This study aims to present a new concept of a knee hinge based on a crossed four-bar linkage mechanism which has been designed to optimally follow a motion curve representing the knee kinematics in the position at which the knee hinge should be placed. The methodology used to determine the optimal knee hinge is based on the optimization of certain variables of the crossed four-bar mechanism using genetic algorithms in order to follow a certain motion curve, which was determined using a biomechanical model of the knee motion. Two current, commercially available knee hinges have been used to theoretically determine their motion by means of the path performed by their instantaneous helical axis. Comparison between these two different knee hinges, Optimal Knee Hinge and the theoretical motion performed by a human knee reveals that a common monocentric hinge has a maximum misalignment of up to 27.2 mm; a polycentric hinge has a maximum misalignment of 23.9 mm. In contrast, the maximum misalignment produced by the Optimal Knee Hinge is 1.99 mm. The orthotic joint presented significantly improves the kinematical compatibility and the adjustment between orthotic and human joint motion, and should provide several advantages in terms of comfort and safety. Furthermore, the determination of the instantaneous helical axis for a particular user, by means of human movement measurement techniques, will enable the optimal crossed four-bar mechanisms to be determined in a customized and personalized manner. As a consequence, this new concept of orthotic knee joint design may improve the adaptability of lower limb orthoses for the user, and may lead to significant advantages in the field of orthotics for the lower limb.
A Pili, per tot.Trenta-sis persones en cadira de rodes han participat en aquest estudi que ha inclòs la valoració de vint-i-cinc coixins. El principal criteri per a la inclusió d'usuaris en l'estudi ha estat el nivell de risc de desenvolupar úlceres per pressió. Per a la inclusió dels coixins s'ha buscat la representativitat del mercat i la inclusió de tipologies diferents.Des del punt de vista de l'opinió dels usuaris aquest treball d'investigació ha permès identificar els factors de qualitat percebuda (F1. Estabilitat, F3. Encaixament, F4. Col·lapse, i calcular el pes d'ells sobre els factors globals de bondat i evolució dels coixins. Per altra banda, la comparació dels valors de pressió obtinguts amb les persones en cadira de rodes i els mesurats amb el maniquí constata una clara divergència en el comportament. També s'han definit criteris de disseny i valors límit, admissibles i recomanables, per a un conjunt de variables i la seua relació amb els factors de qualitat i les variables subjectives.Els resultats d'aquest treball suporten la importància d'una aproximació global als coixins, que incloga els processos de disseny, desenvolupament i prescripció, on els usuaris siguen molt més protagonistes del que ho han estat fins ara. SummaryWheelchair users represent around 1% of the population. This group is characterised through the number of hours spent each day in a seated position. This can lead to health problems linked mainly to the development of pressure ulcers. In addition, the position in the wheelchair is critical in order to be able to perform different activities comfortably. The aim of the cushions, integrated in the whole seating system, is to contribute to the prevention, positioning and comfort of the person in a wheelchair.Incorporating the user adequately into the assessment, prescription and development of new cushions is a key aspect, clearly identified in the bibliography, which requires the use of innovation models to produce this incorporation systematically. This research paper adopts the cause-effect model, successfully used in other fields such as the car or shoe making industries, but to date not used in the field of tissue management cushions.The use of this model has allowed for the identification of different links between the consequences of the interaction person-cushion (developed perception of the user) with the cushion and person characteristics, as well as with the physiological and biomechanical response resulting from this interaction. This was a necessary step to obtain design and selection criteria for the cushions. The physiological and biomechanical variables which have been analysed are pressure and microclimate. To study the consequences of this interaction we have considered the user perception obtained by means of a questionnaire.Thirty-six wheelchair users have participated in this study which includes the assessment of twenty-five cushions. The main criteria for the inclusion of users in the study has been the risk level of risk of developing pressure ulcers. The in...
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