Comfort level discussion for prosthetic sockets with different fabricating processing conditions

Hsu, Chih-Hung; Ou, Chao Hui; Gao, Yuhan

doi:10.1186/s12938-018-0577-2

Cited by 10 publications

(3 citation statements)

References 4 publications

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“…On the contrary, the integration on and into the socket wall has the main disadvantage of requiring an ad hoc socket design, which involves a considerable amount of skilled prosthetist manual work, which is expensive and time consuming [12]. Reverse engineering, computer aided design (CAD/ CAM) and 3D printing techniques are beginning to be applied in the design and manufacturing of prosthetic sockets and could overcome these limitations [13][14][15][16][17][18]. However, further research is still required to improve the structural integrity of 3D printed sockets.…”

Section: Introductionmentioning

confidence: 99%

A personalised prosthetic liner with embedded sensor technology: a case study

et al. 2020

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Background Numerous sensing techniques have been investigated in an effort to monitor the main parameters influencing the residual limb/prosthesis interface, fundamental to the optimum design of prosthetic socket solutions. Sensing integration within sockets is notoriously complex and can cause user discomfort. A personalised prosthetic liner with embedded sensors could offer a solution. However, to allow for a functional and comfortable instrumented liner, highly customised designs are needed. The aim of this paper is to presents a novel approach to manufacture fully personalised liners using scanned three-dimensional image data of the patient’s residual limb, combined with designs that allow for sensor integration. To demonstrate the feasibility of the proposed approach, a personalised liner with embedded temperature and humidity sensors was realised and tested on a transtibial amputee, presented here as a case study. Methods The residual limb of a below knee amputee was first scanned and a three-dimensional digital image created. The output was used to produce a personalised prosthesis. The liner was manufactured using a cryogenic Computer Numeric Control (CNC) machining approach. This method enables fast, direct and precise manufacture of soft elastomer products. Twelve Hygrochron Data Loggers, able to measure both temperature and humidity, were embedded in specific liner locations, ensuring direct sensor-skin contact. The sensor locations were machined directly into the liner, during the manufacturing process. The sensors outputs were assessed on the below amputee who took part in the study, during resting (50 min) and walking activities (30 min). To better describe the relative thermal properties of new liner, the same tests were repeated with the amputee wearing his existing liner. Quantitative comparisons of the thermal properties of the new liner solution with that currently used in clinical practice are, therefore, reported. Results The liner machining process took approximately 4 h. Fifteen minutes after donning the prosthesis, the skin temperature reached a plateau. Physical activity rapidly increased residuum skin temperatures, while cessation of activity caused a moderate decrease. Humidity increased throughout the observation period. In addition, the new liner showed better thermal properties with respect to the current liner solution (4% reduction in skin temperature). Conclusions This work describes a personalised liner solution, with embedded temperature and humidity sensors, developed through an innovative approach. This new method allows for a range of sensors to be smoothly embedded into a liner, which is capable of measuring changes in intra-socket microclimate conditions, resulting in the design of advanced socket solutions personalised specifically for individual requirements. In future, this method will not only provide a personalised liner but will also enable dynamic assessment of how a residual limb behaves within the socket during daily activities.

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Section: Introductionmentioning

confidence: 99%

A personalised prosthetic liner with embedded sensor technology: a case study

et al. 2020

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“…As in any layer manufacturing process, the strength of the FDM socket depends on how well one layer of material is bonded to another. FDM printed prosthetic leg sockets are rarely made, and limited research has been performed regarding the strength, comfort and long-term tear, and wear of these devices [24][25][26]. In an earlier study, the strength of these low-cost 3D-printed transtibial prosthetic sockets was investigated and evaluated [27].…”

Section: Introductionmentioning

confidence: 99%

Pioneering low-cost 3D-printed transtibial prosthetics to serve a rural population in Sierra Leone – an observational cohort study

et al. 2021

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Background: There is a huge unmet global need for affordable prostheses. Amputations often happen in Sierra Leone due to serious infections, complex wounds, traffic accidents and delayed patient presentation to the hospital. However, purchasing a prosthesis is still beyond reach for most Sierra Leonean amputees. Method: We applied computer-aided design (CAD) and computer-aided manufacturing (CAM) to produce low-cost transtibial prosthetic sockets. In February and March 2020, eight participants received a 3D printed transtibial prosthesis in the village of Masanga in Tonkolili district, Sierra Leone. Research was performed using questionnaires to investigate the use, participants' satisfaction, and possible complications related to the prostheses. Questionnaires were conducted prior to production of the prosthesis and five to six weeks after fitting the prosthesis. A personal short-term goal was set by the participants. Findings: Competitively priced and fully functional prostheses were produced locally. After six weeks, all participants were still wearing the prosthesis and six of the eight participants reached their personal rehabilitation goals. Using their prostheses, all participants were no longer in need of their crutches. Interpretation: We have come a step closer to the production of low-cost prostheses for low-and middleincome countries (LMICs). The goal of our project is to perform long-term follow-up and to refine our concept of 3D printed prostheses for LMICs to provide practical solutions for a global health need unmet to date. Funding: € 15,000 was collected during a crowdfunding campaign in collaboration with the Dutch Albert Schweitzer Fund. Internship allowance for MvdS was obtained from the University of Twente. 3D-scanner, 3D-printer, and printing material were donated by Ultimaker BV and Shining 3D.

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“…In recent years, in the combination of reverse engineering, computer-aided design or manufacturing (CAD/CAM) and 3D printing techniques are used widely for the design and fabrication of prosthetic limb sockets (Hsu et al 2018, Herbert et al 2005, Comotti et al 2013, Nayak et al 2016, Tzeng et al 2015. On the other hand, further research will be needed to improve the structural integrity of the 3D printed sockets.…”

Section: Introductionmentioning

confidence: 99%

Pressures monitored by 3D printed capacitive pressure sensor embedded on prosthetic upper-limb socket; a case study

Lee

Kwon

Jung

et al. 2021

JBSE

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The comfort fit of a limb prosthetic socket is one of the most important considerations for developing the socket for an amputee. The pressure at the touchpoint, which is the interface between the residual limb with natural skin and the prosthetic limb socket with a polymeric material, should be monitored precisely when fabricating the comfort fit. Even a small volume or shape discrepancy between the residual limb and prosthetic limb sock causes several problems in the residual limb, such as skin breakage, tissue irritation, and associated pain. Volume variations of the residual limb due to squeezing by a prosthetic limb sock result in pressure changes that can be detected using a pressure sensor. In this study, the interface pressures between the residual limb and prosthetic upper-limb socket were obtained using a 3D printed capacitive pressure sensor. An upper-limb prosthetic socket and capacitive pressure sensor were fabricated using a dual nozzle 3D Fused Deposition Modelling technique. Polylactic acid, polylactic acid-carbon black compound, and polyurethane were used as the personalized upperlimb socket and sensing electrode, and substrate material, respectively. The as-fabricated sensors were embedded into the sock wall, and their sensing properties were characterized. For a case study, the sensor-embedded sockets were worn on an amputee's residual upper-limb to characterize empirically the contact pressure occurring at the interfaces. A weight was attached to the end of the limb socket to examine the effects of weight on the local pressures acting on the residual upper limb. The observed interface pressures and pressure distribution at the interface can provide valuable information to clinicians and developers that can guide fit improvements.

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Comfort level discussion for prosthetic sockets with different fabricating processing conditions

Cited by 10 publications

References 4 publications

A personalised prosthetic liner with embedded sensor technology: a case study

A personalised prosthetic liner with embedded sensor technology: a case study

Pioneering low-cost 3D-printed transtibial prosthetics to serve a rural population in Sierra Leone – an observational cohort study

Pressures monitored by 3D printed capacitive pressure sensor embedded on prosthetic upper-limb socket; a case study

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