This master thesis deals with the engineering design of a knee-ankle orthosis and subsequent implementation of a functional sample. The subject of the first part of the thesis is the design of internal shape of the shell on the basis of the patient's leg using CAD software. The second part deals with the design of the hydraulic knee. The knee joint with hydraulic controlled bending enables easier movement for patients who are not able to bring up stairs and uneven surfaces than existing joints. In the implementation was used SolidWorks 2012 and Geomagic Studio 12.

The thesis consists of autobiographical soma research-oriented design for bringing somatic attention to the feet by the concept of micro-opportunities embedded in external artifacts to defamiliarize experiences. There is a growing body of work within the HCI community reporting on pressure-sensitive prototypes for raising bodily awareness alongside heat as a positive embodied response. Informed by these, I lead by questioning: How could the feet as the eyes of the body open a space for design estrangement and micro opportunities? Through Research through Design (RtD), I explore where these applications make sense in everyday living. I provide an overview of my somatic explorations within physiotherapy, foot analysis, and physical engagements of materials depicting bodily adjustments, materials, prompts, and objects as tools for estrangement. Lastly, I offer the Soma Design Bodystorming Foot-kit humo encapsulating these insights and drawing on the given premise, seeing feelingly through the feet, to speculate around potential applications and outcomes in everyday living granted by micro-opportunities. Through humo, I provide designers with an open-ended kit for sparking an awakening out of familiar bodily experiences towards somaesthetic (strange) reflections of the being of the feet.

Over one million amputees are living in the United States with major lower limb loss (Ziegler-Graham et al. 2008). Lower limb amputation leads to the functional loss of the ankle plantar flexor muscles, which are important contributors to body support, forward propulsion, and leg swing initiation during walking (Neptune et al. 2001; Liu et al. 2006). Effective prosthetic component design is essential for successful rehabilitation of amputees to return to an active lifestyle by partially replacing the functional role of the ankle muscles. The series of experimental and computer simulation studies presented in this research showed that design characteristics of energy storage and return prosthetic ankles, specifically the elastic stiffness, significantly influence residual and intact leg ground reaction forces, knee joint moments, and muscle activity, thus affecting muscle output. These findings highlight the importance of proper prosthetic foot stiffness prescription for amputees to assure effective rehabilitation outcomes. The research also showed that the ankle muscles serve to stabilize the body during turning the center of mass. When amputees turn while supported by their prosthetic components, they rely more on gravity to redirect the center of mass than active muscle generation. This mechanism increases the risks of falling and identifies a need for prosthetic components and rehabilitation focused on increasing amputee stability during turning. A proper understanding of the effects of prosthetic components on amputee walking mechanics is critical to decreasing complications and risks that are prevalent among lower-limb amputees. The presented research is an important step towards reaching this goal. / text

The thesis deals with the issue of walking and standing in patients with a scoliosis. The theoretical part of this thesis summarizes current knowledge of scoliosis, its classification, etiology, pathogenesis and risk factors of the curve progression. Then the most often changes of the stand and gait stereotype and their main causes are discussed. Goal of the practical part was to identify the difference between particular parameters of gait in an experimental group of patients with scoliosis and a control group of healthy individuals. The examination was performed via the dynamic plantography method using the Zebris FDM-T System. 19 probands with scoliosis aged 8 - 19 and a control group of 19 orthopedically healthy patients in a corresponding age distribution have been selected for the study. The results did not provide any statistically significant difference on a significance level p=0,05. However, there were clear differences between the groups referring to bigger asymmetries in stance and gait stereotype in the scoliosis patients group. Since even in a scientific literature there is a difference in opinion on this issue, more research might be necessary for the exact evaluation of the influence of scoliosis on the stance and gait stereotype.

A neuropatia diabética causa diminuição ou perda da sensibilidade protetora do pé, tornando-o mais vulnerável ao trauma mecânico e térmico. A profilaxia das complicações neuropáticas tem início pela identificação da perda de sensibilidade e, portanto, do comprometimento neurológico. O Pressure Specified Sensory Device(TM) (PSSD) é um equipamento desenvolvido para quantificar o limiar de pressão, aplicada sobre a pele, necessária para que o paciente perceba o estímulo provocado por: um ponto estático, um ponto em movimento, dois pontos estáticos e dois pontos em movimento. Denominamos grupo estudo, aos trinta e quatro pacientes diabéticos do tipo 2, sem história prévia de feridas e/ou amputações nos pés que foram submetidos à avaliação de sensibilidade cutânea utilizando-se o PSSD(TM). Foram realizados testes nos territórios cutâneos dos nervos fibular profundo, plantar medial e ramo calcâneo do nervo tibial posterior. Estímulos foram provocados segundo as modalidades: um ponto estático (1 PE), um ponto em movimento (1 PD), dois pontos estáticos (2 PE) e dois pontos em movimento (2 PD), para as duas últimas modalidades. Previamente às modalidades 2PE e 2PD determinou-se o limiar de discriminação entre dois pontos estáticos (D2PE) e em movimento (D2PD). Foram realizados apenas no grupo estudo, testes com o monofilamento de Semmes-Weisntein nº 5,07 (MSW) e com o diapasão de 128 Hz. Vinte e oito pacientes não-diabéticos, submetidos aos mesmos testes, formaram o grupo controle. Para os limiares de sensibilidade, encontramos valores superiores no grupo estudo (p < 0,05). Ao compararmos os limiares de sensibilidade alcançados pelos pacientes diabéticos sensíveis e não sensíveis ao estímulo promovido pelo MSW nº 5,07 verificamos que o p-valor variou entre 0,018 < p < 0,113 para 1 PE e 0,002 < p < 0,083 para 2 PE, conforme o território cutâneo estudado. Na comparação dos limiares de sensibilidade da modalidade 1 PD entre diabéticos sensíveis e insensíveis à vibração do diapasão de 128 Hz, as diferenças não foram estatisticamente significantes (p = 0,183). Os resultados obtidos nos permitiram sugerir que o dispositivo PSSD(TM) seja utilizado como forma de acompanhamento do comprometimento da fibra nervosa. / Neuropathy is a severe progressive loss of protective sensation on the feet, making the patient more vulnerable to mechanical trauma and consequently more suitable to the development of chronic wounds, major distortion of the foot bone architecture and eventually to limb amputation. Prophylaxis should be enforced to avoid foot ulceration and for that, evaluation of the degree of loss of sensation on the skin is essential. The PSSD (Pressure Specified Sensory Device(TM)) was developed in order to quantify the threshold of pressure applied to the skin that could be recognized as positive by the patient. Pressure of one or two points is tested both statically and with movement, thus assessing the function of fast and slow response nerve fibers. Threshold of two-point discrimination was also measured in mm. Thirty four (n = 34) diabetic patients, type II, with no previous history of wounds on the lower extremity were studied using the tests, one point static (1PE), one point moving (1PD) and two points static (2 PE), and moving (2 PD) on the cutaneous territory of the fibular nerve and posterior tibial nerve (two territories - medial plantar and calcaneous nerves). The control group (28 non diabetic patients) was assessed by the same exams and the results were compared. In the diabetic group the cutaneous territories were also evaluated using the conventional Semmes-Weinstein filament nº 5,07 e vibrometer of the 128 Hz. Altered values were observed for the static and dynamic tests over the three studied nerve territories. The differences were statically significant (p < 0,05). Comparing the threshold of sensibility between sensitive and non sensitive diabetic patients to MSW nº 5,07 test, we observed that p-value range was 0,018 0,113 when 1PE test was applied, and 0,002 0,083 when 2PE test was applied, according to the cutaneous territories evaluated. Numeric quantification of the threshold of pressure allows us to determine the status of the fiber/receptor structures as well as the functional deficit of nerve fibers. Our findings suggest that PSSD(TM) is an adjuvant tool to evaluate the degree of loss of sensation on the skin.

Made available in DSpace on 2016-04-27T18:47:21Z (GMT). No. of bitstreams: 1 GER - Istvan Nagy.pdf: 325846 bytes, checksum: 9149d8cbe8d3b35e04886f589a1b5a54 (MD5) Previous issue date: 2006-10-23 / The general purpose of this investigation is to search for parallels between the causes of some of the most important physical, psychic and behavioral problems of old age and those of foot deformities. The extent to which such foot abnormalities exert an influence on the quality of life of aged people has a direct bearing on the matter under discussion. This study aims at gathering supporting evidence for the analysis of the obstacles old people face in their social commitments when they have defective feet to cope with. Aging entails deleterious anatomical and physiological changes characterizing distinct diseases, which include those affecting the feet. This can cause people to keep away from socio-cultural activities. The feet do not usually receive the same attention as other parts of the body until callosities or odors start to bother. Old people only mention their feet when these are hurting. However, it is nonsensical to keep such problems hidden within the shoes. There are clinical and surgical interventions which can correct one s way of walking and even adjust the anatomical position of the toes. Thus, old people should seek help from health professionals to prevent any worsening of the condition of their feet, which often give us the first indications of serious medical conditions such as the arthritis, diabetes, nervous system and circulation problems. Morphological or physiological alterations occurring in people can, over the long run, involve undesirable consequences in connection with behavior, intellectual ability and physical capacity to proceed with their normal activities. In such cases the feet obviously play, directly or indirectly, an important role in one s eventual inclusion or exclusion in groups which could promote social interactions. After all, as aged people restrict their movements, they start a vicious cycle: reduced activities (sedentary life) lead to muscular atrophy, weakness of the legs and consequently the avoidance of social activities. To solve the problem of the insertion of old people in the social context, the help of health professionals, including physiotherapists, gerontologists, and clinicians amongst others, is essential. Such professionals should harmoniously cooperate to reach a common objective. Some kinds of implements are used to successfully fulfill the purposes which are a good quality of life and longevity / Esta pesquisa tem por objetivo geral confrontar as causas e conseqüências das principais alterações físicas, psíquicas e comportamentais desencadeadas pelas deformidades e patologias que afetam os pés dos idosos. Ao mesmo tempo refletir sobre a qualidade de vida das pessoas que têm distúrbios nos pés. Esse trabalho busca um suporte de análise das dificuldades que as pessoas idosas enfrentam nos compromissos sociais, em virtude das más condições dos seus pés. É pertinente ao assunto, inserir os aspectos do envelhecimento e a sua relação com as diversas doenças, dentre elas, os problemas com os pés que em alguns casos podem afastar o idoso de suas atividades socioculturais. Normalmente, os pés não recebem a mesma atenção que outras partes do corpo até que um calo ou odores comecem a incomodar. Além disso, o idoso só fala dos seus pés quando eles doem. Não é necessário esconder o problema dentro do sapato, uma vez que há tratamentos e intervenções que trazem cura, corrigem os passos e até ajustam a posição anatômica dos artelhos. Outro aspecto importante é que o idoso deve ser atendido por um especialista, para que os pés não fiquem em más condições. Os problemas com nossos pés podem ser os primeiros sinais de condições médicas mais sérias tais como: as artrites, diabetes, e desordens do sistema nervoso e da circulação. Qualquer alteração de caráter morfológico e fisiológico que ocorre no organismo vivo, ao longo do tempo, traz consigo reflexos no comportamento, na habilidade intelectual e na capacidade física de cumprir com as atividades diárias. Nesses eventos estão incluídos, obviamente, os pés que direta ou indiretamente vão interferir nas interações sociais (exclusão/inclusão) do indivíduo. À medida que o idoso vai se restringindo nos seus movimentos entra num círculo vicioso que provoca a diminuição das atividades (sedentarismo) o que vai leválo à atrofia muscular, ao enfraquecimento das pernas e conseqüentemente ao isolamento das atividades sociais. As soluções para a inserção de idosos no contexto social dependem de interatividades profissionais como a gerontologia, a clínica médica e a fisioterapia, dentre outras, que devem cooperar harmonicamente para atingir objetivos comuns. Implementos de várias naturezas, utilizados por equipes, preparadas para isso, tornarão bem-sucedida uma existência, em termos de longevidade e qualidade de vida

Syftet med arbetet är att jämföra två olika metoder för inlärning av fotteknik för spel vid trumset och hur de två olika metoderna påverkar trumspel. För att undersöka detta användes videoobservation samt loggbokförande under de sex veckor som undersökningsperioden varade. Varje vecka filmades tre olika övningstillfällen med varierande fokus. Studien grundar sig i det designteoretiska perspektivet. Resultatet av studien visade att olika metoder kan ge varierande resultat och att utforskandet av nya metoder kan ge positiva och oväntade resultat. Resultatet pekar även på att strategier och struktur ger positiva effekter vid övning. I diskussionsdelen diskuteras vilka resurser som varit mest givande för min utveckling samt hur en trummis måste vara medveten om sina begränsningar för att strategiskt kunna forma övning. / The purpose of this study is to compare two different methods of learning foot-technique and how the two methods affect playing of the drums. To examine this video-observation filled an important role with complement of a journal during the six weeks of practice that were recorded. Each week there were three videos recorded with variating focus each video. The study is based on design theory which is described in the background chapter. The result of this study showed that different methods can result in variating outcome and it also showed that exploring new methods can give positive effects on your practice. The discussion revolves around what resources have been the most impactful for my own personal development and how one must be conscious of one’s own limitations to be able to create a successful plan of practice.

Made available in DSpace on 2016-06-02T20:19:19Z (GMT). No. of bitstreams: 1 4785.pdf: 2071751 bytes, checksum: ddd662f7eac525683cdb682e9e2e0afa (MD5) Previous issue date: 2012-10-24 / Financiadora de Estudos e Projetos / The developmental evaluation in children s feet between the age of two and six years-old may be one of Health Professionals duty in a pre-school. In this age the more important changes in children s feet occur and it may be important to identify dysfunctions that require intervention as soon as possible. Thus the purpose of this study was to evaluate the static structure and dynamic function of pre-school children s feet in order to classify them according to a reference profile. Twenty five healthy children (mean age of 3.4 ± 0.65 years) had their feet anthropometry measured to classify the static foot structure and plantar pressures measured with a platform to evaluate dynamic foot function. The results evidenced that our children showed increased arch índex, midfoot width and peak pressure over the midfoot and decreased force-time integral for the forefoot, compared to a reference study. Thus, our results suggest that our children in some aspects present foot structure and function not as developed as expected for their age. / Avaliar o desenvolvimento dos pés em crianças entre dois e seis anos de idade pode ser uma das tarefas de profissionais da Saúde inseridos na Educação Infantil. Nessa faixa etária ocorrem as principais mudanças na estrutura dos pés e a avaliação destas pode contribuir para a identificação precoce de disfunções que podem exigir intervenção. O objetivo do presente estudo foi avaliar a estrutura estática e a função dinâmica dos pés de um grupo de escolares da educação infantil, a fim de classificá-los de acordo com um perfil de referência. Foram avaliadas 25 crianças saudáveis (idade média de 3,4 ± 0,65 anos) que andaram na passarela, passando sobre a plataforma de pressão. A função dinâmica dos pés foi avaliada pela FRS e a estrutura estática dos pés foi avaliada por meio da plantigrafia. Os resultados evidenciaram que o índice do arco, a largura do mediopé e o pico de pressão na região do mediopé são maiores nas crianças avaliadas em nosso estudo, quando comparadas com um estudo de referência. Tais resultados sugerem que em alguns aspectos tanto a estrutura quanto a função dos pés ainda não estão plenamente desenvolvidos nessas crianças como o esperado para a idade.

Made available in DSpace on 2014-06-11T19:22:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-08-31Bitstream added on 2014-06-13T20:09:44Z : No. of bitstreams: 1 estremote_mm_me_ilha.pdf: 1708238 bytes, checksum: b2b9251aec47823d0f93f23f57209dcb (MD5) / Neste trabalho descreve-se um sistema constituído por duas plataformas de forças e seus respectivos circuitos de condicionamento e interfaceamento de sinais, projetado para medir a distribuição de descarga de peso na região plantar de pacientes. Em cada plataforma de força foram acopladas 24 células de carga construídas com extensômetros. As características estáticas do sistema foram determinadas em laboratório utilizando pesos conhecidos. O sistema apresentou linearidade, com coeficiente de determinação de 0,9997, baixa histerese, precisão de 0,84% e resolução de 0,5 N. As medidas são apresentadas na tela de um computador facilitando a visualização para especialistas da área, principalmente médicos, fisioterapeutas e terapeutas ocupacionais. Utilizando o sistema foram medidas as distribuições de peso na região plantar de 87 indivíduos sem hemiplegia (sem histórico de queixas de dores ou problemas no sistema neuromusculoesquelético) e de 10 hemiplégicos crônicos, com mais de um ano de hemiplegia. Estes foram submetidos à avaliação utilizando a Escala de Equilíbrio de Berg. Entre os indivíduos se hemiplegia, estudou-se mais detalhadamente um grupo de 15 bailarinos e um de 12 ginastas rítmicas. Determinou-se a relação entre a distribuição de pesos nos antepés esquerdo e direito de indivíduos sem hemiplegia e hemiplégicos com o sistema implementado. Através do sistema constatou-se que a relação entre a distribuição de pesos no antepé esquerdo e direito dos indivíduos hemiplégicos é muito mais elevada que a dos indivíduos sem hemiplegia. Este resultado era de se esperar, uma vez que o hemiplégico descarrega seu peso predominantemente no lado não plégico / This work describes a system consisting of two force platforms and their conditioning circuits and interfacing signals, designed to measure the distribution of weight load on the plantar region of patients. Each force platform was constructed with 24 load cells with strain gages. The static characteristics of the system were determined in laboratory using known weights. The system showed linearity with determination coefficient of 0.9997, low hysteresis, accuracy of 0.84% and resolution of 0.5 N. The measurements are presented in a computer screen in a friend way for specialists in the health field, mainly doctors, physiotherapists and occupational therapists. Using the system we measured the weight distributions in the plantar region of 87 normal patients (no history of complaints of pain or problems in the neuromuscular system) and 10 hemiplegic, with more than a year of hemiplegia. The latter were evaluated using the Berg Balance Scale. Among normal subjects, we studied a further group of 15 dancers and one of 12 rhythmic gymnasts. The relationship between the distribution of weights in the left and right forefeet of patients with normal and hemiplegic was determined with the implemented system. Through the system we found that the relationship between weight distribution on the left and right forefoot of hemiplegic patients is much higher than that of normal patients. This result was expected, since the hemiplegic unloads his weight predominantly in non-paralyzed side

The causes of musculoskeletal disorders, at present affecting a considerable pro-portion of the adult population and leading to poor posture, are to be looked for as early as in childhood. In recent decades an enormous increase in poor posture in the children of younger and older school-age has occurred, which is in most cases the result of a bad lifestyle. The lack of physical activity, an inappropriate school regime, unsuitable school furniture or heavy backpacks the children carry on their backs every day are the in-fluencing factors. Another aspect that can lead to poor posture in children is a relatively high number of children with flat feet. An inappropriate lifestyle and one-sidedness of modern life also leads to obesity and thus the restriction of movement in children. In my thesis I focused on poor posture in pupils of selected primary schools in the district of Příbram. The monitored group was children aged 8-15 years, attending 3-9 primary school grades. The purpose of my diploma thesis was to assess the prevalence of poor posture in primary school pupils in relation to their lifestyle and physical activity, to survey the risk factors leading to poor posture in these children, and to map the connection of poor posture in primary school children with prevalence of flat feet in children. In relation to the purpose I stated three hypotheses, assuming that children with a wrong lifestyle and an insufficient physical activity are more prone to poor posture, that the children influenced by more risk factors suffer more often from musculoskeletal disorders and poor posture and also that the children with flat feet are more predisposed to poor posture. To conduct the research, I chose the methodology of quantitative descriptive study through questionnaires. The research was carried out in two schools differently specialized, one of the schools is focused on mathematics and computer science and implements the program the Health Promoting School (Primary School Jiráskovy sady in Příbram), the second is focused on sports, particularly volleyball (Primary School Pod Svatou Horou Příbram). A total of 340 children from both schools were addressed by identical question-naires. The questionnaire was anonymous and the questions were directed primarily at these children lifestyle assessment. The questionnaire contained 37 questions in total, focused primarily on the principles of healthy lifestyle, physical activity, leisure activi-ties, school furniture, the school work regime and the prevalence of poor posture and flat feet. The return rate of the completed questionnaires was 85,3%, which means 290 questionnaires from the two schools. Based on the results from the completed questionnaires, I compared the two groups of examined pupils in terms of their compliance with the principles of healthy lifestyle, the prevalence of poor posture and the prevalence of flat feet.