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1 / France, Jared M.

No description available.

Hip abduction orthosis devices (HAOD) are used to reduce the hip joint of infants affected by developmental dysplasia of the hip (DDH). HAOD have been successful for mild cases of DDH and ineffective for severe cases. Efforts in understanding the biomechanics of lower limbs have been made to improve the success rate of current treatment methods, especially for Grade IV dislocations (G4). The aim of this dissertation is twofold: first, it proposes the use of a varying fulcrum point (FP) located below the leg to improve DDH treatment; and secondly, it defines the optimal FP (OP) location for a broad spectrum of hip joint configurations. An iterative 3D computational model of a 10-week-old infant was developed using parameters of the femur, pelvis, and lower limb muscles along with their anatomical location. The computational model provides a variety of scenarios of closed reduction and the location of the OP, which is believed to be a key parameter for a successful reduction in severe cases of DDH. The problem is posed as a maximization of an objective function whose independent parameter is the location of the FP constrained to vary over an anatomically feasible range along the femur. For each location of the FP, the model computes resultant forces and evaluates a potential energy function. The OP maximizes the projection of the resultant vector force of the femur over the least energy path to assist in achieving G4 reduction. The results of this study suggest that for the range of the parameters used in the model, G4 reduction can be achieved as the FP reaches the femoral head with the aid of additional external traction forces. Results from this study may be used to customize current orthosis design by using patient-specific parameters, which can be obtained from imaging.

Through whatever misfortune people have always had the need for artificial limbs. This study questions current thinking in the field of prosthetics, aiming to address the most prevalent issues affecting the amputee today, such as, fit, comfort and practicality, which have an inarguable baring on patient prostheses satisfaction. Through examination, more obscure problems encountered by users were explained, indicating how design issues and methodologies affect the present and future manufacturing process. As a result of this research a development model for the increased effectiveness of prostheses fitrnent and improvements in patient prosthetic satisfaction have been made. This has included suggestions for potential improvements in limb fitting center protocol, patient education and awareness strategies for the assessment of delivered patient needs and requirements Methods implemented during the research consisted of a comprehensive literature review of current infonnation, technical reports and patient satisfaction findings and assessment techniques. 1bis was accompanied with an investigation and evaluation of the prosthetics industry, including limb fitting, patient requirements, product/service shortfalls, rehabilitation technique and patient lifestyle. Additionally interviews and questionnaires with practitioners and users were undertaken aiding the evaluation of patient satisfaction and the identification of potential improvements in artificial limb fitment procedure. The results revealed several areas that deserved more detailed investigation, notably relating to the hypotheses, that the relationship between the levels of fit, comfort and practicality archived within the prostheses has an effect on the patient's satisfaction. Through the examination ofthis main hypothesis one of the most significant factors which emerged was the effect ofthe communication level held between the patient and prosthetist. The results of"this enquiry indicated that improved patient knowledge with respect oftheir situation and an increased ability to accurately relay issues of concern to the prosthetist, facilitated the delivery of satisfactory prostheses, in turn improving its fit, comfort and practicality. In conclusion, previous conjecture as to the limited effectiveness of current prosthetics in re-establishing patients activity levels were assessed, and suggestions generated by the results of patients dissatisfaction with their limbs. These findings facilitated the realisation of new educational, protocol-based methodologies, tools and theories.

Traditional prosthetic design revolves around functionality, aiming to hide and downplay an individual's limb difference as much as possible. This may not only negatively affect the user's desire to wear their prosthetic but may also negatively affect their self-confidence and sense of identity. Expression is a primary way to communicate identity, yet some traditional prosthetics may deny expression, leaving users without an immediate means to express themselves apart from the stigmatizing label of 'disability'. This study examines the ability of art when combined with bionic prosthetic technology to change the perception of disability, empower self confidence in prosthetics users, and increase the functional benefits of prosthetics. To elevate prosthetic technology, future designs must not only excel at functionally but must support increased aesthetic quality and allowance for personal expression. These objectives are examined through a participatory approach to design, where kids become active participants in the customization and design of their own prosthetic arms. Involving the user in the creative process can bring higher positive results in prosthetic functionality, expressed personal identity, emotional engagement, and ownership of the prosthetic. This study reports the results of this exploration by designing and hand painting expressive, customizable sleeves for bionic arms in preparation for a clinical trial beginning with Limbitless Solutions.

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IKO is a creative prosthetic system designed for children to explore and empower their creativity in a playful, social and friendly way. What if kids could use their imagination to create their own tools according to their own needs; doing participatory observations and interviews in Colombia of two children with congenital hand-disabilities and their families confirmed that the needs of disabled kids are not always related to physical activity but often alternatively the social and psychological aspect; what if kids could make their own prosthetics and have fun at the same time? Learning. Creating. Being kids.

Currently available upper-limb prostheses do not meet the needs or aspirations of the amputee. Many technical challenges have been given as the limiting factors on the further development of these prostheses. Generally developments have occurred as incremental developments on three existing moderately successful archetypes; the cosmetic, body-powered and myoelectric prostheses. Continued development on these archetypes appears to be further separating prostheses into those primarily considered cosmetic and those primarily considered functional. However, amputees have a need both for function and cosmesis from their prostheses. Technology currently being developed for actuation and control in other laboratories indicates that the previous limitations placed on prosthesis design may be challenged. Therefore, it is appropriate to look for new design archetypes. This thesis describes the development, implementation and evaluation of mechanical analogies of the skeletal components of the human hand and arm which have the potential to inform the design of a new generation of upper-limb prostheses integrating cosmesis and function in a single device. The research has been undertaken using a form of practice led design research methodology. This iterative methodology uses physical models for both evaluation and also as a means of encouraging end-user involvement in the design process. These evaluations are then used in subsequent cycles of research activity. The research has concentrated on developing mechanical analogies of the joints of the hand, wrist, forearm and elbow. The joints of the hand are shown to have a simple and similar structure. Therefore, a modular mechanical archetype has been elucidated that results in a hand configuration made from multiple similar modules positioned at different points throughout the hand. However, the wrist and forearm contain more complex joints which have been found to be unique to their anatomical position. The selection of appropriate prototyping techniques has been an integral part of the research. Problems have arisen in assessing the degree of analogy achieved because the intact joints of the human skeleton are covered by soft tissue that has not been part of the skeletal analogy implemented. Additionally, it is postulated that there are subtleties to human movement which are not reflected in standard anthropometric measures. Therefore, a two stage evaluation has been undertaken that assesses the quality of the analogy realised in the models. This consists of goniometric measures to quantify basic angular rotations whilst qualitative evaluations by professionals with a good anatomical knowledge have been used to assess the more subtle movements within the joints. The skeletal mechanical analogy developed through this research has been shown through evaluation to simulate the articulations of the human upper-limb. The model embodies design principles that appear to have short and long term significance to the field of prosthetics. The production of a tangible model has not only aided evaluation but has also stimulated research in other centres into ways of actuating and controlling a future upper-limb prosthesis. Additionally, the mechanical analogy may have applications in the field of telepresence robotics, aerospace and the entertainment industry.

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