scholarly journals Residual limb volume fluctuations in transfemoral amputees

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Linda Paternò ◽  
Michele Ibrahimi ◽  
Elisa Rosini ◽  
Giuseppe Menfi ◽  
Vito Monaco ◽  
...  

AbstractThis study constitutes the first attempt to systematically quantify residual limb volume fluctuations in transfemoral amputees. The study was carried out on 24 amputees to investigate variations due to prosthesis doffing, physical activity, and testing time. A proper experimental set-up was designed, including a 3D optical scanner to improve precision and acceptability by amputees. The first test session aimed at measuring residual limb volume at 7 time-points, with 10 min intervals, after prosthesis doffing. This allowed for evaluating the time required for volume stabilization after prosthesis removal, for each amputee. In subsequent sessions, 16 residual limb scans in a day for each amputee were captured to evaluate volume fluctuations due to prosthesis removal and physical activity, in two times per day (morning and afternoon). These measurements were repeated in three different days, a week apart from each other, for a total of 48 scans for each amputee. Volume fluctuations over time after prosthesis doffing showed a two-term decay exponential trend (R2 = 0.97), with the highest variation in the initial 10 min and an average stabilization time of 30 min. A statistically significant increase in residual limb volume following both prosthesis removal and physical activity was verified. No differences were observed between measures collected in the morning and in the afternoon.Clinical Trials.gov ID: NCT04709367.

2021 ◽  
Author(s):  
Linda Paternò ◽  
Michele Ibrahimi ◽  
Elisa Rosini ◽  
Giuseppe Menfi ◽  
Vito Monaco ◽  
...  

Abstract This study constitute the first attempt to systematically quantify residual limb volume changes in transfemoral amputees. The study was carried out on 24 amputees to investigate changes due to prosthesis doffing, physical activity, and testing time. A proper experimental set-up was designed, including a 3D optical scanner, to improve precision and acceptability by amputees. The first test session aimed at measuring residual limb volume at 7 time-points, with 10 minute intervals, after prosthesis doffing. This allowed for evaluating the time required for volume stabilization after prosthesis removal, for each amputee. In subsequent sessions, 16 residual limb scans in a day for each amputee were captured to evaluate volume changes due to prosthesis removal and physical activity, in two times per day (morning and afternoon). These measurements were repeated in three different days, a week apart from each other, for a total of 48 scans for each amputee. Volume changes overtime after prosthesis doffing showed a two-term decay exponential trend (R2 = 0.97), with the highest change in the initial 10 minutes and an average stabilization time of 30 minutes. A statistically significant increasing effect of both prosthesis removal and physical activity was verified. No differences were observed between measures collected in the morning and in the afternoon.


Author(s):  
Sara Salazar-Salgado ◽  
Fanny Valencia ◽  
Alejandro Uribe ◽  
Elizabeth Rendón-Vélez

Abstract There is a considerable amount of young adults who become amputees due to war and violence. For this population, a successful adaptation to their prosthesis depends on the socket fit, which in turn is caused by the volume change of the residual limb during the day. The literature reports several investigations on this topic, most of which use subjects walking on a treadmill to simulate their daily activity. However, this studies are focused on transtibial amputees and do not mention the relationship between this physical activity and other variables such as comfort, volume changes and gait. Therefore, the objective of this paper is to determine the effect of physical activity on the volume of the residual limb, the comfort and the symmetry of gait in traumatic transfemoral amputees. Plaster positive molds of the residual limb, the comfort perception and the gait data of five individuals were obtained at the first time of the day and after three sessions of treadmill walking of 15, 30 and 45 minutes. The positive molds of each individual were scanned and then, the volume was calculated. The gait data was acquired using a marker-based motion capture system and processed to obtain spatio-temporal, kinematic and kinetic parameters, including the Gait Deviation Index (GDI). Based on the literature, specific points of the gait data were selected and the symmetry index was obtain for each of them. A short comfort test was used after each session of treadmill walking. Data was analyzed throughout the tests within each subject. Statistical analysis was performed for the volume and the gait variables to check for statistical significance. After physical activity, a tendency towards residual limb volume decrease was found on almost all subjects, although it was not significant. The percentage of volume change obtained on almost all subjects are within the range considered “good socket fit” according to previous authors. Our results suggest that transfemoral amputees may have smaller volume changes than transtibial after treadmill walking. Significant difference was found on the symmetry index of “Swing phase” between the baseline and the 45-minute test. The values of gait symmetry on the gait parameters were consistent with previous findings regarding transfemoral amputees. The difference that arise may be due to the sample difference (cause of amputation, difference in prosthetic elements and use of walking aids). The lowest symmetry was noticed on the ankle kinematics. The comfort did not significantly change with the selected amount of physical activity. In subsequent research, it is recommended to increase the intensity or time of physical activity and/or increase the number of participants. This results can help the understanding of how the socket/residual limb interface behaves which can improve the design and prescription of prosthetic components.


Author(s):  
Linda Paternò ◽  
Michele Ibrahimi ◽  
Elisa Rosini ◽  
Arianna Menciassi ◽  
Leonardo Ricotti

2016 ◽  
Vol 41 (5) ◽  
pp. 527-531 ◽  
Author(s):  
Kay Mitton ◽  
Jai Kulkarni ◽  
Kenneth William Dunn ◽  
Anthony Hoang Ung

Background: This novel case report describes the problems of prescribing a prosthetic socket in a left transfemoral amputee secondary to chronic patellofemoral instability compounded by complex regional pain syndrome. Case Description and Methods: Following the amputation, complex regional pain syndrome symptoms recurred in the residual limb, presenting mainly with oedema. Due to extreme daily volume fluctuations of the residual limb, a conventional, laminated thermoplastic socket fitting was not feasible. Findings and Outcomes: An adjustable, modular socket design was trialled. The residual limb volume fluctuations were accommodated within the socket. Amputee rehabilitation could be continued, and the rehabilitation goals were achieved. The patient was able to wear the prosthesis for 8 h daily and to walk unaided indoors and outdoors. Conclusion: An adjustable, modular socket design accommodated the daily residual limb volume fluctuations and provided a successful outcome in this case. It demonstrates the complexities of socket fitting and design with volume fluctuations. Clinical relevance Ongoing complex regional pain syndrome symptoms within the residual limb can lead to fitting difficulties in a conventional, laminated thermoplastic socket due to volume fluctuations. An adjustable, modular socket design can accommodate this and provide a successful outcome.


Author(s):  
Sara Salazar-Salgado ◽  
Fanny Valencia ◽  
Alejandro Uribe ◽  
Elizabeth Rendón-Vélez

Abstract For lower limb amputees, the socket fit is affected by the physical activity performed during the day. The majority of the studies in this field include only transtibial amputees and do not examine the effects of this variable. This paper aims to determine the effect of physical activity on the volume of the residual limb (RL), the comfort, and the symmetry of gait in traumatic transfemoral amputees. RL volume and gait data of five individuals were obtained at the first time of the day and after three sessions of treadmill walking. The ratio symmetry index of selected points of gait parameters was calculated. A short comfort test was used after each session. Data were analyzed throughout the tests within each subject, and statistical analysis was performed. After the physical activity, a tendency toward volume decrease was found on almost all subjects, although it was not significant. Transfemoral amputees may have smaller volume variations than transtibial after treadmill walking tasks. Significant difference was found on the symmetry index of “swing phase (SWP).” The values of gait symmetry were consistent with previous findings regarding transfemoral amputees. The lowest symmetry was noticed on the ankle kinematics. The comfort did not significantly change with the selected amount of physical activity. In subsequent research, it is recommended to increase the intensity or time of physical activity and/or increase the number of participants. These results can help the understanding of how the socket/RL interface behaves, which can improve the design and prescription of prosthetic components.


1984 ◽  
Vol 106 (1) ◽  
pp. 29-35 ◽  
Author(s):  
P. Cawley

The susceptibility to bias error of two methods for computing transfer (frequency response) functions from spectra produced by FFT-based analyzers using random excitation has been investigated. Results from tests with an FFT analyzer on a single degree-of-freedom system set up on an analogue computer show good agreement with the theoretical predictions. It has been shown that, around resonance, the bias error in the transfer function estimate H2 (Syy/Sxy*) is considerably less than that in the more commonly used estimate, H1 (Sxy/Sxx). The record length, and hence the testing time, required for a given accuracy is reduced by over 50 percent if the H2 calculation procedure is used. The analysis has also shown that if shaker excitation is used on lightly damped structures with low modal mass, it is important to minimize the mass of the force gage and the moving element of the shaker.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Rianne Kofman ◽  
Raoul E Winter ◽  
Cornelis H Emmelot ◽  
Jan HB Geertzen ◽  
Pieter U Dijkstra

2019 ◽  
Vol 90 (12) ◽  
pp. 1000-1008
Author(s):  
Caleb D. Johnson ◽  
Alice D. LaGoy ◽  
Gert-Jan Pepping ◽  
Shawn R. Eagle ◽  
Anne Z. Beethe ◽  
...  

INTRODUCTION: Designed as a more ecological measure of reaction times, the Perception-Action Coupling Task (PACT) has shown good reliability and within-subject stability. However, a lengthy testing period was required. Perceptual-motor judgments are known to be affected by proximity of the stimulus to the action boundary. The current study sought to determine the effects of action boundary proximity on PACT performance, and whether redundant levels of stimuli, eliciting similar responses, can be eliminated to shorten the PACT.METHODS: There were 9 men and 7 women who completed 4 testing sessions, consisting of 3 familiarization cycles and 6 testing cycles of the PACT. For the PACT, subjects made judgments on whether a series of balls presented on a tablet afford “posting” (can fit) through a series of apertures. There were 8 ratios of ball to aperture size (B-AR) presented, ranging from 0.2 to 1.8, with each ratio appearing 12 times (12 trials) per cycle. Reaction times and judgment accuracy were calculated, and averaged across all B-ARs. Ratios and individual trials within each B-AR were systematically eliminated. Variables were re-averaged, and intraclass correlation coefficients (ICC) and coefficients of variation (CVTE) were calculated in an iterative manner.RESULTS: With elimination of the 0.2 and 1.8 B-ARs, the PACT showed good reliability (ICC = 0.81–0.99) and consistent within-subject stability (CVTE = 2.2–14.7%). Reliability (ICC = 0.81–0.97) and stability (CVTE = 2.6–15.6%) were unaffected with elimination of up to 8 trials from each B-AR.DISCUSSION: The shortened PACT resulted in an almost 50% reduction in total familiarization/testing time required, significantly increasing usability.Johnson CD, LaGoy AD, Pepping G-J, Eagle SR, Beethe AZ, Bower JL, Alfano CA, Simpson RJ, Connaboy C. Action boundary proximity effects on perceptual-motor judgments. Aerosp Med Hum Perform. 2019; 90(12):1000–1008.


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