Magister Scientiae (Physiotherapy) - MSc(Physio) / Persons with lower limb amputations (LLA) experience different challenges in the community. These challenges include the physical, psychological and social function of an individual. Little is known in Malawi on what persons with lower limb amputations go through in the communities where they live. Therefore, the study aimed at exploring and determining community experiences of persons with LLA in Malawi. The study sought to address the following objectives: 1) To determine the functional and psychological status of persons with LLA in the community; 2) To explore and describe experiences on social participation of persons with LLA in the community; 3). To explore experiences on community re-integration following LLA.

Microelectronic vision prostheses aim to restore visual percepts through electrical stimulation of the surviving visual pathways in the blind. Electrical stimulation has been shown to produce spots of light in the visual field. A neurostimulator that forms the basis of a vision prosthesis was designed using a high voltage CMOS process to allow it to be able to stimulate when faced with high electrode-tissue impedances. It was implemented with novel features that allow it to be scalable, and to focus charge injection, and can stimulate multiple sites simultaneously using a current source and sink at each site. To reduce electrical cross-talk between multiple stimulation sites, six-return electrodes surround each stimulating electrode, electrically guarding them from each other. The six-return electrode configuration was shown to reduce electrical cross-talk in saline bath tests compared to single-return electrode configurations. The neurostimulator was used to evoke responses from cats through electrical stimulation via intravitreal ball electrodes, corneal electrodes, and planar electrode arrays in the suprachoroidal space. Responses were measured on the visual cortex through optical imaging of intrinsic signals, and through surface electrodes. Using the planar electrode array in the suprachoroidal space, responses were elicited to biphasic, bipolar and monopolar stimuli, with each stimulating electrode coupled with either six-return electrodes, two-return electrodes, or a single-return electrode. The average charge threshold to elicit a response for biphasic, bipolar stimulation with six-return electrodes was 76.47 ?? 8.76 nC (standard error of the mean). For biphasic, bipolar stimulation, the magnitude and area of cortical response with the six-return electrode configurations was on average 2.18 ?? 0.19 times smaller than single-return electrode configurations, and 1.89 ?? 0.19 times smaller than two-return electrode configurations (P < 0.0001). It was also found that for biphasic stimulation, a greater magnitude and area of response was elicited for monopolar stimulation compared to bipolar stimulation. This dissertation details the design and testing of a novel, scalable neurostimulator to focus charge injection. It also shows that suprachoroidal, bipolar stimulation can elicit visual responses, and that the area of cortical activation was more focused when using bipolar, biphasic stimulation, and six-return electrodes.

Typescript. Bibliography: leaves 131-167.

The purpose of this study was to analyze kinetic and kinematic data of individuals with unilateral transtibial limb loss and the effect different alignments have on the individual’s gait while they walk over uneven terrain. Individuals with lower limb loss are currently having their prostheses dynamically aligned to ensure a satisfactory walking gait on level ground with smooth surfaces, usually in the clinician's office or hallway. This study was looking to determine whether or not current prosthesis alignment procedures are adequate for determining a satisfactory walking gait on non-level and non-smooth terrains as well level smooth surfaces. An effective and efficient walking pattern is necessary to prevent degenerative conditions within the bones, muscles or other tissues of the body, due to compensations of the gait pattern. Sometimes, individuals are able to mask any compensations if their safety is unaffected by their surroundings and they are able to maintain a gait that appears normal or optimal. However, if terrains used on a daily basis present a sense of insecurity, gait compensations could be more problematic to the individual and they need to be addressed and corrected as best they can. This study determined that while there were some changes in gait on the uneven surface, due to the number of subjects it is unclear whether the changes are significant. The individuals showed a decrease in walking speed and step length and an increase in step width. There were also changes in the peak axial force.

Advancement in biotechnology has successfully converted the conventional bearing couples into artificial joints. Materials used today, however, have not been satisfactory. Problems such as osteolysis and aseptic loosening lead to failure of artificial joints and also the lifespan of these joints is to be further improved. This research targets two issues related to the problem: coatings and design of new generation biofluids. Superior to metals and polymers, ceramics are hard and biocompatible and exhibit low wear and friction. The ceramic-on-ceramic bearing pair could last for a long time which could be beneficial to younger and active patients who need a bearing pair which would last for more than 15 years to avoid the possibility of a revision surgery. The first part of this thesis deals with studying the microstructure-property relationship of new ceramic-based materials and coatings. Specifically, alumina (ceramic) coatings at different current intensities were tested in order to determine their feasibility as a biomaterial for artificial joints. In order to find a new avenue for developing biofluids, the second part of this thesis focuses on the failure of artificial joints under inadequate lubrication. Also due to osteoarthritis, synthetic biofluid is injected into joints to help relieve pain but it works for only 6-9 months. We propose a new method using noble gold nanoparticles to modify fluids. This was accomplished by mixing different concentration of nanoparticles with biofluid. This thesis consists of 6 sections. The first section is an introduction to tribology, biotribology and artificial joints which is followed by the second section which discusses the objectives of the research. The third section describes the materials and methods used in the research. The tribological characterization of MAO alumina coatings is discussed in the fourth section and the fifth section discusses the effect of nanoparticles on fluid lubrication. The last section is the conclusion.

Thesis (M.S.)--Rochester Institute of Technology, 2009. / Typescript. Includes bibliographical references (p. 120-126).

Thesis (Ph.D)--Civil and Environmental Engineering, Georgia Institute of Technology, 2009. / Committee Chair: Haj-Ali, Rami; Committee Member: White, Donald; Committee Member: Will, Kenneth; Committee Member: Yavari, Arash; Committee Member: Yoganathan, Ajit. Part of the SMARTech Electronic Thesis and Dissertation Collection.

Thesis (Ph. D.)--University of Washington, 2003. / Vita. Includes bibliographical references (p. 329-334).

As of 2005, there were over 1.5 million amputees living in the United States, more than 548,000 of them with upper extremity involvement. The total number of amputees is projected to rise to at least 2.2 million by 2020. Unfortunately, full functional use of upper extremity prosthetic devices is low. Knowledge gained regarding the cortical systems active in amputees performing motor tasks may reveal atypical motor control strategies that contribute to these issues. Substantial evidence demonstrates a strong dependence on left parietofrontal cortical areas to successfully plan and execute tool-use movements and pantomimes. It was previously unclear how this network functioned in users of prostheses. The hypothesis of this dissertation is that in order to optimally engage the typical parietofrontal network during action imitation with a prosthetic device, the action being imitated should be performed by a matching prosthesis. Also, that greater engagement of the parietofrontal network will result in increased ability to perform tool-use movements. First, this dissertation showed that when imitating motor tasks performed by intact actors, prosthesis users exhibit lower engagement of the parietofrontal action encoding system. This network is crucial for motor adaptation. Left parietofrontal engagement was only observed when prosthesis users imitated matched limb prosthesis demonstrations, which suggests that matched limb imitation may be optimal to establish motor representations. Next, intact subjects donned a fictive amputee model system (FAMS) to simulate the limb movement that transradial amputees experience. Matched limb imitation in FAMS users yielded better movement technique compared to mismatched imitation. Finally, the longitudinal effects of a matched limb training paradigm on the cortical action encoding activity and motor behavior in FAMS users were investigated. Matched limb imitation subjects showed greater engagement of the parietofrontal network and better movement technique compared to those trained with mismatched limb. This dissertation has clinical relevance as it supports the notion that matched limb imitation could play an important role in the performance of motor tasks using a prosthetic device. These findings could be used to inform the development of improved rehabilitation protocols that may lead to greater functional adaptation of prosthetic devices into the lives of amputees.

The human vestibular system is responsible for maintaining balance and orientation, and stabilizing gaze during head motion. Head motion is sensed by vestibular sensors and encoded via the firing rate of vestibular neurons. Vestibular disorders can result in dizziness, imbalance, and disequilibrium. Currently there are no therapeutic options for individuals suffering from bilateral vestibular dysfunction. A potential solution is a vestibular prosthesis (VP). This device serves to replace peripheral vestibular organs by sensing angular motion, detected by semicircular canals (SCCs), and linear head motion, detected by the otolith organs, and selectively stimulating the corresponding vestibular afferents. An ideal VP will not only mimic the patient-dependent vestibular neural dynamics, but also consume low power. In this study, three energy-efficient ways to implement the motion encoding function required in a vestibular prosthesis are presented. Both analog and digital signal processing techniques to implement the vestibular signal processing functions are investigated.