scholarly journals Survey of transfemoral amputee experience and priorities for the user-centered design of powered robotic transfemoral prostheses

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Chiara Fanciullacci ◽  
Zach McKinney ◽  
Vito Monaco ◽  
Giovanni Milandri ◽  
Angelo Davalli ◽  
...  
Keyword(s):  
Survey Data ◽  
User Experience ◽  
Age Distribution ◽  
Rehabilitation Program ◽  
Prosthesis Design ◽  
Transfemoral Amputee ◽  
Overall Stability ◽  
Transfemoral Amputees ◽  
Functional Autonomy ◽  
Transfemoral Prosthesis

Abstract Background Transfemoral amputees experience a complex host of physical, psychological, and social challenges, compounded by the functional limitations of current transfemoral prostheses. However, the specific relationships between human factors and prosthesis design and performance characteristics have not yet been adequately investigated. The present study aims to address this knowledge gap. Methods A comprehensive single-cohort survey of 114 unilateral transfemoral amputees addressed a broad range of demographic and clinical characteristics, functional autonomy, satisfaction and attitudes towards their current prostheses, and design priorities for an ideal transfemoral prosthesis, including the possibility of active assistance from a robotic knee unit. The survey was custom-developed based on several standard questionnaires used to assess motor abilities and autonomy in activities of daily living, prosthesis satisfaction, and quality of life in lower-limb amputees. Survey data were analyzed to compare the experience (including autonomy and satisfaction) and design priorities of users of transfemoral prostheses with versus without microprocessor-controlled knee units (MPKs and NMPKs, respectively), with a subsequent analyses of cross-category correlation, principal component analysis (PCA), cost-sensitivity segmentation, and unsupervised K-means clustering applied within the most cost-sensitive participants, to identify functional groupings of users with respect to their design priorities. Results The cohort featured predominantly younger (< 50 years) traumatic male amputees with respect to the general transfemoral amputee population, with pronounced differences in age distribution and amputation etiology (traumatic vs. non-traumatic) between MPK and NMPK groups. These differences were further reflected in user experience, with MPK users reporting significantly greater overall functional autonomy, satisfaction, and sense of prosthesis ownership than those with NMPKs, in conjunction with a decreased incidence of instability and falls. Across all participants, the leading functional priorities for an ideal transfemoral prosthesis were overall stability, adaptability to variable walking velocity, and lifestyle-related functionality, while the highest-prioritized general characteristics were reliability, comfort, and weight, with highly variable prioritization of cost according to reimbursement status. PCA and user clustering analyses revealed the possibility for functionally relevant groupings of prosthesis features and users, based on their differential prioritization of these features—with implications towards prosthesis design tradeoffs. Conclusions This study’s findings support the understanding that when appropriately prescribed according to patient characteristics and needs in the context of a proactive rehabilitation program, advanced transfemoral prostheses promote patient mobility, autonomy, and overall health. Survey data indicate overall stability, modularity, and versatility as key design priorities for the continued development of transfemoral prosthesis technology. Finally, observed associations between prosthesis type, user experience, and attitudes concerning prosthesis ownership suggest both that prosthesis characteristics influence device acceptance and functional outcomes, and that psychosocial factors should be specifically and proactively addressed during the rehabilitation process.

scholarly journals Evaluation of Human Factors for the User-centered Design of Powered Robotic Transfemoral Prostheses: A Survey of Transfemoral Amputee Experience and Priorities

2020 ◽  
Author(s):  
Chiara Fanciullacci ◽  
Zach McKinney ◽  
Vito Monaco ◽  
Giovanni Milandri ◽  
Angelo Davalli ◽  
...  
Keyword(s):  
Human Factors ◽  
Survey Data ◽  
User Experience ◽  
Age Distribution ◽  
User Centered Design ◽  
Transfemoral Amputee ◽  
Overall Stability ◽  
Transfemoral Amputees ◽  
Functional Autonomy ◽  
Transfemoral Prosthesis

Abstract BACKGROUND: Transfemoral amputees experience a complex host of physical, psychological, and social challenges, compounded by the functional limitations of current transfemoral prostheses. However, the specific relationships between human factors and prosthesis design and performance characteristics have not yet been adequately investigated. The present study aims to address this knowledge gap. METHODS: A comprehensive single-cohort survey of 114 unilateral transfemoral amputees addressed a broad range of demographic and clinical characteristics, functional autonomy, satisfaction and attitudes towards their current prostheses, and design priorities for an ideal transfemoral prosthesis, including the possibility of active assistance from a robotic knee unit. The survey was custom-developed based on several standard questionnaires used to assess motor abilities and autonomy in activities of daily living, prosthesis satisfaction, and quality of life in lower-limb amputees. Survey data are summarized with descriptive statistics applied separately to users of transfemoral prostheses with versus without microprocessor-controlled knee units (MPKs and NMPKs, respectively). RESULTS: The cohort featured predominantly younger (< 50 yrs.) traumatic male amputees with respect to the general transfemoral amputee population, with pronounced differences in age distribution and amputation etiology (traumatic vs. non-traumatic) between MPK and NMPK groups. These differences were further reflected in user experience, with MPK users reporting markedly greater functional autonomy, satisfaction, and sense of prosthesis ownership than those with NMPKs, in conjunction with a decreased incidence of instability and falls. Across all subjects, the leading functional priorities for an ideal transfemoral prosthesis were overall stability, adaptability to variable walking velocity, and lifestyle-related functionality, while the highest-prioritized general characteristics were reliability, comfort, and weight, with highly variable prioritization of cost. CONCLUSIONS: This study’s findings support the understanding that when appropriately prescribed according to patient characteristics and needs, advanced transfemoral prostheses promote patient mobility, autonomy, and overall health. Survey data indicate overall stability, modularity, and versatility as key design priorities for the continued development of transfemoral prosthesis technology. Finally, observed associations between prosthesis type, user experience, and attitudes concerning prosthesis ownership suggest both that prosthesis characteristics influence device acceptance and functional outcomes, and that psychosocial factors should be specifically and proactively addressed during the rehabilitation process.

Factors affecting stair-ascent patterns in unilateral transfemoral amputees

2012 ◽  
Vol 37 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Hiroaki Hobara ◽  
Yoshiyuki Kobayashi ◽  
Shuichi Tominaga ◽  
Takashi Nakamura ◽  
Nobuya Yamasaki ◽  
...  
Keyword(s):  
Limb Length ◽  
Stair Climbing ◽  
Limiting Factor ◽  
Residual Limb ◽  
Cross Sectional Survey ◽  
Assessment Index ◽  
Factors Affecting ◽  
Transfemoral Amputee ◽  
Stair Ascent ◽  
Transfemoral Amputees

Background:Patterns and ease of stair ambulation influence amputees’ level of satisfaction with their rehabilitation, confidence level, and motivation for continued rehabilitation, demonstrating the importance of stair-ascent data for rehabilitation. However, little is known about the determinants of stair-ascent patterns in unilateral transfemoral amputees.Objectives:To investigate the factors affecting stair-ascent patterns in transfemoral amputees.Study Design:Cross-sectional survey.Methods:Stair-ascent patterns were evaluated using the Stair Assessment Index. We collected Stair Assessment Index data as well as demographic and clinical data (sex, age, height, mass, amputation side, reason for amputation, time since amputation, and residual limb length) from 25 transfemoral amputees.Results:Statistical analyses revealed that age was negatively correlated and time since amputation was positively correlated with Stair Assessment Index. In contrast, height, body mass, and residual limb lengths were not correlated with Stair Assessment Index.Conclusion:The results of this study suggest that in unilateral transfemoral amputee, (1) both age and time since amputation could affect stair-climbing patterns and (2) residual limb length should not be a limiting factor for stair climbing if the transfemoral amputee has a certain minimum residual limb length.Clinical relevanceRehabilitation teams should carefully consider nonmodifiable predisposing factors such as age and time since amputation. However, they may be able to carry on stair-ascent rehabilitation for transfemoral amputees disregarding residual limb length (depending on the length).

Load on Osseointegrated Fixation of a Transfemoral Amputee during a Fall: Determination of the Time and Duration of Descent

2010 ◽  
Vol 34 (4) ◽  
pp. 472-487 ◽  
Author(s):  
Laurent Alain Frossard
Keyword(s):  
Fall Detection ◽  
Protective Mechanism ◽  
Protective Device ◽  
Transfemoral Amputee ◽  
Automated Algorithm ◽  
Measurement Session ◽  
Transfemoral Amputees ◽  
The Times ◽  
Automated Methods

Mitigation of fall-related injuries for populations of transfemoral amputees fitted with a socket or an osseointegrated fixation is challenging. Wearing a protective device fitted within the prosthesis might be a possible solution, provided that issues with automated fall detection and time of deployment of the protective mechanism are solved. The first objective of this study was to give some examples of the times and durations of descent during a real forward fall of a transfemoral amputee that occurred inadvertently while attending a gait measurement session to assess the load applied on the residuum. The second objective was to present five semi-automated methods of detection of the time of descent using the load data. The load was measured directly at 200 Hz using a six-channel transducer. The average time and duration of descent were 242 ± 42 ms (145–310 ms) and 619 ± 42 ms (550–715 ms), respectively. This study demonstrated that the transition between walking and falling was characterized by times of descent that occurred sequentially. The sensitivity and specificity of an automated algorithm might be improved by combining several methods of detection based on the deviation of the loads measured from their own trends and from a template previously established.

Evaluation of an e-Advising System

2022 ◽  
Vol 12 (1) ◽  
pp. 0-0
Keyword(s):  
Higher Education ◽  
Survey Data ◽  
User Experience ◽  
Academic Advising ◽  
Female Students ◽  
The Public ◽  
Qualitative Approaches ◽  
Positive Impression ◽  
Applied Education ◽  
And Training

Higher education (HE) in Kuwait suffers from high dropout rates, and one of the leading causes of this desertion is a lack of academic advising. Effective academic advising systems must fulfill its user’s needs and provide a positive user experience (UX), which allows users to successfully and effectively fulfill their goals. This study used quantitative and qualitative approaches to evaluate an electronic advising system (e-Advisor) used by the Public Authority for Applied Education and Training (PAAET). Survey data from 1,095 PAAET students were analyzed to determine students' perceptions and evaluate their experience using e-Adviser. The findings indicated that students were aware of the features and advantages of e-Advisor. Overall, the participants had a moderately positive impression of e-Advisor’s UX. The system’s attractiveness, efficiency, and perspicuity were rated slightly higher than its dependability, stimulation, and novelty. Moreover, female students’ perceptions of e-Advisors UX were significantly more favorable than their male counterparts.

Post-9/11 Veteran Satisfaction With the VA eScreening Program

2020 ◽  
Vol 185 (3-4) ◽  
pp. 519-529
Author(s):  
Erin Almklov ◽  
Niloofar Afari ◽  
Elizabeth Floto ◽  
Laurie Lindamer ◽  
Samantha Hurst ◽  
...  
Keyword(s):  
Focus Group ◽  
Survey Data ◽  
User Experience ◽  
Veterans Health ◽  
Health Administration ◽  
Post Traumatic Stress ◽  
Research Activities ◽  
Group Data ◽  
Measurement Based Care ◽  
Focus Group Data

Abstract Introduction eScreening is a mobile health technology resource for veterans and staff to support Veterans Health Administration initiatives such as early identification of health problems, shared decision-making, and measurement-based care. Methods We conducted an exploratory mixed methods retrospective study with newly enrolling post-9/11 veterans to (1) understand eScreening user experience and obtain practical feedback on the technology to guide improvements, (2) assess veteran satisfaction with eScreening following improvements to the technology, and (3) examine veteran characteristics associated with eScreening satisfaction. Focus group data were collected on user experience with eScreening from a sample of veterans who participated in an eScreening pilot. Guided by a user-centered design approach, findings informed improvements to the technology. Survey data were subsequently collected from a large cohort of veterans to assess satisfaction with the improved program. Questionnaire data were also collected to examine variables associated with eScreening satisfaction. Qualitative focus group data were analyzed using content analysis. Descriptive statistics were used to characterize sociodemographic variables, questionnaires, and satisfaction ratings. Correlations were run to examine the relationship between certain veteran characteristics (eg, age, resiliency, anxiety, insomnia, post-traumatic stress disorder, somatic symptoms, depression, pain) and satisfaction with eScreening. All research activities were conducted at VA San Diego Healthcare System and approved by the Institutional Review Board. Results Focus group data revealed that veterans were largely satisfied with eScreening, but they suggested some improvements (eg, to interface functionality), which were integrated into an updated version of eScreening. Following these changes, survey data revealed that veterans were highly satisfied with eScreening, including its usability, information security, and impact on health services. There were statistically significant, though not clinically meaningful relationships between health-related characteristics and satisfaction with eScreening. However, millennials showed significantly higher satisfaction ratings compared with non-millennials. Conclusions These findings support the use of patient experiences and feedback to aide product development. In addition, post-9/11 veterans support the use of eScreening to assist health screening. However, evaluating the eScreening program in more diverse veteran groups and Veterans Affairs settings is needed to improve the generalizability of these findings to the larger veteran population.

Assessment of aerobic capacity and walking economy of unilateral transfemoral amputees

2013 ◽  
Vol 38 (2) ◽  
pp. 140-147 ◽  
Author(s):  
Terje Gjovaag ◽  
Inger M Starholm ◽  
Peyman Mirtaheri ◽  
Fride W Hegge ◽  
Katrine Skjetne
Keyword(s):  
Standard Deviation ◽  
Independent Living ◽  
Intraclass Correlation ◽  
Control Group ◽  
Validity And Reliability ◽  
Transfemoral Amputee ◽  
Transfemoral Amputees ◽  
Small Muscle ◽  
Walking Economy ◽  
And Control

Background:Studies of the maximal oxygen uptake (VO2max) of transfemoral amputees have mostly used protocols that activate a relatively small muscle mass. Consequently, transfemoral amputee VO2maxmay be systematically underestimated, and the validity of these test protocols is questionable.Objectives:(1) Investigate validity and reliability of a VO2maxwalking protocol and (2) compare the VO2maxof a transfemoral amputee group with a group of matching controls.Study design:(1) Randomized crossover study: walking versus running VO2maxfor the control group and (2) case-control study: transfemoral amputees versus control group VO2max.Methods:Twelve transfemoral amputees and control participants performed a walking VO2maxtest with increasing treadmill inclinations to voluntary exhaustion. The control group also completed a running (“gold-standard”) VO2maxtest.Results:Mean (standard deviation) control group VO2maxfollowing walking and running was similar, that is, 2.99 (0.6) L min−1and 3.09 (0.7) L min−1, respectively. Mean (standard deviation) transfemoral amputee walking VO2maxwas 2.14 (0.8) L min−1(compared to CON; p < 0.01). Mean intraclass correlation coefficient of repeated VO2measurements was 0.97, and within-subjects standard deviation was 60 mL min−1.Conclusions:The walk protocol is valid. Walking VO2maxof transfemoral amputees was 40% lower compared to control group. Reliability of the walking protocol is comparable to other walking protocols.Clinical relevanceThe design, alignment, and materials of prostheses are important for effective ambulation. Cardio-respiratory fitness is, however, also important in this regard, and a low fitness may compromise health and independent living. Hence, transfemoral amputees with low physical fitness should engage in regular physical activity to improve health, gait capacity, and independency.

Study of the Control of Active Transfemoral Prosthesis Based on CPG

2012 ◽  
Vol 468-471 ◽  
pp. 1710-1713
Author(s):  
Yan Li Geng ◽  
Peng Yang ◽  
Ling Ling Chen
Keyword(s):  
Dynamical System ◽  
Power Generation ◽  
Central Pattern Generator ◽  
Lower Limb ◽  
3D Model ◽  
Pattern Generator ◽  
Passive Devices ◽  
Transfemoral Amputees ◽  
Hopf Oscillator ◽  
Transfemoral Prosthesis

Commercial transfemoral prostheses remain limited to energetically passive devices. Intelligent prostheses still do not replace the power generation capabilities of the missing limb. Active Transfemoral Prosthesis is designed to compensate the movements of transfemoral amputees. Base on the function and principle of huaman lower limb, Active transfemoral prosthesis is designed. Virtual prototype of active transfemoral prosthesis 3D model is built through Solidworks. A dynamical system is used to generate a position trajectory to control a linear motor replacing the missing joint. Hopf oscillator is used to construct a central pattern generator (CPG), which makes up the dynamical system.

Normative Spatiotemporal Parameters During 100-m Sprints in Amputee Sprinters Using Running-Specific Prostheses

2016 ◽  
Vol 32 (1) ◽  
pp. 93-96 ◽  
Author(s):  
Hiroaki Hobara ◽  
Wolfgang Potthast ◽  
Ralf Müller ◽  
Yoshiyuki Kobayashi ◽  
Thijs A. Heldoorn ◽  
...  
Keyword(s):  
Step Length ◽  
Normative Sample ◽  
Step Frequency ◽  
Men And Women ◽  
Transfemoral Amputee ◽  
Official Record ◽  
Spatiotemporal Parameters ◽  
Elite Level ◽  
Transfemoral Amputees ◽  
Transtibial Amputees

The aim of this study was to develop a normative sample of step frequency and step length during maximal sprinting in amputee sprinters. We analyzed elite-level 100-m races of 255 amputees and 93 able-bodied sprinters, both men and women, from publicly-available Internet broadcasts. For each sprinter’s run, the average forward velocity, step frequency, and step length over the 100-m distance were analyzed by using the official record and number of steps in each race. The average forward velocity was greatest in able-bodied sprinters (10.04 ± 0.17 m/s), followed by bilateral transtibial (8.77 ± 0.27 m/s), unilateral transtibial (8.65 ± 0.30 m/s), and transfemoral amputee sprinters (7.65 ± 0.38 m/s) in men. Differences in velocity among 4 groups were associated with step length (able-bodied vs transtibial amputees) or both step frequency and step length (able-bodied vs transfemoral amputees). Although we also found that the velocity was greatest in able-bodied sprinters (9.10 ± 0.14 m/s), followed by unilateral transtibial (7.08 ± 0.26 m/s), bilateral transtibial (7.06 ± 0.48 m/s), and transfemoral amputee sprinters (5.92 ± 0.33 m/s) in women, the differences in the velocity among the groups were associated with both step frequency and step length. Current results suggest that spatiotemporal parameters during a 100-m race of amputee sprinters is varied by amputation levels and sex.

scholarly journals SOCIAL PRACTICE AS A REHABILITATION COMPONENT OF INTEGRATION OF YOUNG CHILDREN WITH SPECIAL NEEDS INTO SOCIETY

2018 ◽  
Author(s):  
Olga Stashuk
Keyword(s):  
Young Children ◽  
Special Needs ◽  
Social Practice ◽  
Rehabilitation Program ◽  
Social Emotions ◽  
Rehabilitation Process ◽  
Ability To Act ◽  
The Social ◽  
Functional Autonomy ◽  
Self Service

The article examines the social practice as one of the forms of organization of rehabilitation process, its role in integration of a young child with disabilities into the society. The development of functional autonomy of young children with disabilities is the main priority of rehabilitation process. The author submits that functional autonomy is an ability of a child to act independently of others, according to age and psychophysical possibilities. The author of the article identifies functional autonomy as the basis for the successful integration of a child with special needs into the society. In the article the social practice is considered as one of the forms of organization of rehabilitation process that helps the child to acquire knowledge and develop skills in a convenient and familiar place. The article attempts to state selected conditions for implementation of the objectives of social practice among which are the involvement of a variety of professionals from different areas (social teacher coordinates their work) and the development of an individual rehabilitation program. The article deals with the typical difficulties of social development of young children, which may be complicated by the limited ability to perform daily living activities. The purposes of social practice are dwelt upon. These are: the development of the child's ability to adequate self-identification; the development of the ability to express social emotions; the development of safe livelihoods skills; the development of social norms of behavior; the development of the ability to show favor to others; the development of self-service skills; the development of a child's ability to act in accordance with different social roles.

Hip prosthesis in sitting posture for bilateral transfemoral amputee after burn injury: a case report

2016 ◽  
Vol 41 (5) ◽  
pp. 522-526
Author(s):  
Yukiyo Shimizu ◽  
Hirotaka Mutsuzaki ◽  
Takayuki Maezawa ◽  
Yuji Idei ◽  
Kazuya Takao ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Relevance ◽  
Burn Injury ◽  
Hip Prosthesis ◽  
Balance Training ◽  
Burn Injuries ◽  
Case Description ◽  
Sitting Posture ◽  
Transfemoral Amputee ◽  
Transfemoral Amputees

Background: To overcome the challenges of rehabilitation of bilateral transfemoral amputees, we developed a novel “hip prosthesis in the sitting posture.” Case Description and Methods: A 64-year-old male bilateral transfemoral amputee was transferred for rehabilitation 4 months following a burn injury. His wounds remained unhealed for 20 months; thus, he was unable to participate in standing training with the standard prosthetic sockets. Hip prosthesis in the sitting posture has very little friction between the sockets and residual limbs, which facilitated our patient to begin standing and walking exercises. Findings and Outcomes: The patient’s refractory wounds healed 1 month after initiating exercises using hip prosthesis in the sitting posture, and he could begin rehabilitation with the standard prostheses. Discussion and Conclusion: Hip prosthesis in the sitting posture enabled a bilateral transfemoral amputee with unhealed residual limbs to stand, walk, and begin balance training. Hip prosthesis in the sitting posture is an effective temporary prosthesis to prevent disuse until wounds are healed and to continue rehabilitation with standard prostheses. Clinical relevance Hip prosthesis in the sitting posture is useful for bilateral transfemoral amputees with unhealed residual limbs after burn injuries to prevent disuse and maintain motivation for walking.

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