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Jørgensen, Christina Louise, and Nynne Harrishøj Schultz. "Danish Certified Prosthetists and Orthotists’ experience of their intercultural competencies in the treatment of immigrants : A qualitative interview study." Thesis, Jönköping University, HHJ. Ortopedteknisk plattform, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-52896.
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Background: To be able to meet social harmony in a continuously globalizing world, intercultural competencies are important to possess as an individual. Thus, it is also important for Certified Prosthetists and Orthotists (CPOs) and other health care providers since they meet many diversities in connection to their work. Aim: The aim of this study is to investigate Danish CPOs’ experience and perception of their intercultural competencies in the treatment of immigrants. Method: This study is a qualitative interview study using a phenomenological approach. Semi-structured interviews are used to collect the data from five CPOs working in Danish clinics. A content analysis, with an inductive approach, is used for the analysis. Findings: From the analysis of the participant interviews, seven sub-categories were found and further divided into three categories: Treatment, work environment, and development of competencies. These contribute to describe the main category and the aim of this study. Conclusion: The Danish CPOs, who participated in this study, experienced that they did not treat immigrants differently than non-immigrants. However, they experienced that some challenges could be connected to the treatment of immigrants, such as communication difficulties, but they all had a perception, that they used specific tools and strategies to accommodate these challenges. Furthermore, they all experienced that their intercultural competencies had improved with experience, but most of them were also interested in further development of their competencies.
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Bataweel, Adel Omar. "Lower limb orthotics inprovements for paraplegic mobility." Thesis, University of Salford, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.700292.
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Harrison, Andrew J. "The development and application of biomechanical analysis techniques for evaluation of developmental stages in vertical jump." Thesis, University of Salford, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.265526.
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Magnusson, Lina. "Prosthetic and Orthotic Services in Developing Countries." Doctoral thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. Ortopedteknisk plattform, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-24973.
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Aim: The overall aim of this thesis was to generate further knowledge about prosthetic and orthotic services in developing countries. In particular, the thesis focused on patient mobility and satisfaction with prosthetic and orthotic devices, satisfaction with service delivery, and the views of staff regarding clinical practice and education. Methods: Questionnaires, including QUEST 2.0, were used to collect self-reported data from 83 patients in Malawi and 139 patients in Sierra Leone. In addition, 15 prosthetic/orthotic technicians in Sierra Leone and 15 prosthetists/orthotists in Pakistan were interviewed. Results: The majority of patients used their prosthetic or orthotic devices (90% in Malawi, and 86% in Sierra Leone), but half of the assistive devices in use needed repair. Approximately one third of patients reported pain when using their assistive device (40% in Malawi and 34% in Sierra Leone). Patients had difficulties, or could not walk at all, with their prosthetic and/or orthotic device in the following situations; uneven ground (41% in Malawi and 65% in Sierra Leone), up and down hills (78% in Malawi and 75% in Sierra Leone), on stairs (60% in Malawi and 66% in Sierra Leone). Patients were quite satisfied or very satisfied with their assistive device (mean 3.9 in Malawi and 3.7 in Sierra Leone out of 5) and the services provided (mean 4.4 in Malawi and 3.7 in Sierra Leone out of 5), (p<0.001), but reported many problems (418 comments made in Malawi and 886 in Sierra Leone). About half of the patients did not, or sometimes did not, have the ability to access services (71% in Malawi and 40% in Sierra Leone). In relation to mobility and service delivery, orthotic patients and patients using above-knee assistive devices in Malawi and Sierra Leone had the poorest results. In Sierra Leone, women had poorer results than men. The general condition of devices and the ability to walk on uneven ground and on stairs were associated with both satisfaction of assistive devices and service received. Professionals’ views of service delivery and related education resulted in four themes common to Sierra Leone and Pakistan: 1) Low awareness and prioritising of prosthetic and orthotic services; 2) Difficulty managing specific pathological conditions and problems with materials; 3) The need for further education and desire for professional development; 4) Desire for improvements in prosthetic and orthotic education. A further two themes were unique to Sierra Leone; 1) People with disabilities have low social status; 2) Limited access to prosthetic and orthotic services. Conclusion: High levels of satisfaction and mobility while using assistive devices were reported in Malawi and Sierra Leone, although patients experienced pain and difficulties when walking on challenging surfaces. Limitations to the effectiveness of assistive devices, poor comfort, and limited access to follow-up services and repairs were issues that needed to be addressed. Educating prosthetic and orthotic staff to a higher level was considered necessary in Sierra Leone. In Pakistan, prosthetic and orthotic education could be improved by modifying programme content, improving teachers’ knowledge, improving access to information, and addressing issues of gender equality.
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Kilmartin, Timothy Edward. "The orthotic treatment of juvenile hallux valgus." Thesis, University of Nottingham, 1994. http://eprints.nottingham.ac.uk/11917/.
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Pronation of the foot is proposed as a possible aetiological factor in hallux valgus. Root type foot orthoses have been shown to restrict foot pronation and therefore have been used to treat hallux valgus. A controlled prospective 3 year trial tested the value of a Root foot orthosis in the treatment of juvenile hallux valgus. Six thousand nine year old Kettering children were screened for hallux valgus using goniometric and clinical examination. A clinical diagnosis of hallux valgus was made in 150 children and confirmed using radiography in 122 cases. Pes planus was as common in children with hallux valgus as children with no hallux valgus. The biomechanical examination of hallux valgus children revealed that a plantarflexed first metatarsal was the only consistent biomechanical abnormality. The sagittal plane position of the first metatarsal did not however relate to the degree of metatarsus primus varus which is apparent in the unaffected feet of children with unilateral hallux valgus prior to the development of hallux valgus in both feet. The 122 children with hallux valgus were randomised into a non-treatment control group and a treatment group where Root foot orthoses were worn for three years. Compliance and fit of the orthoses were checked every 4 to 6 months. At the end of the 3 year period, 96 children underwent a second weight bearing radiograph of both feet. The same observer measured the intermetatarsal and hallux valgus angle on all radiographs. The hallux valgus had deteriorated significantly in both the control and treatment group. Though not statistically significant, the deterioration was slightly more marked in the treatment group. A Root foot orthosis prescribed to restrict foot pronation will not significantly alter the progression of juvenile hallux valgus. This may indicate that pronation of the foot is not an important aetiological factor in juvenile hallux valgus.
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Chandrapal, Mervin. "Intelligent Assistive Knee Orthotic Device Utilizing Pneumatic Artificial Muscles." Thesis, University of Canterbury. Mechanical Engineering, 2012. http://hdl.handle.net/10092/7475.
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This thesis presents the development and experimental testing of a lower-limb exoskeleton system. The device supplies assistive torque at the knee joint to alleviate the loading at the knee, and thus reduce the muscular effort required to perform activities of daily living. The hypothesis is that the added torque would facilitate the execution of these movements by people who previously had limited mobility. Only four specific movements were studied: level-waking, gradient-walking, sit-to-stand-to-sit and ascending stairs.
All three major components of the exoskeleton system, i.e. the exoskeleton actuators and actuator control system, the user intention estimation algorithm, and the mechanical construction of the exoskeleton, were investigated in this work. A leg brace was fabricated in accordance with the biomechanics of the human lower-limb. A single rotational degree of freedom at the knee and ankle joints was placed to ensure that the exoskeleton had a high kinematic compliance with the human leg. The position of the pneumatic actuators and sensors were also determined after significant deliberation. The construction of the device allowed the real-world testing of the actuator control algorithm and the user intention estimation algorithms. Pneumatic artificial muscle actuators, that have high power to weight ratio, were utilized on the exoskeleton. An adaptive fuzzy control algorithm was developed to compensate for the inherent nonlinearities in the pneumatic actuators. Experimental results confirmed the effectiveness of the adaptive controller.
The user intention estimation algorithm is responsible for interpreting the user's intended movements by estimating the magnitude of the torque exerted at the knee joint. To accomplish this, the algorithm utilizes biological signals that emanate from the knee extensor and flexor muscles when they are activated. These signals combined with the knee angle data are used as inputs to the estimation algorithm. The output is the magnitude and direction of the estimated torque. This value is then scaled by an assistance ratio, which determines the intensity of the assistive torque provided to the user. The experiments conducted verify the robustness and predictability of the proposed algorithms.
Finally, experimental results from the four activities of daily living, affirm that the desired movements could be performed successfully in cooperation with the exoskeleton. Furthermore, muscle activity recorded during the movements show a reduction in effort when assisted by the exoskeleton.
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Razeghi, Mohsen. "Biomechanical analysis of the effect of orthotic shoe inserts." Thesis, University of Nottingham, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368254.
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Jensen, Rikke Højhus, and Sarah Bugge Larsen. "Exploration of Danish orthotists perceptions on AFOs in early post-stroke management : A qualitative study." Thesis, Jönköping University, Hälsohögskolan, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-52743.
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Mahmood, Nasrul Humaimi. "3D surface reconstruction from multiviews for orthotic and prosthetic design." Thesis, University of Reading, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.494971.
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Existing methods that use a fringe projection technique for orthotic and prosthetic designs produce good results for the trunk and lower limbs; however, the devices used for this purpose are expensive. This thesis investigates the use of an inexpensive passive method involving 3D surface reconstruction from video images taken at multiple views. The design and evaluation methodology, consisting of a number of techniques suitable for orthotic and prosthetic design, is developed. The method that focuses on fitting the reference model (3D model) of an object to the target data (3D data) is presented. The 3D model is obtained by a computer program while the 3D data uses the shape-from silhouette technique in an approximately circular motion.
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Herbert-Copley, Andrew. "Design and Evaluation of a Variable Resistance Orthotic Knee Joint." Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/32380.
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Knee-ankle-foot orthoses (KAFOs) are full leg braces for individuals with knee extensor
weakness, designed to support the person during weight bearing activities by preventing knee
flexion. KAFOs typically result in an unnatural gait pattern and are primarily used for level
ground walking. A novel variable resistance orthotic knee joint was designed and evaluated to
address these limitations. This low profile design fits beneath normal clothing. Mechanical and
biomechanical testing demonstrated that the design resisted knee motion during stance phase,
released the knee joint without restricting the knee’s range of movement, and provided flexion
resistance during stair descent. Design modifications and related testing procedures were
developed to further improve joint performance and to validate the design prior to testing on
individuals with knee extensor weakness.
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Najafi, Bijan, James Wrobel, and Joshua Burns. "Mechanism of orthotic therapy for the painful cavus foot deformity." BioMed Central, 2014. http://hdl.handle.net/10150/610181.
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BACKGROUND:People who have extremely high arched feet or pes cavus often suffer from substantial foot pain. Custom-made foot orthoses (CFO) have been shown to be an effective treatment option, but their specificity is unclear. It is generally thought that one of the primary functions of CFO is redistributing abnormal plantar pressures. This study sought to identify variables associated with pain relief after CFO intervention.METHODS:Plantar pressure data from a randomized controlled trial of 154 participants with painful pes cavus were retrospectively re-analyzed at baseline and three month post CFO intervention. The participants were randomized to a treatment group given CFO or a control group given sham orthoses.RESULTS:No relationship between change in pressure magnitude and change in symptoms was found in either group. However, redistribution of plantar pressure, measured with the Dynamic Plantar Loading Index, had a significant effect on pain relief (p=0.001). Our final model predicted 73% of the variance in pain relief from CFO and consisted of initial pain level, BMI, foot alignment, and changes in both Dynamic Plantar Loading Index and pressure-time integral.CONCLUSION:Our data suggest that a primary function of effective orthotic therapy with CFO is redistribution of abnormal plantar pressures. Results of this study add to the growing body of literature providing mechanistic support for CFO providing pain relief in painful foot conditions. The proposed model may assist in better designing and assessing orthotic therapy for pain relief in patients suffering painful cavus foot deformity.TRIAL REGISTRATION:Randomized controlled trial: ISRCTN84913516
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Prasad, Monica. "The biomechanics of foot orthotics in people with medial compartment knee osteoarthritis." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/mq52938.pdf.
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Kamyab, Mojtaba. "A novel orthotic approach to the management of low back pain." Thesis, University of Strathclyde, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.501876.
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Mechanical low back pain is a common and costly medical problem. Most treatment options for low back pain have been reported to provide only short-term improvements in symptoms. Increasing the endurance of the local abdominal muscles, particularly transversus abdominis, by means of the so-called hollowing manoeuvre is a recommended method for long-term improvement in spinal stability and ultimately for prevention and alleviation of low back pain.
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Westergren, Robert, and Mehdi Nasser. "Patient satisfaction and mobility with their assistive device and service." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ. Ortopedteknisk plattform, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-30386.
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Objective: To gather knowledge related to patient satisfaction and mobility with lower limb prosthetic and orthotic devices and to investigate satisfaction with services received. Another purpose of this study is to analyze potential differences between orthotic and prosthetic patients in relation to patient satisfaction and mobility. Design: Cross-sectional study Subjects: 21 participants with a mean age of 58 (SD 16) with an average duration of use of devices of 10 (SD 10) years. 12 out of the 21 participants were orthotic users and 9 were prosthetic users. Methods: Patients were asked to complete two questionnaires, one regarding satisfaction with assistive device and service (QUEST 2.0) and one regarding mobility. Results: Patients mean score regarding satisfaction with assistive device and service were 4.0 (SD 0.8) and 4.2 (SD 1.0) respectively. 91% reported that they had the ability to walk at least 100 meters with their assistive device. The areas where participants experienced most difficulties were walking on uneven ground (70%), walking up and down a hill (57%) and walking on stairs (57%). Conclusion: Overall this study demonstrates that participants were quite satisfied with their assistive device and the service received by the P&O clinic. No statistically significant differences regarding satisfaction with assistive device and service, or mobility, were found between prosthetic and orthotic participants.
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Eby, Wesley R. "Feasibility Analysis of a Powered Lower-Limb Orthotic for the Mobility Impaired User." Thesis, University of Waterloo, 2005. http://hdl.handle.net/10012/952.
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Powered orthotic devices can be used to restore mobility to the impaired user, and may thereby assist them in daily living tasks. An investigation is performed herein to examine the feasibility of a powered lower-limb orthotic in assisting the sit-to-stand task by 50% of the required torque. Feasibility is considered via simulation.
A three-link sit-to-stand model, which is driven by kinematic data, is developed. Models of a Pneumatic Muscle Actuator and a DC motor are used to determine which of the two technologies can make a more appropriate contribution to the sit-to-stand task. Simulation revealed that both the Pneumatic Muscle Actuator and the DC motor are reasonable actuator choices, and neither limited the ability to achieve 50% torque assistance. The ability to assist the task was, however, limited by the ability to derive a control signal for the actuator from the user-orthotic interface.
It was concluded that the user-orthotic interface requires further investigation. It was also found that while both actuator technologies are suitable for contributing 50% of the required torque, the Pneumatic Muscle Actuator is preferable due to its ability to scale to greater torques.
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Larsen, Josefin, and Matilda Strömbäck. "Comparison of orthotic interventions for patients with congenital talipes equinovarus: a systematic review." Thesis, Jönköping University, HHJ. Ortopedteknisk plattform, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-53054.
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Aim: The aim with this study is to compare different orthotic solutions for pediatric patients with congenital talipes equnivarus. Method: A search in the databases MEDLINE, CINAHL, PubMed and Scopus were made, and studies was included after the predefined criteria. The included studies were reviewed for risk of bias and validity, relevant data was extract and analyzed with regards to the research question. Result: The result was presented on 15 different orthotic interventions in 21 different articles. The reported outcome measures were compliance, recurrence of deformity, Pirani- and Dimeglio score, range of motion and functional outcomes. Conclusion: Based on the results a recommendation cannot be made on what orthosis that gives the best result. Future research should focus on developing and designing an orthosis that satisfies the patient's needs.Syfte: Syftet med detta arbete är att undersöka olika ortos-lösningar med dess inkluderade resultat för patienter med kongenital idiopatisk klumpfot. Metod: En systematisk sökning i databaserna MEDLINE, CINAHL, PubMed and Scopus genomfördes och väsentliga studier inkluderades utefter de förbestämda kriterierna. Inkluderade studiers validitet och möjliga partiskhet bedömdes samt att relevant data utifrån frågeställningen analyserades och besvarades. Resultat: Resultatet presenterade 15 olika typer av ortoser, i 21 olika artiklar. De presenterade utfallsmåtten var inom komplians, återfall av deformationen, Pirani- och Dimeglio poäng, rörelseomfång samt inom funktionellt resultat. Slutsats: Baserat på resultat går det inte att presentera en övervägande slutsats om vilken ortos-lösning som ger bäst resultat. Framtida forskning måste utveckla och framställa ortoser som tillfredsställer och möter patienternas behov.
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Tessier, Isabelle Sylvie. "Development of a Prototype Active Ankle-Foot Orthotic Design Tool Using Novel Integrated Algorithms." Miami University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=miami1588163374532685.
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Santos, Diego Pedroso dos. "Projeto mecânico de exoesqueleto robótico para membros inferiores." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/3/3152/tde-04112011-150124/.
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Este trabalho consiste no projeto mecânico de um exoesqueleto robótico para paraplégicos com lesões medulares entre T2 a L1, ou seja, sem mobilidade da cintura para baixo e com mobilidade do peito para cima, inclusive das mãos. A utilização do equipamento necessita da utilização de muletas ou andadores. O mecanismo possui seis graus de liberdade, sendo quatro atuados por motorredutores (joelhos e quadris) e dois suportados por molas (tornozelos). Os motorredutores são projetados especialmente para o exoesqueleto, sendo compostos de um motor de corrente continua de imã permanente e um redutor harmônico do tipo panqueca acoplados de forma adequada para minimizar peso e volume. Para calcular os esforços solicitados em cada articulação foi desenvolvido um modelo dinâmico do corpo humano para simular os movimentos que o exoesqueleto é capaz de realizar, que são: marchar, sentar, levantar e subir e descer escadas. O modelo utilizado do corpo humano possui cinco ligamentos rígidos e é capaz de simular movimentos no plano vertical. Os resultados obtidos da simulação são comparados com resultados experimentais da literatura e são considerados satisfatórios.This work presents a mechanical design of a robotic exoskeleton for paraplegics with spinal cord injuries between T2 to L1, that means, without mobility from the waist down and with mobility from the chest up, including the hands. For using the equipment the paraplegic needs the aid of crutches or walkers. The mechanism has six degrees of freedom, with four degrees actuated by gear motors (knees and hips), and two degrees supported by springs (ankles). The gear motors are designed especially for the exoskeleton. They are composed by an permanent magnet brushless electric motor conveniently coupled with an pancake harmonic speed reducer to minimize weight and volume. For calculating the efforts in each joint a model for the human body is developed to simulate the movements the exoskeleton can perform, which are: walk, sit, standup and climb up and down stairs. The human body model has five rigid links and it is capable to simulate movements in the vertical plane. The results obtained in the simulations are compared very well with experimental results from the literature.
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Miguel, Olivier. "A Low-Cost Custom Knee Brace Via Smartphone Photogrammetry." Thesis, Université d'Ottawa / University of Ottawa, 2019. http://hdl.handle.net/10393/38746.
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This thesis provided the foundational work for a low-cost three-dimensional (3D) printed custom knee brace. Specifically, the objective was to research, develop and implement a novel workflow aimed to be easy to use and available to anyone who has access to a smartphone camera and 3D printing services. The developed workflow was used to manufacture two prototypes which proved valuable in the design iterations. As a result, an improved hinge was designed which has increased mechanical strength. Additionally, a smartphone photogrammetry validation study was included which provided preliminary results on the accuracy and precision. This novel measurement method has the potential to require little training and could be disseminated through video instructions posted online. The intention is to enable the patient to collect their own “3D scan” with the help of a friend or family member, effectively removing the need to book an appointment simply for collecting custom measurements. Lastly, it would allow the clinician to focus all their time on clinically relevant design tasks such as checking alignment, fit and comfort, which could all potentially be improved by adopting such digital methods. The ultimate vision for this work is to enable manufacturing of better custom knee braces at a reduce cost which are easily accessible for low-income populations.
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Sadeghi, Demneh Ebrahim. "The effects of orthotics on the sensori-motor problems of the foot and ankle after stroke." Thesis, University of Salford, 2011. http://usir.salford.ac.uk/26886/.
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The foot and ankle forms the interface between the body and ground hence stroke related changes impact on mobility but there is little research has considered the foot and ankle post-stroke. This thesis bridges these knowledge gaps to enable clinical trials to be carried out. Methods The initial chapters (1-3) review the knowledge about stroke-related problems in the foot and ankle and their association with mobility limitations. The following chapters (4-5) evaluate interventions targeting motor and sensory foot and ankle problems with a systematic review and clinical trial. The final chapter draws overall conclusions integrating the motor and sensory components. Results There is relatively little literature concerning the foot and ankle after stroke and that available focuses on activity without examining the underlying mechanisms. Pooled analysis of data from 251 stroke patients showed that foot sensory problems are common (37%) and significantly contribute to balance (p<0.03), mobility (p<0.01) and independence in ADLs (p<0.001) along with muscle weakness, time since stroke, neglect and age. In all models the independent variables explained about a half of the variance in mobility measures (p<0.001). To investigate the treatment of motor impairments, a systematic review of the effect of an ankle foot orthosis (AFO) on the biomechanics of walking was undertaken. It showed that an AFO improved dorsiflexion at initial contact (PO.00001) and weight transfer over the affected foot (PO.001). To investigate the treatment of sensory impairments, 29 stroke survivors participated in a randomised controlled crossover trial of supplementary sensory stimulation to the foot. This stimulation improved ankle strength (P<0.03) and sensation (P<0.025), and functional balance (P<0.003). Conclusion To date research about the foot-ankle complex post-stroke has emphasised the motor aspects. This work shows that sensory problems are also common and stroke survivors may be responsive to a sensory enhancing intervention.
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Stewart, Leslie-Ann. "Effects of orthotic wear on the kinetic, kinematic and electromyographic characteristics of walking and running." Thesis, McGill University, 2007. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=100211.
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Although custom-made foot orthotics are commonly prescribed to relieve lower limb injuries, few studies have documented their effects on the biomechanics of locomotion. The objective of this project was to quantify the effect of orthotic wear on kinematic, kinetic and electromyographic characteristics of the legs during walking and running. Fourteen subjects with custom-made foot orthotics were asked to run and walk over a 10-m walkway. Kinematic, kinetic and electromyographical parameters were recorded during all trials. One-way repeated measures ANOVA and paired students t-tests were used to evaluate the effect of orthotic wear as well as foot type (flat, normal). With orthotic wear, the activity of the soleus muscle was decreased for both groups of subjects with and without flat feet during running. The effect of orthotic wear on all other parameters was not significant. More in-depth studies are needed to generalize these results on the overall population of orthotic wearers.
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Keating, Jennifer. "Relating forearm muscle electrical activity to finger forces." Digital WPI, 2014. https://digitalcommons.wpi.edu/etd-theses/580.
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The electromyogram (EMG) signal is desired to be used as a control signal for applications such as multifunction prostheses, wheelchair navigation, gait generation, grasping control, virtual keyboards, and gesture-based interfaces [25]. Several research studies have attempted to relate the electromyogram (EMG) activity of the forearm muscles to the mechanical activity of the wrist, hand and/or fingers [41], [42], [43]. A primary interest is for EMG control of powered upper-limb prostheses and rehabilitation orthotics. Existing commercial EMG-controlled devices are limited to rudimentary control capabilities of either discrete states (e.g. hand close/open), or one degree of freedom proportional control [4], [36]. Classification schemes for discriminating between hand/wrist functions and individual finger movements have demonstrated accuracy up to 95% [38], [39], [29]. These methods may provide for increased amputee function, though continuous control of movement is not generally achieved. This thesis considered proportional control via EMG-based estimation of finger forces with the goal of identifying whether multiple degrees of freedom of proportional control information are available from the surface EMG of the forearm. Electromyogram (EMG) activity from the extensor and flexor muscles of the forearm was sensed with bipolar surface electrodes and related to the force produced at the four fingertips during constant-posture, slowly force-varying contractions from 20 healthy subjects. The contractions ranged between 30% maximum voluntary contractions (MVC) extension and 30% MVC flexion. EMG amplitude sampling rate, least squares regularization, linear vs. nonlinear models and number of electrodes used in the system identification were studied. Results are supportive that multiple degrees of freedom of proportional control information are available from the surface EMG of the forearm, at least in healthy subjects. An EMG amplitude sampling frequency of 4.096 Hz was found to produce models which allowed for good EMG amplitude estimates. Least squares regularization with a pseudo-inverse tolerance of 0.055 resulted in significant improvement in modeling results, with an average error of 4.69% MVC-6.59% MVC (maximum voluntary contraction). Increasing polynomial order did not significantly improve modeling results. Results from smaller electrode arrays remained fairly good with as few as six electrodes, with the average %MVC error ranging from 5.13%-7.01% across the four fingers. This study also identified challenges in the current experimental study design and subsequent system identification when EMG-force modeling is performed with four fingers simultaneously. Methods to compensate for these issues have been proposed in this thesis.
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Forghany, Saeed. "The biomechanics of foot and ankle problems after stroke and the effects of orthotics on such problems." Thesis, University of Salford, 2009. http://usir.salford.ac.uk/26680/.
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Stroke is the leading cause of adult disability and -50% of people with stroke suffer foot deformities which influence walking. The aim of this study was to investigate foot and ankle biomechanics, posture, multi-segment kinematics and plantar pressure in people with stroke and explore the possible causes and functional consequences of any abnormalities. A cross-sectional survey of the static foot posture in 72 people with stroke showed that one-third had abnormal and asymmetrical foot posture with almost equal numbers having pronated and supinated affected foot associated with limited walking ability. Stance phase foot and ankle biomechanics were quantified using a multisegment foot model on the affected side of twenty stroke and fifteen healthy age-matched subjects. The role of neuromuscular impairments in biomechanical abnormalities was characterised by concurrently measuring the electromyography and spasticity of major posterior and anterior lower leg muscles and the dynamometric measures of plantarflexor stiffness, plantarflexor and dorsiflexor strength and ankle proprioception. The following abnormalities in people with stroke were found: Reduced range of motion across most segments and planes A more pronated foot A less supinated foot during propulsion Deficit in the foot rocker function Disruption in the timing of joint motion Change in the coupling mechanisms Greater variability The changes in pronation and supination were associated with limited walking ability and soleus spasticity and plantarflexor stiffness. The work also investigated the effects of lateral wedges orthoses on the eight lower leg muscles to understand the interactions between foot and ankle biomechanics and neuromuscular function. In eight healthy subjects, there was a trend for peak muscle length, excursion and lengthening velocity to increase when wearing lateral wedges orthoses. The observed changes strongly support a follow-on study in a stroke population to explore the effects of lateral wedge orthoses on muscle length and lengthening characteristics
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Evans, Helen. "The effect of orthotic tuning on the energy cost of walking in children with cerebral palsy." Thesis, University of Nottingham, 2018. http://eprints.nottingham.ac.uk/51746/.
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Introduction Children with cerebral palsy (CP) often have to wear orthoses to help them walk. There is a growing body of evidence that orthotic tuning, that is, optimisation of the ground reaction forces in the lower limbs during walking, is recommended to ensure the maximum potential benefit for each child. Research demonstrates that orthoses can reduce the energy cost of walking for children with CP, but to-date there is no evidence as to whether this tuning process results in further energy efficiency or not [1]. Aim The aim of this research programme was to validate a method that would help to determine when an orthosis was optimised for each child; and then to investigate whether the use of orthoses that were optimally tuned for each child allowed a further reduction in energy cost during walking, compared with orthoses that had not been optimally tuned. Method A video vector system was used to allow visualisation of the alignment of ground reaction forces in relation to the lower limbs during walking. A simple measurement tool was validated that allowed quantification of the moment arm at the knee in stance, which was used to confirm when optimal alignment had occurred following orthotic tuning. The energy cost of walking was measured using the Total Heart Beat Index (THBI). Data were collected barefoot, with the original ‘un-tuned’ orthosis and with the final ‘tuned’ orthosis. Results Analysis of energy cost showed that for some children, energy cost was further reduced through orthotic tuning, but that this was not the case for all children. Preliminary findings suggest the influence of underlying level of disability, as determined by the GMFCS. Conclusion Orthotic tuning may help to reduce the energy cost of walking for some children with CP, especially those with greater levels of disability. Further studies with large participant numbers are warranted to further investigate this area.
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Richardson, Kevin Thomas. "DESIGN AND ANALYSIS OF A 3D-PRINTED, THERMOPLASTIC ELASTOMER (TPE) SPRING ELEMENT FOR USE IN CORRECTIVE HAND ORTHOTICS." UKnowledge, 2018. https://uknowledge.uky.edu/me_etds/127.
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This thesis proposes an algorithm that determine the geometry of 3D-printed, custom-designed spring element bands made of thermoplastic elastomer (TPE) for use in a wearable orthotic device to aid in the physical therapy of a human hand exhibiting spasticity after stroke. Each finger of the hand is modeled as a mechanical system consisting of a triple-rod pendulum with nonlinear stiffness at each joint and forces applied at the attachment point of each flexor muscle. The system is assumed quasi-static, which leads to a torque balance between the flexor tendons in the hand, joint stiffness and the design force applied to the fingertip by the 3D-printed spring element. To better understand material properties of the spring element’s material, several tests are performed on TPE specimens printed with different infill geometries, including tensile tests and cyclic loading tests. The data and stress-strain curves for each geometry type are presented, which yield a nonlinear relationship between stress and strain as well as apparent hysteresis. Polynomial curves are used to fit the data, which allows for the band geometry to be designed. A hypothetical hand is presented along with how input measurements might be taken for the algorithm. The inputs are entered into the algorithm, and the geometry of the bands for each finger are generated. Results are discussed, and future work is noted, providing a means for the design of a customized orthotic device.
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Magalhães, Eduardo de Paiva. "Efeito do uso de palmilhas no tratamento de pes reumatoides." [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/310637.
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Orientadores: Manoel Barros Bertolo, Linamara Rizzo BattistellaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Objetivo: Avaliar a eficácia de palmilhas em pacientes com artrite reumatóide (AR) utilizando o Índice de Função dos Pés (FFI) durante 6 meses. Estudar a alteração na distribuição da pressão plantar em pés reumatóides após 15 dias em uso de palmilhas. Material e Métodos: Foram avaliados trinta e seis pacientes com AR e dor nos pés e prescritas palmilhas conforme as necessidades individuais. Todos os pacientes foram reavaliados em 30, 90 e 180 dias da avaliação inicial. Em cada consulta foi aplicado FFI e verificados o tempo de utilização das órteses e eventuais efeitos adversos. O Health Assessment Questionaire (HAQ) foi verificado na consulta inicial para avaliar a influência da condição física na evolução do FFI. Quinze mulheres com AR e dor nos pés foram submetidas a avaliação da pressão na superfície plantar pelo programa F-SCAN em avaliação inicial e após 15 dias em uso de palmilhas. Resultados: Durante o estudo os valores do FFI reduziram em todas as sub-escalas (dor, incapacidade e limitação de atividade). Esta redução foi notada no primeiro mês e mantida durante todo o período de avaliação. Os pacientes que utilizaram palmilhas com EVA convencionais (n=28) apresentaram melhores resultados. Pacientes utilizando palmilhas sob molde de gesso (n=8) apresentaram valores mais elevados do FFI na consulta inicial e menor redução deste índice com resultados ainda significantes para as sub-escalas de dor e incapacidade, mas não para limitação de atividade. Efeitos adversos menores foram verificados sem resultar em interrupção do tratamento. Os pacientes utilizaram a palmilha durante um período médio de 7,14 horas por dia durante o primeiro mês sem diferenças significativas nas avaliações subseqüentes. Não foi verificada relação entre o HAQ e a evolução do FFI. Com o uso de palmilhas foi verificada significativa redução dos valores de pressão plantar em ante-pé e retro-pé. Conclusões: As palmilhas foram efetivas como adjuvantes no tratamento de pés reumatóides com redução dos índices de dor, incapacidade e limitação de atividade avaliados pelo FFI, com poucos efeitos adversos. Também proporcionaram melhor distribuição da pressão na superfície plantar com redução dos seus valores em ante-pé e retro-pé
Abstract: Objective: To evaluate the effectiveness of foot orthoses, using the Foot Function Index (FFI), in a group of patients with rheumatoid arthritis (RA) in a period of six months. To compare the foot pressures in rheumatoid patients after the use of foot orthoses during a period of fifteen days. Methods: Thirty-six rheumatoid subjects with foot pain were examined and appropriate foot orthoses were prescribed according to each patient needs. All the patients were evaluated in 30, 90 and 180 days after baseline visit. FFI values, daily wearing time and adverse effects were noted in each appointment. The Stanford Health Assessment Questionnaire (HAQ) was obtained in the initial visit and it was used to evaluate the influence of physical condition on FFI response. Fifteen women with RA and foot pain were also examined and their foot pressure values measured using the F-SCAN program in first appointment and after fifteen days using appropriate insoles. Results: After the use foot orthoses, FFI values decreased in all subscales (pain, disability and activity limitation) for the patients studied. This reduction was noted early, in the first month and maintained during all the trial. Those using EVA (n=28) orthoses presented similar results to the total group. Otherwise, patients with made to measure orthoses (n=8) exhibited higher initial FFI values and worse evolution during the trial, still significant for pain and disability, but not for activity limitation. Minor adverse reactions were noted and none of them required treatment interruption. Orthoses were worn on an average for 7.14 hours in the first month without significant differences in the others visits. There was no relation between HAQ and FFI evolution. The patients using the foot orthoses achieved a significant plantar pressure reduction in forefoot and hindfoot. Conclusions: Foot orthoses were effective as an adjuvant management of rheumatoid foot. They significantly reduced pain, disability and activity limitation accessed by the FFI, with minor adverse effects. They also promote a better plantar pressure distribution and relief in forefoot and hindfoot
Doutorado
Clinica Medica
Doutor em Clínica Médica
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Zequera, DiÌaz Martha Lucia. "A computer assisted model for orthotic management of the diabetic foot in the early stages of the disease." Thesis, University of Strathclyde, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.423862.
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Dall, Philippa Margaret. "The function of orthotic hip and knee joints during gait for individuals with thoracic level spinal cord injury." Thesis, University of Strathclyde, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.401337.
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Goodson, Caleb Benjamin. "Mechanical Redesign and Fabrication of a 12 DOF Orthotic Lower Limb Exoskeleton and 6 Axis Force-Torque Sensor." Thesis, Virginia Tech, 2020. http://hdl.handle.net/10919/100734.
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This thesis details several modifications to the mechanical design of the Orthotic Lower Limb Exoskeleton (OLL-E) that improve upon the functionality and manufacturability of parts and their assemblies. The changes made to these parts maintain or improve the factor of safety against yield and fatigue failure as compared to the original designs. Design changes are verified by FEA simulations and hand calculations. The changes included in this thesis also allowed parts that were previously difficult or impossible to manufacture using traditional methods to be made in house or outsourced to another machine shop. In addition to the mechanical design changes, this thesis also details the design and implementation of a six axis force-torque sensor built into the foot of OLL-E. The purpose of this sensor is to provide feedback to the central control system and allow OLL-E to be self-balancing. This foot sensor design is calibrated and initial results are discussed and shown to be favorable.Master of Science
Recent developments in the fields of robotics and exoskeleton design have increased their feasibility for use in medical rehabilitation and mobility enhancement for persons with limited mobility. The Orthotic Lower Limb Exoskeleton (OLL-E) is an exoskeleton specifically designed for enhancing mobility by allowing users with lower limb disabilities such as spinal cord injuries or paraplegia to walk. The research detailed in this thesis explains the design and manufacturing processes used to make OLL-E as well as providing design details for a force sensor built into the exoskeleton foot. Before manufacturing could take place some parts needed to be redesigned and this thesis provides insight into the reasons for these changes. After the manufacturing and design process was completed the OLL-E was assembled and the project can now move forward with physical testing.
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Näslund, Annika. "Dynamic ankle-foot orthoses in children with spastic diplegia : interview and experimental studies /." Luleå : Division of Physiotherapy, Department of Health Sciences, Luleå University of Technology, 2007. http://epubl.ltu.se/1402-1544/2007/11/.
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Livengood, Ann L. "EFFECT OF THE SMARTSTEPTM STABILIZATION SYSTEM ON BALANCE IN OLDER ADULTS IN AN INDEPENDENT LIVING RESIDENCE." Lexington, Ky. : [University of Kentucky Libraries], 2008. http://hdl.handle.net/10225/974.
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Thesis (Ph. D.)--University of Kentucky, 2008.Title from document title page (viewed on February 3, 2009). Document formatted into pages; contains: vii, 122 p. : ill. (some col.). On t.p. the registered trademark symbol "TM" is superscript following SmartStep in the title. Includes abstract and vita. Includes bibliographical references (p. 103-119).
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Black, Michael P. "The development of a three-dimensional measurement system for the clinical evaluation of orthotic therapy in patients with foot valgus." Thesis, University of Dundee, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.521687.
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André, Marie. "Patient education and foot disability in juvenile idiopathic arthritis : a physiotherapy perspective /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-439-2/.
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Souza, Alessandra Cavalcanti de Albuquerque e. "An?lise funcional do design das ?rteses para rizartrose." Universidade Federal do Rio Grande do Norte, 2006. http://repositorio.ufrn.br:8080/jspui/handle/123456789/15106.
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Previous issue date: 2006-05-19The purpose of this paper is to identify the utilization of two models of orthotics used in the conservative treatment of rizartrose in patients/consumers that were referred by the medical clinic to the LAI (Laboratory of Integrated Accessibility). It describes this group s perception related to the functional aspects of the two models, evaluates the value of the product attributed by the patient/consumer and describes the importance attributed to each model. The research s objective consists in identifying which model this is preferred from the point of view by the patients that use either the dorsal or ventral models used in the conservative treatment of rizartrose . This work is then based on the exploratory research through the investigation of the bibliography available and in the research field. The research field used the case study methodology to investigate the phenomenon in the real context. The data were collected using a patient questionnaire during two times after the use of the dorsal orthotic and after the use of the ventral orthotic. The questionnaire was used to identify the relationship between the patients/consumers and the two different types of orthotics. A general descriptive analysis was used in order to verify the patient s abilities executing certain activities daily living using the dorsal and ventral orthotics, the product s functional aspects and its value from the patient s/consumer s point of view. The results show that the preference for the dorsal or ventral models is determined by the individual needs of each person. The results also show that other variables, such as the use of the orthotic on the dominant or non-dominant hand, play a role in the preferred model by the patient/consumer and need to be further investigated
Esta pesquisa tem como proposta investigar a utiliza??o de dois modelos de dispositivo ort?tico usados no tratamento conservador da rizartrose de pacientes/consumidores que foram encaminhados ao LAI (Laborat?rio de Acessibilidade Integrada) pela cl?nica m?dica. Ainda, descreve as percep??es deste grupo sobre os aspectos funcionais dos dois modelos do dispositivo, avalia o valor do produto atribu?do pelo paciente/consumidor e descreve a import?ncia conferida a cada modelo. O objetivo desta pesquisa consiste em identificar entre os modelos de ?rtese dorsal e ventral, utilizados no tratamento conservador da rizartrose, aquele que ? preferido para uso sob a ?tica do pr?prio paciente/consumidor. Desta forma, o trabalho tem sua forma??o baseada na pesquisa do tipo explorat?ria atrav?s de investiga??o em fontes bibliogr?ficas e em pesquisa de campo. Na pesquisa de campo foi adotado como procedimento metodol?gico o estudo de caso, por se propor a investigar o fen?meno em seu contexto real. Os dados foram coletados com a aplica??o de formul?rio junto aos pacientes/consumidores em dois momentos-ap?s uso de ?rtese dorsal e ap?s uso de ?rtese ventral. O formul?rio busca identificar a rela??o de cada paciente/consumidor com os dois modelos do dispositivo. Atrav?s de uma an?lise descritiva geral foi verificado sobre a habilidade do paciente na execu??o de determinadas tarefas cotidianas em uso de ?rtese dorsal e ventral, sendo seguido da apresenta??o dos aspectos funcionais dos produtos e do valor sob a ?tica do paciente/consumidor. Os resultados mostram que a prefer?ncia para uso do modelo dorsal ou ventral ? determinada pelas necessidades individuais de cada pessoa. Os resultados mostram tamb?m a exist?ncia de outros pressupostos que exercem influencia na escolha do modelo pelo paciente/consumidor, como o uso de ?rtese na m?o contralateral a dominante
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Rosenfeld, Louis B. "Are the kinematic changes to gait caused by foot orthotic use in a pronated population permanent, or mitigated during a one-month period of adaptation?" Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ65010.pdf.
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Childers, Walter Lee. "Motor control in persons with a trans-tibial amputation during cycling." Diss., Georgia Institute of Technology, 2011. http://hdl.handle.net/1853/44910.
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Motor control of any movement task involves the integration of neural, muscular and skeletal systems. This integration must occur throughout the sensorimotor system and focus its efforts on controlling the system endpoint, e.g. the foot during locomotion. A person with a uni-lateral trans-tibial amputation has lost the foot, ankle joint, and muscles crossing those joints, hence the residuum becomes the new terminus of the motor system. The amputee must now adjust to the additional challenges of utilizing a compromised motor system as well as the challenges of controlling an external device, i.e. prosthesis, through the mechanical interface between the residuum and prosthetic socket.
The obvious physical and physiologic asymmetries between the sound and amputated limbs are also involved in strategies for locomotion involving kinematic and kinetic asymmetries (Winter&Sienko, 1988). There are many questions as to why these asymmetric locomotor strategies are selected and what factors may be influencing that strategy. Factors influencing a change in locomotor strategy could be related to 1) the central nervous system accounting for the loss of sensorimotor feedback, 2) the altered mechanics of this new human/prosthetic system, or some combination of these factors. Understanding how the human motor system adjusts to the amputation and to the addition of an external mechanical device can provide useful insight into how robust the human control system may be and to adaptations in human motor control.
This research uses a group of individuals with a uni-lateral trans-tibial amputation and a group of intact individuals using an Ankle Foot Orthosis (AFO) performing a cycling task to understand the "motor adjustments" necessary to utilize an external device for locomotion. Results of these experiments suggest 1) the motor system does account for the activation-contraction dynamics when coordinating muscle activity post amputation, 2) the motor system also changes joint kinetics and muscle activity, 3) these changes are related to control of the interface between the limb and the external device, and 4) the motor system does not alter kinetic asymmetries when kinematic asymmetries are minimized, contrary to a common practice in rehabilitation (Kapp, 2004).
Results suggest that control of the external device, i.e. prosthesis or AFO, via the interface between the limb and the device reflect "motor adjustments" made by the nervous system and may be viewed in the context of tool use. Clinical goals in rehabilitation currently focus on minimizing gait deviations whereas the clinical application of these results suggest these deviations from normal locomotion are motor adjustments necessary to control a tool, i.e. prosthesis, by the motor system. Examining amputee locomotion in the context of tool use changes the clinical paradigm from one designed to minimize deviations to one intended to understand this behavior as related to interface control of the device thereby shifting the focus to improving function of the limb/prosthesis system.
Kapp SL. (2004) Atlas amp limb def: surg pros rehab princ. 3rd ed: 385 - 394.
Winter&Sienko. (1988) J Biomech, 21: 361 - 367.
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Delacroix, Sébastien. "Évaluation des effets cinématiques et dynamiques induits par le port d’orthèses plantaires lors de la marche." Thesis, Lyon 1, 2014. http://www.theses.fr/2014LYO10303/document.
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La connaissance des effets biomécaniques induits par les orthèses plantaires représente un enjeu important afin de faire reconnaitre le rôle du podologue dans le traitement des pathologies ostéo-articulaires et musculo-tendineuses de l'appareil locomoteur. Ainsi, ce travail de thèse consiste à modéliser, par la biomécanique, l'appareil locomoteur afin d'évaluer les effets du port des orthèses plantaires durant la marche. Avant toute chose, une étude méthodologique a été menée afin de vérifier la reproductibilité des données biomécaniques de la marche. Les principaux résultats montrent que ces données biomécaniques peuvent présenter une variabilité importante, principalement causée par des erreurs de positionnement des capteurs sur le sujet, rendant parfois difficile l'interprétation clinique. Toutefois, la deuxième partie de cette étude a montré que l'utilisation d'une méthodologie de correction segmentaire à partir d'une position statique imposée permettait de réduire cette variabilité. Une étude clinique a donc été menée sur les répercussions de l'utilisation d'une orthèse plantaire de supination sur la correction instantanée du pied valgus. Les principales conclusions montrent que les données cinématiques et dynamiques, notamment du pied et de la cheville, sont impactées. Enfin, afin de démontrer l'intérêt d'utiliser la méthodologie de correction segmentaire pour l'interprétation des effets biomécaniques du traitement par orthèses plantaires à plus ou moins long terme, deux cas cliniques ont été analysés, l'un concernait un patient atteint d'un syndrome de loge de la jambe et l'autre d'une gonarthrose. Les principales conclusions indiquent que les orthèses plantaires ont une action sur des pathologies de la cheville et du genou mais que l'interprétation de cette action peut être erronée si la variabilité des données biomécaniques de la marche n'est pas prise en considérationThe knowledge of the biomechanical effects induced by foot orthotics is an important issue in order to recognize the role of the podiatrist in the treatment of osteoarticular and musculotendinous disorders of the musculoskeletal system. So, this work consists in modeling, by the biomechanics, the musculoskeletal system to assess the effects of wearing foot orthotics during walking. A first study was conducted to check the reproducibility of gait biomechanical data through two different sessions. The results show that these biomechanical data may show significant variability, mainly caused by errors in the positioning of sensors on the subject, making it difficult clinical interpretation. However, the second part of this study showed that the use of a methodology for segmental correction, from a static position imposed, allowed reducing this variability. Thus, a study was conducted on the impact of the use of supinated foot orthotics on immediate correction of valgus foot. The main findings show that the kinematic and dynamic data, notably the foot and ankle, are impacted. Before being able to estimate if this correction lasts over time, a second study was conducted. Thus, to demonstrate the benefits of using this methodology for the interpretation of the biomechanical effects of treatment with foot orthotic in the longer term, two clinical cases were analyzed, one involved a patient with compartment syndrome of the leg and the other with knee osteoarthritis. The main findings indicate that the insoles have an impact on diseases of the ankle and knee but that the interpretation of these actions may be wrong if the variability of gait biomechanical data is not considered
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Rodrigues, Priscilla Teixeira. "Tratamento da osteoartrite do joelho valgo com palmilha em cunha medial." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5145/tde-07122006-201935/.
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Objetivo: Avaliar a eficácia da palmilha em cunha medial na osteoartrite (OA) com joelho valgo. Método: 30 mulheres com OA de joelhos e deformidade em valgo > 8 graus, foram randomizados em 2 grupos: o experimental, que utilizou palmilha com elevação medial no retropé de 8 mm (n = 16) e o controle que usou uma palmilha similar, sem elevação (n = 14), e em ambos associou-se um estabilizador de tornozelo. Um examinador cego avaliou dor noturna, ao movimento e ao repouso (Escala Visual Analógica), índice de Lequesne e questionário WOMAC, e os ângulos femurotibial, talocalcâneo e de inclinação do talus, no início e após 8 semanas de uso das palmilhas. Resultados: No grupo experimental, houve redução da dor ao repouso (5,06 + 2,29 vs 2,73 + 2,40, p = 0,002), ao movimento (8,13 + 1,50 vs 4,20 + 2,36, p = 0,001), e noturna (6,06 + 2,74 vs 3,13 + 2,07, p = 0,001), Lequesne (14,75 + 3,36 vs 9,60 + 3,83, p = 0,001 ) e WOMAC (74,13 + 14,20 vs 56,13 + 14,94, p = 0,001). No grupo controle, houve apenas uma leve redução da dor noturna (5,79 + 2,39 vs 4,64 + 2,38, p = 0,019). Houve um aumento do ângulo femurotibial no grupo experimental (169,05 +3,43 vs 170,81 + 3,73, p = 0,001). Os demais ângulos permaneceram inalterados em ambos os grupos. Conclusão: O uso de palmilha em cunha medial foi eficaz no controle da osteoartrite do joelho valgo.Objective: To assess the efficacy of medial-wedge insole in valgus knee osteoarthritis (OA). Method: 30 females with valgus deformity knee OA > 8 degrees were randomized into 2 groups: an experimental group, which used insoles with medial elevation at the hindfoot of 8 mm (n = 16), and a control group which used a similar insole without elevation (n = 14), where both groups also wore ankle supports. A blinded examiner assessed pain on movement, at rest and at night (Visual Analog Scale), the Lequesne index and WOMAC questionnaire, along with femorotibial, talocalcaneal and talar tilt angles, at baseline and following 8 weeks? insole use. Results: Reductions were observed in the experimental group for pain at rest (5.06 + 2.29 vs 2.73 + 2.40, p = 0.002), on movement (8.13 + 1.50 vs 4.20 + 2.36, p = 0.001), at night (6.06 + 2.74 vs 3.13 + 2.07, p = 0.001), and in Lequesne (14.75 + 3.36 vs 9.60 + 3.83, p = 0.001 ) and WOMAC scores (74.13 + 14.20 vs 56.13 + 14.94, p = 0.001). For the control group, only a slight reduction in night pain was seen (5.79 + 2.39 vs 4.64 + 2.38, p = 0.019). There was an increase in the femorotibial angle in the experimental group (169.05 +3.43 vs 170.81 + 3.73, p = 0.001). The other angles remained unchanged in both groups. Conclusion: The use of medial-wedge insoles proved effective in controlling symptoms of valgus knee osteoarthritis
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Ferreira, Vanessa Maria de Vargas 1986. "Avaliação clínica e cinemática da função manual de pessoas com tetraplegia com a utilização de EENM e sistema híbrido = Clinical and kinematic analysis of the hand function of persons with tetraplegic using NMES and hybrid system." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309568.
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Orientador: Alberto Cliquet JuniorDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Pacientes com lesão medular cervical apresentam disfunção dos membros superiores com grande perda de funcionalidade. A eletroestimulação neuromuscular (EENM) é considerada uma ferramenta importante para a reabilitação desses pacientes. O presente estudo tem como objetivo avaliar a função de pacientes tetraplégicos na tarefa mimética de beber e comparar com a utilização de EENM e um sistema híbrido (órtese dinâmica e EENM) para membros superiores, por meio de análise clínica e cinemática. Participaram desta pesquisa 14 pacientes com tetraplegia com nível motor entre C4 a C7 e 5 voluntários saudáveis. Foram aplicadas escalas clínicas para definir o nível de acometimento neurológico e funcional do paciente (AIS e MIF) e foi realizada avaliação cinemática da tarefa mimética de beber, sendo que os pacientes realizaram a atividade em 3 situações: movimento livre, com EENM e com o sistema híbrido. As variáveis cinemáticas utilizadas foram: tempo do movimento, razão do pico de velocidade máxima, índice de curvatura, trajetória do esterno, distância punho-esterno e abertura da mão. Também foi computado o número de acertos para a realização da tarefa. Os resultados indicam que pacientes que realizam a preensão por tenodese possuem maior independência funcional pela MIF (p=0,0008). Na tarefa mimética de beber houve 60% de acertos no movimento livre, 72,8% com EENM e apenas 47,6% com o sistema híbrido. Pela análise cinemática o uso da EENM não foi diferente do movimento livre, no entanto, os pacientes apresentaram maior tempo e menor suavidade no movimento e realizaram maior trajetória do punho e esterno durante a atividade quando comparado com o controle. O uso do sistema híbrido alterou o padrão de movimento dos pacientes, apresentando um aumento na trajetória do esterno e diminuição da suavidade do movimento. Em suma, a EENM promoveu uma melhor atividade funcional para os pacientes com nível C5, no entanto, o uso do sistema híbrido não parece facilitar a manipulação de objetos por pessoas com tetraplegia
Abstract: Patients with cervical spinal cord injury have dysfunction of the upper limbs with great loss of motor function. Neuromuscular electrical stimulation (NMES) is considered an important tool in rehabilitation. The aim of the present study is to evaluate the function of patients with tetraplegia in the mimetic task of drinking and compare with the use of NMES and a hybrid system (NMES and dynamic orthosis) through clinical evaluation and kinematic analysis. Fourteen patients with tetraplegia level C4 to C7 and 5 able-bodied volunteers participated in the study. Clinical tests were applied to verify the neurological and functional impairment (AIS and FIM) and the mimetic task of drinking was assessed with kinematic during three situations: free movement, with NMES and with the hybrid system. The kinematic variables used were: movement time, peak velocity ratio, index of curvature, sternum trajectory, wrist-sternum distance and hand opening. We also computed the number of successes to perform the task. The results indicate that patients that are able to perform tenodesis grip have greater functional independence through FIM (p=0.0008). The rate of success of the free movement was 60%, 72.8% with NMES and only 47.6% with the hybrid system. In the kinematic analysis the NMES was not different from the free movement, however, patients performed the task in a longer time, the movement was less smooth and the sternum and wrist trajectories were greater than the control group. The use of the hybrid system modified the pattern of movement of the patients, with an increase of the sternum trajectory and decrease of the smoothness. In conclusion, NMES improved the functional activity of patients with C5 level; on the other hand, the use of the hybrid system does not appear to facilitate the prehension of persons with tetraplegia
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências
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Wiedenhoft, Aldoni Gabriel. "Desenvolvimento de uma bancada de teste para torque de parafusos para implantes." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2008. http://hdl.handle.net/10183/13666.
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Componentes de próteses e órteses humanas devem ser confortáveis, capazes de realizar as funções esperadas e, mais do que tudo, confiáveis. O foco deste trabalho é no desenvolvimento e aplicação de uma metodologia de análise de parafusos cirúrgicos. Para tanto foi desenvolvido um aparato mecânico, que consiste em um atuador de torque e um sistema de aquisição de dados. O atuador, composto por um motor elétrico acoplado a um redutor, aplica torque sobre o parafuso em teste, que o transfere a uma célula de carga e, assim, ao sistema de aquisição de dados. Parafusos canulados de aço inoxidável e corticais de titânio, de diferentes fabricantes, foram testados para torque de inserção e remoção, torque máximo e ângulo de ruptura. Os resultados mostraram que, apesar de todos os parafusos canulados seguirem os padrões recomendados, foram encontradas dispersões significativas entre os resultados verificados para os parafusos corticais de titânio, o que indica problemas de material ou manufatura. Os resultados mostraram valores mais elevados para torque de remoção que de inserção, o que, apesar de esperado, não é um efeito desejável, uma vez que facilita a fratura após a convalescência do paciente, em uma eventual remoção do parafuso. A análise dos resultados mostra a eficiência da metodologia desenvolvida, e chama a atenção para a confiabilidade dos componentes de órteses e próteses.Human orthotic device components must be comfortable, able to execute the expected functions and, most of everything reliable. The focus of this work is the development and application of a surgical screw resistance analysis methodology. For this, a mechanical apparatus, consisting of a torque actuator and a data acquisition system was developed. The actuator, composed by an electric engine and reducer, applied torque on the tested screw, who transfers it to a load cell, especially developed, and thus to the data acquisition system. Cortical titanium and cannulated stainless steel bone screws were tested, from different manufacturers, for insertion and removal torque, maximum torque and rupture angle. The results showed that, despite that all cannulated screws had followed the recommended standards, it was found significant dispersion among the results for titanium cortical screws, which indicates manufacturing or material defects. Results also showed that removal torque was always higher than insertion torque. This is an undesirable, yet expected, effect, once fractures may come to happen after the healing of the patient, or even on the occasion of a substitution. The analysis showed the efficiency of the methodology developed, and opens a point of discussion on orthotic reliability.
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Kim, Dale Sang Hyun. "Assessment of wedge and flare designs of shoes on basketball movements." Thesis, Georgia Institute of Technology, 2010. http://hdl.handle.net/1853/37221.
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The ankle sprain is a common injury in basketball. A mechanism for this injury occurs when landing improperly from a jump. The concept of wedge and flare designs in shoes is (1) to offer benefit in reducing the potential for an ankle sprain while (2) not hindering performance or usability concerning basketball movements that are needed for successful play. The purpose was to take conceptual designs of the wedge and flare through an iterative design process. Therefore, the objectives were to fabricate shoe prototypes with these conceptual designs, to test the performance of these prototypes, and to develop the next iteration of design based upon the results of testing. The results of this design process are discussed.
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Hösl, Matthias. "Spastic equinus deformity in children with Cerebral Palsy – Treatment effects in terms of muscular morphology and function." Doctoral thesis, Humboldt-Universität zu Berlin, 2018. http://dx.doi.org/10.18452/18861.
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Die meisten Kinder mit infantiler Zerebralparese (IZP) entwickeln eine spastische Parese, was zu Schwäche, erhöhtem Muskel-Dehnungswiderstand und Kontrakturen führt. Der Spitzfuß ist eines ihrer häufigsten Defizite. Das übergeordnete Ziel dieser Arbeit war es, nicht-invasive Behandlungsstrategien für diese Pathologie näher zu untersuchen. In der ersten Studie wurden die Effekte einer Unterschenkel-Lagerungsorthese auf die Muskelmorphometrie des Gastrocnemius unter zu Hilfenahme von Ultraschall und 3D Bewegungsanalyse untersucht. Lagerungsorthesen konnten das Gangbild verbessern, führten gleichzeitig aber zu Atrophie. Um eine alternative Therapieform zu finden, wurde in der zweiten Studie die kontraktile Aktivität des Gastrocnemius mittels Ultraschall, Bewegungsanalyse und EMG während des Gehens, Vorwärts-Bergauf, bzw. Rückwärts-Bergab, sowie in der Ebene untersucht. Das Bergaufgehen steigerte die konzentrische Exkursion der Faszikel, wohingegen das Rückwärts-Bergabgehen zu vermehrter Exzentrik führte. Da sich exzentrisches Training positiv auf Faszikellängenwachstum auswirken kann, wurde in der dritten Studie das Rückwärts-Bergabgehen mit statischem Dehnen als traditionelle Therapieform verglichen. Ultraschall, Bewegungsanalyse und handgesteuerte Dynamometrie wurden verwendet, um die Plantarflexorenkraft, die passive Sprunggelenksbeweglichkeit, die Gastrocnemius Morphometrie sowie die Steifigkeit und Dehnbarkeit auf Muskel-Sehnen und Gelenkebene zu untersuchen. Dehnen zeigte keinerlei Benefits gegenüber dem Laufbandtraining. Rückwärts-Bergabgehen war dagegen ein effektives Gangtraining und setzt vermutlich neuronale und koordinative Reize. In der Zusammenschau scheinen positive Änderungen im Gangbild bei IZP Kindern sowohl durch Unterschenkelorthesen, als auch durch Rückwärts-Bergabgehen erreichbar zu sein. Beides führte aber nicht zu Muskelwachstum. Funktionelle Verbesserungen scheinen daher auch stark von neuronal, koordinativen Aspekten abhängig zu sein.Most children with Cerebral Palsy (CP) develop spastic paresis, which leads to muscle weakness, increased stretch-resistance and joint contractures. The gastrocnemius muscle is frequently targeted to alleviate a common deficiency known as equinus. The overall objective of this thesis was to investigate several non-invasive treatment strategies for this pathology. The first study investigated the effects of ankle foot orthotics on spastic gastrocnemius morphometrics as well as on gait by using ultrasound and motion capturing. We concluded that braces improved walking function but also lead to atrophy. During the second study, we searched for a readily available, substituting stimulus and compared the contractile activity of the gastrocnemius on treadmills, namely during flat-forward, forward-uphill and backward-downhill gait using ultrasound, motion capturing and EMG. Uphill gait promoted concentric fascicle action, while backward-downhill gait increased eccentric fascicle action. Since eccentric training had been previously shown to increase fascicle length in controls, during the third study, we compared backward-downhill walking versus static, manual stretching. Ultrasound, motion analysis and handheld dynamometry were used to test plantarflexor strength, passive ankle joint flexibility, as well as gastrocnemius morphometrics, stiffness and strain on muscle-tendon and joint level. Backward-downhill walking led to larger single stance dorsiflexion and faster achievable walking velocities while stretching aggravated knee flexion in swing. Strength, joint flexibility, as well as stiffness on muscle-tendon and joint level were not altered. Backward-downhill walking can be an effective gait treatment, probably improving coordination. Nevertheless, more intense training might be necessary to alter muscle-tendon properties. In sum, backward-downhill walking and bracing increased function without promoting or even by harming muscle growth.
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Silva, Larissa Galvão da. "Órteses em PVC para membro superior: utilização por terapeutas ocupacionais brasileiros, propriedades físicomecânicas e de toxicidade e desempenhos funcional e mioelétrico." Universidade Federal de São Carlos, 2013. https://repositorio.ufscar.br/handle/ufscar/6876.
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Previous issue date: 2013-12-13Financiadora de Estudos e Projetos
Splints are devices whose function to stabilize, immobilize, prevent and correct deformities and maximizing the function and are currently manufactured in thermoplastic , especially low temperature. Was created a technique for making splints from thermoplastic PVC and high temperature due to the lack of scientific studies of the applicability of PVC for orthosis for the upper limb, proposed a study aiming to meet , compare and analyze aspects concerning the applicability of the materials and wrist splints made of two types of thermoplastics , the high temperature PVC and a low temperature Ezeform ®, commonly used for orthosis . The research involved the analysis of the factors for the use of materials, the analysis of the mechanical properties, thermal and toxicity of both materials and analysis of myoelectric and functional performances of subjects with and without orthoses on functional tests of manual dexterity . It was found that occupational therapists using PVC do this by being accessible in terms of cost of material and using Ezeform, the ease in modeling, PVC has high recyclability, and Ezeform, is more susceptible to deformation; functional performance volunteers with orthotics PVC and Ezeform is hindered significantly; especially with the PVC; the myoelectric activity of the upper fibers of the trapezius increases with both orthoses; especially with Ezeform of the biceps muscle did not change significantly and muscles radial extensor and flexor digitorum superficialis had the myoelectric amplitude decreased when the orthoses used and so that the orthosis with PVC myoelectric activity was lower.
As órteses são dispositivos que tem como função, estabilizar, imobilizar, prevenir e corrigir deformidades e maximizar a função e atualmente são confeccionadas em termoplásticos, especialmente os de baixa temperatura, moldados diretamente sobre o membro. Foi criada uma técnica de confecção em órteses a partir do termoplástico de alta temperatura PVC e devido à falta de estudos científicos da aplicabilidade do PVC para confecção de órteses de membro superior, propôs-se um estudo com o objetivo de conhecer, comparar e analisar os aspectos que envolvem a aplicabilidade e os materiais de órteses de punho confeccionadas em dois tipos de termoplástico, o de alta temperatura, PVC e um de baixa temperatura, Ezeform®, comumente usado para confecção de órteses. A investigação envolveu a análise dos fatores de utilização dos materiais, a análise das propriedades mecânicas, térmicas e toxicidade de ambos os materiais e a análise dos desempenhos funcional e mioelétrico dos sujeitos sem e com as órteses em testes funcionais de destreza manual. Foi verificado que os terapeutas ocupacionais que utilizam PVC o fazem por este ser acessível em termo de custo do material e os que utilizam Ezeform, pela facilidade na modelagem; o PVC possui alta reciclabilidade, e o Ezeform, é mais susceptível à deformações; o desempenho funcional dos voluntários com as órteses de PVC e de Ezeform é dificultado significativamente, especialmente com a de PVC; a atividade mioelétrica das fibras superiores do trapézio aumenta com ambas as órteses, especialmente com a de Ezeform, o músculo bíceps não sofreu alterações significativas e os músculos extensor radial e flexor superficial dos dedos tiveram a amplitude mioelétrica diminuída quando utilizadas as órteses, de modo que com a órtese de PVC a atividade mioelétrica foi menor.
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Lindblad, Pontus, Emil Rune, and David Johansson. "kil-inlägg som behandlingsmetod för gonartros jämfört med neutrala inlägg, en systematisk översikt." Thesis, Hälsohögskolan, Jönköping University, HHJ. Ortopedteknisk plattform, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-49763.
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Bakgrund: Många individer oftast äldre drabbas av gonartros, denna diagnos kan orsaka smärta och nedsatt funktion vilket i sin tur kan leda till begränsningar i det dagliga livet. Detta är en systematisk litteraturöversikt över studier som har undersökt laterala kil-inlägg som behandlingsmetod för att minska smärta och förbättra funktion hos patienter med medial gonartros. Syfte: Att studera om laterala kil-inlägg leder till reducerad smärta och främjad funktion jämfört med neutrala inlägg. Vidare utreds också om resultatet är baserat på olika undergrupper. Metod: En systematisk sökning i databaserna PubMed, MEDLINE, AMED, CINAHL och Cochrane Library utfördes för att hitta relevanta studier som sedan inkluderades utifrån förutbestämda kriterier. Data analyserades utifrån dessa artiklar för att besvara frågeställningen i detta arbete. Artiklarnas evidens och validitet/reliabilitet har bedömts. Resultat: Resultaten visar att laterala kilinlägg inte ger reducerad smärta och främjad funktion. Det finns heller inga samband kopplat till undergrupperna som studeras i denna systematiska översikt. Slussats: Det finns i denna rapport blandat med bevis för huruvida laterala kilinlägg reducerar smärta och främjar funktion. Även om ett antal studier påvisar positiva effekter är detta inte tillräckligt för att på ett statistiskt signifikant sätt säga att det hjälper. Det går inte att säga om behandlingen är mer lämpad för någon specifik undergrupp.Background: Many individuals often the elderly suffering of gonatros, this diagnosis can cause pain and impaired function which in turn can lead to limitations in daily living. This is a systematic review of studies that have investigated lateral wedged insoles as a treatment to reduce pain and improve function in patients with medial gonartros. Aim: To study whether lateral wedge insoles lead to reduced pain and improved function compared with neutral insoles. Furthermore, it is also investigated if the result is based on different sub-groups. Method: A systematic search in the databases PubMed, MEDLINE, AMED, CINAHL and Cochrane Library was performed to find relevant studies which then were included based of predetermined criteria. Data from these articles where analysed to answer our question in this paper. The articles were examined for risk of bias and validity/reliability. Results: The results show that lateral wedge insoles do not reduce pain and improve function. There are also no signs that a certain sub-group would be more suited for the treatment. Conclusion: There is in this paper a contradictory result of whether lateral wedge insoles reduce pain and improve function. Although several studies indicate positive effects it is not enough to prove in a statistically significant way that it helps. It is not possible to say whether the treatment is more suitable for any specific subgroup.
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Bjerregaard, Jørgensen Mille, and Laura Ane Jakobsen. "Description of Orthotists Level of Involvement in Early Post Stroke Management in Denmark: A Cross-Sectional Survey." Thesis, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-52801.
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Background: Following a stroke the ability to walk is often impaired due to compromised motor-control, muscle weakness and spasticity, resulting in deviations during gait. Ankle-foot orthoses (AFO) can be used for people with hemiparesis to improve stability during stance phase and clearance during swing phase. There has been much discussion whether AFOs have a positive effect during early rehabilitation post stroke (in this study defined as six weeks from the initial stroke onset).Objectives: The aim was to describe the level of involvement of Danish Certified Prosthetists and Orthotists (CPO) in early rehabilitation of stroke patients in Denmark, and to describe danish orthotists view on their involvement in early rehabilitation of stroke patients.Method: A cross-sectional survey, in form of a self-administered questionnaire, was conducted during March and April 2021 in Denmark. The survey was sent to Danish CPOs who were currently members of the Danish professional organization for prosthetists/orthotists. A total of 110 members received the questionnaire by e-mail, 80 of which were registered as certified. The questionnaire consisted of 43 items (of which a minimum of 26 questions needed answering) with mainly closed ended questions. Descriptive statistics were used for data analysis, with frequencies, percentage and summarizing tables.Results: The response rate was 31.25 % (n=25). The survey demonstrated that only few participants (n=3) were involved in early gait rehabilitation, stroke patients were seen as out-patients in orthotic clinics (92%, n=23), usually 4–6-month post stoke (44%, n=11) and often with a referral from another member of the multidisciplinary team (MDT) (56%, n=14). Danish CPOs believed that orthotic assessment was an essential part of gait re-education (80% n=20), and that the orthotist should be part of the early gait rehabilitation (88%, n=22). Most of the orthotists (72%, n=18) were confident in recommending a treatment plan including lower extremity orthosis and were confident in advising the multidisciplinary team (MDT) in the use of orthosis (80%, n=20).Conclusion: It is uncommon for danish CPOs to be involved in the early rehabilitation of stroke patients and the Danish CPOs often first meet the patient late in the rehabilitation process. The CPOs believe that they should be part of early gait rehabilitation and that orthotic assessment should be part of gait re-education.
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Trinidad, Lieselle E. "Engineering Analysis Of Custom Foot Orthotics." 2008. https://scholarworks.umass.edu/theses/213.
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This thesis presents an engineering approach to the modeling and analysis of custom foot orthotics. Although orthotics are widely used and accepted as devices for the prevention of and recovery from injuries, the design process continues to be based on empirical means. There have been many clinical studies investigating the various effects that the orthotics can have on the kinematics and kinetics of human locomotion. The results from these studies are not always consistent, primarily due to subject variability and experimental nature of the design. Alternatively, a better understanding of the therapeutic effects of custom foot orthotics, as well as designing for optimal performance, can be achieved through simulation-based engineering modeling and analysis studies. Such an approach will pave the way to clarify some of the ambiguous findings found in the clinical studies-based literature. Towards this goal, this research presents a methodical process for the replication of the orthotics’ complex three-dimensional geometry and for the construction of finite element analysis models using estimated nonlinear material properties.
As part of this research, laser scanning techniques are used to capture the objects’ details and geometry through generation of point cloud surface images by taking multiple scans from all angles. Material testing and Mooney-Rivlin equations were used to construct the hyperelastic nonlinear material properties. Using the mid-stance phase of gait for loading conditions, the ANSYS finite element package was utilized to run analyses on three different load classifications and the corresponding maximum stresses and deflection results were generated.
The results indicate that the simulated models can augment and validate the use of empirical tables for designing custom foot orthotics. They can also provide the basis for the optimal design thicknesses of custom foot orthotics based on an end-users’ weight and activities. From a practical perspective, they can also be useful in further exploring different orthotics, loading conditions, material properties, as well as the effectiveness of orthotics for different foot and lower extremity deformities.
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Gi, Saon Wei, and 紀尚緯. "Orthotic Insole for Archery Performance Assessmen." Thesis, 2014. http://ndltd.ncl.edu.tw/handle/40879371991297960039.
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碩士國立臺南大學
機電系統工程研究所產業碩士專班
102
When the orthotics for making Archery to discussion, Application of stability and the center of pressure by orthotics to correlation of affect. The process for experimental subjects of archery, hope the ability to more precisely control by himself enough to achieve stability and the center of pressure. The experiment is divided into two stages of testing. The process of archery interventional a patent certification of orthotics by arch index to Achievements and arch index changes observed through excel complete analysis of numerical to computation . Another is an indoor experiment subjects from the outdoor as two test object to prove the accuracy of the experiment by Outdoor experiments. During the experiment intervention orthotics with VICON cameras and pressure plates, data capture for archery action phase (Drawing to Release).In the standard game mode inning 36 arrows context mode, the focus shifted archery range observation and shoulder point shift focus and stability , and in accordance with the arrows point to statistics, the arrows point in the score of arrows ( 10 points ) , the more precise the twelve ( 10 points inner ) total , with a focused and stability data comparison analysis, data processing software after VICON collected v through excel spreadsheets to complete numerical computation . The experimental results,orthodontic intervention in the outdoor experiment,archery action at all stages of the subjects archery an action phase for are influence be affected gravity by orthotics.In the initial test results will have major changes when orthotics intervention.Poor performance in the second week of the adaptation period.End of the adaptation period,average score recovery levels and it's better than before the intervention orthotics;In laboratory experiments,archery action phase (Drawing to Release) of the focus shifted archery range and shoulder point shift focus and stability that Value stability of initial test by orthodontic intervention is the excellent similarly,the poor performance in the second week of the adaptation period.With the adaptation period of orthotics,the Value of shoulder point and the center of plantar both are improved.
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Li, Chin Cheng, and 李晉成. "Design of an orthotic knee mechanism." Thesis, 1996. http://ndltd.ncl.edu.tw/handle/54716578501414689471.
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Yu-ChiChen and 陳郁琪. "Foot Orthotics on Gait Analysis and Simulation." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/27118277893132224897.
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博士國立成功大學
生物醫學工程學系
100
Foot orthotics is widely prescribed for the patients with diseases in the lower extremity such as osteoarthritis and flatfoot. However, the biomechanical effects of the orthotics used in the clinical treatment are not yet fully understood. Furthermore, the published literature focuses principally on the effects of orthotic devices on the foot structure rather than on the lower limbs. Last but not least, the biomechanical investigations reported in the literature are invariably performed using healthy subjects rather than patients. In order to propose effective estimation of the validity and comfort of the use of functional insoles, using the simulation software in development of computer models to emulate human gait would understand more about loads on the bone, joints and muscles. Not only the models can be used to better understand the physical properties of the shoes and insoles regarding the potential of correcting foot structure, but it can study the mechanics of interaction between the insoles and the body. The purposes of this study are: (1) to evaluate the biomechanical effects of orthotic devices on the gait patterns of patients with flatfoot and osteoarthritis, (2) to develop and validate a three-dimensional simulation model of human walking with orthotic devices. (3) to investigate the effects to the users when alternating the parameters of the related orthotic devices. Eleven adults with flatfoot deformities and twelve adults with knee osteoarthritis (OA) were recruited. For each participant, kinematic and kinetic data were measured under three test conditions, i.e. walking barefoot, walking with shoes, and walking with shoes and insoles. During each test, the participants’ gaits patterns were recorded and analyzed using a motion analysis system, two Kistler force plates and EVaRT software. And then, simulations were performed by ADAMS-LifeMOD. The results of patients with flatfoot showed that walking with shoes and insoles and walking with shoes conditions increased the peak ankle dorsiflexion angle and moment, and also reduced the peak ankle plantarflexion angle and moment. Furthermore, walking with shoes and insoles and walking with shoes conditions increased the peak knee varus moment. The effects of the orthoese on knee and hip were minimal and no significant differences were observed between walking with shoes and insoles and walking with shoes. The results suggested that the foot insoles and shoes developed in this study might benefit the ankle joint in patients with flat feet. In view of the minimal changes between walking with shoes and insoles and walking with shoes, further studies may be required to clarify the interaction between the foot and the insole/shoe. In the results of patients with osteoarthritis (OA), walking with shoes and insoles significantly increased peak knee flexion angle, and peak dorsiflexion and external rotation angles of the ankle, but reduced the peak ankle internal rotation angle. Both walking with shoes and insoles and walking with shoes conditions significantly reduced the toe-out angle. Furthermore, the peak ankle internal rotation moment was significantly reduced in walking with shoes and insoles. However, no significant difference was observed in the peak knee varus moment. In view of the significantly decreased toe-out angle of the foot and increasing trend existed in knee varus moment, the use of the shoes and insoles may be unsuitable for OA knee patients. The peak ground reaction forces (GRF) of the simulation model were similar to the measured forces under the walking with shoes and insoles condition. Simulations showed that peak GRF was sensitive to stiffness of the contact element (between the ground and the shoes), although these changes were small. The results showed that the peak GRF were variable when the stiffness and damping properties of the bushing elements (between the insole and the foot) were changed. The increase in the shoes-height results in the most dominates reduction on peak GRF. Comparison with the experimental data, the simulated angular excursions in the three motion plane at the ankle, knee and hip joint were highly correlated with the measured values under walking with shoes and insoles condition. The differences of the values between the simulated and measured joint angle were below 5 degrees. The percentage errors of peak ankle and knee joint moments between simulated and measured values were within 3~20%. However, the percentage errors of peak hip joint moments between simulated and measured values were higher than 30%. Based on the reasonable agreement between simulated data and experimental values, it can be concluded that the modeling approach is viable. The accuracy of this approach is mainly limited by the characteristics of the shoes-insoles and anthropometry of the subjects (e.g. hip center). The current model allows alterations of the properties of the shoes-insoles and advances applications with muscle model to develop or improve orthoses for specific patients efficiently.
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Shih, Ming-Chih, and 施明志. "Active Orthotic Hand for Brain-Computer Interface." Thesis, 2006. http://ndltd.ncl.edu.tw/handle/78533132154015230652.
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碩士國立成功大學
機械工程學系碩博士班
94
Stroke and spinal cord injury frequently lead to the disconnection between central nervous system and muscles. Patients lose the ability of muscle control and cannot exercise on their will. Brain-computer interface (BCI) is one of the important technologies in neural engineering to help patients recover communication between their mind and environment. In a BCI system, orthotic devices are necessary either to enhance the weak muscles or to provide biofeedback to improve performance of the man-machine system. An active orthotic hand with two degrees of freedom was developed in this thesis. Its main body was made of polypropylene and the actuator is a light-weight RC servo motor. For better control, two types of logic controls, namely, on-off and finite state controls are implemented for users with different EEG detection rate. Besides, a mechanical stimulator was set on the orthotic hand and it stimulates the subject’s palm to enhance the event-related desynchronization of m wave by using the principle of stochastic resonance. Finally, clinical trials on seven normal subjects were performed to investigate the factors, namely, right or left hand imaginary task and wearing of orthotic hand which affect the success rate of orthosis operation. The result analyzed by two-way ANOVA indicates that right or left imaginary may affect the EEG detection rate and the average EEG detection rate of the non-habitual-handed imagination is higher than those of habitual-handed about 11.3% under a level of 0.1. Although wearing of orthotic hand has no statistical meaning in ANOVA analysis, its average EEG detection rate is higher than those of orthotic hand free about 6.2%. Compared with previous work, the new orthotic hand has two advantages: light weight and low disturbance to EEG acquisition although the average success rate of operation was low. Further study on combining b wave and biofeedback training might improve the success rate.