Syfte: Syftet med det här examenarbete är att undersöka behovet av snabbkopplingsadaptrar för protesbrukare.   Bakgrund: Snabbkopplingsadapter är en förhållandevis ny produkt som både Otto Bock och Lindhe Xtend erbjuder, men ingen forskning på behovsområdet finns ännu gjord. Fördelen med produkten är enligt leverantörernas hemsidor bl a att man med den enkelt kan byta mellan olika proteskomponenter utan att behöva skruva på några protesinställningar eller byta hylsa.   Metod: För att undersöka behovet av snabbkopplingsadaptrar utfördes semistrukturella intervjuer av fenomenologisk karaktär. En serie med sju frågor sammanställdes som intervjuunderlag, vilka togs fram utifrån de tre behovsfokusområdena: Funktion, delaktighet och livskvalité. I undersökningen ingick n=6 deltagare, varav n=3 transtibialt amputerade och n=3 transfemoralt amputerade. Insamlade data analyserades vidare för framtagning av olika teman och resultat.   Resultat: Utifrån intervjuunderlaget togs följande teman fram: Byte av protesfötter/protesknäleder, På- och avtagning av byxor, Hylspassform, Transport samt Biomekanik. Varje tema utgjorde ett eget potentiellt användningsområde, där de största behoven visade sig ligga inom temana Byte av protesfötter/protesknäleder, Hylspassform samt Transport.   Slutsats: Behovet av snabbkopplingsadaptrar är högst subjektivt, och beror snarare på deltagarens liv än några allmänna faktorer. Däremot upptäcktes ett antal tänkbara användningsområden för den. / Aim: The aim of this thesis was to investigate the necessity of the quick change adapter for lower limb amputees.   Background: Quick Change Adapter is a relatively new product that both Otto Bock and Lindhe Xtend offers, but no research has been done on the area of its necessity yet.  According to the supplier´s websites the benefits of the product is that you with it easily can change prosthetic components without affecting the alignments or change socket.   Method: To investigate the necessity of the Quick Change Adapter, semi structural interviews of phenomenological characteristic were used.  A series of seven questions were compiled as a basis for the interview from the three focus areas: Function, participation and quality of Life. The thesis involved n=6 participants, of who n=3 was trantibial amputated and n=3 transfemoral amputated. Collected data was later analysed to find general themes and results.   Results: From the interviews these themes were exposed: Changing prosthetic feet/prosthetic knee joints, Donn and doff of pants, Socket fit, Transport and Biomechanics. Each theme presented a potential application area where the biggest needs seemed to be in Changing prosthetic feet/prosthetic knee joints, Socket fit and Transport.   Conclusions: The necessity of the Quick Change Adapter turned out to be very subjective, and depended more on the participant´s life then any general factors. Still there were some potential application areas detected for it.

Aim: The aim with this study is to compare different orthotic solutions for pediatric patients with congenital talipes equnivarus.  Method: A search in the databases MEDLINE, CINAHL, PubMed and Scopus were made, and studies was included after the predefined criteria. The included studies were reviewed for risk of bias and validity, relevant data was extract and analyzed with regards to the research question.  Result: The result was presented on 15 different orthotic interventions in 21 different articles. The reported outcome measures were compliance, recurrence of deformity, Pirani- and Dimeglio score, range of motion and functional outcomes.  Conclusion: Based on the results a recommendation cannot be made on what orthosis that gives the best result. Future research should focus on developing and designing an orthosis that satisfies the patient's needs. / Syfte: Syftet med detta arbete är att undersöka olika ortos-lösningar med dess inkluderade resultat för patienter med kongenital idiopatisk klumpfot. Metod: En systematisk sökning i databaserna MEDLINE, CINAHL, PubMed and Scopus genomfördes och väsentliga studier inkluderades utefter de förbestämda kriterierna. Inkluderade studiers validitet och möjliga partiskhet bedömdes samt att relevant data utifrån frågeställningen analyserades och besvarades.  Resultat: Resultatet presenterade 15 olika typer av ortoser, i 21 olika artiklar. De presenterade utfallsmåtten var inom komplians, återfall av deformationen, Pirani- och Dimeglio poäng, rörelseomfång samt inom funktionellt resultat. Slutsats: Baserat på resultat går det inte att presentera en övervägande slutsats om vilken ortos-lösning som ger bäst resultat. Framtida forskning måste utveckla och framställa ortoser som tillfredsställer och möter patienternas behov.

Transtibial amputation is a major surgical procedure where both short- and long-term perspectives are important. The surgical method can directly impact stump quality which can affect the prosthetic user’squality of life.  The aim of this scoping review is to summarize and give an overview of the research area of different incision types in relation to prosthetic rehabilitation, to help future researchers and potentially unveil areas where further research is needed. The research question: What is the data available for Different Transtibial Amputation Techniques in Prosthetic Rehabilitation, which was divided into three sub questions. The 6-step framework for scoping reviews by the Joanna Briggs Institute was used to structure the review. From a total of 736 studies screened, 28 were selected and mapped onto 12 different outcome measures. Extensive data were found regarding what amputation method has what surgical outcomes. Areas that appear to have research gaps are dressing types and contractures when contrasted with surgical methods. No study could be found regarding length of hospital stay and the Skew flap method. We conclude that there is a research gap when it comes to patient reported assessments, surveys and qualitative evaluations. / Transtibial amputation är ett större kirurgiskt ingrepp där både kort- och långsiktiga perspektiv är viktiga. Den kirurgiska metoden kan direkt påverka stumpkvalitet vilket kan vidare påverka protesanvändarens livskvalitet. Syftet med denna Scoping Review är att summera och ge en överblick över forskningsområdet inom olika typer av kirurgiska snittföringar i relation till protesrehabilitering för att hjälpa framtida forskare och eventuellt avslöja områden där vidare forskning behövs. Forskningsfrågan var: Vad finns det för data tillgänglig för olika transtibial amputationsmetoder i protesrehabilitering, vilket delades upp i tre delfrågor. Ett sex-stegs ramverk för Scoping Reviews från Joanna Briggs Institutet användes för att strukturera översikten.Av totalt 737 studier som granskades var 28 utvalda och kartlagda till 12 olika utfallsmått.  Omfattande data hittades om vilken amputationsmetod som har vilka kirurgiska resultat. Områden som verkar ha forskningsluckor är postoperativt förband och kontrakturer i kontrast till amputationsmetod. Ingen studie kunde hittas angående längden på sjukhusvistelsen med vriden sidolambå. Vi drar även slutsatsen att det finns en forskningslucka när det gäller patientrapporterade bedömningar, undersökningar och kvalitativa utvärderingar

A steady increase in parcel volume has put more pressure on the freight transportation industry and will only continue to do so in the future. The whole industry will continue to grow as the volume increases which in turn will put more pressure on the drivers responsible that the goods arrive safely to their destination. There are many reasons to try and facilitate their working environment. It is very common for delivery drivers nowadays to use different mapping services to help navigate. The maps have helped a lot since their arrival, but this does not mean that they are faultless, there is still room for improvement. This study examines how mapping services can be used and updated to help drivers save time while deliveries. It focuses on public, free-to-use maps. A survey was conducted where drivers in the industry were asked questions about their use of mapping services and where they got to give their opinion on possible improvements to these. Motivated by observations in the field and the literature, the survey presented two potential improvements to the maps to gather opinions from the drivers. The first one was a possible addition of loading zones and loading docks to the mapping services in order to help drivers find their destination’s drop-off area. Previous studies have shown that drivers lose time in the last mile of their trip. The second problem occurs when a map navigates so that you approach your destination from the wrong direction. The study showed that delivery drivers today use maps very frequently. All 33 respondents in the study use a mapping service for their work at least once a week, 29 of them using one at least once a day. The drivers were very positive about a possible addition of loading zones and docks to the maps, all of them thought it would facilitate their work. After analysing the data collected it could be seen that an average driver loses 20 minutes a day searching for a place to load. The drivers were overall frustrated with the maps despite using them very frequently. They agreed with the problems presented in the survey and gave further examples of how they are being held back by the maps.

The increasing incidence of disc degeneration and its correlation with lower back pain is an alarming trend in modern society. The research of intervertebral disc degeneration and low back pain would greatly benefit from additional methods to study its etiology and possible treatment methods. A large animal model that maintains the biological and mechanical environment that is most similar to the human lumbar spine could provide substantial improvements in understanding and resolving the problem of intervertebral disc related low back pain.This dissertation presents my doctoral work of investigating the potential for the camelid cervical spine to serve as a suitable animal model for advancing biomechanical research of low back pain and intervertebral disc degeneration in the human lumbar spine. Specifically, this work identifies the cellular, morphological and biomechanical characteristics of the camelid cervical spine and intervertebral disc as compared to the human lumbar spine. My results demonstrate that there are remarkable similarities in all aspects. Many of the similarities with respect to the cellular environment of the intervertebral disc are a consequence of the camelid status as a large mammal. Additional testing of the cellular makeup of the camelid intervertebral disc cells revealed that many human qRT-PCR primers associated with disc degeneration are suitable for use in alpacas without modification. From a biomechanics standpoint, the camelid cervical spine also has a vertically oriented spinal posture and is unsupported near the end in an open kinetic chain, providing a mechanical parallel with the human lumbar spine. The camelid cervical intervertebral disc size is closer to the human lumbar intervertebral disc than all other currently used animal models available for comparison in the literature. Average flexibility (range of motion) of a camelid spinal motion segment showed similarities in all modes of loading. Based on magnetic resonance imaging and radiologic grading of the intervertebral disc, almost 90% of elderly camelids exhibited advanced degeneration (Pfirrmann grade 3 or higher) in their cervical spine, and about half of aged camelids have developed severe degeneration (Pfirrmann grade 4 or higher) in at least one or more of their cervical segments, most commonly within the two lowest cervical segments (e.g. c6c7 and/or c7t1). Thus, while there remain differences, the remarkable similarities between the camelid and human spine strengthen the case for using camelids as a model for human disc degeneration, normal and pathological biomechanics and fluid transport, and potentially as a pre-clinical model for investigating the efficacy of novel spinal devices.

Metal-on-polymer prostheses in orthopaedics are often subject to high wear level producing large polyethylene particles that the body has difficulties to eliminate. Those debris can lead to prosthesis loosening. This study investigates the wear behaviour of TA6V, a CoCr alloy, M30NW and 316L stainless steels against UHMWPE on a pin-on-disc tribometer under lubricated conditions. Friction coefficient of 316L showed an inflection in their rise while the increase of others was linear. 316L also produced the most friction and wear. On the contrary, CoCr confirmed its good properties. Both stainless steels showed similar behaviour and metal manufacturing process only modified UHMWPE loss and not the wear rates.

ABSTRACT The Characterization and Analysis of In-vitro and Elevated Temperature Repassivation of Ti-6Al-4V via AFM Techniques Aaron J Guerrero Research in the corrosion of orthopaedic implants is a growing research field where implants have been known to show adverse effects in patients who have encountered the unfortunate dissolution of their implants due to corrosion. Once corrosion begins within the body, many adverse biological reactions can occur such as late on-set infections resulting in severe health complications. The focus of this research is specifically related to the problem of late on-set infections caused by localized corrosion of orthopaedic implants. In medical implants today the most common form of corrosion protection is the implant materials’ ability to impede corrosion through the formation of an oxide layer. This ability to passivate and quickly repassivate a uniform and stable oxide layer dictates how well an orthopaedic implant will survive in-vivo. To better understand the repassivation of orthopaedic implant materials, research was conducted at the nanoscale via atomic force microscopy (AFM) on anodized Ti-6Al-4V. Using an Asylum Research MFP-3DTM AFM and AFM lithography techniques, nano scratch test methods were created simulating in-vitro surface repassivation conditions. These nano-scratches were created and characterized in Hank’s balanced saline solution (HBSS) with the AFM in contact mode at 1 and 3 Hz scan rates. HBSS was used as it best simulates the pH, ionic compounds, and constituents that are commonly found in blood. It was discovered that the AFM was successful in creating in-vitro repassivation conditions. However, the ability of the AFM to successfully observe repassivation was limited by the speed of the AFM scanner. Using the same AFM scratch methods, experiments were performed in air and in-vitro and characterized with AFM conductance measurements at 20, 37, & 45 °C. The conductance measurements were taken using an AFM conductance module and allowed for observations of decreasing current measurements over time. The current data was then used to calculate current density, resistivity, conductance, and electron mobility and compared to similar experiments This study highlights the ability of the AFM to create and characterize repassivation and shows promise in developing further capability to use the AFM for characterization of repassivation on the nanoscale. Keywords: Orthopaedics, late on-set infections, repassivation, AFM, lithography, conductive measurements.

The aim of this study was to explore the knowledge, practices, and the sources of knowledge that certified prosthetists/orthotists (CPOs) have experienced regarding early pressure injury assessment for different skin tones. This was examined across different contexts of skin tone demographics using qualitative semi-structured interviews with CPOs from different contexts. Seven participants from six different clinics were recruited using purposive sampling. Of the interviewed participants, five were from Scandinavia, one from South Africa, and one from Nigeria. The interviews were conducted to explore the participants’ own experience of this phenomenon using a phenomenological approach and an interpretivist paradigm. Qualitative content analysis was used to analyse the transcribed interviews inductively. The results consisted of five main categories: Assessment, Standardized Methods, Perceptions of Assessment regarding Skin Tones, Sources of Knowledge regarding Skin Tones, and Relevance of Knowledge Improvement, each with a number of subcategories. There were two main findings. Firstly, CPOs lack systematized knowledge of early pressure injuries irrespective of skin tones. Secondly, many CPOs lack assessment knowledge for darker skin tones as it is only learned from experience and is not taught in education or literature. In conclusion, the field of prosthetics and orthotics must develop to improve systematic early pressure injury knowledge and assessment differences between skin tones.

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