Digital design and fabrication of multi-material hand orthoses to allow an athlete with scleroderma to play sitting volleyball.

Scleroderma is a chronic and progressive autoimmune disorder of connective tissues often causing lesions and deformities of the hands. Individuals affected by this condition experience daily life limitations and are typically unable to take part in sport activities that involve impacts on the hands. In this article we describe the design and manufacturing of custom-made hand orthoses to play sitting volleyball, for an elite paralympic athlete affected by scleroderma.

A retrospective multidimensional comparison of microprocessor and mechanical knee users: Analysis of quality of life and satisfaction with the prosthesis.

Background: Despite the demonstrated greater efficacy of microprocessor knees (MPK) over mechanical knees (MK), the latter is still widely used by persons with transfemoral amputation. Besides motivations related to local insurance policies, quality of life (QoL) and satisfaction with the prosthesis play a key role in user preference.

Objective: The aim of this study is to compare QoL and satisfaction in a large sample of MPK and MK users and to assess how these outcomes are explained by clinical and demographic characteristics.

Accuracy, Repeatability, and Reproducibility of a Hand-Held Structured-Light 3D Scanner across Multi-Site Settings in Lower Limb Prosthetics.

The aim of this work was to assess the accuracy, repeatability, and reproducibility of a hand-held, structured-light 3D scanner (EINScan Pro 2X Plus with High Definition Prime Pack, SHINING 3D Tech. Co., Ltd.

A digital process to replicate the socket-foot alignment in below-knee running specific prostheses.

A well-fitting socket and a fine-tuned foot alignment are crucial elements in a running-specific prosthesis to allow Paralympic athletes with below-knee amputation to express their full competitive potential. For this reason, once a satisfactory socket-foot configuration is established after dynamic alignment, it is fundamental to reproduce the same conditions when constructing the definitive carbon fiber socket, and when renewing or constructing a back-up prosthesis, without dismantling the original. In addition, to cope with emerging needs of the athlete, it would be beneficial to implement fine-tuning adjustments of the alignment in a very controlled manner.

A Workflow for Studying the Stump-Socket Interface in Persons with Transtibial Amputation through 3D Thermographic Mapping.

The design and fitting of prosthetic sockets can significantly affect the acceptance of an artificial limb by persons with lower limb amputations. Clinical fitting is typically an iterative process, which requires patients' feedback and professional assessment. When feedback is unreliable due to the patient's physical or psychological conditions, quantitative measures can support decision-making.

Static strength of lower-limb prosthetic sockets: An exploratory study on the influence of stratigraphy, distal adapter and lamination resin.

Knowledge about the mechanical properties of lower-limb prosthetic sockets fabricated with resin infusion lamination and composite materials is limited. Therefore, sockets can be subject to mechanical failure and over-dimensioning, both of which can have severe consequences for patients. For this reason, an exploratory study was conducted to analyze the effect of stratigraphy (layup and fibers), matrix (resin) and mechanical connection (socket distal adapter) on socket static strength, with the objectives of: 1) implementing a mechanical testing system for lower-limb prosthetic sockets based on ISO 10328:2016 and provide the mechanical design of the loading plates, 2) apply the testing system to a series of laminated sockets, and 3) for each type of distal adapter, identify the combinations of stratigraphy and matrix with acceptable strength and minimum weight.

Shoulder Rehabilitation Exercises With Kinematic Biofeedback After Arthroscopic Rotator Cuff Repair: Protocol for a New Integrated Rehabilitation Program.

Background: The recovery of scapular and humeral physiological kinematic parameters, as well as the sensorimotor control of movement, plays a primary role in the rehabilitation process after arthroscopic rotator cuff repair. A highly customized rehabilitation approach is required to achieve this aim. Biofeedback can be a useful tool, but there is poor evidence of its application in the rehabilitation after arthroscopic rotator cuff tear repair.

Mechanical testing of transtibial prosthetic sockets: A discussion paper from the American Orthotic and Prosthetic Association Socket Guidance Workgroup.

Background: The advent of novel manufacturing technologies, materials, and socket design concepts could introduce risks to prosthetic limb users, as the existing knowledge base for safe fabrication may not apply. Moreover, although structural test standards exist for mass-produced prosthetic components, they are not applicable to prosthetic sockets.

Methods: The "AOPA Socket Guidance Workgroup" was formed in 2020 to provide the prosthetic community with evidence-based clinical best practices and methods in the field of prosthetic socket structural analysis.

Biomechanical determinants of top running speeds in para-athletes with unilateral transfemoral amputation.

Background: An increased understanding of biomechanical determinants that influence the sprint performance of para-athletes with a unilateral transfemoral amputation will provide us with a basis for better evaluating athletes' sprint performance and would be expected to aid in the development of more effective training methods and running-specific prosthesis selection guidelines.

Objectives: The aim of this study was to investigate the relative contributions of mechanical determinants to the top running speeds of para-athletes with unilateral transfemoral amputation wearing a running-specific prosthesis.

Study Design: Observational study within the subject.

Structural testing of lower-limb prosthetic sockets: A systematic review.

A lower-limb prosthetic socket is the custom-made structural element interfacing the residual limb of a person with an amputation to their prosthetic leg comprising off-the-shelf componentry. The socket can be subject to mechanical failure, especially when new fabrication methods and materials are introduced (e.g.

A kinematic and electromyographic comparison of a Grammont-style reverse arthroplasty combined with a l'Episcopo transfer compared to a lateralized humeral component reverse for restoration of active external rotation.

Purpose: To assess kinematic and electromyographic findings of two designs of reverse total shoulder arthroplasty (RTSA). We tested two hypotheses: (H) Grammont-style (RTSA) with l'Episcopo tendon transfer gains similar postoperative kinematic findings of a lateralized humeral component RTSA without a tendon transfer; (H) RTSA with lateralized humeral component induces earlier shoulder muscle activation during shoulder motion compared with standard Grammont prosthesis with l'Episcopo transfer.

Methods: Twenty-five patients with a cuff tear arthropathy, pseudoparalysis, and a positive dropping sign were sequentially included.

Innovative alignment of sprinting prostheses for persons with transfemoral amputation: Exploratory study on a gold medal Paralympic athlete.

Background: Recommendations for the alignment of the socket and foot in the sprinting prosthesis of athletes with transfemoral amputation are either based on walking biomechanics or lack public scientific evidence.

Objectives: To explore the biomechanical changes and the sensations of a gold medal Paralympic sprinter, while running with three bench alignments: a conventional reference (A0), an innovative alignment based on the biomechanics of elite able-bodied sprinters (A2), and an intermediate alignment (A1).

Study Design: Single subject with repeated measures.

Development of Instrumented Running Prosthetic Feet for the Collection of Track Loads on Elite Athletes.

Knowledge of loads acting on running specific prostheses (RSP), and in particular on running prosthetic feet (RPF), is crucial for evaluating athletes' technique, designing safe feet, and biomechanical modelling. The aim of this work was to develop a J-shaped and a C-shaped wearable instrumented running prosthetic foot (iRPF) starting from commercial RPF, suitable for load data collection on the track. The sensing elements are strain gauge bridges mounted on the foot in a configuration that allows decoupling loads parallel and normal to the socket-foot clamp during the stance phase.

Targeted Muscle Reinnervation and Osseointegration for Pain Relief and Prosthetic Arm Control in a Woman with Bilateral Proximal Upper Limb Amputation.

Background: Bilateral proximal upper limb loss is a dramatic life-changing event. Replacement of the lost function with prosthetic arms, including multiple mechatronic joints, has remained a challenge from the control, comfort, and pain management perspectives. Targeted muscle reinnervation (TMR) is a peripheral nerve surgical procedure proposed to improve the intuitive control of the prosthetic arm and for neuroma and phantom pain management.

Trends and advancements in shoulder biomechanics research.

The 12th International Shoulder Group (ISG) Conference was held at Mayo Clinic in Rochester, Minnesota, USA, from August 12-13, 2018, and was hosted by Dr. Melissa (Missy) Morrow of Mayo Clinic and Dr. Meghan Vidt of Pennsylvania State University.

Reference values for gait temporal and loading symmetry of lower-limb amputees can help in refocusing rehabilitation targets.

Background: The literature suggests that optimal levels of gait symmetry might exist for lower-limb amputees. Not only these optimal values are unknown, but we also don't know typical symmetry ratios or which measures of symmetry are essential. Focusing on the symmetries of stance, step, first peak and impulse of the ground reaction force, the aim of this work was to answer to three methodological and three clinical questions.

Energy storing and return prosthetic feet improve step length symmetry while preserving margins of stability in persons with transtibial amputation.

Background: Energy storing and return (ESAR) feet are generally preferred over solid ankle cushioned heel (SACH) feet by people with a lower limb amputation. While ESAR feet have been shown to have only limited effect on gait economy, other functional benefits should account for this preference. A simple biomechanical model suggests that enhanced gait stability and gait symmetry could prove to explain part of the difference in the subjective preference between both feet.

Gaitography on lower-limb amputees: Repeatability and between-methods agreement.

Background:: Gaitography is gait parametrization from center-of-pressure trajectories of walking on an instrumented treadmill. Gaitograms may be useful for prosthetic gait analyses, as they can be rapidly and unobtrusively collected over multiple gait cycles without constraining foot placement. However, its reliability must still be established for prosthetic gait.

Assessment of anatomical and reverse total shoulder arthroplasty with the scapula-weighted Constant-Murley score.

Aim Of The Study: To evaluate total (TSA) and reverse total shoulder arthroplasty (RTSA) using the Constant-Murley score (CMS) and the scapula-weighted (SW) CMS, an integrated outcome measure that takes into account the compensatory movements of the scapula.

Methods: Twenty-five consecutive patients, 12 with TSA and 13 with RTSA, underwent kinematic analysis before and after shoulder replacement. Measurements included flexion (FLEX) and abduction (ABD) for the humerus and Protraction-Retraction (PR-RE), Medio-Lateral rotation (ME-LA), and Posterior-Anterior tilting (P-A) for the scapula.

Corrections to "Treatment of the Partial Hand Amputation: An Engineering Perspective".

In the above paper, by Imbinto et al. (IEEE Rev. Biomed.

A Motion Analysis Protocol for Kinematic Assessment of Poly-Articulated Prosthetic Hands With Cosmetic Gloves.

To provide upper-limb amputees with devices that best fit their needs and to test innovative solutions, it is necessary to quantitatively appraise a device performance with rigorous measurement methods. The aim of this work was to define an optimal motion analysis protocol, suitable for optoelectronic systems, to measure the kinematics of poly-articulated hands even when covered by a cosmetic glove. This is a fundamental aspect, because gloves can decrease device speed and range of motion and, ultimately, patients' acceptance of the artificial limb.

SIAMOC position paper on gait analysis in clinical practice: General requirements, methods and appropriateness. Results of an Italian consensus conference.

Gait analysis is recognized as a useful assessment tool in the field of human movement research. However, doubts remain on its real effectiveness as a clinical tool, i.e.

Methodological factors affecting joint moments estimation in clinical gait analysis: a systematic review.

Quantitative gait analysis can provide a description of joint kinematics and dynamics, and it is recognized as a clinically useful tool for functional assessment, diagnosis and intervention planning. Clinically interpretable parameters are estimated from quantitative measures (i.e.

Intermanual Transfer Effects in Below-Elbow Myoelectric Prosthesis Users.

Objectives: To determine intermanual transfer effects in patients with a below-elbow amputation using a myoelectric prosthesis and to establish whether laterality affects these effects.

Design: Case-control.

Setting: A standardized setting in a rehabilitation clinic.