In a Split Second

<p>Children and adolescents with the medical condition Spastic Cerebral Palsy (CP) may develop an abnormal gait, resulting in walking difficulties. This may be helped overtime with noninvasive Ankle Foot Orthotics (AFOs) braces, such as Solid Ankle Foot Orthotics (SAFOs), customised to suit patients needs. However, the acquisition of patient measurements for customisation and manufacturing itself is manual, slow, intrusive, subjective, and requires specialist skills to accomplish. This can commonly result in negative experiences for patients and reduce the access to healthcare to many people. This can especially affect vulnerable patients such as children or adolescents with Spastic CP. Research has identified that a 3D digital system that scans patients’ limbs and prints orthotics has the potential to improve the AFO creation process through speed, accuracy, and data availability. However, this system requires new technologies to fulfill its required performance, including a reliable way to acquire the three-dimensional shape of the limbs. As such, a close-range photogrammetry system was identified as a fast and accurate alternative for producing surface measurements through 3D models compiled from images taken simultaneously. This research portfolio explores the design development of such a system by identifying areas of improvement, barriers, and solutions in a multi-method iterative research-through-design approach and pragmatic design framework. The aim was to achieve quick and accurate acquisition of a patient’s’ lower half measurements, while focusing on the experience of users during system interaction. The final output is a formally evaluated close-range photogrammetry scanner prototype, that created a non-intrusive and accurate alternative to traditional methods via quick and detailed capturing of patient surface measurements for later analysis. While also facilitating the needs of two user groups: vulnerable patients, and operating technician, to better their user experience.</p>

In a Split Second

<p>Children and adolescents with the medical condition Spastic Cerebral Palsy (CP) may develop an abnormal gait, resulting in walking difficulties. This may be helped overtime with noninvasive Ankle Foot Orthotics (AFOs) braces, such as Solid Ankle Foot Orthotics (SAFOs), customised to suit patients needs. However, the acquisition of patient measurements for customisation and manufacturing itself is manual, slow, intrusive, subjective, and requires specialist skills to accomplish. This can commonly result in negative experiences for patients and reduce the access to healthcare to many people. This can especially affect vulnerable patients such as children or adolescents with Spastic CP. Research has identified that a 3D digital system that scans patients’ limbs and prints orthotics has the potential to improve the AFO creation process through speed, accuracy, and data availability. However, this system requires new technologies to fulfill its required performance, including a reliable way to acquire the three-dimensional shape of the limbs. As such, a close-range photogrammetry system was identified as a fast and accurate alternative for producing surface measurements through 3D models compiled from images taken simultaneously. This research portfolio explores the design development of such a system by identifying areas of improvement, barriers, and solutions in a multi-method iterative research-through-design approach and pragmatic design framework. The aim was to achieve quick and accurate acquisition of a patient’s’ lower half measurements, while focusing on the experience of users during system interaction. The final output is a formally evaluated close-range photogrammetry scanner prototype, that created a non-intrusive and accurate alternative to traditional methods via quick and detailed capturing of patient surface measurements for later analysis. While also facilitating the needs of two user groups: vulnerable patients, and operating technician, to better their user experience.</p>

Charcot-Marie-Tooth neuropathy score and ambulation index are both predictors of orthotic need for patients with CMT

Charcot-Marie-Tooth (CMT) disease is the most common hereditary neuropathy with an estimated prevalence of 1 person affected on 2500. Frequent symptoms include distal weakness and muscle wasting, sensory loss, reduced deep tendon reflexes, and skeletal deformities, such as hammer toes and pes cavus. CMT is a progressive disease and patients’ needs change over their lifetime. In particular, ambulation aids are increasingly needed to maintain ambulation and reduce the risk of falls. We performed a retrospective analysis of medical records from 149 patients with confirmed CMT to evaluate patients ambulation needs related to the severity of their CMT as measured by the CMT Neuropathy Score (CMTNS) and Ambulation Index (AI). Most patients required some form of orthotics (86.6%). The CMTNS and AI scores both differed significantly between patients with no orthotics compared to those who wore insoles/inserts. The CMTNS and AI also differed significantly between patients wearing insoles and those with ankle foot orthotics (AFOs). CMTNS and the AI were valid predictors of the type and choice of the orthotics. Both the CMTNS and AI can be effective tools to aid in the correct choice of orthotics in patients affected by CMT.

EXOSEKETONS: A REHAB TECH CONSUMER’S UNEXPECTED MARCH TO ACTION

This paper is both a stakeholder perspectives as well as a ‘case study’ describing a journey from sudden disability to participant and investor in exoskeleton design. It tells of my experiences and opinions, as a successful fashion designer, when my life took a drastic turn on becoming paralysed from the waist down over the course of 24 hours, by a spinal tumour. Getting this diagnosis was ‘the worst day in my life’, and it was quickly followed by the ‘second worst’ when, in my determination to walk again, I received Knee Ankle Foot Orthotics (KAFOs) and was shocked to learn that this appeared to be the best technology solution available on the market ‘suitable’ for use in the community. Initial anger at the system for not being better, at the rehab team for their complacency, and at myself for allowing a feeling of helplessness to take over led to questions such as: what does this say about our society? and what are we all willing to accept, for ourselves and others? This is professional opinion and an essay about how we see ourselves and how others see us. The journey from pre-injury ‘consumer’ to post-injury ‘disabled’ person and learning that being labeled ‘disabled’ leads to the additional handicap of the narrow vision of “cost” taken by the mobility industry where innovative ideas are stripped down to the bare minimum with the excuse that patients are “lucky” to have what they have been “given”. Grappling with these labels and inequities and seeking a better outcome, I became an integral team member of an exoskeleton development team, leading to the design of The Next Generation Exoskeleton! This is MY story, the story of Chloe Angus. It is the story of inclusive, user focused design and is a call to include and respect the end users of all assistive device technology design early in the design process and it is being told from the perspective of a person having experience and success in the world of business. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/37250/28296 How To Cite: Angus C. Exoseketons: a rehab tech consumer’s unexpected march to action. Canadian Prosthetics & Orthotics Journal. 2021; Volume 4, Issue 2, No.2. https://doi.org/10.33137/cpoj.v4i2.37250 Corresponding Author: Chloe AngusChloe Angus Design, Vancouver, BC, Canada.E-Mail: [email protected] ID: https://orcid.org/0000-0002-5468-3121

Optimal Design and Fabrication of Shoe Lasts for Ankle Foot Orthotics for Patients With Diabetes

Patients with diabetes often desperately need ankle foot orthotics (AFO) to perform daily activities. In Indonesia, experienced shoemakers employ manual procedures and follow the prescriptions given by a doctor or orthopaedic technician. This process remains traditional in that each pair of AFO is handmade, not precise, and is time consuming. This article describes the development of the design process and fabrication of a new AFO product for patients with diabetes based on a computer aided reverse engineering system (CARESystem). The reverse innovative design approach method discussed in this paper sought to achieve the best shoe last. The results also shows a functional test with highly satisfactory results. The shape of the shoe fit the standard AFO and the first patient experienced comfort for the 4-week long testing period. This article proves that the CARESystem technology successfully reduced the time for both the design and fabrication of the AFOs by 64%.

Un-Tethered, Active Ankle-Foot Orthotic

Foot drop, or the inability to dorsiflex the foot (i.e., point your toe upward) is a fairly common lasting side-effect of a stroke, affecting approximately 20% of stroke survivors (∼1.3 million people each year). The customers have adopted the use of Ankle Foot Orthotics (AFOs) in order to aid in the dorsi-flexion of the foot. These passive devices do not allow users to safely move down inclines or stairs as the user’s foot will always be pointed upwards when off the ground.