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Citations
The loss of an upper limb significantly limits the functional activities of daily living. A huge emphasis is placed on the manipulation, shape, weight, and comfort of a prosthesis, to enable its use as an inherent body part. Even with technological advances, customized upper-extremity myoelectric prosthesis remain heavy and expensive. The high cost of upper-extremity prosthesis is an especially steep economic barrier for patients. Three-dimensional (3D) printing is a promising avenue for reducing the cost of prosthesis. We applied 3D-printed pressure-sensored prosthetics to a traumatic transradial amputee, and compared the hand functions with a customized myoelectric prosthesis. The 3D-printed pressure-sensored prosthetics showed low grip strength and decreased dexterity compared to the conventional myoelectric prosthesis. Although there were a few limitations, the fabrication of prosthesis with 3D printing technology can overcome previous problems such as high production cost, long fabrication period and heavy weight.
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To assess prosthetic use by upper extremity amputees, and their difficulties with prostheses in activities of daily living and occupations.
This study is based on a survey of 307 subjects, who were using prostheses manufactured in the Center of Prosthetics and Orthotics. The survey questionnaire included items about general demographic characteristics, side and level of amputation, type of prosthesis and its use, and difficulties in the activities of daily living, employment and driving.
The most common type of prosthesis was the cosmetic hand type (80.2%). There were no statistically significant correlations between satisfaction with prosthesis and the amputation level or type of prosthesis. The most common difficulties in daily living activities experienced by amputees were lacing shoes, removing bottle-tops with a bottle opener, and using scissors. Only 7.3% of amputees received rehabilitation services. Less than half of the amputees (44.7%) used their prostheses for eight or more hours a day, and 76.9% used their prostheses for regular or irregular cosmetic purposes. After amputation, most of the respondents (69.0%) became unemployed or changed workplaces.
In our study, respondents preferred cosmetic usage to functional usage. Only 30.0% of respondents reported satisfaction with their prostheses. Many of the amputees had difficulties in complex tasks and either changed jobs or became unemployed. Clerical workers were the occupation group, which was most likely to return to work. The development of a more functional prosthetic hand and additional rehabilitation services are required.
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Objective: This study aimed to evaluate the kinematic data and energy consumption of domestic swing and stance phase (SNS) control knee assembly in transfemoral amputees.
Method: Five male transfemoral amputees took prosthetic training of more than one week and evaluated with random applying 3 types of knee assembly; mechanical type, pneumatic type, and domestic SNS type. Kinematic data was obtained by the VICON 370 system (Oxford Metrics Ltd., UK.). Energy consumption was measured using a KB1-C (Aerosport Inc, U.S.A).
Results: Domestic SNS type showed a significantly increased walking speed, cadence and step length compared with mechanical type and pneumatic type (p＜0.05). Domestic SNS type showed a significantly increased maximal hip flexion and extension compared with mechanical type and pneumatic type (p＜0.05). Domestic SNS type showed decreased peak knee flexion at swing phase and significantly increased peak knee extension at stance phase compard with mechanical type and pneumatic type (p＜0.05). In energy consumption, the domestic SNS type tended to show a lower O2 cost and faster walking speed than the mechanical type and pneumatic type at free-walking.
Conclusion: We concluded the domestic SNS type had more tendency toward a normal gait pattern and lower energy consumption compared with mechanical type and pneumatic type.
Objective: To analyze morphologic differences between only spondylolysis group and mild spondylolisthesis one in young-aged persons and to find useful parameters for radiological assessment of mild spondylolisthesis.
Method: Twenty patients with only lumbar spondylolysis, 18 patients with mild lumbar spondylolisthesis and 19 normal subjects were recruited in this study. Their radiological findings were examined. The films of subjects were evaluated with respect to variables describing wedging of the spondylolytic vertebra, relative thickness and lengths of the transverse processes. The evaluation was made with attention to possible signs which could mean vertebral slipping. The lumbar index reflects the degree of wedge deformity of the spondylolytic vertebra.
Results: Lumbar index was significantly lower in spondylolisthesis group than only spondylolysis group. There was no significant difference in relative thickness of L5 transverse process between two groups. The incidence of a midline lumbar or sacral defect in the spondylolisthesis group was higher than other groups.
Conclusion: Our results support the usefulness of lumbar index as a supplement parameter for radiological assessment of mild spondylolisthesis.
Objective: To evaluate how to influence static lumbar lordosis by different heel heights in normal adults and patients with spondylolisthesis.
Method: The lumbolumbar angles, lumbosacral angles and slip angles were examined while standing on barefoot, on heel support with 5 cm heel, and with 10 cm heel in 14 normal adults and 10 patients with first grade of spondylolisthesis. Standing lumbar spine lateral view was performed by one half hour adaptation with corresponding shoe types.
Result: The lumbolumbar angles (angles between upper margin of 2nd lumbar body and low margin of 5th lumbar body) and the lumbosacral angles (between upper margin of 2nd lumbar body and low margin of 1st sacral body) in normal are 36.8⁑6.5o, 50.1⁑9.5o on barefoot, 36.0⁑7.3o, 49.6⁑7.4o on heel support with 5 cm heel, and 36.1⁑7.6o, 49.7⁑8.3o with 10 cm heel. Lumbolumbar angles and lumbosacral angles in 10 patients with spondylolisthesis 38.8⁑8.3°on barefoot, 47.2⁑10.4o on heel support with 5 cm heel, 38.3⁑7.0o, 47.7⁑9.2o with 10 cm heel. The slip angles in 10 patients with spondylolisthesis are 29.8⁑1.2o on barefoot, 30.2⁑1.8o on heel support with 5 cm heel, and with 10 cm heel.
Conclusion: The changes of heel height did not significantly influence the lumbar lordosis in normal adults and patients with spondylolisthesis. There were no significant differences in average slip angle according to heel height in patients with spondylolisthesis were found.
Objective: Many amputees do not use their prostheses consistently because of the unhelpfulness or discomfort. In this point, this survey was to assess the prosthetic problems in their function and willingness to use.
Method: We investigated the 18 burn induced upper extremity amputees of Hankang Sacred Heart Hospital Burn Center with the questionnaire or interview.
Results: The mean age was 39.6 years at the time of amputation & 43.3 years at the time of survey. Their amputation levels were composed of 72.2% of below elbow and 27.8% of above elbow. The using time of prosthesis was revealed that 'all day long' use in 50%, 'going out' use in 33.3% and 'living activity' use in 11.1%. Their complaint for prosthetic problems were discoloration (38.9%), poor appearance (27.8%), sweating (27.8%) and inadequate function (22.2%). Considerable number of them suffered from residual burn wound or scar in contact with a socket (27.8%) and itching and tingling sensation (22.2%). Employment was not accomplished in 61.1% of the amputees.
Conclusion: The information thus obtained in this investigation would be expected to be helpful in the prosthetic prescription and rehabilitation training of upper extremity amputees for their welfare.
There have been a many reports of observational analysis on hip disarticulation prosthetic ambulation, but not a scientific analysis by a computerized motion analyzer. We present to share with our professional colleague our invaluable experience gained from the study on the gait analysis of a left hip disarticulation prosthetic gait.
Using a Vicon 370 three dimensional gait analysis system, the gait analysis was performed in a left hip disarticulation patient fitted with a left Canadian type hip disarticulation prosthesis.
In linear parameters, the cadence showed 79 steps/min, the gait speed was 0.68 m/sec, and the double support phase was 25.27% of a total gait cycle. In kinematics, the maximal pelvic tilt angle showed 29.92o at pre-swing phase, and significantly increased as compared with normal person. Hip motion change remained flexed, and maximal knee flexion angle disclosed 22.07o at the terminal stage of initial swing phase. In kinetics, the hip extension moment on initial contact stage was 0.089 NM/kg, which was impaired being compared with normal person.
In conclusion, the increased pelvic tilt which implies that initiation of a prosthetic gait for hip disarticulation comes from a forward swing of the pelvis on the affected side, and an overall decrease of gait parameters accounts for the degree of disability of hip disarticulation amputee.
Partial hand amputation may leave a significant functional limitations for amputee that are difficult to ameliorate by either orthoses or prostheses. Many kinds of devices have been tried to promote the function and cosmesis. Cosmetic hand was the best answer to the person with first and second metacarpophalangeal joint disarticulation and the strength and range of motion of remaining three fingers were not in optimal status till now. We applied a new device of wrist driven prehension prosthesis consist of forearm stabilizer, short opponens, actuator rod, artificial thumb, artificial index and attached 2 rings was designed and fabricated. As a result, it is possible to provide considerable improvement in function and cosmesis with this new device.
Burn patients with associated limb amputations present demanding rehabilitation problems, many of which might lead them to chronic issues. The authors studied 77 male and 9 female burn patients with amputations. Most amputations occurred with high voltage electrical burns. The fingers were the most frequent target for amputations. The most frequent site of amputation was the entrance at the right side and multiple amputation in nature.
The prosthetic fittings were delayed because of burn wounds and grafts and fragile skin at the stump. Also, limited range of motion, decreased strength, hypertrophic scar contracture, heterotopic ossification and bony overgrowth were additional limiting factors.
We conclude that early rehabilitation intervention would be critical to prevent complications and to improve rehabilitation outcome of burn amputee patients.
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