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Squibb CO, Madigan ML, Philen MK. A high precision laser scanning system for measuring shape and volume of transtibial amputee residual limbs: Design and validation. PLoS One 2024; 19:e0301619. [PMID: 38991031 PMCID: PMC11239001 DOI: 10.1371/journal.pone.0301619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/19/2024] [Indexed: 07/13/2024] Open
Abstract
Changes in limb volume and shape among transtibial amputees affects socket fit and comfort. The ability to accurately measure residual limb volume and shape and relate it to comfort could contribute to advances in socket design and overall care. This work designed and validated a novel 3D laser scanner that measures the volume and shape of residual limbs. The system was designed to provide accurate and repeatable scans, minimize scan duration, and account for limb motion during scans. The scanner was first validated using a cylindrical body with a known shape. Mean volumetric errors of 0.17% were found under static conditions, corresponding to a radial spatial resolution of 0.1 mm. Limb scans were also performed on a transtibial amputee and yielded a standard deviation of 8.1 ml (0.7%) across five scans, and a 46 ml (4%) change in limb volume when the socket was doffed after 15 minutes of standing.
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Affiliation(s)
- Carson O Squibb
- Kevin T. Crofton Department of Aerospace and Ocean Engineering, Virginia Tech (Mail Code 0203), Blacksburg, VA, United States of America
| | - Michael L Madigan
- Grado Department of Industrial and Systems Engineering, Virginia Tech (Mail Code 0118), Blacksburg, VA, United States of America
| | - Michael K Philen
- Kevin T. Crofton Department of Aerospace and Ocean Engineering, Virginia Tech (Mail Code 0203), Blacksburg, VA, United States of America
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Owolabi EO, Chu KM. Knowledge, attitude and perception towards lower limb amputation amongst persons living with diabetes in rural South Africa: A qualitative study. Afr J Prim Health Care Fam Med 2022; 14:e1-e10. [PMID: 36226936 PMCID: PMC9623825 DOI: 10.4102/phcfm.v14i1.3398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/28/2022] [Accepted: 05/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background South Africa has a high prevalence of diabetes mellitus (DM), a leading risk factor for lower limb amputation (LLA). Lower limb amputation is associated with significant morbidity and mortality. Lower limb amputation incidence can be mitigated through prompt identification and treatment of individuals at risk and engagement in self-management practices. Also, when LLA is inevitable, outcomes or prognosis can be improved with timely surgery. Aim This study explored the knowledge, attitude and perception of persons living with diabetes towards LLA and its prevention. Setting Nqamakwe, a rural community in the Eastern Cape province of South Africa. Method This was a descriptive, qualitative study involving persons living with DM, with and without LLA, and community leaders. Fifteen participants were recruited purposively and conveniently from a rural community in the Eastern Cape, South Africa. Data collection took place through semistructured interviews, in English and a local language, Xhosa. Interviews were transcribed and translated, and an inductive approach was used for thematic analysis. Results A total of 15 individual interviews were conducted. Of those, 13 were persons with DM, five with LLA, including one with bilateral LLA. There was a gap in knowledge on foot self-examination as a measure of preventing LLA amongst persons with DM. The attitude of persons without LLA was mostly fearful and their fears centred around perioperative death, risk for contralateral amputation, loss of limb and independence. Consent to LLA procedure was a last resort and only when pain levels were unbearable. Family support and information on rehabilitation services and assistive devices also fostered consent to LLA surgery. Conclusion There is a need for awareness creation and adequate health education for persons living with DM on LLA and its prevention measures, especially foot care practices. Also, health education programmes for persons living with DM in rural areas should address the various misperceptions of LLA to reduce delays. Contribution The article revealed gaps in knowledge on LLA and its prevention among individuals living with diabetes as well as areas of concerns that may potentially delay acceptance when LLA is inevitable. Findings from our study may assist primary health care providers to determine important issues to be addressed during routine and pre-operative patient education.
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Affiliation(s)
- Eyitayo O Owolabi
- Centre for Global Surgery, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.
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Ngan CC, Sivasambu H, Ramdial S, Andrysek J. Evaluating the Reliability of a Shape Capturing Process for Transradial Residual Limb Using a Non-Contact Scanner. SENSORS (BASEL, SWITZERLAND) 2022; 22:6863. [PMID: 36146212 PMCID: PMC9505365 DOI: 10.3390/s22186863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
Advancements in digital imaging technologies hold the potential to transform prosthetic and orthotic practices. Non-contact optical scanners can capture the shape of the residual limb quickly, accurately, and reliably. However, their suitability in clinical practice, particularly for the transradial (below-elbow) residual limb, is unknown. This project aimed to evaluate the reliability of an optical scanner-based shape capture process for transradial residual limbs related to volumetric measurements and shape assessment in a clinical setting. A dedicated setup for digitally shape capturing transradial residual limbs was developed, addressing challenges with scanning of small residual limb size and aspects such as positioning and patient movement. Two observers performed three measurements each on 15 participants with transradial-level limb absence. Overall, the developed shape capture process was found to be highly repeatable, with excellent intra- and inter-rater reliability that was comparable to the scanning of residual limb cast models. Future work in this area should compare the differences between residual limb shapes captured through digital and manual methods.
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Affiliation(s)
- Calvin C. Ngan
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada
| | - Harry Sivasambu
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada
| | - Sandra Ramdial
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada
| | - Jan Andrysek
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON M4G 1R8, Canada
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Reliability of three different methods for assessing amputee residuum shape and volume: 3D scanners vs. circumferential measurements. Prosthet Orthot Int 2022; 46:327-334. [PMID: 35320149 DOI: 10.1097/pxr.0000000000000105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 01/06/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Objective and reliable methods are necessary to monitor and manage amputee residuum shape and volume and design prosthetic residuum-prosthesis interfaces. Portable 3D scanners are potential solutions for digitally recording the amputee residuum characteristics. OBJECTIVE To investigate test-operator reliability when measuring lower limb residuum shape and volume using two different types of 3D laser-free scanners compared with tape measurements generally adopted in clinic. STUDY DESIGN Ten lower limb amputees took part in this study. Residuum volume, cross sectional areas, and perimeter lengths were measured by three different operators on three different occasions using two types of 3D scanners (Artec Eva scanner and OMEGA Scanner 3D) and circumferential measurements. METHODS Variance components, intraclass correlation coefficients and intra-rater and inter-rater reliability coefficients were calculated for all measurement conditions. RESULTS Residuum volume outputs ranged from 569 to 3115 mL. The factor contributing mostly to the residuum volume error variance was the shape of the residuum (75.85%). Volume intraclass correlation coefficients for both intra-rater and inter-rater reliability exceeded 0.9 for all three conditions. Volume reliability coefficients ranged from 70.68 mL (Artec Eva intra-rater reliability) to 256.85 mL (circumferential measurements inter-rater reliability). Shape relative error reached the highest values for the circumferential measurements (>10% for the cross-sectional areas and >5% for the perimeters). CONCLUSIONS The Artec Eva scanner resulted in the lowest test-operator reliability coefficients. However, both investigated scanners are a potential alternative for measuring small and macroscopic changes in residuum characteristics.
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Clinical usability, reliability, and repeatability of noncontact scanners in measuring residual limb volume in persons with transtibial amputation. Prosthet Orthot Int 2022; 46:164-169. [PMID: 34932511 DOI: 10.1097/pxr.0000000000000087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 11/01/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND In previous studies, noncontact 3D scanners were found to be the most reliable in measuring volume of the residual limb after a transtibial amputation (TTA). Meanwhile newly developed noncontact scanners became available to measure residual limb volume after TTA but should be tested for clinical usability and reliability. OBJECTIVE To determine the clinical usability, reliability, and repeatability of noncontact scanners in measuring residual limb volume in persons with a TTA. STUDY DESIGN Original research report; repeated measurements. METHODS Three noncontact scanners (Rodin4D, Omega Tracer, and Biosculptor) were used to measure the residual limb volume on two occasions by two observers in 30 persons with an unilateral or bilateral TTA. Clinical usability was assessed as scores of the Post-Study System Usability Questionnaire, participant satisfaction (0-10 scale), and time to take the measurement. RESULTS The usability score of the Omega Scanner 3D (123.4) and Rodin4D (121.3) was significantly better compared with the Biosculptor (117.8). Participant experience was equal for all. The residual variance was 8.4%, where participant and scanning system explained most of the error variance (80.7%). Repeatability coefficients of the systems were 16.5 cc (Omega Scanner 3D), 26.4 cc (Rodin4D), and 32.8 cc (Biosculptor). The time to perform the measurements was significantly longer (+80 seconds) for the Omega Scanner 3D. CONCLUSIONS For measuring residual limb volume in TT amputees, Omega software (state version 12.2) combined with the Rodin4D scanner was more usable and reliable than the Rodin 4D or Biosculptor systems, when operated by staff with limited experience and training.
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Afiqah Hamzah N, Razak NAA, Sayuti Ab Karim M, Gholizadeh H. A review of history of CAD/CAM system application in the productionof transtibial prosthetic socket in developing countries (from 1980to 2019). Proc Inst Mech Eng H 2021; 235:1359-1374. [PMID: 34304625 DOI: 10.1177/09544119211035200] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The development of the CAD/CAM (Computer-aided design and computer-aided manufacturing) system has globally changed the fabrication and delivery of prosthetics and orthotics. Furthermore, since the introduction of CAD/CAM in the 1980s, many successful CAD/CAM system are available in the market today. However, less than 20% of amputees have access to digital fabrication technology and large portion of the amputees are from the developing countries. This review designed to examine selected studies from 1980 to 2019 on CAD/CAM systems in the production of transtibial prosthetic sockets. A review was conducted based on articles gathered from Web of Science, Pubmed and Science Direct. From the findings, 92 articles found related to CAD/CAM-derived transtibial prosthetic socket (TPS). After a further screening of the articles, 20 studies were chosen and only one study was done in a developing country. The results showed an increase interest in CAD/CAM application in Transtibial prosthetic socket (TPS) production for both developed and developing countries, yet the technology has not fully utilised in the developing countries. Factors such as resources, accessibility, knowledge-gap and lack of experienced prosthetists remain the major causes of the lack of CAD/CAM system studies. Large-scale trials are required to employ digital fabrication in the developing regions, consequently advancing the production of high-quality CAD-CAM-derived TPS where most prosthetic and orthotics are needed.
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Affiliation(s)
- Nur Afiqah Hamzah
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Nasrul Anuar Abd Razak
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohd Sayuti Ab Karim
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
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Paternò L, Ibrahimi M, Rosini E, Menfi G, Monaco V, Gruppioni E, Ricotti L, Menciassi A. Residual limb volume fluctuations in transfemoral amputees. Sci Rep 2021; 11:12273. [PMID: 34112873 PMCID: PMC8192500 DOI: 10.1038/s41598-021-91647-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/31/2021] [Indexed: 11/08/2022] Open
Abstract
This study constitutes the first attempt to systematically quantify residual limb volume fluctuations in transfemoral amputees. The study was carried out on 24 amputees to investigate variations due to prosthesis doffing, physical activity, and testing time. A proper experimental set-up was designed, including a 3D optical scanner to improve precision and acceptability by amputees. The first test session aimed at measuring residual limb volume at 7 time-points, with 10 min intervals, after prosthesis doffing. This allowed for evaluating the time required for volume stabilization after prosthesis removal, for each amputee. In subsequent sessions, 16 residual limb scans in a day for each amputee were captured to evaluate volume fluctuations due to prosthesis removal and physical activity, in two times per day (morning and afternoon). These measurements were repeated in three different days, a week apart from each other, for a total of 48 scans for each amputee. Volume fluctuations over time after prosthesis doffing showed a two-term decay exponential trend (R2 = 0.97), with the highest variation in the initial 10 min and an average stabilization time of 30 min. A statistically significant increase in residual limb volume following both prosthesis removal and physical activity was verified. No differences were observed between measures collected in the morning and in the afternoon.Clinical Trials.gov ID: NCT04709367.
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Affiliation(s)
- Linda Paternò
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy.
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy.
| | - Michele Ibrahimi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Elisa Rosini
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Giuseppe Menfi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Vito Monaco
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
- IRCCS Fondazione Don Carlo Gnocchi, 20148, Milan, Italy
| | | | - Leonardo Ricotti
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Arianna Menciassi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
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Safari R. Lower limb prosthetic interfaces: Clinical and technological advancement and potential future direction. Prosthet Orthot Int 2020; 44:384-401. [PMID: 33164655 DOI: 10.1177/0309364620969226] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The human-prosthesis interface is one of the most complicated challenges facing the field of prosthetics, despite substantive investments in research and development by researchers and clinicians around the world. The journal of the International Society for Prosthetics and Orthotics, Prosthetics and Orthotics International, has contributed substantively to the growing body of knowledge on this topic. In celebrating the 50th anniversary of the International Society for Prosthetics and Orthotics, this narrative review aims to explore how human-prosthesis interfaces have changed over the last five decades; how research has contributed to an understanding of interface mechanics; how clinical practice has been informed as a result; and what might be potential future directions. Studies reporting on comparison, design, manufacturing and evaluation of lower limb prosthetic sockets, and osseointegration were considered. This review demonstrates that, over the last 50 years, clinical research has improved our understanding of socket designs and their effects; however, high-quality research is still needed. In particular, there have been advances in the development of volume and thermal control mechanisms with a few designs having the potential for clinical application. Similarly, advances in sensing technology, soft tissue quantification techniques, computing technology, and additive manufacturing are moving towards enabling automated, data-driven manufacturing of sockets. In people who are unable to use a prosthetic socket, osseointegration provides a functional solution not available 50 years ago. Furthermore, osseointegration has the potential to facilitate neuromuscular integration. Despite these advances, further improvement in mechanical features of implants, and infection control and prevention are needed.
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Affiliation(s)
- Reza Safari
- Health and Social Care Research Centre, University of Derby, Derby, UK
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Suyi Yang E, Aslani N, McGarry A. Influences and trends of various shape-capture methods on outcomes in trans-tibial prosthetics: A systematic review. Prosthet Orthot Int 2019; 43:540-555. [PMID: 31364475 DOI: 10.1177/0309364619865424] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION In trans-tibial prosthetics, shape-capture methods are employed to create a representation of the residuum. Shape-capture methods can be grouped into the categories of 'hands-on', 'hands-off' and computer-aided design. OBJECTIVE This review examines the influences and trends of shape-capture methods on the outcomes of quality, comfort of user and clinical efficiency, in the population of trans-tibial prosthesis users. STUDY DESIGN Systematic Review. METHOD Databases and relevant journals were searched. Participants included trans-tibial prosthetics users/limb models. Interventions included shape-capture methods. Outcomes included quality, comfort of user and clinical efficiency. RESULTS Overall, 22 papers were evaluated; 8 papers evaluated hands-on and hands-off methods, 2 evaluated computer-aided design and 12 evaluated measurement systems used with shape capture. No papers relating to clinical efficiency were found. CONCLUSION Overall evidence was weak in suggesting that effects on outcomes were due to the sole influences of shape capture. However, studies suggest that hands-on methods are dependent on a prosthetist's skill. Hands-off methods, although repeatable, might still require experience to attain a good fit. Computer-aided design studies were mostly done on theoretical models. Shape-capture measurements require more consistent 'gold standards'. The relation between socket fit and comfort is still unclear. Overall, more research is required in each area. CLINICAL RELEVANCE A good fitting prosthetic socket is crucial for efficient and comfortable use of a prosthesis. To attain the best chances of a good fit, it is important that the characteristics of the residuum are captured as accurately as possible during the initial "shape capture" stage. This paper attempts to categorize and evaluate the existing shape capture methods on their influence and trends on various outcomes - Quality of shape capture, comfort of user and clinical efficiency.
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Affiliation(s)
- Eddie Suyi Yang
- National Centre for Prosthetics and Orthotics, Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Navid Aslani
- National Centre for Prosthetics and Orthotics, Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Anthony McGarry
- National Centre for Prosthetics and Orthotics, Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
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Armitage L, Kark L, Czerniec S, Kwah LK. Reliability and Validity of Measurement Tools for Residual Limb Volume in People With Limb Amputations: A Systematic Review. Phys Ther 2019; 99:612-626. [PMID: 30722026 DOI: 10.1093/ptj/pzz010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 09/30/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Measurements of residual limb volume often guide decisions on the type and timing of prosthetic prescription. To help inform these decisions, it is important that clinicians use measurement tools that are reliable and valid. PURPOSE The aim of this systematic review was to investigate the reliability and validity of measurement tools for residual limb volume in people with limb amputations. DATA SOURCES A comprehensive search on MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science was performed on July 11, 2016. STUDY SELECTION Studies were included if they examined the reliability or validity of measurement tools for residual limb volume, were conducted on humans, and were published in English. DATA EXTRACTION Data were extracted from 11 reliability and 4 validity studies and included study characteristics, volumetric estimates, and reliability and validity estimates. The quality of the studies was also rated. DATA SYNTHESIS Data from 2 studies (38 participants) indicated good to excellent intrarater (intraclass correlation coefficient [ICC] ≥0.88) and interrater (ICC ≥0.88) reliability and high between-session reliability (coefficient of variation [CV] = 10%) for water displacement volumetry. One study (28 participants) reported excellent intrarater and interrater reliability (ICC ≥0.93) for the circumferential method, and data from 2 studies (19 participants) indicated high between-session reliability for the optical surface scanner (CV ≤9.8%). Three studies (26 participants) indicated good to excellent between-session reliability results for computed tomography (CV = 9.2%-10.9%). One study (7 participants) showed moderate within-session reliability (CV = 50%). Using water displacement volumetry as the gold standard, 2 studies (79 participants) indicated excellent validity for the circumferential method ( r ≥0.92; ICC ≥0.92). All studies reporting measures of reliability or validity were performed with people who had transtibial amputations. LIMITATIONS Only studies published in English and in which water displacement volumetry was used as the gold standard were included in this review. The reliability and validity of the quality rating scale used in this review have not been tested. CONCLUSIONS On the basis of a limited number of moderate- to high-quality studies with small sample sizes, circumferential and water displacement methods were found to be reliable, and the circumferential method was found to be valid in people with transtibial amputations. There are inadequate data for drawing conclusions about volume measurement methods in people with other types of limb amputations.
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Affiliation(s)
- Lucy Armitage
- Graduate School of Biomedical Engineering, UNSW Sydney, Sydney, New South Wales, Australia 2052
| | - Lauren Kark
- Graduate School of Biomedical Engineering, UNSW Sydney
| | - Sharon Czerniec
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Li Khim Kwah
- Discipline of Physiotherapy, Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Armitage L, Kwah LK, Kark L. Reliability and validity of the iSense optical scanner for measuring volume of transtibial residual limb models. Prosthet Orthot Int 2019; 43:213-220. [PMID: 30343619 DOI: 10.1177/0309364618806038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND: Residual limb volume is often measured as part of routine care for people with amputations. These measurements assist in the timing of prosthetic fitting or replacement. In order to make well informed decisions, clinicians need access to measurement tools that are valid and reliable. OBJECTIVES: To assess the reliability and criterion validity of the iSense optical scanner in measuring volume of transtibial residual limb models. STUDY DESIGN: Three assessors performed two measurements each on 13 residual limb models with an iSense optical scanner (3D systems, USA). Intra-rater and inter-rater reliability were calculated using intraclass correlation coefficients. Bland Altman plots were inspected for agreement. Criterion validity was assessed using a steel rod of known dimensions. Ten repeated measurements were performed by one assessor. A t-test was used to determine differences between measured and true rod volume. RESULTS: Intra-rater reliability was excellent (range of intraclass correlation coefficients: 0.991-0.997, all with narrow 95% confidence intervals). While the intraclass correlation coefficients suggest excellent inter-rater reliability between all three assessors (range of intraclass correlation coefficients: 0.952-0.986), the 95% confidence intervals were wide between assessor 3 and the other two assessors. Poor agreement with assessor 3 was also seen in the Bland-Altman plots. Criterion validity was very poor with a significant difference between the mean iSense measurement and the true rod volume (difference: 221.18 mL; p < 0.001). CONCLUSIONS: Although intra-rater reliability was excellent for the iSense scanner, we did not find similar results for inter-rater reliability and validity. These results suggest that further testing of the iSense scanner is required prior to use in clinical practice. CLINICAL RELEVANCE The iSense offers a low cost scanning option for residual limb volume measurement. Intra-rater reliability was excellent, but inter-rater reliability and validity were such that clinical adoption is not indicated at present.
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Affiliation(s)
| | - Li Khim Kwah
- 2 University of Technology Sydney, Sydney, NSW, Australia
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Kofman R, Beekman AM, Emmelot CH, Geertzen JHB, Dijkstra PU. Measurement properties and usability of non-contact scanners for measuring transtibial residual limb volume. Prosthet Orthot Int 2018; 42:280-287. [PMID: 29113533 DOI: 10.1177/0309364617736088] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Non-contact scanners may have potential for measurement of residual limb volume. Different non-contact scanners have been introduced during the last decades. Reliability and usability (practicality and user friendliness) should be assessed before introducing these systems in clinical practice. OBJECTIVES The aim of this study was to analyze the measurement properties and usability of four non-contact scanners (TT Design, Omega Scanner, BioSculptor Bioscanner, and Rodin4D Scanner). STUDY DESIGN Quasi experimental. METHODS Nine (geometric and residual limb) models were measured on two occasions, each consisting of two sessions, thus in total 4 sessions. In each session, four observers used the four systems for volume measurement. Mean for each model, repeatability coefficients for each system, variance components, and their two-way interactions of measurement conditions were calculated. User satisfaction was evaluated with the Post-Study System Usability Questionnaire. RESULTS Systematic differences between the systems were found in volume measurements. Most of the variances were explained by the model (97%), while error variance was 3%. Measurement system and the interaction between system and model explained 44% of the error variance. Repeatability coefficient of the systems ranged from 0.101 (Omega Scanner) to 0.131 L (Rodin4D). Differences in Post-Study System Usability Questionnaire scores between the systems were small and not significant. CONCLUSION The systems were reliable in determining residual limb volume. Measurement systems and the interaction between system and residual limb model explained most of the error variances. The differences in repeatability coefficient and usability between the four CAD/CAM systems were small. Clinical relevance If accurate measurements of residual limb volume are required (in case of research), modern non-contact scanners should be taken in consideration nowadays.
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Affiliation(s)
- Rianne Kofman
- 1 Vogellanden-Centre for Rehabilitation, Zwolle, The Netherlands
| | - Anna M Beekman
- 2 Region Kronoberg-Center for Rehabilitation, Växjö, Sweden
| | | | - Jan H B Geertzen
- 4 University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, the Netherlands
| | - Pieter U Dijkstra
- 4 University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, the Netherlands
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Mduzana LL, Visagie S, Mji G. Suitability of 'Guidelines for Screening of Prosthetic Candidates: Lower Limb' for the Eastern Cape, South Africa: A qualitative study. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2018; 74:396. [PMID: 30135914 PMCID: PMC6093117 DOI: 10.4102/sajp.v74i1.396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 09/19/2017] [Indexed: 11/03/2022] Open
Abstract
Background Major lower limb amputation has a severe impact on functional mobility. Mobility can be salvaged with a prosthesis, but this is not always the best option. It is often difficult to decide whether to refer someone for a prosthesis or not. A prosthetic screening tool 'Guidelines for Screening of Prosthetic Candidates: Lower Limb' was developed and is used for prosthetic prescription in parts of the Western Cape province of South Africa. Objectives This study aimed to explore the suitability of the tool 'Guidelines for Screening of Prosthetic Candidates: Lower Limb' for use in the Eastern Cape province of South Africa. Method A qualitative study was conducted with conveniently sampled occupational therapists (OTs) (n = 10), physiotherapists (PTs) (n = 12) and prosthetists (n = 6) in government employment in the Buffalo City Metro Municipality. Participants were trained in the use of the tool and used it for four weeks with patients. Their experiences of the tool were assessed through three focus group discussions with emergent themes being identified during inductive data analysis. Findings Participants indicated that the tool could assist with prosthetic prescription, goal setting, communication and teamwork. They thought that the tool was multidisciplinary in nature, comprehensive and practical. Findings showed a lack of teamwork in this study setting. Resistance to change and a lack of time might also hamper implementation of the tool. Conclusion The tool can assist with managing the backlog for prostheses and to guide prosthetic prescription in the Eastern Cape province. Clinical implications A prosthesis can help to salvage functional mobility after lower limb amputation. However, not all people who had above knee amputation manage to walk with a prosthesis. The tool reported on in this article provides information that can guide prosthetic prescription and rehabilitation goals.
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Affiliation(s)
- Luphiwo L Mduzana
- Department of Rehabilitation Medicine, Faculty of Health Sciences, Walter Sisulu University, South Africa
| | - Surona Visagie
- Centre for Rehabilitation Studies, University of Stellenbosch, South Africa
| | - Gubela Mji
- Centre for Rehabilitation Studies, University of Stellenbosch, South Africa
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Seminati E, Canepa Talamas D, Young M, Twiste M, Dhokia V, Bilzon JLJ. Validity and reliability of a novel 3D scanner for assessment of the shape and volume of amputees' residual limb models. PLoS One 2017; 12:e0184498. [PMID: 28886154 PMCID: PMC5590959 DOI: 10.1371/journal.pone.0184498] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 08/24/2017] [Indexed: 11/19/2022] Open
Abstract
Background Objective assessment methods to monitor residual limb volume following lower-limb amputation are required to enhance practitioner-led prosthetic fitting. Computer aided systems, including 3D scanners, present numerous advantages and the recent Artec Eva scanner, based on laser free technology, could potentially be an effective solution for monitoring residual limb volumes. Purpose The aim of this study was to assess the validity and reliability of the Artec Eva scanner (practical measurement) against a high precision laser 3D scanner (criterion measurement) for the determination of residual limb model shape and volume. Methods Three observers completed three repeat assessments of ten residual limb models, using both the scanners. Validity of the Artec Eva scanner was assessed (mean percentage error <2%) and Bland-Altman statistics were adopted to assess the agreement between the two scanners. Intra and inter-rater reliability (repeatability coefficient <5%) of the Artec Eva scanner was calculated for measuring indices of residual limb model volume and shape (i.e. residual limb cross sectional areas and perimeters). Results Residual limb model volumes ranged from 885 to 4399 ml. Mean percentage error of the Artec Eva scanner (validity) was 1.4% of the criterion volumes. Correlation coefficients between the Artec Eva and the Romer determined variables were higher than 0.9. Volume intra-rater and inter-rater reliability coefficients were 0.5% and 0.7%, respectively. Shape percentage maximal error was 2% at the distal end of the residual limb, with intra-rater reliability coefficients presenting the lowest errors (0.2%), both for cross sectional areas and perimeters of the residual limb models. Conclusion The Artec Eva scanner is a valid and reliable method for assessing residual limb model shapes and volumes. While the method needs to be tested on human residual limbs and the results compared with the current system used in clinical practice, it has the potential to quantify shape and volume fluctuations with greater resolution.
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Affiliation(s)
- Elena Seminati
- Department for Health, University of Bath, Bath, United Kingdom
- CAMERA Centre, University of Bath, Bath, United Kingdom
| | | | - Matthew Young
- CAMERA Centre, University of Bath, Bath, United Kingdom
| | - Martin Twiste
- School of Health Sciences, University of Salford, Salford, United Kingdom
- United National Institute for Prosthetics & Orthotics Development (UNIPOD), University of Salford, Salford, United Kingdom
| | - Vimal Dhokia
- Department of Mechanical Engineering, University of Bath, Bath, United Kingdom
| | - James L. J. Bilzon
- Department for Health, University of Bath, Bath, United Kingdom
- CAMERA Centre, University of Bath, Bath, United Kingdom
- * E-mail:
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15
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Dickinson AS, Steer JW, Woods CJ, Worsley PR. Registering methodology for imaging and analysis of residual-limb shape after transtibial amputation. ACTA ACUST UNITED AC 2016; 53:207-18. [DOI: 10.1682/jrrd.2014.10.0272] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 06/23/2015] [Indexed: 11/05/2022]
Affiliation(s)
| | - Joshua W. Steer
- Bioengineering Science Research Group, Faculty of Engineering and the Environment, and
| | - Christopher J. Woods
- Bioengineering Science Research Group, Faculty of Engineering and the Environment, and
| | - Peter R. Worsley
- Skin Health and Continence Technologies Research Group, Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
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16
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Geertzen J, van der Linde H, Rosenbrand K, Conradi M, Deckers J, Koning J, Rietman HS, van der Schaaf D, van der Ploeg R, Schapendonk J, Schrier E, Duijzentkunst RS, Spruit-van Eijk M, Versteegen G, Voesten H. Dutch evidence-based guidelines for amputation and prosthetics of the lower extremity: Rehabilitation process and prosthetics. Part 2. Prosthet Orthot Int 2015; 39:361-71. [PMID: 25060393 DOI: 10.1177/0309364614542725] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 06/02/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND A structured, multidisciplinary approach in the rehabilitation process after amputation is needed that includes a greater focus on the involvement of both (para)medics and prosthetists. There is considerable variation in prosthetic prescription concerning the moment of initial prosthesis fitting and the use of replacement parts. OBJECTIVES To produce an evidence-based guideline for the amputation and prosthetics of the lower extremities. This guideline provides recommendations in support of daily practice and is based on the results of scientific research and further discussions focussed on establishing good medical practice. Part 2 focuses on rehabilitation process and prosthetics. STUDY DESIGN Systematic literature design. METHODS Literature search in five databases and quality assessment on the basis of evidence-based guideline development. RESULTS An evidence-based multidisciplinary guideline on amputation and prosthetics of the lower extremity. CONCLUSION The best care (in general) for patients undergoing amputation of a lower extremity is presented and discussed. This part of the guideline provides recommendations for treatment and reintegration of patients undergoing amputation of a lower extremity and can be used to provide patient information. CLINICAL RELEVANCE This guideline provides recommendations in support of daily practice and is based on the results of scientific research and further discussions focussed on establishing good medical practice.
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Affiliation(s)
- Jan Geertzen
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | | | | | - Jos Deckers
- Royal Dutch Society for Physical Therapies, Utrecht, The Netherlands
| | - Jan Koning
- Dutch Society for Surgery, Utrecht, The Netherlands
| | | | | | | | | | - Ernst Schrier
- Netherlands Institute of Psychologists, Utrecht, The Netherlands
| | - Rob Smit Duijzentkunst
- Netherlands Association for Occupational and Industrial Medicine, Utrecht, The Netherlands
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17
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Tantua AT, Geertzen JHB, van den Dungen JJAM, Breek JKC, Dijkstra PU. Reduction of residual limb volume in people with transtibial amputation. ACTA ACUST UNITED AC 2014; 51:1119-26. [DOI: 10.1682/jrrd.2013.11.0243] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 05/06/2014] [Indexed: 11/05/2022]
Affiliation(s)
- Audrey T. Tantua
- Department of Rehabilitation Medicine, University Medical Center Groningen, Center for Rehabilitation, Groningen, the Netherlands
| | - Jan H. B. Geertzen
- Department of Rehabilitation Medicine, University Medical Center Groningen, Center for Rehabilitation, Groningen, the Netherlands
| | - Jan J. A. M. van den Dungen
- Department of Vascular Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jan-Kees C. Breek
- Department of Surgery, Martini Hospital Groningen, Groningen, the Netherlands
| | - Pieter U. Dijkstra
- Department of Rehabilitation Medicine, University Medical Center Groningen, Center for Rehabilitation, Groningen, the Netherlands;Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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