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.

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.

The purpose of this literature review was to identify any adaptations that could be made to the rehabilitation process for Traumatic Transfemoral Amputees. Traumatic Transfemoral Amputation is particularly debilitating with the amputees encountering many obstacles throughout the rehabilitation process. These obstacles can prevent the return to pre-morbid functioning. With an ever-increasing number of amputees within the United States, it is imperative the rehabilitation process be addressed. This literature review addresses possible adjustments in the initial stages of rehabilitation examining the post-operative, pre-prosthetic, and prosthetic rehabilitation stage to enhance the physical functioning for the amputee. This comprehensive literature review encompassing 63 academic and medical journals analyzes the research literature regarding each of the three stages of the post-operative procedure. The literature review synthesizes the research findings to see how procedures may be adapted to reduce the risk of further co-morbidities such as loss of bone mineral density and disuse atrophy. Loss of bone mineral density and disuse atrophy are the major contributing factors to the amputees decreased mobility. Reducing this loss can be addressed within the initial post-operative, pre-prosthetic, and prosthetic rehabilitation stages. Further research is required to examine the efficacy of these alterations in relation to this specific population.

Knee osteoarthritis (OA) is a debilitating disease affecting the entire knee joint by inducing pathological changes to the cartilage and menisci. Currently, the etiology of OA is not completely understood. However, altered gait mechanics, specifically increased joint loading, of OA patients have a clear association with both symptomatic and structural OA progression. Non-surgical intervention tools, such as variable stiffness shoes (VSS), have been developed as a way to decrease loading within the knee joint. However, with external moments being surrogate measures for knee loading, it is unclear if changes in knee moments with the footwear are sufficient to result in a clinical benefit. Therefore, this project’s purpose was to investigate whether a VSS intervention can alter knee joint loading and menisci function in a knee OA population. We used gait analysis, musculoskeletal modeling, and finite element (FE) analysis to determine the effect of VSS on gait mechanics, knee joint contact force, and menisci stress and strain, compared to a control shoe. We found knee moments did not decrease with the VSS intervention. Furthermore, participants who did experience a decrease in knee adduction moment did not always experience a decrease in medial compartment contact force. However, results from our FE modeling of the tibiofemoral joint indicate significant changes in knee joint contact force can influence stress placed on the menisci. Results from this study suggest knee contact forces and tissue stress, not only external moments, should be considered when investigating if VSS can positively impact an OA population.

This thesis proposes an algorithm that determine the geometry of 3D-printed, custom-designed spring element bands made of thermoplastic elastomer (TPE) for use in a wearable orthotic device to aid in the physical therapy of a human hand exhibiting spasticity after stroke. Each finger of the hand is modeled as a mechanical system consisting of a triple-rod pendulum with nonlinear stiffness at each joint and forces applied at the attachment point of each flexor muscle. The system is assumed quasi-static, which leads to a torque balance between the flexor tendons in the hand, joint stiffness and the design force applied to the fingertip by the 3D-printed spring element. To better understand material properties of the spring element’s material, several tests are performed on TPE specimens printed with different infill geometries, including tensile tests and cyclic loading tests. The data and stress-strain curves for each geometry type are presented, which yield a nonlinear relationship between stress and strain as well as apparent hysteresis. Polynomial curves are used to fit the data, which allows for the band geometry to be designed. A hypothetical hand is presented along with how input measurements might be taken for the algorithm. The inputs are entered into the algorithm, and the geometry of the bands for each finger are generated. Results are discussed, and future work is noted, providing a means for the design of a customized orthotic device.

Background: Disruptive technology describes technology that is significantly more advanced than previous iterations, such as: 3D printing, genetic manipulation, stem cell research, innovative surgical procedures, and computer-based charting software. These technologies often require extensive overhauls to implement into older systems and must overcome many difficult financial and societal complications before they can be widely used. In a field like healthcare that makes frequent advancements, these difficulties can mean that the technology will not be utilized to its full potential or implemented at all. Objective: To determine the inhibiting factors that prevent disruptive technology from being implemented in conventional healthcare. Methods: Peer reviewed articles were gathered from Cumulative Index to Nursing and Allied Health Literature (CINAHL), Educational Resources Information Center (ERIC), Elton B. Stephens Co. Host (Ebsco Host), Medical Literature On-line (Medline), and Psychological Information Database (PsychINFO). Articles were included if written in English and focusing on technology that was or is difficult to implement. Results: Research suggests that the primary reason disruptive technology is not implemented sooner is the cost versus benefit ratio. Those technologies with extremely high benefits that greatly improve efficiency, safety, or expense are integrated relatively quickly, especially if their cost is reasonable. Secondary reasons for difficulty with integration include ethical dilemmas, extreme complexity, technical limitations, maintenance, security, and fallibility. Conclusion: Research indicates that a decrease in production cost and selling price along with removing any issues that may depreciate the technology will provide better incentives for healthcare systems to integrate disruptive technologies on a wider scale.