Selecting Appropriate 3D Scanning Technologies for Prosthetic Socket Design and Transtibial Residual Limb Shape Characterization

Dickinson, Alexander; Donovan‐Hall, Maggie; Kheng, Sisary; Bou, Ky; Tech, Auntouch; Steer, Joshua; Metcalf, Cheryl; Worsley, Peter

doi:10.1097/jpo.0000000000000350

Cited by 18 publications

(35 citation statements)

References 35 publications

(101 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Its root mean squared error (RMSE) was calculated in comparison to the full model's mean shape. A threshold RMSE of 1mm was defined, based on consistency measures of manual rectifications [37], plaster casting and 3D scanning in limb shape capture for socket design [38]. The k-means clustering process validity was measured by its accuracy in capturing the prevalence of each rectification across the training population.…”

Section: Discussionmentioning

confidence: 99%

Characterising Residual Limb Morphology and Prosthetic Socket Design Based on Expert Clinician Practice

Dickinson

Diment

Morris³

et al. 2021

Prosthesis

View full text Add to dashboard Cite

Functional, comfortable prosthetic limbs depend on personalised sockets, currently designed using an iterative, expert-led process, which can be expensive and inconvenient. Computer-aided design and manufacturing (CAD/CAM) offers enhanced repeatability, but far more use could be made from clinicians’ extensive digital design records. Knowledge-based socket design using smart templates could collate successful design features and tailor them to a new patient. Based on 67 residual limb scans and corresponding sockets, this paper develops a method of objectively analysing personalised design approaches by expert prosthetists, using machine learning: principal component analysis (PCA) to extract key categories in anatomic and surgical variation, and k-means clustering to identify local ‘rectification’ design features. Rectification patterns representing Total Surface Bearing and Patella Tendon Bearing design philosophies are identified automatically by PCA, which reveals trends in socket design choice for different limb shapes that match clinical guidelines. Expert design practice is quantified by measuring the size of local rectifications identified by k-means clustering. Implementing smart templates based on these trends requires clinical assessment by prosthetists and does not substitute training. This study provides methods for population-based socket design analysis, and example data, which will support developments in CAD/CAM clinical practice and accuracy of biomechanics research.

show abstract

Section: Discussionmentioning

confidence: 99%

Characterising Residual Limb Morphology and Prosthetic Socket Design Based on Expert Clinician Practice

Dickinson

Diment

Morris³

et al. 2021

Prosthesis

View full text Add to dashboard Cite

show abstract

“…Each training population shape was left out of the statistical model generation and then reconstructed using its weighting coefficients from the complete model, and its root mean squared error (RMSE) of reconstruction was calculated. A threshold RMSE of 1mm was defined, based on consistency measures of manual rectifications [35], plaster casting and 3D scanning in limb shape capture for socket design [36].…”

Section: Discussionmentioning

confidence: 99%

Characterising Residual Limb Morphology and Prosthetic Socket Design based on Expert Clinician Practice

Dickinson¹,

Diment²,

Morris³

et al. 2021

Preprint

View full text Add to dashboard Cite

Functional, comfortable prosthetic limbs depend on personalised sockets, currently designed using an iterative, expert-led process, which can be expensive and inconvenient. Computer aided design and manufacturing (CAD/CAM) offers enhanced repeatability, but far more use could be made from clinicians’ extensive digital design records. Knowledge-based socket design using smart templates could collate successful design features and tailor them to a new patient. Based on 67 residual limb scans and corresponding sockets, this paper develops a method of objectively analysing personalised design approaches by expert prosthetists, using machine learning: principal component analysis (PCA) to extract key categories in anatomic and surgical variation, and K-Means Clustering to identify local ‘rectification’ design features. Rectification patterns representing Total Surface Bearing and Patella Tendon Bearing design philosophies are identified automatically by PCA, which reveals trends in socket design choice for different limb shapes that match clinical guidelines. Expert design practice is quantified by measuring the size of local rectifications identified by k-means clustering. Implementing smart templates based on these trends requires clinical assessment by prosthetists and does not substitute training. This study provides methods for population-based socket design analysis, and example data, which will support developments in CAD/CAM clinical practice and accuracy of biomechanics research.

show abstract

“…Shortly after doffing the prosthesis, participants had their residual limb 3D scanned using a Sense scanner (3D Systems, South Carolina) (Fig. 1 A), which has shown 95% repeatability to less than 79 ml for residuum volumes and 15 mm for perimeters [ 18 ]. An alginate mould was created from their socket (Fig.…”

Section: Methodsmentioning

confidence: 99%

Activity, socket fit, comfort and community participation in lower limb prosthesis users: a Cambodian cohort study

Diment

Nguon²,

Seng³

et al. 2022

J NeuroEngineering Rehabil

Self Cite

View full text Add to dashboard Cite

Background After amputation, many people become less active, feel lonely and lose independence. Understanding the factors associated with low physical activity levels and participation could contribute to defining key interventions which can support prosthesis users so they can live a more active and socially included lifestyle. This longitudinal observational study aims to assess relationships between physical activity, community participation, prosthetic fit, comfort and user satisfaction using actimetry, 3D scans and questionnaires in a Cambodian cohort of established lower limb prosthesis users. Methods Twenty participants (5F:15M, nine transfemoral, eleven transtibial, 24–60 years old and 3–43 years since amputation) were recruited. They completed a questionnaire which included their demographics, community participation, prosthesis satisfaction and comfort at the start of the study, and between three and six months later. Their prosthetic sockets and residual limbs were 3D scanned at the start and end of the study. Accelerometers were embedded under the cosmesis on the shank of the prosthesis, to collect ten weeks of activity data. Results Participants averaged 4470 steps/day (743–7315 steps/day), and wore their prosthesis for most waking hours, averaging 13.4 h/day (4.5–17.6 h/day). Self-reported measures of activity and hours of wear correlated with these accelerometer data (Spearman’s rho rs = 0.59, and rs = 0.71, respectively). Participants who were more active wore their prosthesis for more hours/day (Pearson r = 0.73) and were more satisfied with socket fit (rs = 0.49). A longer residual limb correlated with better community participation (rs = 0.56) and comfort (rs = 0.56). Self-reported community participation did not correlate with a person’s activity level (rs = 0.13), or their prosthesis comfort (rs = 0.19), and there was only weak correlation between how important the activity was to an individual, and how often they participated in it (rs = 0.37). A simple 0–10 scale of overall comfort did not provide enough detail to understand the types and severity of discomfort experienced. Conclusion Associations between perceived and measured activity levels correlated with socket satisfaction in this cohort of people with established lower limb amputations. The small sample size means these correlations should be interpreted with caution, but they indicate variables worthy of further study to understand barriers to community engagement and physical activity for prosthesis users in Cambodia, and potentially in other settings.

show abstract

Selecting Appropriate 3D Scanning Technologies for Prosthetic Socket Design and Transtibial Residual Limb Shape Characterization

Cited by 18 publications

References 35 publications

Characterising Residual Limb Morphology and Prosthetic Socket Design Based on Expert Clinician Practice

Characterising Residual Limb Morphology and Prosthetic Socket Design Based on Expert Clinician Practice

Characterising Residual Limb Morphology and Prosthetic Socket Design based on Expert Clinician Practice

Activity, socket fit, comfort and community participation in lower limb prosthesis users: a Cambodian cohort study

Contact Info

Product

Resources

About