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QUICK TIPS (--THIS SECTION DOES NOT PRINT--) This PowerPoint template requires basic PowerPoint (version 2007 or newer) skills. Below is a list of commonly.

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Presentation on theme: "QUICK TIPS (--THIS SECTION DOES NOT PRINT--) This PowerPoint template requires basic PowerPoint (version 2007 or newer) skills. Below is a list of commonly."— Presentation transcript:

1 QUICK TIPS (--THIS SECTION DOES NOT PRINT--) This PowerPoint template requires basic PowerPoint (version 2007 or newer) skills. Below is a list of commonly asked questions specific to this template. If you are using an older version of PowerPoint some template features may not work properly. Using the template Verifying the quality of your graphics Go to the VIEW menu and click on ZOOM to set your preferred magnification. This template is at 100% the size of the final poster. All text and graphics will be printed at 100% their size. To see what your poster will look like when printed, set the zoom to 100% and evaluate the quality of all your graphics before you submit your poster for printing. Using the placeholders To add text to this template click inside a placeholder and type in or paste your text. To move a placeholder, click on it once (to select it), place your cursor on its frame and your cursor will change to this symbol: Then, click once and drag it to its new location where you can resize it as needed. Additional placeholders can be found on the left side of this template. Modifying the layout This template has four different column layouts. Right-click your mouse on the background and click on “Layout” to see the layout options. The columns in the provided layouts are fixed and cannot be moved but advanced users can modify any layout by going to VIEW and then SLIDE MASTER. Importing text and graphics from external sources TEXT: Paste or type your text into a pre-existing placeholder or drag in a new placeholder from the left side of the template. Move it anywhere as needed. PHOTOS: Drag in a picture placeholder, size it first, click in it and insert a photo from the menu. TABLES: You can copy and paste a table from an external document onto this poster template. To adjust the way the text fits within the cells of a table that has been pasted, right-click on the table, click FORMAT SHAPE then click on TEXT BOX and change the INTERNAL MARGIN values to 0.25 Modifying the color scheme To change the color scheme of this template go to the “Design” menu and click on “Colors”. You can choose from the provide color combinations or you can create your own. QUICK DESIGN GUIDE (--THIS SECTION DOES NOT PRINT--) This PowerPoint 2007 template produces a 36”x48” professional poster. It will save you valuable time placing titles, subtitles, text, and graphics. Use it to create your presentation. Then send it to PosterPresentations.com for premium quality, same day affordable printing. We provide a series of online tutorials that will guide you through the poster design process and answer your poster production questions. View our online tutorials at: (copy and paste the link into your web browser). For assistance and to order your printed poster call PosterPresentations.com at Object Placeholders Use the placeholders provided below to add new elements to your poster: Drag a placeholder onto the poster area, size it, and click it to edit. Section Header placeholder Move this preformatted section header placeholder to the poster area to add another section header. Use section headers to separate topics or concepts within your presentation. Text placeholder Move this preformatted text placeholder to the poster to add a new body of text. Picture placeholder Move this graphic placeholder onto your poster, size it first, and then click it to add a picture to the poster. RESEARCH POSTER PRESENTATION DESIGN © © 2011 PosterPresentations.com 2117 Fourth Street, Unit C Berkeley CA Student discounts are available on our Facebook page. Go to PosterPresentations.com and click on the FB icon. Analyzing the Forces Within Unilateral Transtibial Prosthetic Sockets and Design of an Improved Force Minimizing Socket Transtibial Amputees Over 40,000 transtibial (below the knee) amputations are performed annually in United States [4]. Current research is focused more on financial gains for companies rather than improved comfort and reduced pain for patients or establishing a quantitative picture of pressure distribution of the interface. Skin irritation, pain, tissue breakdown, pressure ulcerations, and infections at the socket interface result from socket inadequacies in regards to discomfort and improper force distribution [2],[3]. A typical prosthetic leg system includes a foot, liner, and socket (see display). Regions of Interest Research has identified areas of the residual limb that are tolerant and sensitive to pressure [4]. See Figure 1. Tolerant regions: tibialis anterior (1), medial tibial flare (3), mid patella tendon (4), gastrocnemius (5) Sensitive regions: distal end of limb (2), fibula head (6), distal tibia (7), tibial tubercle(8) Figure 1: Identified pressure sensitive and tolerant regions. The left is the front of the residual limb, the center is the right of the residual limb, and the right is the left side of the limb. The region at the end of the stump is the distal end (2) and the tibialis anterior (1) is on the back of the limb and is not pictured. Cost Analysis/Implications of Project The current process is mostly qualitative, force data would help prosthetists to produce sockets more efficiently, reduce costs, and decrease the number of refittings. Process includes 3 test socket fittings and 2 laminated socket fittings over 1 month with a total cost of $2500. The average patient requires 1 refitting. An improved initial socket would increase comfort and potentially eliminate refittings, saving The Surgical Clinic $180,000 per year. INTRODUCTION OBJECTIVES Force Measurement Force data were measured using force-sensing resistors (FSRs, Figure 3) placed on the 4 pressure tolerant and 4 pressure sensitive regions (Figure 2). A circuit composed of 8 individual current-to-voltage converters in combination with NI LabVIEW was used to gather voltage data from the changing resistances (Figure 3). Each FSR was calibrated in order to convert the voltage obtained to a pressure. Figure 2: Aaron Fitzsmmons places the FSRs on the pressure tolerant and pressure sensitive regions of the patient’s residual limb. Figure 3: On the left is a schematic of the circuit used to convert resistance to voltage. On the right is an FSR. Experimental Tests All testing was performed on one patient. Data was obtained for both standing and walking. Tests performed to determine the force minimizing socket components (see display): Three feet (flex-foot and multi-axial ankle, SACH foot, and vertical shank ESF foot) were tested with each of three liners (thermoplastic elastomer, silicone, and urethane) Tests performed with redesigned sockets using the socket components shown to minimize forces the most: Current socket used by patient Redesigned sockets A, B, and C The Socket Comfort Score (SCS) was determined by the patient for each socket. MATERIALS AND METHODS Liner and Foot Combination Figure 4 shows the maximum pressures during walking for trials with the three different feet and the three different liners. The silicone liner and flex foot showed the lowest pressures and were used for future testing. Figure 4: Pressures during walking for different feet and liners. Redesigned Sockets Socket redesign focused on altering the contour and/or material of the socket. Socket A: void on distal end, thermaline soft and carbon fiber Socket B: most flexible, proflex with silicone, urethane insert, PETG outer layer Socket C: less rigid material near top of residual limb, thermaline soft and carbon fiber Figure 5: Maximum pressures during walking Figure 6: Average pressures during walking Figure 7: Average pressures during standing RESULTS RESULTS Continued The Socket Comfort Score (SCS) is a number that the patient assigns to the socket based upon his level of comfort from 0-10 with 0 being most uncomfortable and 10 being completely comfortable [1]. The combination of the silicone liner and flex foot decreased pressures the most. Socket B decreased the pressure in the 3 of the sensitive regions during walking. Socket C decreased the pressure in 2 of the sensitive regions during walking and was more comfortable than the patient’s normal socket. Socket A was specifically designed to decrease the pressure at the distal end and succeeded in doing so. Future Work Repeat similar testing situations with multiple patients. Design a socket with voids in additional pressure sensitive areas because Socket A was successful in reducing pressure at the distal end. Repeat testing using different suspension systems REFERENCES [1] Hanspal, R. S., Fisher, K., Nieveen, R. (2003). Prosthetic socket fit comfort score. Disability and Rehabilitation, 25 (22), [2] Jendrzejczyk, D. J. (1985). Flexible Socket Systems. Clin. Prosthet. Orthot. 9 (4), [3] Polliack, A.A., Sieh, R.C., Craig, D.D., Landsberger, S., Mcneil, D.R., and E. Ayyappa. (2000). Scientific validation of two commercial pressure sensor systems for prosthetic socket fit. Prosthetics and Orthotics International, 24, [4] Smith, D. G., Michael, J. W., Bowker, J. H. (2004). Atlas of Amputations and Limb Deficiencies. Rosemont, IL: American Academy of Orthopaedic Surgeons. ACKNOWLEDGMENTS We would like to thank Aaron Fitzsimmons for his support and assistance throughout the duration of the project, Cody for his patience in all our trials, and The Surgical Clinic for providing us with the necessary resources. We would also like to thank Franz Baudenbacher, John Dunbar, Michael Goldfarb, Max Hammond, Rene Harder, and Paul King for their helpful advice, as well as the Department of Biomedical Engineering at Vanderbilt University. Acquire accurate measurements of the pressures on the residual limb of an amputee patient during standing and walking conditions. Select the components (liner and foot) that work best to reduce peak pressures. Design a socket system in which the pressures are optimally distributed throughout the interface. Advisor: Aaron Fitzsimmons, CP, OTR, The Surgical Clinic, PLLC Christine Bronikowski, Amanda Chen, Jared Mulford, and Amy Ostrowski CONCLUSIONS


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