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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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Pelzer D, Beaudart C, Bornheim S, Maertens de Noordhout B, Schwartz C, Kaux JF. Outcomes of Patients with Lower Limb Loss after Using a Training Prosthesis: A Retrospective Case Series Study. Healthcare (Basel) 2024; 12:567. [PMID: 38470678 PMCID: PMC10931137 DOI: 10.3390/healthcare12050567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/15/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
The aim of this retrospective case series study was to investigate outcomes in patients with lower limb loss based on whether or not they used a training prosthesis (TP) during rehabilitation. The medical records of 171 consecutive patients admitted to rehabilitation hospitalization between January 2014 and December 2018 following a major amputation of the lower limb were reviewed. Patients were categorized into two groups: patients who underwent rehabilitation with a TP and patients who did not use a TP. Outcomes (i.e., discharge destination, length of stay, number of sockets required, and number of the size adaptation of each socket, as well as functional level) were compared between groups. Of the 171 patients, 126 underwent rehabilitation with a TP, and 45 patients underwent rehabilitation without any TP. In conclusion, we found that patients who used a TP had a significantly shorter hospital length of stay when compared to those who did not. This length of stay for patients with TP was not influenced by age but was lowered by a higher body mass index (BMI), tibial instead of femoral amputation, and the male gender. No association was found between the use of TP and discharge destination, functional level, number of socket modifications, and number of sockets required.
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Affiliation(s)
- Doriane Pelzer
- Physical Medicine, Rehabilitation and Sports Traumatology Department, University and University Hospital of Liège, 4000 Liège, Belgium; (D.P.); (S.B.); (B.M.d.N.); (C.S.)
| | - Charlotte Beaudart
- Clinical Pharmacology and Toxicology Research Unit, Department of Biomedical Sciences, Namur Research Institute for Life Sciences (NARILIS), Faculty of Medicine, University of Namur, 5000 Namur, Belgium;
| | - Stephen Bornheim
- Physical Medicine, Rehabilitation and Sports Traumatology Department, University and University Hospital of Liège, 4000 Liège, Belgium; (D.P.); (S.B.); (B.M.d.N.); (C.S.)
| | - Benoît Maertens de Noordhout
- Physical Medicine, Rehabilitation and Sports Traumatology Department, University and University Hospital of Liège, 4000 Liège, Belgium; (D.P.); (S.B.); (B.M.d.N.); (C.S.)
| | - Cédric Schwartz
- Physical Medicine, Rehabilitation and Sports Traumatology Department, University and University Hospital of Liège, 4000 Liège, Belgium; (D.P.); (S.B.); (B.M.d.N.); (C.S.)
| | - Jean-François Kaux
- Physical Medicine, Rehabilitation and Sports Traumatology Department, University and University Hospital of Liège, 4000 Liège, Belgium; (D.P.); (S.B.); (B.M.d.N.); (C.S.)
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Volume Fluctuations in Active and Nonactive Transtibial Prosthetics Users. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2669484. [PMID: 36132074 PMCID: PMC9484881 DOI: 10.1155/2022/2669484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 05/07/2022] [Accepted: 07/21/2022] [Indexed: 11/18/2022]
Abstract
This study aims to evaluate the validity and reliability of the Biosculptor’s Bioscanner system in capturing transtibial residual limb volume fluctuations in active and nonactive amputees during walking activity. Residual limb volume was obtained by measuring the limb circumference after amputees walked for 5 to 25 minutes for five consecutive days. The comparison of mean circumference between Bioscanner and manual measurements (i.e., tape measure) showed that the Bioscanner gave a higher estimation of circumference for the different amputees. Short-term changes in girth and volume due to an activity such as walking do not fluctuate uniformly. The results reflected as such as nonconsistence circumference change identified at different locations of the circumference profiles. Both amputees experienced a significant increase in circumference at the distal end of the limbs after 5 minutes of walking (7.35% change in nonactive and 8.83% in active amputees), and the measurement decreased as amputees walked longer. At 4-8 cm below the mid-patella tendon (pressure tolerant areas), both amputees experienced minor changes in the size of their circumference. The residual limb volume calculation resulted in the percentage difference between the two methods ranging from 2.4% to 9.3%. Pearson coefficient correlation obtained showed a high correlation between the two techniques, ranging from 0.97 to 1. The analysis of the limit of agreements showed that the majority of measurements were closed to the mean, suggesting that Bioscanner and manual techniques may be interchangeable and agree with one another. This study has implied that Bioscanner is comparable to the standard measurement method and may serve as an alternative tool in managing daily residual limb volume change.
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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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Etzel L, Schenck TL, Giunta RE, Li Z, Xu Y, Koban KC. Digital Leg Volume Quantification: Precision Assessment of a Novel Workflow Based on Single Capture Three-dimensional Whole-Body Surface Imaging. J Digit Imaging 2021; 34:1171-1182. [PMID: 34581929 PMCID: PMC8554908 DOI: 10.1007/s10278-021-00493-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 06/03/2021] [Accepted: 07/05/2021] [Indexed: 11/25/2022] Open
Abstract
Whole-body three-dimensional surface imaging (3DSI) offers the ability to monitor morphologic changes in multiple areas without the need to individually scan every anatomical region of interest. One area of application is the digital quantification of leg volume. Certain types of morphology do not permit complete circumferential scan of the leg surface. A workflow capable of precisely estimating the missing data is therefore required. We thus aimed to describe and apply a novel workflow to collect bilateral leg volume measurements from whole-body 3D surface scans regardless of leg morphology and to assess workflow precision. For each study participant, whole-body 3DSI was conducted twice successively in a single session with subject repositioning between scans. Paired samples of bilateral leg volume were calculated from the 3D surface data, with workflow variations for complete and limited leg surface visibility. Workflow precision was assessed by calculating the relative percent differences between repeated leg volumes. A total of 82 subjects were included in this study. The mean relative differences between paired left and right leg volumes were 0.73 ± 0.62% and 0.82 ± 0.65%. The workflow variations for completely and partially visible leg surfaces yielded similarly low values. The workflow examined in this study provides a precise method to digitally monitor leg volume regardless of leg morphology. It could aid in objectively comparing medical treatment options of the leg in a clinical setting. Whole-body scans acquired using the described 3DSI routine may allow simultaneous assessment of other changes in body morphology after further validation.
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Affiliation(s)
- Lucas Etzel
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Pettenkoferstraße 8a, 80336, Munich, Germany.
| | - Thilo L Schenck
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Pettenkoferstraße 8a, 80336, Munich, Germany
| | - Riccardo E Giunta
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Pettenkoferstraße 8a, 80336, Munich, Germany
| | - Zhouxiao Li
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Pettenkoferstraße 8a, 80336, Munich, Germany
| | - Ya Xu
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Pettenkoferstraße 8a, 80336, Munich, Germany
| | - Konstantin C Koban
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Pettenkoferstraße 8a, 80336, Munich, Germany
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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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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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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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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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15
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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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Variation in Results of Volume Measurements of Stumps of Lower-Limb Amputees: A Comparison of 4 Methods. Arch Phys Med Rehabil 2011; 92:941-6. [DOI: 10.1016/j.apmr.2011.01.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Revised: 12/22/2010] [Accepted: 01/03/2011] [Indexed: 11/21/2022]
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Laing S, Lee PVS, Goh JCH. Engineering a Trans-Tibial Prosthetic Socket for the Lower Limb Amputee. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2011. [DOI: 10.47102/annals-acadmedsg.v40n5p252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction: This review addresses the different prosthetic socket designs for trans-tibial amputees, the biomechanics behind the designs and the current state of the field. Of particular focus is the classic patella-tendon bearing (PTB) socket and the more recent sockets manufactured using pressure casting techniques and the theory, biomechanics and clinical implications of the two designs. Methods to examine and compare these designs are also addressed. Materials and Methods: Journal papers by various investigators which have clinical significance/impact on the field of trans-tibial socket design were chosen for this review. Articles were chosen over a period of over 50 years to demonstrate the evolution of knowledge. Results: The engineering of the trans-tibial socket has been largely subjected to empirical derivations and biomechanical theory that remains, for the most part, unproven. The fundamental principles of the PTB socket have been widely refuted. Hydrostatic theory based on pressure casting techniques, on the other hand, provides an optimal scenario to produce a more uniform stump/socket interface pressure. Conclusion: Preliminary studies indicate the pressure casting technique has the potential to produce comfortable sockets, providing an alternative to the PTB design. Various studies have been attempted to quantitatively compare the 2 types of socket designs. However, further quantitative biomechanical studies are needed to explain the fundamental theory surrounding the pressure cast technique. Methods that could help further understand the pressure cast concept include amputee gait analysis, stump/socket interface pressure measurements, computer aided socket design and finite element modelling techniques.
Key words: Biomechanics, Patella-tendon bearing, Pressure casting, Pressure measurement, Prosthetic socket, Trans-tibial amputee
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Affiliation(s)
- Sheridan Laing
- Melbourne School of Engineering, University of Melbourne, Australia
| | - Peter VS Lee
- Melbourne School of Engineering, University of Melbourne, Australia
| | - James CH Goh
- Faculty of Engineering, National University of Singapore, Singapore
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