Article
Engineering, Biomedical
Daniel Ballesteros, Robert T. Youngblood, Andrew C. Vamos, Joseph L. Garbini, Katheryn J. Allyn, Brian J. Hafner, Brian G. Larsen, Marcia A. Ciol, Janna L. Friedly, Joan E. Sanders
Summary: The purpose of this research was to investigate the effects of an innovative cyclic panel-pull strategy on minimizing limb fluid volume loss in transtibial prosthesis users during ambulation. Results showed that adding panel-pull resulted in increased fluid volume for some participants, while uncoupling the liner from the panels and executing panel-pull led to decreased fluid volume for some participants. Panel-pull may be beneficial for retaining limb fluid volume in transtibial prosthesis users.
MEDICAL ENGINEERING & PHYSICS
(2022)
Article
Biotechnology & Applied Microbiology
Nur Afiqah Hamzah, Nasrul Anuar Abd Razak, Mohd Sayuti Ab Karim, Siti Zuliana Salleh
Summary: This study aims to evaluate the validity and reliability of the Biosculptor's Bioscanner system in capturing transtibial residual limb volume fluctuations in active and nonactive amputees during walking activity. The study found that the Bioscanner system provided a higher estimation of limb circumference compared to manual measurements, but there was a high correlation between the two techniques. The results suggest that the Bioscanner system can be used as an alternative tool in managing daily residual limb volume change.
BIOMED RESEARCH INTERNATIONAL
(2022)
Article
Engineering, Biomedical
Conor R. Lanahan, Kendrick A. Coburn, Brian J. Hafner, Daniel Ballesteros, Katheryn J. Allyn, Janna L. Friedly, Marcia A. Ciol, Ryan V. Carter, Joseph C. Mertens, Adam J. Krout, Joan E. Sanders
Summary: People with lower extremity amputation often face challenges in managing the fit of their prosthetic socket due to changes in fluid volume. This study found that intermittently doffing the prosthetic socket for as short as 4 minutes can help stabilize limb fluid volume. Further trials in real-life settings should be conducted.
CLINICAL BIOMECHANICS
(2023)
Article
Engineering, Biomedical
Clement J. Gurrey, Joseph L. Garbini, Samuel P. Bennett, Horace Y. Wang, Katheryn J. Allyn, Janna L. Friedly, Brian J. Hafner, Jake B. McLean, Brian G. Larsen, Joan E. Sanders
Summary: The research developed a system that allows lower-limb prosthesis users to quickly release and relock the socket while sitting, addressing the challenges of residual limb volume fluctuation. Users preferred a specific tether length during partial doffing, with the system being easy to operate and capable of releasing and relocking in a short time.
MEDICAL ENGINEERING & PHYSICS
(2021)
Article
Biochemical Research Methods
Peter S. Lee, Run Ze Gao, Alyson Colpitts, Robin W. Murdock, Doug Dittmer, Andreas Schirm, James Y. Tung, Carolyn L. Ren
Summary: Residual limb volume fluctuations and contact pressures are key factors leading to skin ulcerations, pain, and decreased quality of life for transtibial amputees. A novel transtibial prosthetic socket liner with a small air microfluidic chip has been introduced, allowing for dynamic adjustment of the fit between the limb and socket. Proof-of-concept testing has shown that the pressures can be varied and redistributed as desired.
Article
Veterinary Sciences
Theresa M. Wendland, Bernard Seguin, Felix M. Duerr
Summary: This study investigated the mid-term clinical outcomes of partial limb amputation with a socket prosthesis (PLASP) in dogs. The results showed that PLASP allowed restoration of quadrupedal gait patterns in most patients, but a high complication rate was observed.
VETERINARY MEDICINE AND SCIENCE
(2023)
Article
Biophysics
Nathan Brown, Meredith K. Owen, Anthony Garland, John D. DesJardins, Georges M. Fadel
Summary: This research investigates an additively manufactured metamaterial inlay with a tailored mechanical response to reduce peak pressure gradients around the limb, providing potential personalized medicine solutions for transtibial amputees.
JOURNAL OF BIOMECHANICAL ENGINEERING-TRANSACTIONS OF THE ASME
(2021)
Article
Chemistry, Multidisciplinary
Vasja Plesec, Gregor Harih
Summary: A generic numerical transtibial model was developed using the finite element method (FEM) to evaluate and develop lower-limb prosthetics. The model was validated through simulations, showing consistent results with literature reports. It provides a valuable tool for comparing different socket-liner designs prior to fabrication.
APPLIED SCIENCES-BASEL
(2023)
Article
Engineering, Biomedical
Sheila Clemens, Corey Pew
Summary: This study provides the first phase-specific quantification of turning biomechanics in individuals with lower limb amputation. The results indicate that individuals with unilateral transtibial amputation spend more time and experience higher impulses through their sound limb compared to their prosthetic limb during 90-degree turns, and that the prosthetic limb performs differently than the sound limb, potentially increasing risks of injury or falls.
CLINICAL BIOMECHANICS
(2023)
Article
Orthopedics
Ashley D. Knight, Brad D. Hendershot, Todd J. Sleeman, Christopher L. Dearth, Felix Starker, Urs Schneider, Sara R. Koehler-McNicholas, Kyle Barrons, Eric Nickel, Spencer Mion, John Ferguson, Billie Savvas Slater, Gregory O. Voss, Karl Koester, Andrew H. Hansen
Summary: This study aims to improve the comfort and residual limb health of individuals with lower limb loss by implementing a passively ventilated liner-socket system. Through focus group meetings and an iterative design approach, a passively ventilated liner-socket system has been developed. The ex vivo design supports the feasibility of this system, but further development and human subject testing are required.
PROSTHETICS AND ORTHOTICS INTERNATIONAL
(2022)
Article
Engineering, Biomedical
Bryan J. Ranger, Kevin M. Moerman, Brian W. Anthony, Hugh M. Herr
Summary: Finite element analysis (FEA) is used to evaluate interface pressures and tissue strains in prosthetic socket design. Realistic limb geometry and constitutive properties are required. This study proposes a novel approach utilizing FEA, ultrasound indentation, and shear wave elastography for constitutive parameter identification. The local shear modulus measurements using elastography are significant for biomechanical modeling of the residual limb and have implications for muscle health and disease monitoring.
JOURNAL OF THE MECHANICAL BEHAVIOR OF BIOMEDICAL MATERIALS
(2023)
Review
Anesthesiology
Emile B. List, David D. Krijgh, Enrico Martin, J. Henk Coert
Summary: Residual limb pain (RLP) and symptomatic neuromas have a prevalence of 59% and 15%, respectively, in patients who have undergone lower extremity amputations. Studies show a higher prevalence in patients over 50 years old, with follow-up beyond 2 years, and in those using self-administered questionnaires for data collection.
Article
Engineering, Biomedical
Khaled Nedal Mahmoud Sobh, Nasrul Anuar Abd Razak, Noor Azuan Abu Osman
Summary: This study aimed to investigate the best positional parameter of electromyography for transtibial prosthetic users and found differences in muscle activity during various movement activities. Static positioning of the electromyography sensor may lead to errors in signal detection.
PROCEEDINGS OF THE INSTITUTION OF MECHANICAL ENGINEERS PART H-JOURNAL OF ENGINEERING IN MEDICINE
(2021)
Article
Engineering, Biomedical
Joseph C. Mertens, Jacob T. Brzostowski, Andrew Vamos, Katheryn J. Allyn, Brian J. Hafner, Janna L. Friedly, Nicholas S. DeGrasse, Daniel Ballesteros, Adam Krout, Brian G. Larsen, Joseph L. Garbini, Joan E. Sanders
Summary: By attaching thin inductive distance sensors to the insides of sockets of transtibial prosthesis users, this study developed and tested a technology to monitor bodily position and type of activity. The findings showed high accuracy in detecting sit and walk, but step count was not proportional to active use time.
CLINICAL BIOMECHANICS
(2022)
Article
Orthopedics
Sam Bennett, Clement Gurrey, Horace Wang, Mathew Weissinger, Brian Larsen, Joan E. Sanders
Summary: A sensor was developed to monitor the depth of a locking pin in transtibial sockets and small motions during ambulation. The sensor showed good accuracy in both bench testing and participant testing, but calibration is required based on individual user's socket and pin.
PROSTHETICS AND ORTHOTICS INTERNATIONAL
(2021)
Article
Rehabilitation
Robert S. Gailey, Ignacio Gaunaurd, Sara J. Morgan, Anat Kristal, Geoffrey S. Balkman, Eavey M. Newton, Jose J. Palomo, Kevin M. Shay, Rana Salem, Brian J. Hafner
Summary: The study aimed to determine if the two-minute walk test could serve as an alternative measure of high-level mobility in lower limb prosthesis users when the Comprehensive High-level Activity Mobility Predictor cannot be administered. The results showed a strong positive relationship between the 2MWT and CHAMP, suggesting that the former can be used as an alternative measure for assessing high-level mobility capabilities in this population.
CLINICAL REHABILITATION
(2022)
Article
Rehabilitation
Geoffrey S. Balkman, Brian J. Hafner, Rachael E. Rosen, Sara J. Morgan
Summary: This study explored the mobility experiences of 29 lower limb orthosis users, identifying personal factors, situational contexts, and assistance as key elements influencing their mobility. Participants described modifying their mobility through the use and non-use of mobility aids. These findings may assist clinicians in optimizing orthosis users' mobility and inform the development of new outcome measures.
DISABILITY AND REHABILITATION
(2022)
Article
Orthopedics
Moaz Tobaigy, Brian J. Hafner, Andrew Sawers
Summary: The number of recalled falls and Prosthetic Limb Users Survey of Mobility T-scores can predict the incidence of falls over the next 6 months in unilateral lower limb prosthesis users. The final model may serve as a screening tool for clinicians to assess risk of falls in this population. Further research is needed to validate the proposed model.
Article
Orthopedics
Elizabeth G. Halsne, Anne T. Turner, Carl S. Curran, Andrew H. Hansen, Brian J. Hafner, Joshua M. Caputo, David C. Morgenroth
Summary: This study compared techniques for reducing shear forces during mechanical testing of prosthetic feet and evaluated variation in linear stiffness across testing sessions. The results showed that a low-friction interface can be used as a less expensive and less complex method for reducing shear force in prosthetic foot testing. Additionally, the mechanical testing results were relatively consistent across multiple test sessions.
PROSTHETICS AND ORTHOTICS INTERNATIONAL
(2022)
Article
Orthopedics
Geoffrey S. Balkman, Soshi Samejima, Kazuki Fujimoto, Brian J. Hafner
Summary: This research aimed to translate the PLUS-M survey from English to Japanese according to guidelines and validate it with Japanese prosthesis users through cognitive interviews. The translation process involved multiple revisions and testing, resulting in a linguistically comparable Japanese version. This will facilitate international comparison of prosthetic mobility data.
PROSTHETICS AND ORTHOTICS INTERNATIONAL
(2022)
Article
Orthopedics
Robert T. Youngblood, Brian J. Hafner, Joseph M. Czerniecki, Brian G. Larsen, Katheryn J. Allyn, Joan E. Sanders
Summary: This study evaluated the mechanical and physiological effects of elevated vacuum (EV) and determined the optimal vacuum pressure for three individuals. Results showed that increasing socket vacuum pressure reduced limb-socket displacement, with a pressure setting of 12 eliminating 81% to 93% of limb movement. The relative limb-socket displacement varied by sensor location, suggesting differences in socket fit or residual limb tissue content. The rate of limb fluid volume change and socket comfort did not consistently differ with socket vacuum pressure, indicating a unique complex relationship for each individual.
JOURNAL OF PROSTHETICS AND ORTHOTICS
(2022)
Article
Rehabilitation
Sara J. Morgan, Kimberly Rowe, Chantelle C. Fitting, Ignacio A. Gaunaurd, Anat Kristal, Geoffrey S. Balkman, Rana Salem, Alyssa M. Bamer, Brian J. Hafner
Summary: This study aimed to assess the clinical resources available for assessing health outcomes in people with lower limb amputation and to explore barriers and facilitators associated with the use of standardized outcome measures in clinical practice. The survey results showed that the majority of prosthetic practitioners are encouraged or required to use standardized outcome measures in their clinics or facilities. Most participants reported having the necessary knowledge and skills for implementing patient-reported and performance-based outcome measures. However, there is a perceived lack of standardization across the profession. The participants generally had access to adequate space and equipment for conducting outcome measures and had a willingness to allocate time for surveys and tests.
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
(2022)
Article
Engineering, Biomedical
Daniel Ballesteros, Robert T. Youngblood, Andrew C. Vamos, Joseph L. Garbini, Katheryn J. Allyn, Brian J. Hafner, Brian G. Larsen, Marcia A. Ciol, Janna L. Friedly, Joan E. Sanders
Summary: The purpose of this research was to investigate the effects of an innovative cyclic panel-pull strategy on minimizing limb fluid volume loss in transtibial prosthesis users during ambulation. Results showed that adding panel-pull resulted in increased fluid volume for some participants, while uncoupling the liner from the panels and executing panel-pull led to decreased fluid volume for some participants. Panel-pull may be beneficial for retaining limb fluid volume in transtibial prosthesis users.
MEDICAL ENGINEERING & PHYSICS
(2022)
Article
Rehabilitation
Geoffrey S. Balkman, Sara J. Morgan, Dagmar Amtmann, Carolyn Baylor, Brian J. Hafner
Summary: The aim of this research was to develop a new survey instrument to measure the mobility of lower limb orthosis users. Through qualitative methods such as focus groups and cognitive interviews, a candidate item bank consisting of 100 mobility items was generated.
Article
Orthopedics
Christine M. McDonough, Kathleen M. Poploski, Catherine A. Anderson, Thiru M. Annaswamy, Melissa A. Clark, Natalie F. Douglas, Ann Marie Flores, Janet K. Freburger, Brian J. Hafner, Jeanne M. Hoffman, Adam R. Kinney, Kristin Ressel, Jennifer Sanchez, Margarite J. Whitten, Linda Resnik
Summary: The Learning Health Systems Rehabilitation Research Network (LeaRRn), funded by the NIH, aims to enhance the research capacity of learning health systems within the rehabilitation community. A needs assessment survey was conducted to gather data for the development of educational resources.
Article
Rehabilitation
Moaz Tobaigy, Brian J. Hafner, Andrew Sawers
Summary: This study aimed to develop a model that could predict the number of injurious falls over the next 6 months in unilateral LLP users and identify fall-related circumstances that may increase the odds of a fall being injurious. The results showed that the number of falls recalled in the past year and balance confidence scores can predict the number of injurious falls an LLP user will experience in the next 6 months.
Article
Rehabilitation
Cody L. McDonald, Alison Kahn, Brian J. Hafner, Sara J. Morgan
Summary: This study estimated the prevalence of secondary prosthesis use among lower limb prosthesis users and found that most users did not use secondary prostheses. The most common types of secondary prostheses were back-up and activity-specific prostheses. Additionally, secondary prosthesis users differed from non-users in terms of gender, race, and other characteristics.
DISABILITY AND REHABILITATION
(2023)
Article
Multidisciplinary Sciences
Ignacio A. Gaunaurd, Sara J. Morgan, Geoffrey S. Balkman, Anat Kristal, Rachael E. Rosen, Jessica S. Haynes, Robert S. Gailey, Brian J. Hafner
Summary: The Five-time Sit-to-Stand (5xSTS) Test is a performance-based measure used to assess the body functions needed for sit-to-stand transitions. This study aimed to develop a modified protocol for the test, examine its validity among lower limb prosthesis (LLP) users, and assess its correlations with self-reported mobility, balance confidence, and functional capability. The modified test allowed different assistance strategies and showed significant differences in performance based on amputation level, etiology, and functional level. There were also significant negative correlations between the test times and self-reported mobility, balance confidence, and comfortable walking speed.
Article
Rehabilitation
Brian Hafner, Dagmar J. Amtmann, Sara C. Morgan, Daniel L. Abrahamson, Robert M. Askew, Alyssa Bamer, Rana A. Salem, Ignacio S. Gaunaurd, Robert M. Gailey, Stefania Collaborators PLUS-M Advisory Panel, Joseph R. Czerniecki, Stefania Fatone, John E. Fergason, Ian L. Fothergill, Valerie G. Kelly, Eric Weber, Gale Whiteneck
Summary: A PROM called the Prosthetic Limb Users Survey of Mobility (PLUS-M) was developed to measure prosthetic mobility in lower limb amputees. Two short forms with different item lengths were created based on a cross-sectional study. The PLUS-M instruments demonstrated good readability, wide measurement range, strong correlation with existing PROMs, and ability to differentiate between groups with different levels of mobility.
Article
Engineering, Biomedical
Nicholas S. DeGrasse, Joseph C. Mertens, Jacob T. Brzostowski, Katheryn J. Allyn, Andrew C. Vamos, Adam J. Krout, Brian J. Hafner, Joseph L. Garbini, Joan E. Sanders
Summary: The purpose of this study was to test a novel activity monitor that tracks the time a prosthesis is worn and the nature of the ambulatory activity conducted with the prosthesis. The results showed a positive correlation between doff time and active motion time, and a greater amount of time spent in weight shifts compared to walk bouts. This study is important for improving patient care, and further long-term monitoring studies are recommended.
JOURNAL OF REHABILITATION AND ASSISTIVE TECHNOLOGIES ENGINEERING
(2023)
Article
Engineering, Biomedical
Mitchel A. Magrini, Rashelle Hoffman, Taylor Barnett, Jennifer Bruursema, Jacob Siedlik
Summary: This study aimed to assess the effect of a multicomponent rehabilitation protocol on functional outcomes in a post-acute care facility. The results showed that the protocol was able to improve clinical mobility and balance outcomes, such as gait speed, balance scores, and sit-to-stand velocity, in medically complex older patients.
CLINICAL BIOMECHANICS
(2024)
Article
Engineering, Biomedical
K. Doslikova, N. D. Reeves, C. N. Maganaris, V. Baltzopoulos, S. M. P. Verschueren, F. P. Luyten, R. K. Jones, D. T. Felson, M. J. Callaghan
Summary: This study aimed to examine the effect of a sleeve knee brace on knee biomechanics during stair negotiation in patellofemoral joint osteoarthritis patients. The findings showed that the knee brace significantly reduced the maximal flexion angle, adduction angle, sagittal and frontal range of motion, and sagittal peak extension moment during stair ascent. During stair descent, the knee brace significantly reduced the maximal flexion angle and total sagittal range of motion compared to control.
CLINICAL BIOMECHANICS
(2024)
Article
Engineering, Biomedical
Savitha Subramaniam, Shuaijie Wang, Tanvi Bhatt
Summary: This study investigates the dance movement kinematics of people with chronic stroke under different types of assistance, including no assistance, safety harness assistance, and contact guard assistance with gait belt. The results show that there is a decrease in joint angle excursions in the no assistance condition compared to the safety harness assistance and contact guard assistance conditions for all song paces. The safety harness and contact guard assistance conditions have similar levels of joint angle excursions, except for higher hip (slow and fast pace) and ankle (medium pace) joint angle excursions in the contact guard assistance condition compared to the safety harness assistance condition.
CLINICAL BIOMECHANICS
(2024)
Article
Engineering, Biomedical
Richa Gupta, Lauren Judkins, Chet S. Friday, Joseph B. Ulsh, Stephen J. Kovach III, Samir Mehta, Charles Tomonto, Guha Manogharan, Michael W. Hast
Summary: The study compared novel additively manufactured rib implants with a clinically used Control implant, finding that the novel implants had better construct stiffness and rotational performance than the control group, with all implants failing via bone fracture in the end.
CLINICAL BIOMECHANICS
(2024)
Article
Engineering, Biomedical
Matteo Cioni, Antonino Casabona, Rosario Ferlito, Mariangela Pisasale, Domenico Marco Romeo, Giulia Messina, Maria Stella Valle
Summary: The study aimed to investigate the temporal changes of electromyographic activity in lower limb muscles during walking after injecting botulinum toxin A into the calf muscles of children with spastic cerebral palsy. The results showed that botulinum toxin A had a significant effect on electromyographic activity, with the most noticeable changes occurring between 4 and 8 weeks post-injection and full recovery at 16 weeks. Significant changes in muscle co-contraction were also observed on the treadmill.
CLINICAL BIOMECHANICS
(2024)
Review
Engineering, Biomedical
Vitor La Banca, Joao Artur Bonadiman, Felipe Fernandes Gonzalez, Jonathan Adam Gustafson, Gustavo Leporace, Grant E. Garrigues, Jorge Chahla, Leonardo Metsavaht
Summary: Background: Latissimus dorsi transfer is a surgical procedure that can be used for treating posterosuperior rotator cuff tears. However, there is still no consensus on the biomechanical changes resulting from latissimus dorsi transfer.
Methods: We performed a systematic review of the literature on 3D motion analysis studies evaluating the effects of latissimus dorsi transfer on shoulder kinematics.
Findings: Our meta-analysis revealed a significant improvement in forward flexion and abduction following latissimus dorsi transfer. When comparing the latissimus transferred shoulder with an uninjured contralateral side, the meta-analysis found no significant difference in flexion range of motion, while abduction and external rotation were significantly higher in the uninjured shoulders.
CLINICAL BIOMECHANICS
(2024)
Article
Engineering, Biomedical
Judith Bleuel, Igor Komnik, Iris Mittendorfer, Bjoern Michel, Steffen Willwacher
Summary: This study assessed the walking mechanics of patients with total knee arthroplasty during downhill hiking and compared them to a healthy control group. It was found that patients had lower knee flexion angles and weaker muscle strength compared to the controls. The muscle balance between quadriceps and hamstring muscles was related to the persistence of a stiff knee gait pattern after knee arthroplasty.
CLINICAL BIOMECHANICS
(2024)
Article
Engineering, Biomedical
Sangsoo Park, Hyun-Joon Yoo, Jin Su Jang, Sang-Heon Lee
Summary: This study utilizes a neural network to measure spine curvature, providing a real-time, automated, and non-contact method for measuring spine posture. The trained model demonstrates low error rates and holds potential for practical applications.
CLINICAL BIOMECHANICS
(2024)
Article
Engineering, Biomedical
Victor-Estuardo Leon-Roman, David Garcia-Mato, Irene Isabel Lopez-Torres, Javier Vaquero-Martin, Jose Antonio Calvo-Haro, Javier Pascau, Pablo Sanz-Ruiz
Summary: This study compared the tibial rotation between rotating hinge knee prosthesis and constrained condylar knee prosthesis in a clinical setting. The results showed that the postoperative Knee Injury and Osteoarthritis Outcome Score was significantly higher in the rotating hinge knee prosthesis group compared to the constrained condylar knee group, and the degrees of tibial rotation measured by inertial sensors were also significantly higher in the rotating hinge knee prosthesis group.
CLINICAL BIOMECHANICS
(2024)