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Prosthetic and orthotic devices
Published in Alex Mihailidis, Roger Smith, Rehabilitation Engineering, 2023
Joel Kempfer, Renee Lewis, Goeran Fiedler, Barbara Silver-Thorn
Upper extremity prosthetic devices can be classified as: (1) passive, (2) body-powered (Figure 21.9), or (3) externally powered. Passive prostheses are typically cosmetic devices that perform little to no function but fulfill the need for a life-like appearance. Body-powered prosthetic devices, the most common type of upper extremity prosthesis due to their lower cost, high durability, and high function, utilize the mobility of a patient's remnant upper extremity joints to operate the prosthesis using harness and cable systems. With practice, patients can become extremely adept at operating body-powered terminal devices and/or elbows with ease. In contrast, externally powered upper extremity prosthetic components are powered by a rechargeable battery and are typically controlled by switches or myoelectric control. Myoelectric control utilizes surface electrodes placed on the residual limb musculature (e.g., wrist flexors/extensors, elbow flexors/extensors; Fougner et al. 2012). If the patient demonstrates independent control of muscle agonist-antagonist pairs, the respective prosthetic device may incorporate proportional control such that the speed or torque of the terminal device or elbow is regulated by the strength of the muscle signal. Other approaches to increasing the functionality (e.g., the degrees of freedom in controlling the prosthetic device) include pattern recognition and TMR (detailed below).
Medicine and Pharmaceuticals Biomanufacturing – Industry 5.0
Published in Pau Loke Show, Kit Wayne Chew, Tau Chuan Ling, The Prospect of Industry 5.0 in Biomanufacturing, 2021
Zahra Nashath, Doris Ying Ying Tang, Kit Wayne Chew, Pau Loke Show
While prosthetic limbs are still the norm worldwide, bionic limbs are slowly gaining popularity due to their increased motor functionality that is comparable to the human limb. Bionic limbs are linked to the neuromuscular system and exploits the residual human nervous system. The electric signals from nerves or muscles above the amputation controls the movement of the limb, allowing the bionic limbs to feel more natural and comfortable to users. To further enhance the experience, sensors are placed along the bionic limb and an algorithm is used to process and deliver the data to the nerve, enabling the user to experience the sensation on their “phantom limb” (Tan et al. 2014, 6–9). Another promising field of human limb bionics is lab printed bones. Currently, scientists are working on the production of ceramic powder that can print artificial bone scaffolds by using a specially configured inkjet printer and CAD software, which can later dissolve as natural bone grows around it (Du, Fu, and Zhu 2018, 4397–412).
Designing for Veterans
Published in Rupa S. Valdez, Richard J. Holden, The Patient Factor, 2021
Arjun H. Rao, Farzan Sasangohar
Since 2001, the United States has deployed over two million service members to conflicts in Afghanistan (Operation Enduring Freedom [OEF]) and Iraq (Operation Iraqi Freedom [OIF]), with over half of them being deployed more than once (Hautzinger et al., 2015; Seal et al., 2007). Recent estimates from Brown University’s Watson Institute of International & Public Affairs put the combined death toll of U.S. service members at 6,900. In addition, 970,000 veterans report either a physical or cognitive disability upon return (Hautzinger et al., 2015). Common physical injuries include burns, orthopedic injuries (including loss of limbs), and traumatic brain injury. Moreover, many veterans also experience operational stress and mental health disorders including post-traumatic stress disorder (PTSD; Church, 2009). In addition to addressing the health-related aspects of disability, veterans also face several micro- and macroergonomic challenges in reintegrating into society.
Adult moped-related injuries treated in U.S. emergency departments
Published in Traffic Injury Prevention, 2019
Nathaniel K. Johnson, Brandon M. Johnson, Gerene M. Denning, Charles A. Jennissen
Study variables were as previously described (Johnson et al. 2017). Days of the week were grouped as “Weekday” (Mon-Fri) and “Weekend” (Saturday–Sunday). Months were combined into four seasons: “Winter” (December–February), “Spring” (March–May), “Summer” (June–August), and “Fall” (September–November). Years were grouped into 3-year intervals from 2003 to 2014. Ages were grouped as 18–22, 23–39, 40–59, and ≥60 years to compare college-aged riders, and younger, middle-aged and older adults. Race was categorized as “Caucasian”, “African American”, and “Other”. For other variables, specific codes used to create groups were previously provided (Johnson et al. 2017). Crash location was grouped into “Private Property”, “Street/Road”, “Public Property” and “Recreational Area”. For Diagnosis, groups were “Skin”, “Musculoskeletal”, “Internal Organ”, “Brain”, and “Other”. If the victim was classified by NEISS as having a diagnosis of Internal Organ with the body part injured being “Head”, they were reclassified into the “Brain” diagnosis category. Body Part groupings were “Upper Limbs”, “Lower Limbs”, “Head/Neck/Face”, “Torso” and “Multiple Body Parts”. Disposition was categorized as “Left ED” including those treated and released and those who left without medical attention, “Admitted/Transferred”, and “Fatality”.
Implementation of a Scale-Lab Lower-Limb Exoskeleton with Motion in Three Anatomical Planes
Published in Cybernetics and Systems, 2019
Miguel Tovar-Estrada, Angel Rodriguez-Liñan, Griselda Quiroz
An exoskeleton should be analogous to the human lower limbs; that is, its design must approximate the position and distribution of joints similar to those of a human being’s legs (see Figure 1, left). The lower-limb structure is defined by the main bones—femur, tibia, and the set of bones that form foot—which, in turn, form the main joints: hip, knee, ankle, and metatarsophalangeal joint (also called toe joint) (Zhu, Cui, and Zhao 2013). Following the procedure proposed in Cenciarini and Dollar (2011), the range of movement of each DOF was determined based on the main anatomical joints involved in the normal human gait. Hence, the proposed design considers the most important joints involved in gait motion on the three anatomical planes. It is important to mention that the range of movement for each joint was selected to conserve the gait motion, though it is somewhat lower than the anatomical range (Nordin and Frankel 2012). Based on this analysis, seven DOF were selected for each lower limb: toe (ext/flexion SP), ankle (ext/flexion SP, abduction/adduction FP), knee (ext/flexion SP), and hip (ext/flexion SP, abduction/adduction FP, internal/external rotation TP). The range of movement of each DOF is shown in the Table 1.
Adapting isokinetic dynamometry to accommodate transradial amputation: The development of a new dynamometer attachment and user case study
Published in Cogent Engineering, 2019
Jessica Chouinard, Victoria Chester, Usha Kuruganti
While there have been significant advances in the materials used to build prostheses over the last several decades resulting in lighter and stronger artificial limbs, users have indicated that improved function and control strategies are desirable to become more in line with able-bodied limb function. Quantitative clinical assessment has been challenging due to the complexity of the muscle physiology of those with amputations. It is important to examine muscle function in prosthesis users in both the residual and intact limb to better understand mobility. One of the challenges of studying muscle function with prosthesis users is the ability to use standard muscle function devices to examine parameters such as muscle force. Furthermore, it is critical that muscle function is examined under both static and dynamic conditions to improve mobility. Davidson (2004) observed that there were no measures or devices available to specifically evaluate the functional ability of those with upper limb amputations. However, while there are few devices commercially available to obtain such measurements, it is precisely these devices that will in the development, understanding and research in the field of prosthetics (Davidson, 2004; Hermansson, Fisher, Bernpång, & Eliasson, 2005.; Raad, 2012; Wright, 2009).