum stress of 156MPa was found at the neck of the male pyramid.

  15. Design and control of a prosthetic leg for above-knee amputees operated in semi-active and active modes

    Science.gov (United States)

    Park, Jinhyuk; Yoon, Gun-Ha; Kang, Je-Won; Choi, Seung-Bok

    2016-08-01

    This paper proposes a new prosthesis operated in two different modes; the semi-active and active modes. The semi-active mode is achieved from a flow mode magneto-rheological (MR) damper, while the active mode is obtained from an electronically commutated (EC) motor. The knee joint part of the above knee prosthesis is equipped with the MR damper and EC motor. The MR damper generates reaction force by controlling the field-dependent yield stress of the MR fluid, while the EC motor actively controls the knee joint angle during gait cycle. In this work, the MR damper is designed as a two-end type flow mode mechanism without air chamber for compact size. On other hand, in order to predict desired knee joint angle to be controlled by EC motor, a polynomial prediction function using a statistical method is used. A nonlinear proportional-derivative controller integrated with the computed torque method is then designed and applied to both MR damper and EC motor to control the knee joint angle. It is demonstrated that the desired knee joint angle is well achieved in different walking velocities on the ground ground.

  16. Determination of Long Term Motor Control and Cutaneous Sensory Properties of a High Resolution Peripheral Nerve Interface Technology for Limb Amputees

    Science.gov (United States)

    2012-12-01

    still be required.   Figure 2: Example of attempted micro- extrusion of ABS onto SiC/IrOx electrode array. Resolution of the 3D system allowed...biocompatible or readily and completely removed, and the material must also provide enough wetting of the silicon carbide surface to spread along the mandrel...but have enough surface tension so it does not spread between the mandrels. Plans for 2 Month Extension 1. Fabricate an MTA on silicon carbide

  17. 下肢假肢对线与截肢者平衡%Influence of the Alignment of a Lower Limb Prosthesis on the Balance of an Amputee

    Institute of Scientific and Technical Information of China (English)

    方新

    2003-01-01

    目的:探讨下肢假肢对线对截肢者平衡的影响.方法:为1 6名经股骨和胫骨截肢的患者安装组件式假肢,进行假肢对线调整.测量调整前后截肢者综合平衡差值.结果:16位截肢者综合平衡差值在对线调整前为5~35mm,在对线调整后,降到1~9mm.结论:依据综合平衡进行下肢假肢对线调整能达到较好的效果.

  18. Expert Panel recommendations—Based on research and deliberations from VA HSR&D project “Impact of the DOD paradigm shift on VA amputee prosthetic care”

    Directory of Open Access Journals (Sweden)

    Gayle E. Reiber, PhD, MPH

    2010-08-01

    Full Text Available Major limb amputations are part of the sacrifices made by over 2,500 living Vietnam veterans and nearly 1,000 servicemembers to date from the conflicts in Afghanistan and Iraq. The men and women from both conflicts who completed our survey report favorable health and quality of life ratings, tremendous resilience, and hard work to reintegrate into society despite seriousinjuries and comorbidities.

  19. Nursing and Rehabilitaiton Instruction for Amputees after Earthquake%地震伤截肢患者的护理与康复指导

    Institute of Scientific and Technical Information of China (English)

    赵克聪; 孙海燕

    2008-01-01

    截肢是将已失去生存能力、危害健康、丧失生理功能的肢体截除。在这次汶川地震中,许多患者由于肢体受压时间过长,出现肢体坏死或肢体严重感染,因而也造成了对患者生命的威胁。医务人员为了挽救患者生命,为许多患者进行了截肢手术。患者截肢后必然带来不同程度的躯体残疾和缺陷。在护理地震伤截肢患者时,应制定出适当的、有针对性的护理措施。下面就地震伤截肢患者的护理要点简述如下。

  20. Initial Detection and Analysis of Neuro-information from Amputee%首例残肢者神经信息检测与数据分析

    Institute of Scientific and Technical Information of China (English)

    张晓文; 胡天培; 高忠华; 杨煜普; 许晓鸣; 张键; 郑修军; 贾晓枫; 陈中伟; 陈统一

    2006-01-01

    运用实验方法,通过对残肢者神经信息的检测与数据分析,研究了上臂三大主神经(正中神经、桡神经和尺神经)的相互协调关系、信息发放模式以及神经信号支配运动的机理,为神经信息控制假肢的研究创造了条件.

  1. Physical Therapy for Amputees after Earthquake%地震后下肢截肢患者的康复治疗

    Institute of Scientific and Technical Information of China (English)

    李洁辉; 常华; 常冬梅

    2008-01-01

    地震后不同类型的截肢患者需要全面、科学、专业的评价,康复治疗师根据患者的具体情况,制定出相应的治疗方案.佩戴假肢前应着重训练患者的肌力,矫正挛缩的关节;佩戴假肢后,除肌力外还应以恢复日常生活活动能力(ADL)为目的,训练患者各方面的能力,使之尽早回归家庭和社会.

  2. 外伤性截肢病人睡眠质量的研究%Study on sleep quality of patients with traumatic amputees

    Institute of Scientific and Technical Information of China (English)

    林莉清; 林影; 林玉琳

    2013-01-01

    [目的]了解外伤性截肢病人的睡眠质量及影响因素.[方法]采用匹兹堡睡眠质量指数(PSQI)量表及自行设计的影响睡眠质量因素调查表对200例外伤性截肢病人进行问卷调查.[结果]200例病人PSQI得分为9.01分±3.74分,显著高于国内常模(P<0.01);79.00%的病人存在睡眠质量问题,影响因素有幻肢痛、肢体残缺等.[结论]外伤性截肢病人睡眠质量明显低于国内常模,应加强其睡眠护理,提高睡眠质量及生活质量.

  3. 外伤致全骨盆切除者的综合康复1例%Rehabilitation of Hemicorporectomy Amputee: A Case Report

    Institute of Scientific and Technical Information of China (English)

    杨平; 曹学军; 田罡; 崔继龙; 张庭军; 李洁辉; 王安庆

    2008-01-01

    目的 探讨全骨盆切除后的综合康复方法.方法 回顾性个案分析.结果和结论 利用综合康复的手段,可恢复高位截肢患者的正常人体外观,重建他们的站立行走能力,提高生活质量,为回归社会奠定基础.

  4. 集体教育在截肢患者心理干预中的应用%Collective Education on Mental Intervention for Amputees

    Institute of Scientific and Technical Information of China (English)

    江珉; 陈锐; 余沁玲; 李雄燕; 李飞

    2013-01-01

    目的 探讨集体教育在截肢患者心理干预中的应用效果.方法 选择2010年3月-2012年12月在解放军59医院创伤显微外科行截肢术者37例,在全程心理干预的基础上,于术后3~10 d由心理干预小组成员组织实施集体教育,运用抑郁自评量表(SDS)、焦虑自评量表(SAS)及生活质量评定量表(QOL)评价患者干预前后的心理状况和生活质量改善情况.结果 经过心理干预后,患者SDS、SAS评分均较干预前显著降低(P<0.05),8例择期手术患者QOL评分较干预前显著升高(P<0.05).结论 对截肢患者实施集体干预能有效改善不良情绪,提高生活质量.

  5. 模拟上肢截肢者走跑步态特征研究%Characteristics of Walking and running of upper extremity amputee

    Institute of Scientific and Technical Information of China (English)

    孙泊; 危小焰

    2007-01-01

    目的:探讨上肢截肢者基本运动的步态特征与正常人步态特征的差异.进一步阐明上肢运动在人体基本运动中的作用机制.方法:实验中采用Motion analysis system红外自动跟踪捕捉系统和Kisder Force Plate进行同步运动学和动力学测试.通过对正常人的手臂进行限制约束.对上肢截肢者进行模拟实验.结果:通过对手臂约束前后对比分析发现约束前后部分步态参数存在显著差异.结论:在行走时步态参数差异较小,跑动时差异较显著;补偿运动[1]主要发生在躯干、骨盆、摆动腿:慢走时摆臂有利于增大垂直方向的作用力,快跑时没有手臂的摆动在脚着地时向后的阻力增大.

  6. A Research on Anxiety and Depression Symtoms of Amputees%截肢患者焦虑、抑郁症状的研究

    Institute of Scientific and Technical Information of China (English)

    李德禄; 刘步莹; 唐振坤; 陈德彩

    2003-01-01

    目的探讨截肢患者伴发焦虑、抑郁症状的特点.方法对31例截肢患者进行症状自评量表(SCL-90)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)、社会支持评定量表(SSRS)测评.同时以年龄、性别相匹配的31名健康人为对照.结果截肢患者常有焦虑、抑郁症状,其心身健康程度显著低于对照组,表现在SCL-90中的总分和部分因子分、SDS、SAS、HAMA、HAMD总分显著高于对照组,(P<0.01),而SSRS总分显著低于对照组(P<0.01).结论对伴发焦虑、抑郁症状的截肢患者应及时给予心理治疗、抗焦虑剂、抗抑郁剂治疗及良好的家庭照顾和社会支持非常必要.

  7. Application of 3D Gait Analysis in Rehabilitation of Amputees%三维步态分析在截肢患者康复中的应用

    Institute of Scientific and Technical Information of China (English)

    张腾宇; 李立峰; 季润; 王强; 王喜太

    2010-01-01

    采用Vicon三维步态分析系统对健康人和穿戴假肢的下肢截肢患者进行步态分析,表明该系统可提供运动学参数和生物力学参数的变化,由此分析假肢穿戴者与健康人各关节运动的差异.将三维步态分析应用于截肢患者康复方面是切实可行的.

  8. Brain Biology Machine Initiative: Developing Innovative Novel Methods to Improve Neuro-Rehabilitation for Amputees and Treatment for Patients at Remote Sites with Acute Brain Injury

    Science.gov (United States)

    2010-10-01

    impairments following damage to the central (stroke, or TBI) or peripheral nervous systems (amputation, peripheral nerve and/or orthopedic injury). Chronic...for performance with the non-dominant side. We created an experiment plan and designed an apparatus for a new fMRI project (“intermanual transfer

  9. Nursing Experience of Nursing Intervention for Amputees%护理干预用于截肢患者的护理体会

    Institute of Scientific and Technical Information of China (English)

    李舒

    2015-01-01

    目的:探讨护理干预用于严重创伤截肢患者护理的效果。方法选取2014年11月~2O15年11月的30例接受截肢术患者,随机分为观察组和干预组各15例,观察组采用常规护理,干预组则在常规护理的基础上采用护理干预,两组观察其焦虑率。结果观察组焦虑率88.50%,干预组56.33%,干预组的焦虑率明显比观察组低,(P<0.05)数据差异具有统计学意义。结论正确的心理指导和康复措施能降低焦虑率,从而让患者心情舒适,有利于疾病治疗和预后康复。%Objective To investigate the effect of nursing intervention for patients with severe traumatic amputation.MethodsSelected 30 patients who underwent amputation patients were randomly divided into observation group and intervention group in November 2014~November 2015, 15 cases each group by routine nursing care, while the intervention group on the basis of conventional nursing care and nursing intervention, the anxiety rate was observed in both groups.Results observation group anxiety rate 88.50%, intervention group was 56.33%, the rate of anxiety in the intervention group was obviously lower than the observation group,( P <0.05) data difference is statistically significant. Conclusion correct psychological guidance and rehabilitation measures can decrease the rate of anxiety, so as to make patients feel comfortable, conducive to disease treatment and prognosis of rehabilitation.

  10. Capability Enhancement and Amputee Care in Operation Iraqi Freedom: The Role of a Rehabilitation and Prosthetics Assistance Team in Reconstruction Operations

    Science.gov (United States)

    2009-05-01

    prosthetic devices were delivered (21% of patients seen) with the remainder of patients either BK (36% Multiple (1%) Bilateral Upper (1% Partial Foot (2% KD...femoral limb loss KO- knee disarticulation Seines- ankle disarticulation P;u1ial Foot - Carpal-in et a carpal amputation Bilateral lower extremity limb loss...prosthetic limb lypi- cally marked the transition in rehabilitation goals to functional outcomes such as using an upper extremity prosthesis to per

  11. Heterotopic Ossification in Combat Amputees from Afghanistan and Iraq wars: Five Case Histories and Results from a Small Series of Patients

    Science.gov (United States)

    2011-01-01

    ossification, Iraq war, physical medicine, prosthesis , radiograph, rehabilitation. INTRODUCTION Heterotopic ossification (HO) is a significant post- injury...mechanism for suspension of the residual limb within the prosthetic socket [16]. The patient continued to use the prosthesis without significant issues...lower right leg and foot . An electromyogram showed poor chance of recovery of motor control or sensation below the right knee. The frac- tures in the

  12. Body Image, Relationships and Sexuality After Amputation

    Science.gov (United States)

    ... amputee. This includes feelings of anger, fear and frustration. It also includes how the other person feels ... for 30 years, specializing in marriage and sex therapy. She has been a hip-disarticulation amputee since ...

  13. Modular externally-powered system for limb prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Seamone, W.; Hoshall, C.H.; Schmeisser, G.

    Many upper limb amputees especially those who have sustained high level amputations of injury to remaining portions of the body, are unable to use conventional prosthetic devices effectively. In an effort to help the more severely handicapped amputees and those who may for other reasons require capabilities that standard prostheses cannot provide, the Applied Physics Laboratory, in conjunction with the Johns Hopkins Medical Institutions, has developed a prosthetic system which is powered by rechargeable batteries. The amputee need supply only a control signal. This article describes the concept which is now being evaluated with the aid of amputee subjects, and discusses results obtained to data in field tests.

  14. Rotationally actuated prosthetic helping hand

    Science.gov (United States)

    Norton, William E. (Inventor); Belcher, Jewell G., Jr. (Inventor); Carden, James R. (Inventor); West, Thomas W. (Inventor)

    1991-01-01

    A prosthetic device has been developed for below-the-elbow amputees. The device consists of a cuff, a stem, a housing, two hook-like fingers, an elastic band for holding the fingers together, and a brace. The fingers are pivotally mounted on a housing that is secured to the amputee's upper arm with the brace. The stem, which also contains a cam, is rotationally mounted within the housing and is secured to the cuff, which fits over the amputee's stump. By rotating the cammed stem between the fingers with the lower arm, the amputee can open and close the fingers.

  15. Dynamic Loads at Knee Joint of Trans-tibial Amputee on Different Terrains%小腿截肢患者不同路况下膝关节动态载荷研究

    Institute of Scientific and Technical Information of China (English)

    贾晓红; 张明; 樊瑜波; 王人成

    2005-01-01

    研究截肢患者行走过程中的膝关节动态载荷是膝关节损伤康复和假肢设计的基础.本研究以小腿截肢患者为研究对象,建立了膝关节动态载荷三维计算模型,通过平地行走、上、下楼梯三种路况下的步态分析,对一个步态周期内的膝关节载荷进行了计算分析.结果表明,各种路况下患者的步态特征和膝关节载荷各不相同,虽然总体变化规律基本一致,但上下楼梯时的小腿运动范围、地面反力和膝关节载荷比平地行走时幅值较大.这些定量分析结果为小腿截肢患者步态分析和假肢设计提供了理论依据.

  16. Analysis of the effect of the community rehabilitation on the lower limbs amputee disabled people%下肢截肢患者的社区康复效果分析

    Institute of Scientific and Technical Information of China (English)

    许国祥; 宋德香; 温朝阳; 傅彬; 孙莹惠; 陈亮; 邱育; 王子平

    2010-01-01

    @@ 截肢是指通过手术切除已失去生存能力、没有生理功能、危害人体生命的部分或全部肢体,以挽救患者生命,并通过安装假肢和康复训练来改进肢体功能.常见于创伤、感染、肿瘤、神经损伤、周围血管病变、先天畸形等.由于长期受病痛的折磨,机体及精神受到了巨大的损伤,因此做好截肢患者的康复治疗非常重要.2007年3月起,作者对上海市浦东新区(原南汇区)康桥镇24例下肢截肢患者依托社区进行康复治疗,取得良好效果.现报告如下.

  17. 3D finite element dynamic analysis of interface stress at residual limb of a trans-tibial amputee%小腿截肢患者残端应力的三维有限元动态分析

    Institute of Scientific and Technical Information of China (English)

    贾晓红; 张明; 王人成; 金德闻

    2004-01-01

    目的:研究接受腔/残肢界面应力分布特征,为假肢优化设计提供基础.方法:基于核磁共振图像,获得小腿截肢患者残端和假肢几何特征,建立三维非线性有限元模型,通过比较站立状态和行走过程中的界面应力,研究动态载荷对界面压力的影响.结果:界面压力主要分布在髌韧带、胫骨内外侧和腘窝区,一个平地正常速度行走的步态周期内,残肢界面的最大平均正压力是单腿站立状态下的1.15倍,最大平均切应力是单腿站立状态的1.4倍.结论:动态载荷使残肢和接受腔之间的界面应力增大,行走过程的动态影响不宜忽略.

  18. The practice of evidence-based care through nursing process for amputee patients%循证护理在截肢患者护理中的实践

    Institute of Scientific and Technical Information of China (English)

    叶萍

    2008-01-01

    目的 应用循证护理探讨截肢患者护理的有效方法.方法 成立循证小组,对患者全面评估,查阅资料,寻找科学的循证支持,提出循证问题并制定切实可行的护理措施.结果 18例患者住院期间无一例发生并发症,均治愈出院.结论 循证护理有助于护理人员综合素质的提高;循证护理提高了护理服务质量;循证护理促进护理学科的发展.

  19. Improvement of quality of life of amputees by means of good behavioral nursing%做好截肢患者行为护理以提高生活质量

    Institute of Scientific and Technical Information of China (English)

    朱雪辉; 吴坤

    2009-01-01

    @@ 行为护理是在行为科学与行为医学的基础上提出来的新概念,是适应现代生物、心理、社会医学模式的需要,对患者实施的一种护理手段,是对生物心理社会模式护理的一个补充[1],是现代整体护理中的一个组成部分.大多数截肢是为挽救或延长伤病员的生命而不得已采用手术;有时也会由于有的肢体完全丧失功能,截除后安装假肢可更有利于恢复功能而截肢.负性情绪和行为是久病难愈的重要因素,因此,实施优秀的行为护理对提高截肢病人生活质量和早期康复有着重要意义.现将护理体会介绍如下.1 观察患者的情绪与行为表现

  20. INFLUENCE OF HOMECARE ON THE LIFE QUALITY OF AMPUTEES SUFFERING FROM DIABETIES FOOT%家居护理对糖尿病足截肢患者生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    黄雪萍; 刘洁珍; 谢青梅; 张成娟; 张光明

    2013-01-01

    目的 探讨家居护理对糖尿病足截肢患者生活质量的影响.方法 采用生活质量测定量表和疼痛程度评估对36例糖尿病足截肢患者干预前后的生活质量进行调查,并分析相关数据.结果 干预后观察组残肢疼痛程度明显减轻,与对照组比较有显著性差异(P<0.01);在生活质量评分中生理功能、心理状态、独立性、社会关系、总平均分等领域观察组均有不同程度的提高,与对照组比较有差异(P<0.05).结论 通过采取有针对性的家居干预措施,可提高糖尿病足截肢患者的生活质量.

  1. Study of rehabilitation requirements of amputee during WenChuan Earthquake%汶川地震伤截肢患者的康复需求调查分析

    Institute of Scientific and Technical Information of China (English)

    李诗雨; 陈忠兰; 敬沛嘉; 宁宁

    2009-01-01

    目的:了解汶川地震后截肢患者存在的功能障碍及康复需求情况.方法:选取我院骨科2008 年5 月12 日至2008 年6 月1 日收治的19 例截肢患者为研究对象,采用自行设计的调查表,由康复医师在征得研究对象同意的情况下完成资料的收集. 结果:63.2%的患者存在肌力下降,36.8%的患者生活需要帮助,其中生活依赖明显占31.6%,完全依赖占5.3 %,几乎所有患者存在参与功能障碍. 结论:大多数截肢患者存在不同程度的功能障碍,应该引起高度重视其康复锻炼.

  2. Effect of prosthetic alignment on the biomechanics of the lower extremity for trans-tibial amputees%对线对小腿截肢患者残侧下肢生物力学特性的影响

    Institute of Scientific and Technical Information of China (English)

    李小兵; 贾晓红; 王人成; 金德闻

    2007-01-01

    为定量研究假肢对线对小腿截肢患者行走过程中残侧下肢生物力学特性的综合影响,建立了考虑对线设置的三维刚体动力学模型,并结合步态实验,得到膝关节力矩、步态时相对称性和残端界面压力等参数.结果表明:异常对线主要影响残侧膝关节力矩和步态时相对称性,对残端压力影响较小;腿管近端适配器的调整在对线设置中的作用较远端适配器明显;由于患者的自身调节作用,假肢正常对线要实现患者下肢生物力学性能的总体最优而非单项最优.

  3. Slip risk analysis for trans-femoral amputees during level walking%膝上截肢患者行走过程中的滑倒危险性分析

    Institute of Scientific and Technical Information of China (English)

    杨建坤; 金德闻; 季林红; 王人成; 张济川; 方新; 周大伟

    2006-01-01

    为了研究膝上截肢患者在平地行走过程中所面临的滑倒危险性,共有10名男性健康受试者和6名男性单侧膝上截肢患者参加了试验.每位受试者均在干燥路面条件下,以自然步态进行3次行走试验.试验过程中,分别采集受试者的运动学参数和地面反力.利用地面反力计算出每位受试者行走过程中所需最大摩擦因数(RCOFPEAK)以及额状面内的侧向力对所需最大摩擦因数的贡献率(RX),并且分别进行单因素方差分析(ANOVA).结果表明:截肢患者所面临的滑倒危险性明显大于健康受试者;行走过程中截肢患者的身体在额状面内的摇摆增大,使得侧向地面反力明显增大,这是截肢患者的滑倒危险性显著增大的主要原因.

  4. "5·12"汶川地震伤员截肢时机对预后的影响%A retrospective study on the amputation time and prognosis of the amputees wounded in the"5·12"earthquake

    Institute of Scientific and Technical Information of China (English)

    李效全; 刘佳易; 李自会; 舒为民

    2009-01-01

    目的 探讨地震灾害群体伤事件时,伤员截肢的时机对术后伤员康复的影响.方法 地震伤住院病员中有22例不同部位肢体截肢,按截肢时间分为急诊截肢组18例和延迟截肢组4例,对比分析截肢时机对术后伤口愈合、 感染、二次截肢、术后并发症、特殊感染的影响.结果 两组术后切口感染率比较,差异有显著性意义(P<0.01);并发 症发生率比较,差异有显著性意义(P<0.05);术后感染后二次截肢率比较,差异无显著性意义(P>0.05);特殊感染 发生率比较,差异无显著性意义(P>0.05).结论 地震灾害群体伤事件时,有截肢指征的伤员在入院后12小时内截 肢能有效降低伤员术后伤口感染率及并症发生率,提高医疗救治质量.

  5. Effect of dynamic loads on the interface pressure at the residual limb of a trans-tibial amputee%动态载荷对小腿截肢患者残端压力的影响

    Institute of Scientific and Technical Information of China (English)

    贾晓红; 张明; 王人成; 金德闻; 李超俊

    2004-01-01

    接受腔/残肢界面压力分布特征是假肢优化设计的基础,传统的有限元模型只限于静态分析,不符合实际情况.该文基于患者行走过程的运动学和动力学特性,建立三维非线性有限元模型,研究动态载荷对界面压力的影响.结果表明: 界面压力主要分布在髌韧带、胫骨内外侧和窝区; 一个平地正常速度行走的步态周期内,残肢界面的最大平均正压力是单腿站立状态下的1.15倍,是双腿站立状态下的 1.73 倍.动态载荷使残肢和接受腔之间的界面压力增大,行走过程的动态影响不能忽略.

  6. 对电击伤截肢后幻肢痛病人的心理因素分析及行为治疗%Psychological factors and behavior treatment of imagined pain of amputee limb after electric injury

    Institute of Scientific and Technical Information of China (English)

    柴学红

    2001-01-01

    目的分析电击伤截肢后幻肢痛病人的心理因素及观察对其施以行为治疗的疗效。方法取 42例电击伤截肢后出现幻肢痛的患者,随机分为观察组与对照组。两组病人在截肢手术后及出院前分别采用麦基尔疼痛量表和情境一特质焦虑量表进行测评。对照组常规药物止痛;观察组则在此基础上增加认知行为调整及放松训练等。结果经过 3~ 4周的治疗,观察幻肢痛减轻或消失,两组比较差异有显著性 P<0.05。结论电击伤截肢病人的焦虑程度与幻肢痛相关;行为治疗对幻肢痛的疗效明显。

  7. Effect of cable-controlled forearm prosthesis on reconstruction of upper extremity functions for forearm amputees%索控式前臂假肢对前臂截肢者上肢功能重建的影响

    Institute of Scientific and Technical Information of China (English)

    张艳艳; 翁懿

    2013-01-01

    目的:探索索控式前臂假肢对前臂截肢者上肢功能重建的影响.方法:随机选取23名符合条件的截肢者,先进行康复训练,再装配索控式前臂假肢,之后参照Carroll量表进行上肢功能试验(UEFT),对截肢者上肢功能进行评定,对所得数据进行分析.结果:装配后上肢功能评分有显著提高,可以实现抓握、捏、侧捏、放置等上肢功能.结论:索控式前臂假肢的装配能有效重建前臂截肢者的上肢功能.

  8. Energy expenditure during walking in amputees after disarticulation of the hip. A microprocessor-controlled swing-phase control knee versus a mechanical-controlled stance-phase control knee.

    Science.gov (United States)

    Chin, T; Sawamura, S; Shiba, R; Oyabu, H; Nagakura, Y; Nakagawa, A

    2005-01-01

    We have compared the energy expenditure during walking in three patients, aged between 51 and 55 years, with unilateral disarticulation of the hip when using the mechanical-controlled stance-phase control knee (Otto Bock 3R15) and the microprocessor-controlled pneumatic swing-phase control knee (Intelligent Prosthesis, IP). All had an endoskeletal hip disarticulation prosthesis with an Otto Bock 7E7 hip and a single-axis foot. The energy expenditure was measured when walking at speeds of 30, 50, and 70 m/min. Two patients showed a decreased uptake of oxygen (energy expenditure per unit time, ml/kg/min) of between 10.3% and 39.6% when using the IP compared with the Otto Bock 3R15 at the same speeds. One did not show any significant difference in the uptake of oxygen at 30 m/min, but at 50 and 70 m/min, a decrease in uptake of between 10.5% and 11.6% was found when using the IP. The use of the IP decreased the energy expenditure of walking in these patients.

  9. Investigation of the syndrome of apotemnophilia and course of a cognitive-behavioural therapy

    NARCIS (Netherlands)

    Braam, A.W.; Visser, S.; Cath, D.C.; Hoogendijk, W.J.G.

    2005-01-01

    Background: The syndrome of apotemnophilia, body integrity or amputee identity disorder, is defined as the desire for amputation of a healthy limb, and may be accompanied by behaviour of pretending to be an amputee and sometimes, but not necessarily, by sexual arousal. Sampling and Methods: A case h

  10. Semi-flexible sockets for amputation below the knee.

    Science.gov (United States)

    Symington, D C; Lowe, P J; Mackay, S

    1975-09-01

    A semi-flexible socket fitted to a series of 47 consecutive below-knee amputees is evaluated, and the problems in assessing prosthetic components and appropriate methodology are discussed. The results suggest that this type of socket deserves wider use and further evaluation in active amputees, where comfort, perspiration control or the condition of the skin is interfering with the patient's function.

  11. Job satisfaction and health experience of people with a lower-limb amputation in comparison with healthy colleagues

    NARCIS (Netherlands)

    Schoppen, Tanneke; Boonstra, A; Groothoff, JW; de Vries, J; Goeken, LN; Eisma, Willem

    2002-01-01

    Objectives: To describe indicators of job dissatisfaction among amputee employees and to compare job satisfaction and health experience of working amputee employees with that of control subjects. Design: A cross-sectional study, mailed questionnaire. Setting: Patients were recruited by the orthopedi

  12. The Locomotor Capabilities Index; validity and reliability of the Swedish version in adults with lower limb amputation

    Directory of Open Access Journals (Sweden)

    Andersson Ingemar H

    2009-05-01

    Full Text Available Abstract Background The Locomotor Capabilities Index (LCI is a validated measure of lower-limb amputees' ability to perform activities with prosthesis. We have developed the LCI Swedish version and evaluated its validity and reliability. Methods Cross-cultural adaptation to Swedish included forward/backward translations and field testing. The Swedish LCI was then administered to 144 amputees (55 women, mean age 74 (40–93 years, attending post-rehabilitation prosthetic training. Construct validity was assessed by examining the relationship between the LCI and Timed "Up-and-Go" (TUG test and between the LCI and EQ-5D health utility index in 2 subgroups of 40 and 20 amputees, respectively. Discriminative validity was assessed by comparing scores in different age groups and in unilateral and bilateral amputees. Test-retest reliability (1–2 weeks was evaluated in 20 amputees (14 unilateral. Results The Swedish LCI showed good construct convergent validity, with high correlation with the TUG (r = -0.75 and the EQ-5D (r = 0.84, and discriminative validity, with significantly worse mean scores for older than younger and for bilateral than unilateral amputees (p Conclusion The Swedish version of the LCI demonstrated good validity and internal consistency in adult amputees. Test-retest reliability in a small subsample appears to be acceptable. The high ceiling effect of the LCI may imply that it would be most useful in assessing amputees with low to moderate functional abilities.

  13. A review of the long-term health outcomes associated with war-related amputation.

    Science.gov (United States)

    Robbins, Christopher B; Vreeman, Daniel J; Sothmann, Mark S; Wilson, Stephen L; Oldridge, Neil B

    2009-06-01

    The rate of war-related amputations in current U.S. military personnel is now twice that experienced by military personnel in previous wars. We reviewed the literature for health outcomes following war-related amputations and 17 studies were retrieved with evidence that (a) amputees are at a significant risk for developing cardiovascular disease; (b) insulin may play an important role in regulating blood pressure in maturity-onset obesity; (c) lower-extremity amputees are at risk for joint pain and osteoarthritis; (d) transfemoral amputees report a higher incidence of low back pain than transtibial amputees; and (e) 50 to 80% report phantom limb pain, with many amputees stating they were either told that their pain was imagined or their mental state was questioned. The consistency of the observations on health outcomes in these studies warrants careful examination for their implication in the contemporary treatment of war-related amputation.

  14. [Pre-prosthetics: role of the physiotherapist in the treatment of the residual limb and prosthetic preparation of the person].

    Science.gov (United States)

    Maffi, Alberto; Mulè, Chiara; Taveggia, Giovanni

    2015-01-01

    The rehabilitation of amputees requires a multi-discipline approach. Within the work of the team, physiotherapy plays a central role both in terms of the technical skills made available to the patient, as well as in terms of the psychological-motivational support offered to the amputee during treatment. The pre-prosthetic phase of rehabilitation is the beginning of a complex rehabilitative process during which starts with an assessment of the general clinical condition of the patient and their residual capacities, so as to develop personalised rehabilitative strategies based upon the needs of the amputee. This whole process aims to get the amputee standing with a prosthetic as quickly as possible, thus allowing the social reintegration of the amputee.

  15. BELOW-ELBOW COSMETIC CONDYLE-SUSPENDED PROSTHESIS

    Science.gov (United States)

    particular appeal to those amputees who desire a prosthesis for cosmetic reasons. However this type of prosthesis can be so built to provide a means for operating the active mechanical terminal device. (Author)

  16. Sport Opportunities for Athletes with Disabilities.

    Science.gov (United States)

    Journal of Physical Education, Recreation & Dance, 1984

    1984-01-01

    This series outlines sport opportunities for athletes with disabilities. Included are articles discussing sports for athletes with cerebral palsy, deaf athletes, blind athletes, wheelchair bound athletes, amputee athletes, as well as a discussion of the Special Olympics. (JMK)

  17. Custom design in lower limb prosthetics for athletic activity.

    Science.gov (United States)

    Fergason, J R; Boone, D A

    2000-08-01

    In summary, the prosthetist is the best source of information with regard to the fast-changing lower extremity prosthetics technology for sports. The needs and desires of the amputee should be outlined and balanced with the cost of the desired components and design. In many cases, one carefully designed prosthesis can serve in dual roles for everyday ambulation and certain athletic activities. In other cases, the amputee is limited severely by a prosthesis that is not designed for a specific activity. Using a prosthesis for activities that it was not designed to accommodate can cause physical injury to the amputee as well as structural failure of the device. A properly designed and fitted prosthesis can open a whole new world of activity to the amputee and helps him or her to reach the desired a vocational goals.

  18. Rehabilitation in limb deficiency. 1. Gait and motion analysis.

    Science.gov (United States)

    Czerniecki, J M

    1996-03-01

    This self-directed learning module highlights new advances in this topic area. It is part of the chapter on rehabilitation in limb deficiency in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses normal gait, the influence of prosthetic alignment on amputee function, and the effects of prosthetic components on the metabolic costs and the biomechanical function of the amputee. The biomechanics of normal ambulation are presented as a background to enable the practitioner to gain an understanding of the typical gait adaptations that occur in below-knee and above-knee amputees. The effects of newer prosthetic components and socket designs on the biomechanical adaptations are reviewed. The metabolic costs of amputee ambulation are significantly greater than normal. The theoretical mechanisms for this are discussed, and the effects of newer socket designs, ultra-light-weight components, and energy-storing prosthetic components are presented.

  19. Talking With Your Doctor: MedlinePlus Health Topic

    Science.gov (United States)

    ... PDF Also in Spanish Let's Talk...and Listen (Amputee Coalition of America) - PDF Living Well with a ... Services, Office on Women's Health) Seniors Living with Multiple Health Problems: What Older Adults Should Know (AGS ...

  20. Prosthetic Care FAQs

    Science.gov (United States)

    ... satisfaction in improving the quality of life for amputees. The field began to expand in the late ... that a good treatment plan will often include multiple visits, so it is helpful to consider a ...

  1. The College of Podiatry Annual Conference 2015: meeting abstracts

    OpenAIRE

    Tong, Jasper W. K.; Kong, Veni P.; Sze, Lily; Gale, Susie; Veto, John; Tunprasert, Thanaporn; Bradley, Victoria; Strike, Siobhan; Ashford, Robert; Naemi, Roozbeth; Chocklingam, Nachiappan; de Blasc, Xavi; Robinson, Vicki; Nicholls, Emily; Birch, Tabitha

    2016-01-01

    Table of content P3 Medial longitudinal arch development of school children Jasper W.K. Tong, Veni P. Kong P4 Is measuring the subtalar joint reliable? Lily Sze, Susie Gale, John Veto, Carla McArdle P5 Comparison of turning gait biomechanics between able-bodied and unilateral transtibial amputee participants Thanaporn Tunprasert, Victoria Bradley, Siobhan Strike P6 Comparison of walking gait biomechanics between able-bodied and unilateral transtibial amputee participants using a new model of ...

  2. Metabolic and Biomechanical Measures of Gait Efficiency of Three Multi-Axial, Vertical Shock and Energy Storing Return Prosthetic Feet During Simple & Complex Mobility Activities

    Science.gov (United States)

    2013-10-01

    AD_________________ Award Number: W81XWH-11-1-0748 TITLE: Metabolic and Biomechanical Measures of Gait Efficiency of Three Multi-Axial...Metabolic and Biomechanical Measures of Gait Efficiency of Three Multi-Axial, Vertical Shock and Energy Storing Return Prosthetic Feet During Simple... athlete . Amputee performance will also be compared to a non-amputee control group. Body At this time we can report that 100% of experimental

  3. Determining the Marker Configuration and Modeling Technique to Optimize the Biomechanical Analysis of Running-Specific Prostheses

    Science.gov (United States)

    2012-03-01

    Prosthetics; 2005. 13. Nolan L. Carbon fibre prostheses and running in amputees: A review. Foot and Ankle Surgery 2008;14:125-9. 14. Gailey R...activity level may be insufficient guidelines for prescribing a stiffness category. A stiffer forefoot , wider c-curve, and thinner lay-up resulted... Surgery 2008;14:125-9. 14. Gailey R. Optimizing prosthetic running performance of the transtibial amputee. Proceedings of the Proceedings of the

  4. Plasticity in the visual system is associated with prosthesis use in phantom limb pain

    OpenAIRE

    2013-01-01

    The experience of strong phantom limb pain (PLP) in arm amputees was previously shown to be associated with structural neural plasticity in parts of the cortex that belong to dorsal and ventral visual streams. It has been speculated that this plasticity results from the extensive use of a functional prosthesis which is associated with increased visual feedback to control the artificial hand. To test this hypothesis, we reanalyzed data of cortical volumes of 21 upper limb amputees and tested t...

  5. Ten Years at War: Comprehensive Analysis of Amputation Trends

    Science.gov (United States)

    2012-01-01

    ceptionally difficult to manage .11,12 There have been numerous studies published examining major amputations caused by extremity trauma during the OIF, OEF...Disarticulation, knee disarticulation, elbow disarticulation, wrist disarticulation 1 0 Total 366 30 (of all amputees) J Trauma Acute Care Surg Volume 73...to amputation, Injury Severity Score (ISS), age, rank, number of trauma admissions, and number of troops deployed. RESULTS: There were 1,221 amputees

  6. Patient-based Outcomes and Quality of Life after Salvageable Wartime Extremity Vascular Injury

    Science.gov (United States)

    2014-01-01

    Quality of life evaluation. The SF-36 consists of 36 multiple -choice questions that seek to evaluate the overall quality of life of a patient in a...shunt use or nonuse, and associated primary amputation, were not predictive of unfavorable outcomes on multivariate analysis. Secondary amputees ...secondary amputees reported elevated Vitality scores (50.8 6 10.6 vs 46.5 6 11.3; P ¼ .046). Secondary ampu- tation was not associated with overall mental

  7. Use and Complications of Operative Control of Arterial Inflow in Combat Casualties with Traumatic Lower-extremity Amputations Caused by Improvised Explosive Devices

    Science.gov (United States)

    2013-08-01

    injuries: patterns of injuries and resource utilization associated with the multiple extremity amputee . J Surg Orthop Adv. 2012;21:32Y37. 11. Andersen RC...methods of proximal control in high wartime lower-extremity amputees . Although some casualties will have abdominal injuries that necessitate...of suprainguinal vascular control and complications that arose. In cases where multiple levels of control were used, data on all vessels were collected

  8. An Overview of the Running Performance of Athletes with Lower-Limb Amputation at the Paralympic Games 2004–2012

    Directory of Open Access Journals (Sweden)

    Hossein Hassani

    2015-06-01

    Full Text Available This paper analyses the performances of lower-limb amputees in the 100, 200 and 400 m running events from the 2004, 2008 and 2012 Paralympic Games. In this paper, four hypotheses are pursued. In the first, it investigates whether the running performance of lower-limb amputees over three consecutive Paralympic Games has changed. In the second, it asks whether a bi-lateral amputee has a competitive advantage over a uni-lateral amputee. In the third, the effect of blade classification has been considered and we attempt to see whether amputees in various classifications have different level of performance. Finally, it is considered whether the final round of competition obtains different levels of performance in comparison to the qualification heats. Based on the outcomes of these investigations, it is proposed that future amputee-based running events should be undertaken with separate and not combined events for the T42, T43 and T44 classifications at the Paralympic Games.

  9. Maximum-speed curve-running biomechanics of sprinters with and without unilateral leg amputations.

    Science.gov (United States)

    Taboga, Paolo; Kram, Rodger; Grabowski, Alena M

    2016-03-01

    On curves, non-amputees' maximum running speed is slower on smaller radii and thought to be limited by the inside leg's mechanics. Similar speed decreases would be expected for non-amputees in both counterclockwise and clockwise directions because they have symmetric legs. However, sprinters with unilateral leg amputation have asymmetric legs, which may differentially affect curve-running performance and Paralympic competitions. To investigate this and understand the biomechanical basis of curve running, we compared maximum curve-running (radius 17.2 m) performance and stride kinematics of six non-amputee sprinters and 11 sprinters with a transtibial amputation. Subjects performed randomized, counterbalanced trials: two straight, two counterclockwise curves and two clockwise curves. Non-amputees and sprinters with an amputation all ran slower on curves compared with straight running, but with different kinematics. Non-amputees ran 1.9% slower clockwise compared with counterclockwise (Prunning. Sprinters with an amputation also reduced stride length in both curve-running directions, but reduced stride frequency only on curves with the affected leg on the inside. During curve running, non-amputees and athletes with an amputation had longer contact times with their inside compared with their outside leg, suggesting that the inside leg limits performance. For sprinters with an amputation, the prolonged contact times of the affected versus unaffected leg seem to limit maximum running speed during both straight running and running on curves with the affected leg on the inside.

  10. Running-specific prostheses limit ground-force during sprinting

    Science.gov (United States)

    Grabowski, Alena M.; McGowan, Craig P.; McDermott, William J.; Beale, Matthew T.; Kram, Rodger; Herr, Hugh M.

    2010-01-01

    Running-specific prostheses (RSP) emulate the spring-like behaviour of biological limbs during human running, but little research has examined the mechanical means by which amputees achieve top speeds. To better understand the biomechanical effects of RSP during sprinting, we measured ground reaction forces (GRF) and stride kinematics of elite unilateral trans-tibial amputee sprinters across a range of speeds including top speed. Unilateral amputees are ideal subjects because each amputee's affected leg (AL) can be compared with their unaffected leg (UL). We found that stance average vertical GRF were approximately 9 per cent less for the AL compared with the UL across a range of speeds including top speed (p < 0.0001). In contrast, leg swing times were not significantly different between legs at any speed (p = 0.32). Additionally, AL and UL leg swing times were similar to those reported for non-amputee sprinters. We infer that RSP impair force generation and thus probably limit top speed. Some elite unilateral trans-tibial amputee sprinters appear to have learned or trained to compensate for AL force impairment by swinging both legs rapidly. PMID:19889694

  11. Robotic lower limb prosthesis design through simultaneous computer optimizations of human and prosthesis costs

    Science.gov (United States)

    Handford, Matthew L.; Srinivasan, Manoj

    2016-02-01

    Robotic lower limb prostheses can improve the quality of life for amputees. Development of such devices, currently dominated by long prototyping periods, could be sped up by predictive simulations. In contrast to some amputee simulations which track experimentally determined non-amputee walking kinematics, here, we explicitly model the human-prosthesis interaction to produce a prediction of the user’s walking kinematics. We obtain simulations of an amputee using an ankle-foot prosthesis by simultaneously optimizing human movements and prosthesis actuation, minimizing a weighted sum of human metabolic and prosthesis costs. The resulting Pareto optimal solutions predict that increasing prosthesis energy cost, decreasing prosthesis mass, and allowing asymmetric gaits all decrease human metabolic rate for a given speed and alter human kinematics. The metabolic rates increase monotonically with speed. Remarkably, by performing an analogous optimization for a non-amputee human, we predict that an amputee walking with an appropriately optimized robotic prosthesis can have a lower metabolic cost – even lower than assuming that the non-amputee’s ankle torques are cost-free.

  12. An Analysis of Intrinsic and Extrinsic Hand Muscle EMG for Improved Pattern Recognition Control.

    Science.gov (United States)

    Adewuyi, Adenike A; Hargrove, Levi J; Kuiken, Todd A

    2016-04-01

    Pattern recognition control combined with surface electromyography (EMG) from the extrinsic hand muscles has shown great promise for control of multiple prosthetic functions for transradial amputees. There is, however, a need to adapt this control method when implemented for partial-hand amputees, who possess both a functional wrist and information-rich residual intrinsic hand muscles. We demonstrate that combining EMG data from both intrinsic and extrinsic hand muscles to classify hand grasps and finger motions allows up to 19 classes of hand grasps and individual finger motions to be decoded, with an accuracy of 96% for non-amputees and 85% for partial-hand amputees. We evaluated real-time pattern recognition control of three hand motions in seven different wrist positions. We found that a system trained with both intrinsic and extrinsic muscle EMG data, collected while statically and dynamically varying wrist position increased completion rates from 73% to 96% for partial-hand amputees and from 88% to 100% for non-amputees when compared to a system trained with only extrinsic muscle EMG data collected in a neutral wrist position. Our study shows that incorporating intrinsic muscle EMG data and wrist motion can significantly improve the robustness of pattern recognition control for application to partial-hand prosthetic control.

  13. 下肢动脉硬化闭塞症患者股动脉粥样硬化斑块中巨噬细胞极化表型与自噬信号相关性的研究%Correlation between autophagy and polarization of macrophages in atherosclerosis plaque in arteriosclerosis obliterans amputees

    Institute of Scientific and Technical Information of China (English)

    陈文娜; 郭胜男; 王俊岩; 贾连群; 李大勇; 田英

    2016-01-01

    本文探讨了下肢动脉硬化闭塞症患者股动脉粥样硬化斑块中巨噬细胞自噬与极化的相互联系.取下肢动脉硬化闭塞症截肢患者的股动脉标本,分别行HE (hematoxylin and eosin)、油红O和免疫荧光染色,观察动脉粥样硬化斑块形态、斑块内巨噬细胞表型及自噬体表达;采用实时荧光定量RT-PCR技术检测动脉组织巨噬细胞M1与M2型标记物的mRNA表达水平;采用Western blot方法检测巨噬细胞极化信号通路及自噬蛋白表达水平.结果显示,动脉标本染色可见明显脂质沉积和大量泡沫细胞及炎性细胞浸润,纤维斑块以M1型巨噬细胞为主,粥样斑块M1与M2表型同时高表达,其中M2型巨噬细胞升高尤为显著,且粥样斑块自噬水平明显高于纤维斑块.纤维斑块组织肿瘤坏死因子α(TNF-α)、单核细胞趋化因子1(MCP-1)、诱导性—氧化氮合成酶(iNOS)、白细胞介素6 (IL-6)、白细胞介素12 (IL-12) mRNA表达水平均明显高于粥样斑块组织(P<0.01或0.05),而精氨酸酶1 (Arg-1)、转化生长因子β(TGF-β)、CD163及白细胞介素10 (IL-10)表达水平明显低于粥样斑块组织(P<0.01).纤维斑块组织p-STAT1及NF-κB表达水平显著升高(P<0.01),而粥样斑块组织p-STAT6表达显著升高(P<0.01),粥样斑块组织自噬体蛋白LC3-Ⅱ表达水平明显高于纤维斑块组织(P<0.01).研究提示早期动脉粥样硬化斑块中巨噬细胞通过p-STAT1/NF-κB通路诱导向M1型极化,表达适度的自噬水平;而晚期斑块中巨噬细胞则通过激活p-STAT6通路诱导向M2型极化的过渡,M2型巨噬细胞较M1型具有更高的自噬水平.

  14. Impact of Phased Rehabilitation Programs on the Life Quality of Amputees of the "5 · 12" Wenchuan Earthquake%“5·12”汶川地震截肢伤员分阶段康复方案对生存质量的影响

    Institute of Scientific and Technical Information of China (English)

    龙忠国; 何修平; 杨红英; 毛小春

    2016-01-01

    目的 对“5·12”汶川地震截肢伤员开展康复前、康复满1年(近期)、满3年(中期)及满5年(远期)的生存质量变化,进行调查研究,探索最佳的持续康复方案.方法 2008年9月,把在上级医院救治后,陆续返回绵竹市第二人民医院进行康复治疗的52例“5·12”地震截肢伤员分为A、B两组,每组各26例.A组采用分阶段康复方案,B组采用常规康复方案.于康复前、满1年、3年及5年时,采用“震后德阳市截肢伤员个人情况表”和世界卫生组织生存质量测定量表作为研究工具,进行生存质量调查分析.结果 A、B两组生存质量分值总体呈现持续上升态势,各期分值A组都高于B组,2013年9月远期生存质量调查显示,A组与B组在积极的感觉方面评分分别为(193.0±12.3)、(126.0±11.2)分,做事能力分别为(62.0±5.2)、(41.0±2.3)分,生活满意度分别为(150.0±2.1)、(101.0±6.2)分,行动能力分别为(17.0±2.6)、(11.0±5.2)分,差异有统计学意义(P<0.05).结论 分阶段康复方案较常规康复方案更能促使伤员更好地改善和巩固生存质量,促进伤员更早回归家庭和社会,弥补了现有截肢康复方案的不足,值得推广应用.

  15. 镜像疗法改善截肢患者幻肢感及幻肢痛疗效的系统评价%Efficacy of Mirror Therapy for Phantom Limb Sensation and Phantom Limb Pain in Amputee: A Systematic Review

    Institute of Scientific and Technical Information of China (English)

    王凤怡; 张嘉祺; 张梦杰; 刘沙鑫; 张仁刚; 杨永红

    2016-01-01

    目的 系统评价镜像疗法治疗截肢患者幻肢感及幻肢痛的有效性.方法 计算机检索MEDLINE、PubMed、EMbase、The Cochrane Library(2015年第9期)、CBM、VIP、WanFang Data和CNKI数据库,搜集镜像疗法治疗截肢患者幻肢感及幻肢痛的相关随机对照试验(RCT),检索时限均从建库至2015年9月1日.由2位评价员独立筛选文献、提取资料并评价纳入研究的方法学质量后,采用RevMan 5.3软件进行Meta分析.结果 共纳入5个RCT,包括128例患者.Meta分析结果显示:没有足够的证据支持镜像疗法能够改善截肢患者的幻肢痛[MD=-7.29,95%CI(-27.73,13.16),P=0.48].结论 镜像疗法可能增强截肢患者对幻肢的控制感,但对幻肢痛的改善作用尚不明确,可能存在一过性的积极作用,但其长期效应尚待研究.受纳入研究数量和质量限制,上述结论尚有赖于进一步开展更多大样本、多中心、高质量的RCT加以验证.

  16. Evaluating EMG Feature and Classifier Selection for Application to Partial-Hand Prosthesis Control

    Science.gov (United States)

    Adewuyi, Adenike A.; Hargrove, Levi J.; Kuiken, Todd A.

    2016-01-01

    Pattern recognition-based myoelectric control of upper-limb prostheses has the potential to restore control of multiple degrees of freedom. Though this control method has been extensively studied in individuals with higher-level amputations, few studies have investigated its effectiveness for individuals with partial-hand amputations. Most partial-hand amputees retain a functional wrist and the ability of pattern recognition-based methods to correctly classify hand motions from different wrist positions is not well studied. In this study, focusing on partial-hand amputees, we evaluate (1) the performance of non-linear and linear pattern recognition algorithms and (2) the performance of optimal EMG feature subsets for classification of four hand motion classes in different wrist positions for 16 non-amputees and 4 amputees. Our results show that linear discriminant analysis and linear and non-linear artificial neural networks perform significantly better than the quadratic discriminant analysis for both non-amputees and partial-hand amputees. For amputees, including information from multiple wrist positions significantly decreased error (p < 0.001) but no further significant decrease in error occurred when more than 4, 2, or 3 positions were included for the extrinsic (p = 0.07), intrinsic (p = 0.06), or combined extrinsic and intrinsic muscle EMG (p = 0.08), respectively. Finally, we found that a feature set determined by selecting optimal features from each channel outperformed the commonly used time domain (p < 0.001) and time domain/autoregressive feature sets (p < 0.01). This method can be used as a screening filter to select the features from each channel that provide the best classification of hand postures across different wrist positions. PMID:27807418

  17. Evaluating EMG Feature and Classifier Selection for Application to Partial-Hand Prosthesis Control.

    Science.gov (United States)

    Adewuyi, Adenike A; Hargrove, Levi J; Kuiken, Todd A

    2016-01-01

    Pattern recognition-based myoelectric control of upper-limb prostheses has the potential to restore control of multiple degrees of freedom. Though this control method has been extensively studied in individuals with higher-level amputations, few studies have investigated its effectiveness for individuals with partial-hand amputations. Most partial-hand amputees retain a functional wrist and the ability of pattern recognition-based methods to correctly classify hand motions from different wrist positions is not well studied. In this study, focusing on partial-hand amputees, we evaluate (1) the performance of non-linear and linear pattern recognition algorithms and (2) the performance of optimal EMG feature subsets for classification of four hand motion classes in different wrist positions for 16 non-amputees and 4 amputees. Our results show that linear discriminant analysis and linear and non-linear artificial neural networks perform significantly better than the quadratic discriminant analysis for both non-amputees and partial-hand amputees. For amputees, including information from multiple wrist positions significantly decreased error (p < 0.001) but no further significant decrease in error occurred when more than 4, 2, or 3 positions were included for the extrinsic (p = 0.07), intrinsic (p = 0.06), or combined extrinsic and intrinsic muscle EMG (p = 0.08), respectively. Finally, we found that a feature set determined by selecting optimal features from each channel outperformed the commonly used time domain (p < 0.001) and time domain/autoregressive feature sets (p < 0.01). This method can be used as a screening filter to select the features from each channel that provide the best classification of hand postures across different wrist positions.

  18. Evaluating EMG Feature and Classifier Selection for Application to Partial-Hand Prosthesis Control

    Directory of Open Access Journals (Sweden)

    Adenike A. Adewuyi

    2016-10-01

    Full Text Available Pattern recognition-based myoelectric control of upper limb prostheses has the potential to restore control of multiple degrees of freedom. Though this control method has been extensively studied in individuals with higher-level amputations, few studies have investigated its effectiveness for individuals with partial-hand amputations. Most partial-hand amputees retain a functional wrist and the ability of pattern recognition-based methods to correctly classify hand motions from different wrist positions is not well studied. In this study, focusing on partial-hand amputees, we evaluate (1 the performance of non-linear and linear pattern recognition algorithms and (2 the performance of optimal EMG feature subsets for classification of four hand motion classes in different wrist positions for 16 non-amputees and 4 amputees. Our results show that linear discriminant analysis and linear and non-linear artificial neural networks perform significantly better than the quadratic discriminant analysis for both non-amputees and partial-hand amputees. For amputees, including information from multiple wrist positions significantly decreased error (p<0.001 but no further significant decrease in error occurred when more than 4, 2, or 3 positions were included for the extrinsic (p=0.07, intrinsic (p=0.06, or combined extrinsic and intrinsic muscle EMG (p=0.08, respectively. Finally, we found that a feature set determined by selecting optimal features from each channel outperformed the commonly used time domain (p<0.001 and time domain/autoregressive feature sets (p<0.01. This method can be used as a screening filter to select the features from each channel that provide the best classification of hand postures across different wrist positions.

  19. Systematic variation of prosthetic foot spring affects center-of-mass mechanics and metabolic cost during walking.

    Science.gov (United States)

    Zelik, Karl E; Collins, Steven H; Adamczyk, Peter G; Segal, Ava D; Klute, Glenn K; Morgenroth, David C; Hahn, Michael E; Orendurff, Michael S; Czerniecki, Joseph M; Kuo, Arthur D

    2011-08-01

    Lower-limb amputees expend more energy to walk than non-amputees and have an elevated risk of secondary disabilities. Insufficient push-off by the prosthetic foot may be a contributing factor. We aimed to systematically study the effect of prosthetic foot mechanics on gait, to gain insight into fundamental prosthetic design principles. We varied a single parameter in isolation, the energy-storing spring in a prototype prosthetic foot, the controlled energy storage and return (CESR) foot, and observed the effect on gait. Subjects walked on the CESR foot with three different springs. We performed parallel studies on amputees and on non-amputees wearing prosthetic simulators. In both groups, spring characteristics similarly affected ankle and body center-of-mass (COM) mechanics and metabolic cost. Softer springs led to greater energy storage, energy return, and prosthetic limb COM push-off work. But metabolic energy expenditure was lowest with a spring of intermediate stiffness, suggesting biomechanical disadvantages to the softest spring despite its greater push-off. Disadvantages of the softest spring may include excessive heel displacements and COM collision losses. We also observed some differences in joint kinetics between amputees and non-amputees walking on the prototype foot. During prosthetic push-off, amputees exhibited reduced energy transfer from the prosthesis to the COM along with increased hip work, perhaps due to greater energy dissipation at the knee. Nevertheless, the results indicate that spring compliance can contribute to push-off, but with biomechanical trade-offs that limit the degree to which greater push-off might improve walking economy.

  20. Proportional EMG control of ankle plantar flexion in a powered transtibial prosthesis.

    Science.gov (United States)

    Wang, Jing; Kannape, Oliver A; Herr, Hugh M

    2013-06-01

    The human calf muscle generates 80% of the mechanical work to walk throughout stance-phase, powered plantar flexion. Powered plantar flexion is not only important for walking energetics, but also to minimize the impact on the leading leg at heel-strike. For unilateral transtibial amputees, it has recently been shown that knee load on the leading, intact limb decreases as powered plantar flexion in the trailing prosthetic ankle increases. Not surprisingly, excessive loads on the leading, intact knee are believed to be causative of knee osteoarthritis, a leading secondary impairment in lower-extremity amputees. In this study, we hypothesize that a transtibial amputee can learn how to control a powered ankle-foot prosthesis using a volitional electromyographic (EMG) control to directly modulate ankle powered plantar flexion. We here present preliminary data, and find that an amputee participant is able to modulate toe-off angle, net ankle work and peak power across a broad range of walking speeds by volitionally modulating calf EMG activity. The modulation of these key gait parameters is shown to be comparable to the dynamical response of the same powered prosthesis controlled intrinsically (No EMG), suggesting that transtibial amputees can achieve an adequate level of powered plantar flexion controllability using direct volitional EMG control.

  1. Myoelectric neural interface enables accurate control of a virtual multiple degree-of-freedom foot-ankle prosthesis.

    Science.gov (United States)

    Tkach, D C; Lipschutz, R D; Finucane, S B; Hargrove, L J

    2013-06-01

    Technological advances have enabled clinical use of powered foot-ankle prostheses. Although the fundamental purposes of such devices are to restore natural gait and reduce energy expenditure by amputees during walking, these powered prostheses enable further restoration of ankle function through possible voluntary control of the powered joints. Such control would greatly assist amputees in daily tasks such as reaching, dressing, or simple limb repositioning for comfort. A myoelectric interface between an amputee and the powered foot-ankle prostheses may provide the required control signals for accurate control of multiple degrees of freedom of the ankle joint. Using a pattern recognition classifier we compared the error rates of predicting up to 7 different ankle-joint movements using electromyographic (EMG) signals collected from below-knee, as well as below-knee combined with above-knee muscles of 12 trans-tibial amputee and 5 control subjects. Our findings suggest very accurate (5.3 ± 0.5%SE mean error) real-time control of a 1 degree of freedom (DOF) of ankle joint can be achieved by amputees using EMG from as few as 4 below-knee muscles. Reliable control (9.8 ± 0.7%SE mean error) of 3 DOFs can be achieved using EMG from 8 below-knee and above-knee muscles.

  2. Effects of a powered ankle-foot prosthesis on kinetic loading of the contralateral limb: a case series.

    Science.gov (United States)

    Hill, David; Herr, Hugh

    2013-06-01

    Lower-extremity amputees encounter a series of stress-related challenges. Among them is an increased risk of chronic joint disorders. For unilateral, transtibial amputees, we hypothesize that increasing the power output of the trailing, ankle-foot prosthesis during powered plantar flexion could mitigate kinetic loading applied to the leading, contralateral leg during walking. Here, we present a case series that analyzes kinetic factors of unilateral, transtibial amputee gait and forms a comparison between two types of ankle prostheses with varying power outputs. The factors examined here are impact resultant force, peak foot pressure at heel-strike, step-to-step transition work, and knee external adduction moment. The two prostheses are the amputee participant's daily-use passive ankle-foot prosthesis and the BiOM powered ankle-foot prosthesis capable of biologically accurate powered plantar flexion during late stance. In a preliminary study on two transtibial amputees walking over level terrain at a controlled speed (1.25 m/s), we observed average reductions of 8% in peak impact resultant force, 18% in impact resultant force loading rate, 8% in peak heel-strike foot pressure, and 15% in the 1(st) peak knee external adduction moment when the powered ankle-foot prosthesis was compared to the conventional passive prosthesis. Overall, our preliminary results suggest that more biomimetic prosthetic ankle-foot push-off during late stance may limit leading-leg musculoskeletal stress in walking.

  3. A Training Strategy for Learning Pattern Recognition Control for Myoelectric Prostheses.

    Science.gov (United States)

    Powell, Michael A; Thakor, Nitish V

    2013-01-01

    Pattern recognition-based control of myoelectric prostheses offers amputees a natural, intuitive way of controlling the increasing functionality of modern myoelectric prostheses. While this approach to prosthesis control is certainly attractive, it is a significant departure from existing control methods. The transition from the more traditional methods of direct or proportional control to pattern recognition-based control presents a training challenge that will be unique to each amputee. In this paper we describe specific ways that a transradial amputee, prosthetist, and occupational therapist team can overcome these challenges by developing consistent and distinguishable muscle patterns. A central part of this process is the employment of a computer-based pattern recognition training system with which an amputee can learn and improve pattern recognition skills throughout the process of prosthesis fitting and testing. We describe in detail the manner in which four transradial amputees trained to improve their pattern recognition-based control of a virtual prosthesis by focusing on building consistent, distinguishable muscle patterns. We also describe a three-phase framework for instruction and training: 1) initial demonstration and conceptual instruction, 2) in-clinic testing and initial training, and 3) at-home training.

  4. Using virtual reality environment to facilitate training with advanced upper-limb prosthesis

    Directory of Open Access Journals (Sweden)

    Linda Resnik, PT, PhD, OCS

    2011-07-01

    Full Text Available Technological advances in upper-limb prosthetic design offer dramatically increased possibilities for powered movement. The DEKA Arm system allows users 10 powered degrees of movement. Learning to control these movements by utilizing a set of motions that, in most instances, differ from those used to obtain the desired action prior to amputation is a challenge for users. In the Department of Veterans Affairs "Study to Optimize the DEKA Arm," we attempted to facilitate motor learning by using a virtual reality environment (VRE program. This VRE program allows users to practice controlling an avatar using the controls designed to operate the DEKA Arm in the real world. In this article, we provide highlights from our experiences implementing VRE in training amputees to use the full DEKA Arm. This article discusses the use of VRE in amputee rehabilitation, describes the VRE system used with the DEKA Arm, describes VRE training, provides qualitative data from a case study of a subject, and provides recommendations for future research and implementation of VRE in amputee rehabilitation. Our experience has led us to believe that training with VRE is particularly valuable for upper-limb amputees who must master a large number of controls and for those amputees who need a structured learning environment because of cognitive deficits.

  5. Exploring ethical justification for self-demand amputation.

    Science.gov (United States)

    Tomasini, Floris

    2006-01-01

    Self-demand amputees are persons who need to have one or more healthy limbs or digits amputated to fit the way they see themselves. They want to rid themselves of a limb that they believe does not belong to their body-identity. The obsessive desire to have appendages surgically removed to fit an alternative body-image is medically and ethically controversial. My purpose in this paper is to provide a number of normative and professional ethical perspectives on whether or not it is possible to justify surgery for self-demand amputees. In doing so I proceed dialogically, moving between empirical context and normative theory, revealing the taken for granted normative assumptions (what I call the natural attitude--a technical term borrowed from phenomenology) that provide ethical limits to justifying the treatment of self-demand amputees. While I critically examine both Kantian responses against as well as Utilitarian responses for amputation on demand, I conclude that neither normative tradition can fully incorporate an understanding of what it is like to be a self-demand amputee. Since neither theory can justify the apparent non-rational desire of amputation on demand, ethical justification, I argue, falls short of the recognition that there may be a problem. To end, I introduce a meta-ethical idea, "the struggle for recognition," opening up the theoretical possibility of a hermeneutics of recognition before ethical justification that may be more sensitive to the problem of radical embodied difference exemplified by self-demand amputees.

  6. Suggested guidelines for treatment of phantom limb pain.

    Science.gov (United States)

    Sherman, R A; Tippens, J K

    1982-12-01

    Eighty to ninety percent of amputees have been shown to suffer significant amounts of phantom limb pain in contrast to the widely accepted level of about 5%. Surveys of the literature, of physicians actively treating phantom pain, and of over 3,000 American veteran amputees have shown that most of the usual treatments are not efficacious when followups of a year or more are done. A diagnostic and therapeutic schemata is presented, which incorporates the above surveys, research, and clinical experience into a unified approach optimizing the few treatments showing a reasonable hope of long term success. Every effort is made to identify the source of pain being referred into the phantom. Stump, back, prosthetic, and other physical problems are corrected prior to initiation of other treatments, including EMG or temperature feedback from the stump, sympathetic system alteration, modulation of anxiety and depression, TENS, and ultrasound. Key indexing terms: phantom pain, treatment, amputees, referred pain.

  7. Upper limb prosthetic use in Slovenia.

    Science.gov (United States)

    Burger, H; Marincek, C

    1994-04-01

    The article deals with the use of different types of upper limb prostheses in Slovenia. Four hundred and fourteen upper limb amputees were sent a questionnaire on the type of their prosthesis, its use and reasons for non-use, respectively. The replies were subject to statistical analysis. Most of the questioned upper limb amputees (70%) wear a prosthesis only for cosmesis. The use of a prosthesis depends on the level of upper limb amputation, loss of the dominant hand, and time from amputation. Prosthetic success appears to be unrelated to age at the time of amputation and the rehabilitation programme. The most frequent reason for not wearing a prosthesis is heat and consequent sweating of the stump. More than a third of amputees are dissatisfied with their prostheses.

  8. Designing for scale: development of the ReMotion Knee for global emerging markets.

    Science.gov (United States)

    Hamner, Samuel R; Narayan, Vinesh G; Donaldson, Krista M

    2013-09-01

    Amputees living in developing countries have a profound need for affordable and reliable lower limb prosthetic devices. The World Health Organization estimates there are approximately 30 million amputees living in low-income countries, with up to 95% lacking access to prosthetic devices. Effective prosthetics can significantly affect the lives of these amputees by increasing opportunity for employment and providing improvements to long-term health and well-being. However, current solutions are inadequate: state-of-the-art solutions from the US and Europe are cost-prohibitive, while low-cost devices have been challenged by poor quality and/or unreliable performance, and have yet to achieve large scale impact. The introduction of new devices is hampered by the lack of a cohesive prosthetics industry in low-income areas; the current network of low-cost prosthetic clinics is informal and loosely organized with significant disparities in geography, patient volume and demographics, device procurement, clinical and logistical infrastructure, and funding. At D-Rev (Design Revolution) we are creating the ReMotion Knee, which is an affordable polycentric prosthetic knee joint that performs on par with devices in more industrialized regions, like the US and Europe. As of September 2012, over 4200 amputees have been fitted with the initial version of the ReMotion Knee through a partnership with the JaipurFoot Organization, with an 79% compliance rate after 2 years. We are currently scaling production of the ReMotion Knee using centralized manufacturing and distribution to serve the existing clinics in low-income countries and increase the availability of devices for amputees without access to appropriate care. At D-Rev, we develop products that target these customers through economically-sustainable models and provide a measurable impact in the lives of the world's amputees.

  9. Management of neglected femoral neck fracture in above knee amputated limb: A case report

    Institute of Scientific and Technical Information of China (English)

    Umesh Meena; Ramesh Meena; Balaji S; Sahil Gaba

    2015-01-01

    The treatment of an above knee amputee who has sustained a fracture of the femoral neck is a challenging situation for both the orthopedic surgeon and the rehabilitation team.These fractures may be managed acutely either by reduction and internal fixation or by endoprosthetic replacement based on the same criteria as in any other patient with otherwise intact limbs.We present a neglected case treated successfully with valgus osteotomy.We conclude that these fractures should be treated with the same urgency and expertise as similar fractures in non-amputees as long-term survival and good quality of life can be expected.

  10. Functional assessment of the Vanderbilt Multigrasp myoelectric hand: a continuing case study.

    Science.gov (United States)

    Dalley, Skyler A; Bennett, Daniel A; Goldfarb, Michael

    2014-01-01

    This paper presents a case study involving the functional assessment of the Vanderbilt Multigrasp (VMG) hand prosthesis on a single transradial amputee subject. In particular, a transradial amputee subject performed the Southampton Hand Assessment Procedure (SHAP) using the hand prosthesis and multigrasp myoelectric controller in a series of experimental sessions occurring over a multi-week time span. The subject's index of function (IoF) improved with each session, although essentially plateaued after the fourth session, resulting in a IoF score of 87, which compares favorably to SHAP scores published in previous studies.

  11. Effect of different prosthetic knees/feet on the roll-over shape

    OpenAIRE

    Abouhossein, A; Awad, MI; Crisp, C; Dehghani-Sanij, AA; Messenger, N.; Stewart, TD; Querin, OM; Richardson, R; Bradley, D

    2016-01-01

    Roll-over shape (ROS) of knee-ankle-foot (KAF) is a scientific method which has been used to compare performance and design of the different prosthetic foot. In the current study, however, we aimed to understand the influence of the prosthetic components (i.e. knee and foot) on the knee-ankle-foot roll-over shape in a unilateral transfemoral amputee. We performed a case study based on series of experiments with repeated measures on single amputee wearing two different commercially available m...

  12. Discrimination of Combined Motions for Prosthetic Hands Using Surface EMG Signals

    Science.gov (United States)

    Ibe, Ayuko; Gouko, Manabu; Ito, Koji

    The present paper proposes a multiple step discrimination method to determine single and combined movements intended by an amputee from surface electromyogram (EMG) signals. Most previous approaches to the discrimination of movement using EMG signals have been restricted to single joint movements. Our approach enables the amputee's intended movement to be determined from among four single and two combined limb functions using an initial rise zone 125 msec long. Experiments with ten subjects and four electrodes demonstrated that our proposal determines six forearm movements at a discrimination rate exceeding than 90%.

  13. Energy storage and release of prosthetic feet Part 1: Biomechanical analysis related to user benefits

    NARCIS (Netherlands)

    Postema, K.; Hermens, H.J.; Vries, de J.; Koopman, H.F.J.M.; Eisma, W.H.

    1997-01-01

    The energy storing and releasing behaviour of 2 energy storing feet (ESF) and 2 conventional prosthetic feet (CF) were compared (ESF: Otto Bock Dynamic Pro and Hanger Quantum; CF: Otto Bock Multi Axial and Otto Bock Lager). Ten trans-tibial amputees were selected. The study was designed as a double-

  14. Lower-Limb Amputation and Effect of Posttraumatic Stress Disorder on Department of Veterans Affairs Outpatient Cost Trends

    Science.gov (United States)

    2015-07-01

    highlighting the importance of accurate diagnosis, treatment, and support for PTSD. Key words: amputation, amputee, Department of Veterans Affairs...2014;51(5):697–710. [PMID:25509056] http://dx.doi.org/10.1682/JRRD.2013.06.0143 33. Reger MA, Gahm GA, Swanson RD, Duma SJ. Associa- tion between number

  15. Vocational reintegration after a lower limb amputation: A qualitative study

    NARCIS (Netherlands)

    Bruins, Ria; Bruins, M.; Geertzen, J.H.B.; Groothoff, J.W.; Schoppen, T.

    2003-01-01

    The objectives of this study were to describe the process of job reintegration, to obtain more detailed information about workplace adjustments, and to assess the positive and negative experiences of amputees (in the Netherlands) who returned to paid work after their lower limb amputation. The study

  16. Simplified, low cost below-knee prosthesis.

    Science.gov (United States)

    Kijkusol, D

    1986-08-01

    Problems are encountered in using standard prostheses in developing countries, especially when the prostheses need repair and the amputees cannot come back to the workshop. Very simple, low cost and durable prostheses can solve this problem. The solution described has worked well with villagers in some rural areas of Thailand, where the inexpensive prosthesis permits walking bare-foot and through water and mud.

  17. SPARKy-Spring Ankle with Regenerative Kinematics

    Science.gov (United States)

    2011-09-01

    89-93215-02-1 98560/10/$15 ©ICROS 142 1 BIONIC RUNNING FOR UNILATERAL TRANSTIBIAL MILITARY AMPUTEES Joseph Hitt, James Merlo, and Jonathan...ankle joint, and n optical switch embedded at the heel provides the necessary ensor feedback. Advantech’s 650MHZ PC-104 with 512MB on oard memory is

  18. Osseointegrated prostheses for rehabilitation following amputation : The pioneering Swedish model.

    Science.gov (United States)

    Li, Yan; Brånemark, Rickard

    2017-04-01

    The direct attachment of osseointegrated (OI) prostheses to the skeleton avoids the inherent problems of socket suspension. It also provides physiological weight bearing, improved range of motion in the proximal joint, as well as osseoperceptive sensory feedback, enabling better control of the artificial limbs by amputees. The present article briefly reviews the pioneering efforts on extremity osseointegration surgeries in Sweden and the development of the OPRA (Osseointegrated Prostheses for the Rehabilitation of Amputees) program. The standard implant design of the OPRA system and surgical techniques are described as well as the special rehabilitation protocols based on surgical sites. The results of long-term follow-up for transradial, transhumeral, and thumb amputee operations are briefly reported including the prospective study of transfemoral amputees according to OPRA protocol. The importance of refinement on implant designs and surgical techniques based on the biomechanical analysis and early clinical trials is emphasized. Future aspects on osseointegration surgery are briefly described, including novel treatment options using implanted electrodes.

  19. A systematic literature review of the effect of different prosthetic components on human functioning with a lower-limb prosthesis

    NARCIS (Netherlands)

    van der Linde, H; Hofstad, CJ; Postema, K; Geertzen, JHB

    2004-01-01

    A correct prosthetic prescription can be derived from adapting the functional benefits of a prosthesis to the functional needs of the prosthetic user. For adequate matching, the functional abilities of the amputees are of value, as well as the technical and functional aspects of the various prosthet

  20. WalkMECH: design and control of an energy recycling transfemoral prosthesis

    NARCIS (Netherlands)

    Ünal, R.

    2014-01-01

    This study presents the design and realization of an energy-efficient trans-femoral prosthesis called WalkMECH. Trans-femoral amputees consume significant amount of extra metabolic energy (more than 65% extra) during walking compared to the ablebodied person. Therefore, we mainly focused on the desi

  1. 活血通脉液内外并治动脉硬化性闭塞症患肢体麻木、溃疡40例%Management of limbs numb and ulcer in 40 patients with atherosclerotic occlusion by fluid promoting blood circulation to remove obstruction in channels externally and internally applied

    Institute of Scientific and Technical Information of China (English)

    杜振芳; 袁曙光

    2002-01-01

    Background:Atherosclerotic Occlusion(ASO) is common among middle aged and elderly population to which atherosclerosis of vital organs,disorder of blood supply in limbs,as well as limbs numb or ulcer are secondary.Rate of disbilitation and amputee is high.So,management and prevention of disbilation are very important.

  2. Memantine (a N-Methyl-D-aspartate receptor antagonist) in the treatment of neuropathic pain after amputation or surgery: A randomised, double-blinded, crossover study

    DEFF Research Database (Denmark)

    Nikolajsen, Lone; Gottrup, Hanne; Kristensen, Anders Due;

    2000-01-01

    (pressure and von Frey hair). A total of 15 patients (12 amputees and three patients with other nerve injuries) completed the study. There was no difference between memantine and placebo on any of the outcome measures. We conclude that memantine at a dosage of 20 mg/d does not reduce spontaneous or evoked...

  3. Leg stiffness of sprinters using running-specific prostheses

    Science.gov (United States)

    McGowan, Craig P.; Grabowski, Alena M.; McDermott, William J.; Herr, Hugh M.; Kram, Rodger

    2012-01-01

    Running-specific prostheses (RSF) are designed to replicate the spring-like nature of biological legs (bioL) during running. However, it is not clear how these devices affect whole leg stiffness characteristics or running dynamics over a range of speeds. We used a simple spring–mass model to examine running mechanics across a range of speeds, in unilateral and bilateral transtibial amputees and performance-matched controls. We found significant differences between the affected leg (AL) of unilateral amputees and both ALs of bilateral amputees compared with the bioL of non-amputees for nearly every variable measured. Leg stiffness remained constant or increased with speed in bioL, but decreased with speed in legs with RSPs. The decrease in leg stiffness in legs with RSPs was mainly owing to a combination of lower peak ground reaction forces and increased leg compression with increasing speeds. Leg stiffness is an important parameter affecting contact time and the force exerted on the ground. It is likely that the fixed stiffness of the prosthesis coupled with differences in the limb posture required to run with the prosthesis limits the ability to modulate whole leg stiffness and the ability to apply high vertical ground reaction forces during sprinting. PMID:22337629

  4. A study of technical changes to lower limb prostheses after initial fitting

    NARCIS (Netherlands)

    Rommers, GM; Vos, LDW; Klein, L; Groothoff, JW; Eisma, W H

    2000-01-01

    There is little published material in recent years about the use of lower limb prostheses in an elderly amputee population. In this study the authors were interested in the technical changes to lower limb prostheses after a first limb fitting procedure in a post-rehabilitation population in the Neth

  5. Mobility of people with lower limb amputations : scales and questionnaires: a review

    NARCIS (Netherlands)

    Rommers, G.M.; Groothoff, J.W.; Eisma, W.H.

    2001-01-01

    Objective and design: A systematic literature review to compare mobility scales used for lower limb amputees. A literature search was carried out by computerized search of biomedical literature including Medline and Embase. The studies included were published between 1978 and 1998 and including the

  6. A multichannel sEMG method for myoelectric control of a forearm prosthesis

    NARCIS (Netherlands)

    Baal, van D.W.; Witteveen, H.J.B.; Kallenberg, L.A.C.; Hermens, H.J.; Rietman, J.S.

    2009-01-01

    A large number of amputee patients doesn't use their myoelectric prosthesis, mainly due to the limited functionality of the prosthesis. The aim of this study was to investigate if it is possible to distinguish 8 different contractions by using multi-electrode sEMG. We analysed sEMG signals of a gri

  7. Prosthetic prescription in the Netherlands: An observational study

    NARCIS (Netherlands)

    Van Der Linde, H.; Geertzen, J.H.B.; Hofstad, C.J.; Van Limbeek, J.; Postema, K.

    2003-01-01

    Prosthetic prescription for lower limb amputees and the methodology used are primarily based on empirical knowledge. Clinical expertise plays an important role that can lead to an adequate prescription; however, a clear evidence based motivation for the choices made cannot be given. This can lead to

  8. Brug af nervestimulator ved anlaeggelse af nervus ischiadicus-blokade hos en crusamputeret patient

    DEFF Research Database (Denmark)

    Heiring, Christian; Kristensen, Billy B

    2008-01-01

    We present a case of a sciatic nerve block performed with the nerve stimulation technique. This technique is normally not used in amputees because detection of a motor response to an electrical stimulation is impossible. In our patient the stimulation provoked a phantom sensation of movement...

  9. Prosthetic Hand Lifts Heavy Loads

    Science.gov (United States)

    Carden, James R.; Norton, William; Belcher, Jewell G.; Vest, Thomas W.

    1991-01-01

    Prosthetic hand designed to enable amputee to lift diverse heavy objects like rocks and logs. Has simple serrated end effector with no moving parts. Prosthesis held on forearm by system of flexible straps. Features include ruggedness, simplicity, and relatively low cost.

  10. How Depressive Levels Are Related to the Adults' Experiences of Lower-Limb Amputation: A Mixed Methods Pilot Study

    Science.gov (United States)

    Senra, Hugo

    2013-01-01

    The current pilot study aims to explore whether different adults' experiences of lower-limb amputation could be associated with different levels of depression. To achieve these study objectives, a convergent parallel mixed methods design was used in a convenience sample of 42 adult amputees (mean age of 61 years; SD = 13.5). All of them had…

  11. The Capability of Fiber Bragg Grating Sensors to Measure Amputees’ Trans-Tibial Stump/Socket Interface Pressures

    Directory of Open Access Journals (Sweden)

    Faisal Rafiq Mahamd Adikan

    2013-08-01

    Full Text Available This study presents the first investigation into the capability of fiber Bragg grating (FBG sensors to measure interface pressure between the stump and the prosthetic sockets of a trans-tibial amputee. FBG element(s were recoated with and embedded in a thin layer of epoxy material to form a sensing pad, which was in turn embedded in a silicone polymer material to form a pressure sensor. The sensor was tested in real time by inserting a heavy-duty balloon into the socket and inflating it by using an air compressor. This test was conducted to examine the sensitivity and repeatability of the sensor when subjected to pressure from the stump of the trans-tibial amputee and to mimic the actual environment of the amputee’s Patellar Tendon (PT bar. The sensor exhibited a sensitivity of 127 pm/N and a maximum FSO hysteresis of around ~0.09 in real-time operation. Very good reliability was achieved when the sensor was utilized for in situ measurements. This study may lead to smart FBG-based amputee stump/socket structures for pressure monitoring in amputee socket systems, which will result in better-designed prosthetic sockets that ensure improved patient satisfaction.

  12. A pressure and shear sensor system for stress measurement at lower limb residuum/socket interface.

    Science.gov (United States)

    Laszczak, P; McGrath, M; Tang, J; Gao, J; Jiang, L; Bader, D L; Moser, D; Zahedi, S

    2016-07-01

    A sensor system for measurement of pressure and shear at the lower limb residuum/socket interface is described. The system comprises of a flexible sensor unit and a data acquisition unit with wireless data transmission capability. Static and dynamic performance of the sensor system was characterised using a mechanical test machine. The static calibration results suggest that the developed sensor system presents high linearity (linearity error ≤ 3.8%) and resolution (0.9 kPa for pressure and 0.2 kPa for shear). Dynamic characterisation of the sensor system shows hysteresis error of approximately 15% for pressure and 8% for shear. Subsequently, a pilot amputee walking test was conducted. Three sensors were placed at the residuum/socket interface of a knee disarticulation amputee and simultaneous measurements were obtained during pilot amputee walking test. The pressure and shear peak values as well as their temporal profiles are presented and discussed. In particular, peak pressure and shear of approximately 58 kPa and 27 kPa, respectively, were recorded. Their temporal profiles also provide dynamic coupling information at this critical residuum/socket interface. These preliminary amputee test results suggest strong potential of the developed sensor system for exploitation as an assistive technology to facilitate socket design, socket fit and effective monitoring of lower limb residuum health.

  13. Take Care of Yourself After an Amputation or Other Surgery

    Centers for Disease Control (CDC) Podcasts

    2010-02-18

    This podcast provides health information for amputees on how to take care of yourself after an amputation or other surgery.  Created: 2/18/2010 by National Center on Birth Defects and Developmental Disability, Disability and Health Program.   Date Released: 2/18/2010.

  14. Vocational reintegration after a lower limb amputation : a qualitative study

    NARCIS (Netherlands)

    Bruins, M.; Geertzen, J.H.; Groothoff, J.W.; Schoppen, T.

    2003-01-01

    The objectives of this study were to describe the process of job reintegration, to obtain more detailed information about workplace adjustments, and to assess the positive and negative experiences of amputees (in the Netherlands) who returned to paid work after their lower limb amputation. The study

  15. A training method for locomotion mode prediction using powered lower limb prostheses.

    Science.gov (United States)

    Young, Aaron J; Simon, Ann M; Hargrove, Levi J

    2014-05-01

    Recently developed lower-limb prostheses are capable of actuating the knee and ankle joints, allowing amputees to perform advanced locomotion modes such as step-over-step stair ascent and walking on sloped surfaces. However, transitions between these locomotion modes and walking are neither automatic nor seamless. This study describes methods for construction and training of a high-level intent recognition system for a lower-limb prosthesis that provides natural transitions between walking, stair ascent, stair descent, ramp ascent, and ramp descent. Using mechanical sensors onboard a powered prosthesis, we collected steady-state and transition data from six transfemoral amputees while the five locomotion modes were performed. An intent recognition system built using only mechanical sensor data was 84.5% accurate using only steady-state training data. Including training data collected while amputees performed seamless transitions between locomotion modes improved the overall accuracy rate to 93.9%. Training using a single analysis window at heel contact and toe off provided higher recognition accuracy than training with multiple analysis windows. This study demonstrates the capability of an intent recognition system to provide automatic, natural, and seamless transitions between five locomotion modes for transfemoral amputees using powered lower limb prostheses.

  16. Wartime Orthopaedic Residency: A Resident’s Perspective

    Science.gov (United States)

    2013-04-01

    From this point in history, Americans have endured multiple wars and armed conflicts, each delivering their own set of devastating and challenging...and external fixation, wound management, limb salvage, and amputee care, all forged from the need to provide higher quality care for our wounded

  17. Addressing the Needs of Children and Families of Combat Injured

    Science.gov (United States)

    2013-04-01

    Liaison Services (inpatient), Psychiatry (inpatient)- Operation Brave Families, Occupational Therapy for amputees , Warrior Clinic (outpatient...average of 7 years. 72% indicated multiple injuries during the focal incident with 51% listing amputation and 48% listing Traumatic Brain Injury as...see their parent, but multiple transitions in caregiving and homestead are made. We are continuing data analysis to examine these patterns and the

  18. Natural grasping, design and evaluation of a voluntary closing adaptive hand prosthesis

    NARCIS (Netherlands)

    Smit, G.

    2013-01-01

    Replacement of a missing hand by an artificial alternative remains one of the biggest challenges in rehabilitation. Although many different terminal devices are available, around 27% of the amputees does not actively use their device and 20% totally refrains from wearing it. There are various reason

  19. Fingernails Yield Clues to Limb Regeneration

    Science.gov (United States)

    ... Diseases has uncovered chemical signals that drive the regeneration of lost digit tips in mice. The findings, published in the journal Nature, could eventually lead to the development of novel treatments for amputees. While salamanders and newts are well known for their ability ...

  20. Principles of obstacle avoidance with a transfemoral prosthetic limb

    NARCIS (Netherlands)

    van Keeken, Helco G.; Vrieling, Aline H.; Hof, At L.; Postema, Klaas; Otten, Bert

    2012-01-01

    In this study, conditions that enable a prosthetic knee flexion strategy in transfemoral amputee subjects during obstacle avoidance were investigated. This study explored the hip torque principle and the static ground principle as object avoidance strategies. A prosthetic limb simulator device was u

  1. The morphology and functions of the muscles around the hip joint after a unilateral transfemoral amputation

    NARCIS (Netherlands)

    Jaegers, Sonja Maria Héléne José

    1993-01-01

    This dissertation is concerned with the consequences of a transfemoral amputation for the morphology and functions of the muscles around the hip joint. Knowledge about and insight into the changes appearing in the morphology and functions of the hip muscles of transfemoral amputees are important to

  2. Bipolar hip hemiarthroplasty in a patient with an above knee amputation: a case report

    Directory of Open Access Journals (Sweden)

    Liebergall Meir

    2009-07-01

    Full Text Available Abstract The treatment of an above knee amputee who has sustained a fracture of femoral neck is a challenge for both the orthopaedic surgeon and the rehabilitation team. We present a case of such a patient and discuss different difficulties in his treatment.

  3. Sexuality and amputation : a systematic literature review

    NARCIS (Netherlands)

    Geertzen, Jan H. B.; Van Es, Corine G.; Dijkstra, Pieter U.

    2009-01-01

    Purpose. To systematically examine the state of research on sexuality and amputees. Methods. A total of five publication databases were searched: Pubmed, Cinahl, Embase, Psychinfo and Recall. Results. A total of 11 eligible studies was found. The studies were characterised by a diversity of study po

  4. How Depressive Levels Are Related to the Adults' Experiences of Lower-Limb Amputation: A Mixed Methods Pilot Study

    Science.gov (United States)

    Senra, Hugo

    2013-01-01

    The current pilot study aims to explore whether different adults' experiences of lower-limb amputation could be associated with different levels of depression. To achieve these study objectives, a convergent parallel mixed methods design was used in a convenience sample of 42 adult amputees (mean age of 61 years; SD = 13.5). All of them had…

  5. Psychological and Educational Studies with Spina Bifida Children. Final Report.

    Science.gov (United States)

    Diller, Leonard; And Others

    To measure school achievements in spina bifida children, to relate these measures to certain variables, to obtain information on educational problems, and to study facets of cognition and its changes with age, 77 spina bifida children and 53 amputees (all aged 5 to 15) were tested. Sixty non-disabled children were at times used for controls. The…

  6. The Lightweight Delft Cylinder Hand, the First Multi-Articulating Hand That Meets the Basic User Requirements

    NARCIS (Netherlands)

    Smit, G.; Plettenburg, D.H.; Van der Helm, F.C.T.

    2014-01-01

    Rejection rates of upper limb prostheses are high (23-45%). Amputees indicate that the highest design priority should be reduction of the mass of the prosthetic device. Despite all efforts, the mass of the new prosthetic hands is 35-73% higher than that of older hands. Furthermore current hands are

  7. Energy storage and release of prosthetic feet Part 2: Subjective ratings of 2 energy storing and 2 conventional feet, user choice of foot and deciding factor

    NARCIS (Netherlands)

    Postema, K.; Hermens, H.J.; Vries, de J.; Koopman, H.F.J.M.; Eisma, W.H.

    1997-01-01

    This paper is the second part of a study on biomechanical and functional properties of prosthetic feet. The first part dealt with a biomechanical analysis related to user benefits. This part deals with subjective ratings and deciding factors for trans-tibial amputees using 2 energy storing feet (ESF

  8. Comparative roll-over analysis of prosthetic feet

    NARCIS (Netherlands)

    Curtze, Carolin; Hof, At L.; van Keeken, Helco G.; Halbertsma, Jan P. K.; Postema, Klaas; Otten, Bert

    2009-01-01

    A prosthetic foot is a key element of a prosthetic leg, literally forming the basis for a stable and efficient amputee gait. We determined the roll-over characteristics of a broad range of prosthetic feet and examined the effect of a variety of shoes on these characteristics. The body weight of a pe

  9. Prosthetic prescription in the Netherlands : an observational study

    NARCIS (Netherlands)

    van der Linde, H; Geertzen, JHB; Hofstad, CJ; Postema, K

    2003-01-01

    Prosthetic prescription for lower limb amputees and the methodology used are primarily based on empirical knowledge. Clinical expertise plays an important role that can lead to an adequate prescription; however, a clear evidence based motivation for the choices made cannot be given. This can lead to

  10. Accelerations due to impact at heel strike using below-knee prosthesis

    NARCIS (Netherlands)

    Jaarsveld, van H.W.L.; Grootenboer, H.J.; Vries, de J.

    1990-01-01

    The acceleration in the sagittal plane of the prosthetic tube at heel strike in normal walking was measured in five healthy amputees with their definitive below-knee prosthesis, every subject using six different prosthetic feet, wearing sport shoes as well as leather shoes. The experiments were carr

  11. Evaluating asymmetry in prosthetic gait with step-length asymmetry alone is flawed

    NARCIS (Netherlands)

    Roerdink, M.; Roeles, S.; der Pas, van S.C.H.; Bosboom, O.; Beek, P.J.

    2012-01-01

    Prosthetic gait is often asymmetric in step length, but the direction of this asymmetry varies inconsistently across amputees. This situation is akin to that seen in stroke patients, where step-length asymmetry has been shown to be the additive result of asymmetries in trunk progression and asymmetr

  12. Prosthetic helping hand

    Science.gov (United States)

    Vest, Thomas W. (Inventor); Carden, James R. (Inventor); Norton, William E. (Inventor); Belcher, Jewell G. (Inventor)

    1992-01-01

    A prosthetic device for below-the-elbow amputees, having a C-shaped clamping mechanism for grasping cylindrical objects, is described. The clamping mechanism is pivotally mounted to a cuff that fits on the amputee's lower arm. The present invention is utilized by placing an arm that has been amputated below the elbow into the cuff. The clamping mechanism then serves as a hand whenever it becomes necessary for the amputee to grasp a cylindrical object such as a handle, a bar, a rod, etc. To grasp the cylindrical object, the object is jammed against the opening in the C-shaped spring, causing the spring to open, the object to pass to the center of the spring, and the spring to snap shut behind the object. Various sizes of clamping mechanisms can be provided and easily interchanged to accommodate a variety of diameters. With the extension that pivots and rotates, the clamping mechanism can be used in a variety of orientations. Thus, this invention provides the amputee with a clamping mechanism that can be used to perform a number of tasks.

  13. Prosthetic Hand For Holding Rods, Tools, And Handles

    Science.gov (United States)

    Belcher, Jewell G., Jr.; Vest, Thomas W.

    1995-01-01

    Prosthetic hand with quick-grip/quick-release lever broadens range of specialized functions available to lower-arm amputee by providing improved capabilities for gripping rods, tools, handles, and like. Includes two stationary lower fingers opposed by one pivoting upper finger. Lever operates in conjunction with attached bracket.

  14. A novel concept for a prosthetic hand with a bidirectional interface: a feasibility study.

    Science.gov (United States)

    Cipriani, Christian; Antfolk, Christian; Balkenius, Christian; Rosén, Birgitta; Lundborg, Goran; Carrozza, Maria Chiara; Sebelius, Fredrik

    2009-11-01

    A conceptually novel prosthesis consisting of a mechatronic hand, an electromyographic classifier, and a tactile display has been developed and evaluated by addressing problems related to controllability in prosthetics: intention extraction, perception, and feeling of ownership. Experiments have been performed, and encouraging results for a young transradial amputee are reported.

  15. Dual window pattern recognition classifier for improved partial-hand prosthesis control

    Directory of Open Access Journals (Sweden)

    Eric Joseph Earley

    2016-02-01

    Full Text Available Although partial-hand amputees largely retain the ability to use their wrist, it is difficult to preserve wrist motion while using a myoelectric partial-hand prosthesis without severely impacting control performance. Electromyogram (EMG pattern recognition is a well-studied control method; however, EMG from wrist motion can obscure myoelectric finger control signals. Thus, to accommodate wrist motion and to provide high classification accuracy and minimize system latency, we developed a training protocol and a classifier that switches between long and short EMG analysis window lengths.Seventeen non-amputee and two partial-hand amputee subjects participated in a study to determine the effects of including EMG from different arm and hand locations during static and/or dynamic wrist motion in the classifier training data. We evaluated several real-time classification techniques to determine which control scheme yielded the highest performance in virtual real-time tasks using a 3-way ANOVA. We found significant interaction between analysis window length and the number of grasps available. Including static and dynamic wrist motion and intrinsic hand muscle EMG with extrinsic muscle EMG significantly reduced pattern recognition classification error by 35%. Classification delay or majority voting techniques significantly improved real-time task completion rates (17%, selection (23% and completion (11% times, and selection attempts (15% for non-amputee subjects, and the dual window classifier significantly reduced the time (8% and average number of attempts required to complete grasp selections (14% made in various wrist positions. Amputee subjects demonstrated improved task timeout rates, and made fewer grasp selection attempts, with classification delay or majority voting techniques.Thus, the proposed techniques show promise for improving control of partial-hand prostheses and more effectively restoring function to individuals using these devices.

  16. The fastest runner on artificial legs: different limbs, similar function?

    Science.gov (United States)

    Weyand, Peter G; Bundle, Matthew W; McGowan, Craig P; Grabowski, Alena; Brown, Mary Beth; Kram, Rodger; Herr, Hugh

    2009-09-01

    The recent competitive successes of a bilateral, transtibial amputee sprint runner who races with modern running prostheses has triggered an international controversy regarding the relative function provided by his artificial limbs. Here, we conducted three tests of functional similarity between this amputee sprinter and competitive male runners with intact limbs: the metabolic cost of running, sprinting endurance, and running mechanics. Metabolic and mechanical data, respectively, were acquired via indirect calorimetry and ground reaction force measurements during constant-speed, level treadmill running. First, we found that the mean gross metabolic cost of transport of our amputee sprint subject (174.9 ml O(2)*kg(-1)*km(-1); speeds: 2.5-4.1 m/s) was only 3.8% lower than mean values for intact-limb elite distance runners and 6.7% lower than for subelite distance runners but 17% lower than for intact-limb 400-m specialists [210.6 (SD 13.2) ml O(2)*kg(-1)*km(-1)]. Second, the speeds that our amputee sprinter maintained for six all-out, constant-speed trials to failure (speeds: 6.6-10.8 m/s; durations: 2-90 s) were within 2.2 (SD 0.6)% of those predicted for intact-limb sprinters. Third, at sprinting speeds of 8.0, 9.0, and 10.0 m/s, our amputee subject had longer foot-ground contact times [+14.7 (SD 4.2)%], shorter aerial [-26.4 (SD 9.9)%] and swing times [-15.2 (SD 6.9)%], and lower stance-averaged vertical forces [-19.3 (SD 3.1)%] than intact-limb sprinters [top speeds = 10.8 vs. 10.8 (SD 0.6) m/s]. We conclude that running on modern, lower-limb sprinting prostheses appears to be physiologically similar but mechanically different from running with intact limbs.

  17. Powered ankle-foot prosthesis to assist level-ground and stair-descent gaits.

    Science.gov (United States)

    Au, Samuel; Berniker, Max; Herr, Hugh

    2008-05-01

    The human ankle varies impedance and delivers net positive work during the stance period of walking. In contrast, commercially available ankle-foot prostheses are passive during stance, causing many clinical problems for transtibial amputees, including non-symmetric gait patterns, higher gait metabolism, and poorer shock absorption. In this investigation, we develop and evaluate a myoelectric-driven, finite state controller for a powered ankle-foot prosthesis that modulates both impedance and power output during stance. The system employs both sensory inputs measured local to the external prosthesis, and myoelectric inputs measured from residual limb muscles. Using local prosthetic sensing, we first develop two finite state controllers to produce biomimetic movement patterns for level-ground and stair-descent gaits. We then employ myoelectric signals as control commands to manage the transition between these finite state controllers. To transition from level-ground to stairs, the amputee flexes the gastrocnemius muscle, triggering the prosthetic ankle to plantar flex at terminal swing, and initiating the stair-descent state machine algorithm. To transition back to level-ground walking, the amputee flexes the tibialis anterior muscle, triggering the ankle to remain dorsiflexed at terminal swing, and initiating the level-ground state machine algorithm. As a preliminary evaluation of clinical efficacy, we test the device on a transtibial amputee with both the proposed controller and a conventional passive-elastic control. We find that the amputee can robustly transition between the finite state controllers through direct muscle activation, allowing rapid transitioning from level-ground to stair walking patterns. Additionally, we find that the proposed finite state controllers result in a more biomimetic ankle response, producing net propulsive work during level-ground walking and greater shock absorption during stair descent. The results of this study highlight the

  18. Hand-to-Face Remapping But No Differences in Temporal Discrimination Observed on the Intact Hand Following Unilateral Upper Limb Amputation

    Science.gov (United States)

    Collins, Kassondra L.; McKean, Danielle L.; Huff, Katherine; Tommerdahl, Mark; Favorov, Oleg Vyacheslavovich; Waters, Robert S.; Tsao, Jack W.

    2017-01-01

    Unilateral major limb amputation causes changes in sensory perception. Changes may occur within not only the residual limb but also the intact limb as well as the brain. We tested the hypothesis that limb amputation may result in the detection of hand sensation during stimulation of a non-limb-related body region. We further investigated the responses of unilateral upper limb amputees and individuals with all limbs intact to temporally based sensory tactile testing of the fingertips to test the hypothesis that changes in sensory perception also have an effect on the intact limb. Upper extremity amputees were assessed for the presence of referred sensations (RSs)—experiencing feelings in the missing limb when a different body region is stimulated, to determine changes within the brain that occur due to an amputation. Eight of 19 amputees (42.1%) experienced RS in the phantom limb with manual tactile mapping on various regions of the face. There was no correlation between whether someone had phantom sensations or phantom limb pain and where RS was found. Six of the amputees had either phantom sensation or pain in addition to RS induced by facial stimulation. Results from the tactile testing showed that there were no significant differences in the accuracy of participants in the temporal order judgment tasks (p = 0.702), whereby participants selected the digit that was tapped first by a tracking paradigm that resulted in correct answers leading to shorter interstimulus intervals (ISIs) and incorrect answers increasing the ISI. There were also no significant differences in timing perception, i.e., the threshold accuracy of the duration discrimination task (p = 0.727), in which participants tracked which of the two digits received a longer stimulus. We conclude that many, but not all, unilateral upper limb amputees experience phantom hand sensation and/or pain with stimulation of the face, suggesting that there could be postamputation changes in neuronal

  19. An implementation of movement classification for prosthesis control using custom-made EMG system

    Directory of Open Access Journals (Sweden)

    Mejić Luka

    2017-01-01

    Full Text Available Electromyography (EMG is a well known technique used for recording electrical activity produced by human muscles. In the last few decades, EMG signals are used as a control input for prosthetic hands. There are several multifunctional myoelectric prosthetic hands for amputees on the market, but so forth, none of these devices permits the natural control of more than two degrees of freedom. In this paper we present our implementation of the pattern classification using custom made components (electrodes and an embedded EMG amplifier. The components were evaluated in offline and online tests, in able bodied as well as amputee subjects. This type of control is based on computing the time domain features of the EMG signals recorded from the forearm and using these features as input for a Linear Discriminant Analysis (LDA classifier estimating the intention of the prosthetic user. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III - 41007

  20. Rehand: Realistic electric prosthetic hand created with a 3D printer.

    Science.gov (United States)

    Yoshikawa, Masahiro; Sato, Ryo; Higashihara, Takanori; Ogasawara, Tsukasa; Kawashima, Noritaka

    2015-01-01

    Myoelectric prosthetic hands provide an appearance with five fingers and a grasping function to forearm amputees. However, they have problems in weight, appearance, and cost. This paper reports on the Rehand, a realistic electric prosthetic hand created with a 3D printer. It provides a realistic appearance that is same as the cosmetic prosthetic hand and a grasping function. A simple link mechanism with one linear actuator for grasping and 3D printed parts achieve low cost, light weight, and ease of maintenance. An operating system based on a distance sensor provides a natural operability equivalent to the myoelectric control system. A supporter socket allows them to wear the prosthetic hand easily. An evaluation using the Southampton Hand Assessment Procedure (SHAP) demonstrated that an amputee was able to operate various objects and do everyday activities with the Rehand.

  1. Relationship between socket pressure and EMG of two muscles in trans-femoral stumps during gait.

    Science.gov (United States)

    Hong, Jung Hwa; Mun, Mu Seong

    2005-04-01

    The biomechanical interaction between the leg stump and the prosthetic socket is critical in achieving close-to-normal ambulation. Although many investigations have been performed to understand the biomechanics of trans-tibial sockets, few studies have measured the socket interface pressure for transfemoral amputees. Furthermore, no report has examined how the residual muscle activities in the transfemoral stump affect the socket interface pressure characteristics during gait. In this study, an experimental method was developed to measure the trans-femoral socket interface pressures and EMG of muscles in the stumps of two trans-femoral amputees. Also, the measurement of three-dimensional prosthetic locomotion was synchronized to understand detailed socket biomechanics. Based on the experimental results, a significant correlation (P socket-interface pressure changes during ambulation.

  2. Finite element analysis of the contact interface between trans-femoral stump and prosthetic socket.

    Science.gov (United States)

    Zhang, Linlin; Zhu, Ming; Shen, Ling; Zheng, Feng

    2013-01-01

    Transfemoral amputees need prosthetic devices after amputation surgery, and the interface pressure between the residual limb and prosthetic socket has a significant effect on an amputee's satisfaction and comfort. The purpose of this study was to build a nonlinear finite element model to investigate the interface pressure between the above-knee residual limb and its prosthetic socket. The model was three-dimensional (3D) with consideration of nonlinear boundary conditions. Contact analysis was used to simulate the friction conditions between skin and the socket. The normal stresses up to 80.57 kPa at the distal end of the soft tissue. The longitudinal and circumferential shear stress distributions at the limb-socket interface were also simulated. This study explores the influences of load transfer between trans-femoral residual limb and its prosthetic socket.

  3. [The psychosocial characteristics of the patient who has undergone amputation for vascular reasons. The work, family and sex life aspects].

    Science.gov (United States)

    García-Viniegras, C R; Rial Blanco, N; Molina Martínez, O; Salazar Fernández, N; Almeida Hernández, L; Herrera Rodríguez, G

    1991-01-01

    Forty-one amputee patients because vascular disease, 20 of them diabetics and 21 non-diabetics, with a mean of 68 years, were studied--from psychosocial aspect--by interviewing them 3 or 4 years after their amputation. Different factors were evaluated, like prosthesis usage, personal cares that patient could do by him self, home activities made by the patients, sexual life quality and labor status. For this evaluation different variables were considered, like age, sex, scholar level, familial economic level, original pathology, amputation level, stump status and phantom [correction of fantasm] limb perception. The most important variables correlated with good psychosocial conditions of amputee patients are noted, and considerations and recommendations for a rehabilitation program are established.

  4. Clinical detection and movement recognition of neuro signals

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao-wen; YANG Yu-pu; XU Xiao-ming; HU Tian-pei; GAO Zhong-hua; ZHANG Jian; CHEN Tong-yi; CHEN Zhong-wei

    2005-01-01

    Neuro signal has many more advantages than myoelectricity in providing information for prosthesis control, and can be an ideal source for developing new prosthesis. In this work, by implanting intrafascicular electrode clinically in the amputee's upper extremity, collective signals from fascicules of three main nerves (radial nerve, ulnar nerve and medium nerve) were successfully detected with sufficient fidelity and without infection. Initial analysis of features under different actions was performed and movement recognition of detected samples was attempted. Singular value decomposition features (SVD) extracted from wavelet coefficients were used as inputs for neural network classifier to predict amputee's movement intentions. The whole training rate was up to 80.94% and the test rate was 56.87% without over-training. This result gives inspiring prospect that collective signals from fascicules of the three main nerves are feasible sources for controlling prosthesis. Ways for improving accuracy in developing prosthesis controlled by neuro signals are discussed in the end.

  5. Combined mirror visual and auditory feedback therapy for upper limb phantom pain: a case report

    Directory of Open Access Journals (Sweden)

    Yan Kun

    2011-01-01

    Full Text Available Abstract Introduction Phantom limb sensation and phantom limb pain is a very common issue after amputations. In recent years there has been accumulating data implicating 'mirror visual feedback' or 'mirror therapy' as helpful in the treatment of phantom limb sensation and phantom limb pain. Case presentation We present the case of a 24-year-old Caucasian man, a left upper limb amputee, treated with mirror visual feedback combined with auditory feedback with improved pain relief. Conclusion This case may suggest that auditory feedback might enhance the effectiveness of mirror visual feedback and serve as a valuable addition to the complex multi-sensory processing of body perception in patients who are amputees.

  6. Running with a powered knee and ankle prosthesis.

    Science.gov (United States)

    Shultz, Amanda H; Lawson, Brian E; Goldfarb, Michael

    2015-05-01

    This paper presents a running control architecture for a powered knee and ankle prosthesis that enables a transfemoral amputee to run with a biomechanically appropriate running gait and to intentionally transition between a walking and running gait. The control architecture consists firstly of a coordination level controller, which provides gait biomechanics representative of healthy running, and secondly of a gait selection controller that enables the user to intentionally transition between a running and walking gait. The running control architecture was implemented on a transfemoral prosthesis with powered knee and ankle joints, and the efficacy of the controller was assessed in a series of running trials with a transfemoral amputee subject. Specifically, treadmill trials were conducted to assess the extent to which the coordination controller provided a biomechanically appropriate running gait. Separate trials were conducted to assess the ability of the user to consistently and reliably transition between walking and running gaits.

  7. Contact dermatitis to a limb prosthesis.

    Science.gov (United States)

    Sood, Apra; Taylor, James S; Billock, John N

    2003-09-01

    PROSTHESIS USERS commonly develop various skin problems on the residual limb, directly under the prosthetic device when the device is in direct contact with the skin. Prolonged occlusion and humidity increase the likelihood of developing contact sensitivity to moisturizing creams, medicaments, and materials in the prosthesis itself.1 Allergic contact dermatitis to various prosthetic design materials is uncommon, and the relevance of positive patch-test results to chemicals present in prostheses may be difficult to establish. Most reports of allergic contact dermatitis to prostheses have been concerned with surgical amputees and not congenital amputees. We report a 5-year-old boy with a transverse partial hemimelia who developed allergic contact dermatitis to an adhesive used in his myoelectric prosthesis. Unlike most prostheses, myoelectric prostheses are worn directly against the skin, for surface electromyography electrode contact.

  8. Eliminating cardiac contamination from myoelectric control signals developed by targeted muscle reinnervation.

    Science.gov (United States)

    Zhou, Ping; Kuiken, Todd A

    2006-12-01

    The electrocardiogram (ECG) artifact is a major noise contaminating the myoelectric control signals when using shoulder disarticulation prosthesis. This is an even more significant problem with targeted muscle reinnervation to develop additional myoelectric sites for improved prosthesis control in a bilateral amputee at shoulder disarticulation level. This study aims at removal of ECG artifacts from the myoelectric prosthesis control signals produced from targeted muscle reinnervation. Three ECG artifact removal methods based on template subtracting, wavelet thresholding and adaptive filtering were investigated, respectively. Surface EMG signals were recorded from the reinnervated pectoralis muscles of the amputee. As a key parameter for clinical myoelectric prosthesis control, the amplitude measurement of the signal was used as a performance indicator to evaluate the proposed methods. The feasibility of the different methods for clinical application was also investigated with consideration of the clinical speed requirements and memory limitations of commercial prosthesis controllers.

  9. The status of application and physiotherapy-rehabilitation of prosthetics in Turkey.

    Science.gov (United States)

    Ünver, Banu; Şahan, Tezel Yıldırım; Türkyılmaz, Seda; Karagözoğlu, Ayşe; Ülger, Özlem

    2016-05-01

    [Purpose] The aim of this study was to determine the frequency of prosthetic applications and to appraise the importance of amputee rehabilitation in Turkey. [Subjects and Methods] Questionnaires were administered to owners or employees of 36 institutions and the obtained data were evaluated. [Results] While 75% of institutions had no physiotherapist, 25% had 1 or 2 physiotherapists; there were 4 or fewer technicians in 86.1%, and the majority of employees were out of profession in almost all institutions. A total of 83.3% of institutions reported falls, 75% reported complications, 58.3% of them occasionally noted the need of repair; 55.6% of institutions made preprosthetic assessments, 63.9% used gait analysis, and 50% performed prosthetic rehabilitation frequently. [Conclusion] The results of this study reveal the need for more physiotherapists in these centers, the utilization of standardized-objective assessment methods, and development of rehabilitation processes for successful prosthetic applications and amputee rehabilitation in Turkey.

  10. Patient-Specific Prosthetic Fingers by Remote Collaboration - A Case Study

    CERN Document Server

    Cabibihan, John-John

    2011-01-01

    The concealment of amputation through prosthesis usage can shield an amputee from social stigma and help improve the emotional healing process especially at the early stages of hand or finger loss. However, the traditional techniques in prosthesis fabrication defy this as the patients need numerous visits to the clinics for measurements, fitting and follow-ups. This paper presents a method for constructing a prosthetic finger through online collaboration with the designer. The main input from the amputee comes from the Computer Tomography (CT) data in the region of the affected and the non-affected fingers. These data are sent over the internet and the prosthesis is constructed using visualization, computer-aided design and manufacturing tools. The finished product is then shipped to the patient. A case study with a single patient having an amputated ring finger at the proximal interphalangeal joint shows that the proposed method has a potential to address the patient's psychosocial concerns and minimize the ...

  11. Recent advances in lower extremity amputations and prosthetics for the combat injured patient.

    Science.gov (United States)

    Fergason, John; Keeling, John J; Bluman, Eric M

    2010-03-01

    Blast-related extremity trauma represents a serious challenge because of the extent of bone and soft tissue damage. Fragmentation and blast injuries account for 56% of all injuries produced within the Iraqi and Afghan theaters where, as of July 2009, 723 combatants have sustained lower extremity limb loss. If limb salvage is not practical, or fails, then amputation should be considered. Amputation can be a reliable means toward pain relief and improvement of function. Optimizing functional outcome is paramount when deciding on definitive amputation level. Preservation of joint function improves limb biomechanics in many cases. Increased limb length also allows for the benefits associated with articular and distal limb proprioception. Amputees with improved lower extremity function also usually exhibit less energy consumption. Function and length are generally directly correlated, whereas energy consumption and length are inversely related. This article discusses the surgical principles of lower extremity amputation and postoperative management of amputees, and the various prosthetic options available.

  12. Assessment of AK (Above Knee) Prosthesis with Different Ankle Assembly Using GRF Pattern in Stance Phase

    Science.gov (United States)

    Kim, Sung-Min; Kim, Sung-Jae; Bae, Ha-Suk

    In this study, ground reaction force (GRF), absolute symmetry index (ASI) and coefficient of variation (CV) of fixed, single-axis and multi-axis prosthetic ankle assemblies were investigated by biomechanical evaluation of above knee amputees. In the experiments, 37 normal male volunteers, two male and two female Above Knee (AK) amputees GRF data were tested with fixed, single-axis and multi-axis prosthetic ankle assembly. A gait analysis was carried out to derive the ratio of GRF to weight as the percentage of total stance phase for ten points. The results showed that fixed-axis ankle assembly was superior to other two ankle assemblies for forwarding and braking forces. Multi-axis ankle was relatively superior to other two ankle assemblies for gait balancing and movement of the mass center. Single-axis ankle was relatively superior to the other two ankle assemblies for CV and ASI of GRF.

  13. Bilateral transtibial amputation with concomitant thoracolumbar vertebral collapse in a Sichuan earthquake survivor.

    Science.gov (United States)

    Wong, Caroline Ngar-Chi; Yu, Joseph Man-Kit; Law, Sheung-Wai; Lau, Herman Mun-Cheung; Chan, Cavor Kai-Ming

    2010-07-14

    The devastating earthquake in Sichuan, China on 12 May 2008 left thousands of survivors requiring medical care and intensive rehabilitation. In view of this great demand, the Chinese Speaking Orthopaedic Society established the "Stand Tall" project to provide voluntary services to aid amputee victims in achieving total rehabilitation and social integration. This case report highlights the multidisciplinary rehabilitation of a girl who suffered thoracolumbar vertebral collapse and underwent bilateral transtibial amputation. The rehabilitation team was involved in all stages of the care process from the pre-operative phase, through amputation, into prosthetic training, and during her life thereafter. Despite this catastrophic event, early rehabilitation and specially designed bilateral prostheses allowed her a high level of functional ability. The joint efforts of the multidisciplinary team and the advancement of new technology have revolutionized the care process for amputees.

  14. An Affordable Virtual Reality System for Treatment of Phantom Limb Pain

    DEFF Research Database (Denmark)

    Henriksen, Bartal; Nielsen, Ronni Nedergaard; Szabo, Laszlo;

    2016-01-01

    . This project focuses on phantom pain in amputees. Using a motion sensor, the system tracks the movement of a user’s hand and translates it onto the virtual hand. The system consists of exercises focusing on opening and closing the hand, rotating the hand, and finer finger movements. These exercises...... are conveyed in the VR as three games: (1) A bending game, where the patients have to bend a rod, (2) a box game where the patients pick up and place boxes with their hands, (3) and a button memory game where the patients have to push buttons in a given sequence. These games were tested on twelve healthy...... participants to see if the games encouraged similar movements as in MT. Prior to the experiment a preliminary test was conducted on an amputee with PLP to gather qualitative feedback from an end-user. The results indicated that the games did convey the exercises from the MT, although further testing is needed....

  15. Trip recoveries of people with unilateral, transfemoral or knee disarticulation amputations: Initial findings.

    Science.gov (United States)

    Crenshaw, Jeremy R; Kaufman, Kenton R; Grabiner, Mark D

    2013-07-01

    The purpose of this report is to provide novel findings from the kinematics of five amputees following a laboratory-induced trip. Only amputees with a unilateral, transfemoral or knee disarticulation amputation were included in this study. When the prosthesis was obstructed, all subjects used a lowering strategy, resulting in three harness-assisted recoveries and one fall. When the non-prosthetic limb was obstructed, one subject fell using an elevating strategy, one subject fell using a lowering strategy, and one subject, who was harness-assisted, used a hopping strategy. These results can be used to guide further studies of how to limit prosthetic knee flexion due to weight-bearing during a lowering strategy, implement compensatory step training to reduce fall risk, and identify appropriate, context-specific recovery strategies for people with transfemoral or knee disarticulation amputations.

  16. Bilateral transtibial amputation with concomitant thoracolumbar vertebral collapse in a Sichuan earthquake survivor

    Directory of Open Access Journals (Sweden)

    Lau Herman

    2010-07-01

    Full Text Available Abstract The devastating earthquake in Sichuan, China on 12 May 2008 left thousands of survivors requiring medical care and intensive rehabilitation. In view of this great demand, the Chinese Speaking Orthopaedic Society established the "Stand Tall" project to provide voluntary services to aid amputee victims in achieving total rehabilitation and social integration. This case report highlights the multidisciplinary rehabilitation of a girl who suffered thoracolumbar vertebral collapse and underwent bilateral transtibial amputation. The rehabilitation team was involved in all stages of the care process from the pre-operative phase, through amputation, into prosthetic training, and during her life thereafter. Despite this catastrophic event, early rehabilitation and specially designed bilateral prostheses allowed her a high level of functional ability. The joint efforts of the multidisciplinary team and the advancement of new technology have revolutionized the care process for amputees.

  17. [Psychological adjustment following lower limb amputation].

    Science.gov (United States)

    Panyi, Lilla Krisztina; Lábadi, Beatrix

    2015-09-27

    Rehabilitation of lower limb amputees and the fitting of their prosthesis depend highly on the psychological adjustment process and motivational state of the patient. The loss of a limb is extremely challenging and can cause various physical and psychological problems. Depression, anxiety, decreased well-being and quality of life, body image dissatisfaction and changes in self-concept and identity are frequent after lower limb amputation. In the interest of adjustment patients have to cope with the emerging changes and difficulties in their lifes as well as the problems in psychological functioning. It is important for them to accept the alterations in their body and identity, and integrate them in a new self-concept in which process motivation is a fundamental issue. The aim of this article is to review the literature on psychological consequences of lower limb amputation, and to propose an integrative way of rehabilitation for lower limb amputees.

  18. Control of prosthetic hands via the peripheral nervous system

    Directory of Open Access Journals (Sweden)

    Anna Lisa eCiancio

    2016-04-01

    Full Text Available This paper intends to provide a critical review of the literature on the technological issues on control and sensorization of hand prostheses interfacing with the Peripheral Nervous System (i.e. PNS, and their experimental validation on amputees. The study opens with an in-depth analysis of control solutions and sensorization features of research and commercially available prosthetic hands. Pros and cons of adopted technologies, signal processing techniques and motion control solutions are investigated. Special emphasis is then dedicated to the recent studies on the restoration of tactile perception in amputees through neural interfaces. The paper finally proposes a number of suggestions for designing the prosthetic system able to re-establish a bidirectional communication with the PNS and foster the prosthesis natural control.

  19. Finite element analysis as a tool for parametric prosthetic foot design and evaluation. Technique development in the solid ankle cushioned heel (SACH) foot.

    Science.gov (United States)

    Saunders, Marnie M; Schwentker, Edwards P; Kay, David B; Bennett, Gordon; Jacobs, Christopher R; Verstraete, Mary C; Njus, Glen O

    2003-02-01

    In this study, we developed an approach for prosthetic foot design incorporating motion analysis, mechanical testing and computer analysis. Using computer modeling and finite element analysis, a three-dimensional (3D), numerical foot model of the solid ankle cushioned heel (SACH) foot was constructed and analyzed based upon loading conditions obtained from the gait analysis of an amputee and validated experimentally using mechanical testing. The model was then used to address effects of viscoelastic heel performance numerically. This is just one example of the type of parametric analysis and design enabled by this approach. More importantly, by incorporating the unique gait characteristics of the amputee, these parametric analyses may lead to prosthetic feet more appropriately representing a particular user's needs, comfort and activity level.

  20. The status of application and physiotherapy-rehabilitation of prosthetics in Turkey

    Science.gov (United States)

    Ünver, Banu; Şahan, Tezel Yıldırım; Türkyılmaz, Seda; Karagözoğlu, Ayşe; Ülger, Özlem

    2016-01-01

    [Purpose] The aim of this study was to determine the frequency of prosthetic applications and to appraise the importance of amputee rehabilitation in Turkey. [Subjects and Methods] Questionnaires were administered to owners or employees of 36 institutions and the obtained data were evaluated. [Results] While 75% of institutions had no physiotherapist, 25% had 1 or 2 physiotherapists; there were 4 or fewer technicians in 86.1%, and the majority of employees were out of profession in almost all institutions. A total of 83.3% of institutions reported falls, 75% reported complications, 58.3% of them occasionally noted the need of repair; 55.6% of institutions made preprosthetic assessments, 63.9% used gait analysis, and 50% performed prosthetic rehabilitation frequently. [Conclusion] The results of this study reveal the need for more physiotherapists in these centers, the utilization of standardized-objective assessment methods, and development of rehabilitation processes for successful prosthetic applications and amputee rehabilitation in Turkey. PMID:27313365

  1. Cybernetic prosthesis

    Science.gov (United States)

    Mann, R. W.

    1974-01-01

    Design and development of a prosthetic device fitted to an above elbow amputee is reported that derives control information from the human to modulate power to an actuator to drive the substitute limb. In turn, the artificial limb generates sensory information feedback to the human nervous system and brain. This synergetic unity feeds efferent or motor control information from the human to the machine, and the machine responds, delivering afferent or sensory information back to the man.

  2. Esthetic prostheses in minor and major upper limb amputations.

    Science.gov (United States)

    Leow, M E; Pho, R W; Pereira, B P

    2001-08-01

    In summary, the impact and value of esthetic prostheses on amputee rehabilitation and their long-term use were demonstrated in this study to have no correlation with the severity of injury and level of amputation. All patients with traumatic amputation should be given equal opportunity to receive prostheses if the service is readily available. Whether use of prostheses is temporary or long-term, they help patients cope with the traumatic life experience of limb loss.

  3. Measurement of Forces and Moments Transmitted to the Residual Limb

    Science.gov (United States)

    2010-10-01

    to assist in prescribing components, to evaluate amputee rehabilitation progress, and to develop specifications for components capable of battle...Fi wireless network access. Figure 1 shows the block diagram of the force sensor system. A PC104/Plus bus based 32bit AMD single board computer...interface design were to: 1. Utilize analysis capabilities inherent in the Tekscan software to the extent possible. 2. Create a visual display that

  4. COMPARATIVE EFFECTIVENESS OF AN ADJUSTABLE TRANSFEMORAL PROSTHETIC INTERFACE ACCOMMODATING VOLUME FLUCTUATION: CASE STUDY

    OpenAIRE

    Kahle, Jason T.; Klenow, Tyler D.; Highsmith, M. Jason

    2016-01-01

    The socket-limb interface is vital for functionality and provides stability and mobility for the amputee. Volume fluctuation can lead to compromised fit and function. Current socket technology does not accommodate for volume fluctuation. An adjustable interface may improve function and comfort by filling this technology gap. The purpose of this study was to compare the effectiveness of the standard of care (SOC) ischial ramus containment to an adjustable transfemoral prosthetic interface sock...

  5. Rehabilitation R&D Progress Reports 1996, Volume 34, May 1997

    Science.gov (United States)

    1997-05-01

    Technique for the CAM of Prosthetic Sockets 2 DOD Software and Equipment Development for Im- proved Computer-Aided Prosthetic Socket Design B. Upper...Phase 2 C. Lower Limb: Transfemoral 18 Development of a Biomechanical Model of the In- terface between the Residual Limb and the Pros- thesis for... Transfemoral Amputees 19 Investigation of 4-Bar Linkage Knees as an Aid to Floor Clearance durig Prosthetic Swing 20 Development of a Pacdiatric

  6. Effect of alignment changes on socket reaction moments during gait in transfemoral and knee-disarticulation prostheses: Case series

    OpenAIRE

    Kobayashi, Toshiki; Orendurff, Michael S.; Boone, David A.

    2013-01-01

    The alignment of a lower-limb prosthesis is critical to the successful prosthetic fitting and utilization by the wearer. Loads generated by the socket applied to the residual limb while walking are thought to be different in transfemoral and knee-disarticulation prostheses. The aim of this case series was to compare the socket reaction moments between transfemoral and knee-disarticulation prostheses and to investigate the effect of alignment changes on them. Two amputees, one with a transfemo...

  7. Sensory cortical re-mapping following upper-limb amputation and subsequent targeted reinnervation: A case report

    OpenAIRE

    Jun Yao; Albert Chen; Todd Kuiken; Carolina Carmona; Julius Dewald

    2015-01-01

    This case study demonstrates the change of sensory cortical representations of the residual parts of the arm in an individual who underwent a trans-humeral amputation and subsequent targeted reinnervation (TR). As a relatively new surgical technique, TR restores a direct neural connection from amputated sensorimotor nerves to specific target muscles. This method has been successfully applied to upper-limb and lower-limb amputees, and has shown effectiveness in regaining control signals via th...

  8. A sleeping phantom leg awakened following hemicolectomy, thrombosis, and chemotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Georgiou-Karistianis Nellie

    2011-05-01

    Full Text Available Abstract Introduction We describe the case of a patient who experienced phantom pain that began 42 years after right above-the-knee amputation. Immediately prior to phantom pain onset, this long-term amputee had experienced, in rapid succession, cancer, hemicolectomy, chemotherapy, and thrombotic occlusion. Very little has been published to date on the association between chemotherapy and exacerbation of neuropathic pain in amputees, let alone the phenomenon of bringing about pain in amputees who have been pain-free for many decades. While this patient presented with a unique profile following a rare sequence of medical events, his case should be recognized considering the frequent co-occurrence of osteomyelitis, chemotherapy, and amputation. Case presentation A 68-year-old Australian Caucasian man presented 42 years after right above-the-knee amputation with phantom pain immediately following hemicolectomy, thrombotic occlusion in the amputated leg, and chemotherapy treatment with leucovorin and 5-fluorouracil. He exhibited probable hyperalgesia with a reduced pinprick threshold and increased stump sensitivity, indicating likely peripheral and central sensitization. Conclusion Our patient, who had long-term nerve injury due to amputation, together with recent ischemic nerve and tissue injury due to thrombosis, exhibited likely chemotherapy-induced neuropathy. While he presented with unique treatment needs, cases such as this one may actually be quite common considering that osteosarcoma can frequently lead to amputation and be followed by chemotherapy. The increased susceptibility of amputees to developing potentially intractable chemotherapy-induced neuropathic pain should be taken into consideration throughout the course of chemotherapy treatment. Patients in whom chronic phantom pain then develops, perhaps together with mobility issues, inevitably place greater demands on healthcare service providers that require treatment by various

  9. Unusual exercise-related stress fractures. Two case reports

    Energy Technology Data Exchange (ETDEWEB)

    Fink-Bennett, D.M.; Benson, M.T.

    1984-08-01

    We describe two unusual exercise-related stress fractures, one in the sacroiliac joint of a long distance runner, the other in the body of the scapulae of an above-knee amputee. Each were detected on a 2-hour delay bone scan. To our knowledge, neither have been described scintigraphically. The bilateral scapular fracture is an unreported entity, and the fractured SI joint is a very uncommon site for an overuse injury.

  10. Leg stiffness of sprinters using running-specific prostheses

    OpenAIRE

    McGowan, Craig P.; Grabowski, Alena M.; McDermott, William J.; Herr, Hugh M.; Kram, Rodger

    2012-01-01

    Running-specific prostheses (RSF) are designed to replicate the spring-like nature of biological legs (bioL) during running. However, it is not clear how these devices affect whole leg stiffness characteristics or running dynamics over a range of speeds. We used a simple spring–mass model to examine running mechanics across a range of speeds, in unilateral and bilateral transtibial amputees and performance-matched controls. We found significant differences between the affected leg (AL) of uni...

  11. Bionic ankle–foot prosthesis normalizes walking gait for persons with leg amputation

    OpenAIRE

    Herr, Hugh M.; Grabowski, Alena M.

    2011-01-01

    Over time, leg prostheses have improved in design, but have been incapable of actively adapting to different walking velocities in a manner comparable to a biological limb. People with a leg amputation using such commercially available passive-elastic prostheses require significantly more metabolic energy to walk at the same velocities, prefer to walk slower and have abnormal biomechanics compared with non-amputees. A bionic prosthesis has been developed that emulates the function of a biolog...

  12. Mobility of people with lower limb amputations: scales and questionnaires: a review

    OpenAIRE

    Rommers, G. M.; Groothoff, J. W.; Eisma, W.H.

    2001-01-01

    Objective and design: A systematic literature review to compare mobility scales used for lower limb amputees. A literature search was carried out by computerized search of biomedical literature including Medline and Embase. The studies included were published between 1978 and 1998 and including the following keywords: amputation, artificial limbs, prosthesis, lower limb, activities of daily living, mobility. Results: Thirty-five studies were identified; 19 had a measurement of separate levels...

  13. Virtual Reality in the Medical Field

    OpenAIRE

    Motomatsu, Haruka

    2014-01-01

    The objective is to analyze the use of the emerging 3D computer technology of VirtualReality in the use of relieving pain in physically impaired conditions such as burn victims,amputees, and phantom limb patients, during therapy and medical procedures. Virtualtechnology generates a three dimensional visual virtual world in which enables interaction.Comparison will be made between the emerging technology of the Virtual Reality and methodsusually used, which are the use of medicine. Medicine ha...

  14. Myoelectric control of prosthetic hands: state-of-the-art review

    OpenAIRE

    2016-01-01

    Purushothaman Geethanjali School of Electrical Engineering Department of Control and Automation VIT University, Vellore, Tamil Nadu, India Abstract: Myoelectric signals (MES) have been used in various applications, in particular, for identification of user intention to potentially control assistive devices for amputees, orthotic devices, and exoskeleton in order to augment capability of the user. MES are also used to estimate force and, hence, torque to actuate the assistive device. The appli...

  15. Residuals of autoregressive model providing additional information for feature extraction of pattern recognition-based myoelectric control.

    Science.gov (United States)

    Pan, Lizhi; Zhang, Dingguo; Sheng, Xinjun; Zhu, Xiangyang

    2015-01-01

    Myoelectric control based on pattern recognition has been studied for several decades. Autoregressive (AR) features are one of the mostly used feature extraction methods among myoelectric control studies. Almost all previous studies only used the AR coefficients without the residuals of AR model for classification. However, the residuals of AR model contain important amplitude information of the electromyography (EMG) signals. In this study, we added the residuals to the AR features (AR+re) and compared its performance with the classical sixth-order AR coefficients. We tested six unilateral transradial amputees and eight able-bodied subjects for eleven hand and wrist motions. The classification accuracy (CA) of the intact side for amputee subjects and the right hand for able-bodied subjects showed that the CA of AR+re features was slightly but significantly higher than that of classical AR features (p = 0.009), which meant that residuals could provide additional information to classical AR features for classification. Interestingly, the CA of the affected side for amputee subjects showed that there was no significant difference between the CA of AR+re features and classical AR features (p > 0.05). We attributed this to the fact that the amputee subjects could not use their affected side to produce consistent EMG patterns as their intact side or the dominant hand of the able-bodied subjects. Since the residuals were already available when the AR coefficients were computed, the results of this study suggested adding the residuals to classical AR features to potentially improve the performance of pattern recognition-based myoelectric control.

  16. Updating upper extremity temporary prosthesis: thermoplastics.

    Science.gov (United States)

    Fletchall, S; Tran, T; Ungaro, V; Hickerson, W

    1992-01-01

    Since 1989 amputees with upper-extremity burns have been fitted with a temporary prosthesis fabricated from low-temperature thermoplastic. Before 1989 conventional temporary prostheses were fabricated with plaster. The use of the thermoplastic material has produced a lightweight, cost-effective, modular system. No patients exhibited skin breakdown with the thermoplastic material. It appears that thermoplastics may be the next major breakthrough in terms of a design for a temporary upper-extremity prosthesis.

  17. Development of a residuum/socket interface simulator for lower limb prosthetics.

    Science.gov (United States)

    McGrath, Michael Paul; Gao, Jianliang; Tang, Jinghua; Laszczak, Piotr; Jiang, Liudi; Bader, Dan; Moser, David; Zahedi, Saeed

    2017-03-01

    Mechanical coupling at the interface between lower limb residua and prosthetic sockets plays an important role in assessing socket fitting and tissue health. However, most research lab-based lower limb prosthetic simulators to-date have implemented a rigid socket coupling. This study describes the fabrication and implementation of a lower limb residuum/socket interface simulator, designed to reproduce the forces and moments present during the key loading phases of amputee walking. An artificial residuum made with model bones encased in silicone was used, mimicking the compliant mechanical loading of a real residuum/socket interface. A 6-degree-of-freedom load cell measured the overall kinetics, having previously been incorporated into an amputee's prosthesis to collect reference data. The developed simulator was compared to a setup where a rigid pylon replaced the artificial residuum. A maximum uniaxial load of 850 N was applied, comparable to the peak vertical ground reaction force component during amputee walking. Load cell outputs from both pylon and residuum setups were compared. During weight acceptance, when including the artificial residuum, compression decreased by 10%, while during push off, sagittal bending and anterior-posterior shear showed a 25% increase and 34% decrease, respectively. Such notable difference by including a compliant residuum further highlighted the need for such an interface simulator. Subsequently, the simulator was adjusted to produce key load cell outputs briefly aligning with those from amputee walking. Force sensing resistors were deployed at load bearing anatomic locations on the residuum/socket interface to measure pressures and were compared to those cited in the literature for similar locations. The development of such a novel simulator provides an objective adjunct, using commonly available mechanical test machines. It could potentially be used to provide further insight into socket design, fit and the complex load

  18. Energy expenditure and cardiovascular response to traumatic lower limb amputees’ gait

    OpenAIRE

    Garcia,Marília Mendes do Nascimento; de Lima, Jorge Roberto Perrout; Costa Junior,José Dilermando; Freire,Humberto Almeida Ottoni de Luna; Mazilão,Jaqueline de Paula; Vicente,Eduardo José Danza

    2015-01-01

    Introduction Amputations cause functional, musculoskeletal and cardiovascular alterations and, the more proximal the amputation, the larger the alterations. Objectives To observe the effect of using lower limb prosthetics and that of gait speed on heart rate (HR), blood pressure (BP), oxygen consumption (VO2) and energy cost (EC) during gait in traumatic lower limbs amputees. Materials and methods The sample was composed of 30 men with unilateral amputations, 10 transfemoral and 10 transtibia...

  19. Validation of the virtual elevation field test method when assessing the aerodynamics of para-cyclists with a uni-lateral trans-tibial amputation.

    Science.gov (United States)

    Dyer, Bryce; Disley, B Xavier

    2017-03-12

    Lower-limb amputees typically require some form of prosthetic limb to ride a bicycle for recreation or when competing. At elite-level racing speeds, aerodynamic drag can represent the majority of the resistance acting against a cyclists' forward motion. As a result, the reduction of such resistance is beneficial to an amputee whereby the form and function of the prosthetic limb can be optimized through engineering. To measure the performance of such limbs, field testing provides a cost-effective and context-specific method of aerodynamic drag measurement. However, few methods have been formally validated and none have been applied to amputees with lower-limb amputations. In this paper, an elite level para-cyclist wore two different prosthetic limb designs and had their total aerodynamic drag of a wind tunnel reference method statistically correlated against a velodrome-based virtual elevation field test method. The calculated coefficient of variation was in the range of 0.7-0.9% for the wind tunnel method and 2-3% for the virtual elevation method. A 0.03 m(2) difference was identified in the absolute values recorded between the two methods. Ultimately, both methods exhibited high levels of precision, yet relative results to each other. The virtual elevation method is proposed as a suitable technique to assess the aerodynamic drag of amputee para-cyclists. Implications for rehabilitation This assessment method will provide practitioners a reliable means of assessing the impact of changes made to prosthetics design for cyclists with limb absence. The proposed method offers a low cost and geographically accessible solution compared to others proposed in the past. This assessment method has significant potential for impact among prosthetic limb users looking to improve their cycling performance whereas previous attention in this field has been extremely limited.

  20. Inter-Trial Gait Variability Reduction Using Continous Curve Registration

    Science.gov (United States)

    2001-10-25

    subjects than in some pathological gait patterns. For subjects with a total hip replacement prosthesis [13], peak muscle powers were not well defined...which may impede the registration of the data. Nonetheless, clear peak power bursts were reported in below- knee amputees for all planes [14]. -150 0...1266- 305. [8] Sadeghi H, Prince F, Sadeghi S, Labelle H. Principal component analysis of the power developed in the flexion /extension muscles of