First results concerning the safety, walking, and satisfaction with an innovative, microprocessor-controlled four-axes prosthetic foot

2018 ◽  
Vol 42 (3) ◽  
pp. 350-356 ◽  
Author(s):  
Andreas Hahn ◽  
Ivana Sreckovic ◽  
Sebastian Reiter ◽  
Milana Mileusnic
Keyword(s):  
User Satisfaction ◽  
Amputation Level ◽  
Prosthetic Foot ◽  
Daily Life Activities ◽  
Uneven Terrain ◽  
Perception Of Safety ◽  
Individual Assessment ◽  
First Results ◽  
Observational Cohort ◽  
Prosthetic Component

Background: The microprocessor-controlled foot Meridium is a prosthetic component with adjustable stance-phase characteristics. Objectives: To investigate subjects’ and prosthetists’ perception of safety, walking, and satisfaction during first routine fittings. Study design: Multicenter, prospective, observational cohort study. Methods: Data regarding demographics, fitting process, safety, daily life activities, and satisfaction were obtained through questionnaires. The follow-up period was 7 months. Results: In all, 89% of 70 users were satisfactorily fitted within the first two visits. Compared to previous feet, users reported improvements in walking on level ground (54% of subjects), uneven ground (82%), ascending (97%), and descending ramps (91%). More than 45% of the users perceived an improvement in safety and stability while standing and walking. No difference was observed in concentration, exertion, and pain. Overall user satisfaction with Meridium was 50% and the foot was preferred by 40% of users. Amputation level, age and mobility grade did not influence subjects’ preference. Prosthetists recommended Meridium for 59% of subjects. A correlation analysis revealed that transfemoral amputees fitted with Genium and/or having a long residual limb strongly preferred Meridium ( p < 0.05). Conclusion: Meridium was appreciated by amputees with a preference for natural walking and requirement to safely and comfortably negotiate uneven terrain and slopes. Clinical relevance Amputees preferring Meridium perceive benefits with safe, comfortable, and natural walking. While the perception of benefits regarding the negotiation of uneven terrain and slopes is very high, the correlation to product preference is moderate. Individual assessment and trial fitting might be essential to identify patients who benefit greatly.

Patient evaluation of the Echelon foot using the Seattle Prosthesis Evaluation Questionnaire

2012 ◽  
Vol 37 (3) ◽  
pp. 250-254 ◽  
Author(s):  
Imad Sedki ◽  
Raymond Moore
Keyword(s):  
User Satisfaction ◽  
Clinical Relevance ◽  
Clinical Impact ◽  
Patient Evaluation ◽  
Case Description ◽  
Evaluation Questionnaire ◽  
Prosthetic Foot ◽  
Potential Benefits ◽  
Prosthetic Feet ◽  
Different Levels

Background: The introduction of the Echelon prosthetic foot with a hydraulic self-aligning ankle adds improved adaptability to varied terrains and uneven walking surfaces. However, the specific indications for prescribing such components and the potential benefits are yet to be fully established. Case Description and Methods: Nine amputees including three bilateral amputees evaluated their standard prostheses using the Seattle Prosthesis Evaluation Questionnaire. They were then provided with Echelon feet, and they evaluated them after 4 weeks of use. Findings and Outcomes: Improved satisfaction in all categories of use in relation to the Echelon foot with the greatest increase reported by bilateral amputees. Conclusion: The use of prosthetic feet with hydraulic self-aligning ankle improves prosthetic users’ satisfaction in general with a particular benefit in bilateral amputees. Clinical relevance Establish the clinical impact and user satisfaction after using Echelon feet in prosthetic users with different levels of amputations.

A Functional Evaluation of Prosthetic Foot Kinematics During Lower-Limb Amputee Gait

2006 ◽  
Vol 30 (2) ◽  
pp. 213-223 ◽  
Author(s):  
H. Goujon ◽  
X. Bonnet ◽  
P. Sautreuil ◽  
M. Maurisset ◽  
L. Darmon ◽  
...  
Keyword(s):  
Ground Reaction Forces ◽  
Functional Evaluation ◽  
Foot Kinematics ◽  
Amputation Level ◽  
Prosthetic Foot ◽  
Ankle Kinematics ◽  
Reaction Forces ◽  
Lower Limb Amputee ◽  
Time Distance ◽  
Prosthetic Feet

This paper reports on a functional evaluation of prosthetic feet based on gait analysis. The aim is to analyse prosthetic feet behaviour under loads applied during gait in order to quantify user benefits for each foot. Ten traumatic amputees (six trans-tibial and four trans-femoral) were tested using their own prosthetic foot. An original protocol is presented to calculate the forefoot kinematics together with the overall body kinematics and ground reaction forces during gait. In this work, sagittal motion of the prosthetic ankle and the forefoot, time-distance parameters and ground reaction forces were examined. It is shown that an analysis of not only trans-tibial but also trans-femoral amputees provides an insight in the performance of prosthetic feet. Symmetry and prosthetic propulsive force were proved to be mainly dependant on amputation level. In contrast, the flexion of the prosthetic forefoot and several time-distance parameters are highly influenced by foot design. Correlations show influential of foot and ankle kinematics on other parameters. These results suggest that prosthetic foot efficiency depends simultaneously on foot design and gait style. The evaluation, proposed in this article, associated to clinical examination should help to achieve the best prosthetic foot match to a patient.

scholarly journals The first results of a 6-year follow-up study of a patient with early psoriatic arthritis treated with a treat-to-target strategy

2020 ◽  
Vol 14 (3) ◽  
pp. 91-96
Author(s):  
P. O. Tremaskina ◽  
E. Yu. Loginova ◽  
T. V. Korotaeva ◽  
A. V. Sukhinina
Keyword(s):  
Psoriatic Arthritis ◽  
Early Stage ◽  
Treat To Target ◽  
Open Label ◽  
Basic Principles ◽  
Follow Up Study ◽  
Structural Progression ◽  
First Results ◽  
Observational Cohort

The paper characterizes the basic principles of a treat-to-target (T2T) strategy for spondyloarthritis, including psoriatic arthritis (PsA). The data from observational cohort studies suggest that inadequate therapy for PsA increases the risk of structural progression. The results, obtained in the international randomized controlled Tight Control of Psoriatic Arthritis (TICOPA) trial and the Russian open-label observational REMARCA study, have justified the necessity of using the T2T strategy for early-stage PsA. The authors have analyzed their own results of a 6-year follow-up study of a patient with early PsA, in whom the T2T strategy was used.

Bevacizumab (BV) plus chemotherapy (CT) as first-line treatment of patients with metastatic colorectal cancer (mCRC): First results from a large community-based observational cohort study in Germany

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15057-e15057
Author(s):  
D. Arnold ◽  
M. Kindler ◽  
V. Petersen ◽  
D. Tummes ◽  
M. Moelle ◽  
...  
Keyword(s):  
Cohort Study ◽  
Progression Free Survival ◽  
Observational Cohort Study ◽  
First Line ◽  
Eligibility Criteria ◽  
First Results ◽  
Observational Cohort ◽  
Abstract Data ◽  
Ecog Ps ◽  
Cutoff Date

e15057 Background: BV prolongs overall survival (OS) and progression-free survival (PFS) when added to standard CT for patients (pts) with mCRC. After approval of BV in Germany in 01/05, this observational cohort study was initiated in pts receiving BV with various first-line CT regimens to evaluate safety events and effectiveness. Methods: To facilitate and evaluate enrollment of a typical mCRC population, eligibility criteria were minimized. Choice of the CT regimen was at physician´s discretion, but influenced by the current registration status. Predefined endpoints were treatment characteristics, response rate (RR), PFS, OS, and adverse events assessed as potentially related to the treatment (AERT) or as severe (SAE). Pts are followed for up to 4 years, and clinical data were updated every cycle (2–4 weeks). Results: 1,300 pts were enrolled at 261 sites from 01/05 through 06/08; abstract data cutoff date was 11/24/08. Median age: 64 (range 19–100) years, > 70 years.: 25%; male 63%; ECOG PS status 0–1/2/>2 88%/11%/1%. CT choice was fluoropyrimidine (FU)/BV alone (any 5-FU or capecitabine) 12%; FU/BV/oxaliplatin 18%; FU/BV/irinotecan 69%; other 1%. Median treatment duration with BV was 7.4 (range 0–28) months; duration > 10 months 21%. 60-day mortality was 4.0%. In total, 183 AERT were reported in 10% of pts., most commonly diarrhea (34 AERT), nausea (26) and hypertension (18). Reported SAE were deep venous TE in 0.8% of pts, bleeding 1.2%, pulmonary embolism 0.5%, arterial TE 0.4%. Best investigator- assessed RR was 59% (CR 10%, PR 49%; all pts) with 64% for FU/BV/oxaliplatin, 59% for FU/BV/irinotecan and 53% for FU/BV alone. Conclusions: The safety profile of BV in this population of mCRC pts with different CT regimens appears consistent with that observed in the other reports like BRiTE or first BEATrial. RR in this preliminary dataset are higher than that reported in the randomized controlled trials, but likely biased by the methodology of evaluation. However, activity with FU/BV alone was surprisingly high. Updated efficacy data including PFS will be presented. [Table: see text]

scholarly journals A Coronally Clutching Ankle to Improve Amputee Balance on Coronally Uneven and Unpredictable Terrain

2018 ◽  
Vol 12 (3) ◽  
Author(s):  
Kyle H. Yeates ◽  
Ava D. Segal ◽  
Richard R. Neptune ◽  
Glenn K. Klute
Keyword(s):  
Lower Limb ◽  
Dynamic Balance ◽  
Center Of Mass ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Initial Contact ◽  
Plane Angle ◽  
Prosthetic Foot ◽  
Uneven Terrain ◽  
Recovery Strategies

To improve the balance of individuals with lower limb amputation on coronally uneven terrain, a coronally clutching ankle (CCA) was developed to actively adapt through ±15 deg of free coronal foot rotation during the first ∼60 ms of initial contact. Three individuals with lower limb amputations were fit with the CCA and walked across an instrumented walkway with a middle step that was either flush, 15 deg inverted, or 15 deg everted. An opaque latex membrane was placed over the middle step, making the coronally uneven terrain unpredictable. Compared to participants' clinically prescribed prosthesis, the CCA exhibited significantly more coronal angular adaption during early stance. The CCA also improved participants' center of mass (COM) path regulation during the recovery step (reduced variation in mediolateral position) and reduced the use of the hip and stepping recovery strategies, suggesting it improved participants' balance and enabled a quicker recovery from the disturbance. However, use of the CCA did not significantly affect participants' ability to regulate their coronal angular momentum during the disturbance, suggesting that the CCA did not improve all elements of dynamic balance. Reducing the distance between the CCA's pivot axis and the base of the prosthetic foot might resolve this issue. These findings suggest that actively adapting the coronal plane angle of a prosthetic ankle can improve certain elements of balance for individuals with lower limb amputation who walk on coronally uneven and unpredictable terrain.

Discussion of the Oblique Rotator Model Cases Of 108 Aqr and x Serp.

1976 ◽  
Vol 32 ◽  
pp. 577-588
Author(s):  
C. Mégessier ◽  
V. Khokhlova ◽  
T. Ryabchikova
Keyword(s):  
Mathematical Formulation ◽  
The Other ◽  
Rotator Model ◽  
Oblique Rotator ◽  
First Results

My talk will be on the oblique rotator model which was first proposed by Stibbs (1950), and since received success and further developments. I shall present two different attempts at describing a star according to this model and the first results obtained in the framework of a Russian-French collaboration in order to test the precision of the two methods. The aim is to give the best possible representation of the element distributions on the Ap stellar surfaces. The first method is the mathematical formulation proposed by Deutsch (1958-1970) and applied by Deutsch (1958) to HD 125248, by Pyper (1969) to α2CVn and by Mégessier (1975) to 108 Aqr. The other one was proposed by Khokhlova (1974) and used by her group.

Meridional Circulation, Turbulence, and Diffusion Processes in Stars

1976 ◽  
Vol 32 ◽  
pp. 109-116 ◽  
Author(s):  
S. Vauclair
Keyword(s):  
Convection Zone ◽  
Diffusion Processes ◽  
Meridional Circulation ◽  
Diffusion Time ◽  
Work In Progress ◽  
First Results ◽  
Stellar Envelopes ◽  
And Diffusion ◽  
Turbulence And Diffusion ◽  
Hr Diagram

This paper gives the first results of a work in progress, in collaboration with G. Michaud and G. Vauclair. It is a first attempt to compute the effects of meridional circulation and turbulence on diffusion processes in stellar envelopes. Computations have been made for a 2 Mʘstar, which lies in the Am - δ Scuti region of the HR diagram.Let us recall that in Am stars diffusion cannot occur between the two outer convection zones, contrary to what was assumed by Watson (1970, 1971) and Smith (1971), since they are linked by overshooting (Latour, 1972; Toomre et al., 1975). But diffusion may occur at the bottom of the second convection zone. According to Vauclair et al. (1974), the second convection zone, due to He II ionization, disappears after a time equal to the helium diffusion time, and then diffusion may happen at the bottom of the first convection zone, so that the arguments by Watson and Smith are preserved.

Investigation of cluster layers of small netal particles by TEM, SEM, EELS and by photoacoustic spectroscopy

1990 ◽  
Vol 48 (4) ◽  
pp. 250-251
Author(s):  
H. Seiler ◽  
U. Haas ◽  
K.H. Körtje
Keyword(s):  
Bulk Material ◽  
High Vacuum ◽  
Optical Methods ◽  
Metal Particles ◽  
Silver Particles ◽  
Low Loss ◽  
Plasmon Excitation ◽  
First Results ◽  
Diffraction Patterns ◽  
Small Metal Particles

The physical properties of small metal particles reveal an intermediate position between atomic and bulk material. Especially Ag has shown pronounced size effects. We compared silver layers evaporated in high vacuum with cluster layers of small silver particles, evaporated in N2 at a pressure of about 102 Pa. The investigations were performed by electron optical methods (TEM, SEM, EELS) and by Photoacoustic (PA) Spectroscopy (gas-microphone detection).The observation of cluster layers with TEM and high resolution SEM show small silver particles with diameters of about 50 nm (Fig. 1 and Figure 2, respectively). The electron diffraction patterns of homogeneous Ag layers and of cluster layers are similar, whereas the low loss EELS spectra due to plasmon excitation are quite different. Fig. 3 and Figure 4 show first results of EELS spectra of a cluster layer of small silver particles on carbon foil and of a homogeneous Ag layer, respectively.

Towards 1-Ångstrom-resolution STEM

1993 ◽  
Vol 51 ◽  
pp. 996-997
Author(s):  
H.S. von Harrach ◽  
D.E. Jesson ◽  
S.J. Pennycook
Keyword(s):  
High Resolution ◽  
Field Emission ◽  
Phase Contrast ◽  
Spherical Aberration ◽  
A Priori ◽  
Dark Field ◽  
Image Resolution ◽  
Objective Lens ◽  
Annular Dark Field ◽  
First Results

Phase contrast TEM has been the leading technique for high resolution imaging of materials for many years, whilst STEM has been the principal method for high-resolution microanalysis. However, it was demonstrated many years ago that low angle dark-field STEM imaging is a priori capable of almost 50% higher point resolution than coherent bright-field imaging (i.e. phase contrast TEM or STEM). This advantage was not exploited until Pennycook developed the high-angle annular dark-field (ADF) technique which can provide an incoherent image showing both high image resolution and atomic number contrast.This paper describes the design and first results of a 300kV field-emission STEM (VG Microscopes HB603U) which has improved ADF STEM image resolution towards the 1 angstrom target. The instrument uses a cold field-emission gun, generating a 300 kV beam of up to 1 μA from an 11-stage accelerator. The beam is focussed on to the specimen by two condensers and a condenser-objective lens with a spherical aberration coefficient of 1.0 mm.

Imaging of polymer single crystals in low-voltage, high-resolution scanning electron microscopy

1990 ◽  
Vol 48 (4) ◽  
pp. 1106-1107
Author(s):  
W.W. Adams ◽  
G. Price ◽  
A. Krause
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
High Resolution ◽  
Single Crystals ◽  
Low Voltage ◽  
Polymer Surface ◽  
Beam Current ◽  
Image Features ◽  
First Results ◽  
Scanning Electron

It has been shown that there are numerous advantages in imaging both coated and uncoated polymers in scanning electron microscopy (SEM) at low voltages (LV) from 0.5 to 2.0 keV compared to imaging at conventional voltages of 10 to 20 keV. The disadvantages of LVSEM of degraded resolution and decreased beam current have been overcome with the new generation of field emission gun SEMs. In imaging metal coated polymers in LVSEM beam damage is reduced, contrast is improved, and charging from irregularly shaped features (which may be unevenly coated) is reduced or eliminated. Imaging uncoated polymers in LVSEM allows direct observation of the surface with little or no charging and with no alterations of surface features from the metal coating process required for higher voltage imaging. This is particularly important for high resolution (HR) studies of polymers where it is desired to image features 1 to 10 nm in size. Metal sputter coating techniques produce a 10 - 20 nm film that has its own texture which can obscure topographical features of the original polymer surface. In examining thin, uncoated insulating samples on a conducting substrate at low voltages the effect of sample-beam interactions on image formation and resolution will differ significantly from the effect at higher accelerating voltages. We discuss here sample-beam interactions in single crystals on conducting substrates at low voltages and also present the first results on HRSEM of single crystal morphologies which show some of these effects.

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