Displaying publications 1 - 20 of 32 in total

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  1. Afiqah Hamzah N, Razak NAA, Sayuti Ab Karim M, Gholizadeh H
    Proc Inst Mech Eng H, 2021 Dec;235(12):1359-1374.
    PMID: 34304625 DOI: 10.1177/09544119211035200
    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.
  2. Sobh KNM, Abd Razak NA, Abu Osman NA
    Proc Inst Mech Eng H, 2021 Apr;235(4):419-427.
    PMID: 33517847 DOI: 10.1177/0954411920985753
    Electromyography signal has been used widely as input for prosthetic's leg movements. C-Leg, for example, is among the prosthetics devices that use electromyography as the main input. The main challenge facing the industrial party is the position of the electromyography sensor as it is fixed inside the socket. The study aims to investigate the best positional parameter of electromyography for transtibial prosthetic users for the device to be effective in multiple movement activities and compare with normal human muscle's activities. DELSYS Trigno wireless electromyography instrument was used in this study to achieve this aim. Ten non-amputee subjects and two transtibial amputees were involved in this study. The surface electromyography signals were recorded from two anterior and posterior below the knee muscles and above the knee muscles, respectively: tibial anterior and gastrocnemius lateral head as well as rectus femoris and biceps femoris during two activities (flexion and extension of knee joint and gait cycle for normal walking). The result during flexion and extension activities for gastrocnemius lateral head and biceps femoris muscles was found to be more useful for the control subjects, while the tibial anterior and also gastrocnemius lateral head are more active for amputee subjects. Also, during normal walking activity for biceps femoris and gastrocnemius lateral head, it was more useful for the control subjects, while for transtibial amputee subject-1, the rectus femoris was the highest signal of the average normal walking activity (0.0001 V) compared to biceps femoris (0.00007 V), as for transtibial amputee subject-2, the biceps femoris was the highest signals of the average normal walking activity (0.0001 V) compared to rectus femoris (0.00004 V). So, it is difficult to rely entirely on the static positioning of the electromyography sensor within the socket as there is a possibility of the sensor to contact with inactive muscle, which will be a gap in the control, leading to a decrease in the functional efficiency of the powered prostheses.
  3. Shaari IH, Abu Osman NA, Shasmin HN
    Proc Inst Mech Eng H, 2020 Aug;234(8):884-894.
    PMID: 32459140 DOI: 10.1177/0954411920923541
    Many studies have shown that medical compression products produce different levels of interface pressure during the usage of the products. However, limited studies have explored the pattern of interface pressure exerted by orthotic garments. This case study aimed to investigate the pattern of interface pressure exerted by two types of orthotic garments on a child with cerebral palsy. A 13-year-old child diagnosed with ataxic spastic diplegia cerebral palsy has difficulty to perform sit-to-stand motion even with a walking frame due to his truncal ataxia. A TheraTogsTM orthosis and a Dynamic Lycra® Fabric Orthosis (DLFO) were prepared for the child. The child's sit-to-stand ability without and with the usage of orthoses was recorded using five sit-to-stand tests. The garments' interface pressure was measured using F-scan (9811E) and F-scan 6.5.1 version software. The pressure was recorded when the child was in sitting position and performing sit-to-stand-to-sit motion. Overall, the child completed the five sit-to-stand test duration within 2.53 ± 0.04 s and 2.51 ± 0.09 s with the usage of TheraTogsTM orthosis and DLFO, respectively. Higher pressure was exerted by Dynamic Lycra Fabric Orthosis (axillary = 122 mmHg) in contrast to TheraTogsTM orthosis (77 mmHg) when the child was in a sitting position. Lower pressure was exerted by DLFO (7 mmHg), over xiphoid level and for TheraTogsTM orthosis is 1.2 mmHg over axillary level when the child was performing sit-to-stand motion. The largest range of pressure was exerted by TheraTogsTM orthosis with a minimum pressure of 5 mmHg and a maximum pressure of 155 mmHg during sit-to-stand motion. Overall, the DLFO exerted higher mean interface pressure on the child in comparison to TheraTogsTM orthosis when the child's body was in a sitting position wearing both upper garment and pants. Both TheraTogsTM orthosis and DLFO presented a different range of interface pressure over different body segments and activities.
  4. Khan SJ, Khan SS, Usman J, Mokhtar AH, Abu Osman NA
    Proc Inst Mech Eng H, 2020 Jul;234(7):749-757.
    PMID: 32459132 DOI: 10.1177/0954411920924525
    The conservative techniques of treating knee osteoarthritis (kOA) include wearing orthoses such as knee braces and laterally wedged insoles and applying gait modification techniques such as toe-in gait and toe-out gait. This study aimed at assessing the immediate effects of these techniques in improving physical function of healthy and kOA participants. Five Osteoarthritis Research Society International (OARSI) recommended performance-based tests were randomly applied to measure physical function: (1) 30-second chair stand test (30CST), (2) 40-m (4 × 10) fast-paced walk test (40FPW), (3) stair climb test (SCT), (4) timed up and go test (TUGT) and (5) 6-minute walk test (6MWT) during a single-visit on 20 healthy and 20 kOA patients (age: 59.5 ± 7.33 and 61.5 ± 8.63 years, BMI: 69.95 ± 9.86 and 70.45 ± 8.80 kg/m2). The interventions included natural gait, toe-out gait, toe-in gait, laterally wedged insoles and knee brace. Analysis was performed through repeated-measures ANOVA and independent sample t-test. 30CST and TUGT showed no significant differences for the five test conditions (p > 0.05). Toe-out showed profound effects via pairwise comparison in impairing the physical function while knee brace improved it during 40FPW, SCT and 6MWT. In general, all the tested conservative techniques except laterally wedged insoles had immediate effects on physical performance measures in both healthy and medial knee osteoarthritis participants. The valgus knee brace improved the parameters the most, while toe-out gait impaired them the most. Future studies can develop strategies for improving gait retraining methods on the basis of issues identified by this study.
  5. Singh R, Singh G, Singh J, Kumar R, Rahman MM, Ramakrishna S
    Proc Inst Mech Eng H, 2019 Nov;233(11):1196-1203.
    PMID: 31545132 DOI: 10.1177/0954411919877979
    In this experimental study, a composite of poly-ether-ketone-ketone by reinforcement of hydroxyapatite and chitosan has been prepared for possible applications as orthopaedic scaffolds. Initially, different weight percentages of hydroxyapatite and chitosan were reinforced in the poly-ether-ketone-ketone matrix and tested for melt flow index in order to check the flowability of different compositions/proportions. Suitable compositions revealed by the melt flow index test were then taken forward for the extrusion of filament required for fused deposition modelling. For thermomechanical investigations, Taguchi-based design of experiments has been used with input variables in the extrusion process as follows: temperature, load applied and different composition/proportions. The specimens in the form of feedstock filament produced by the extrusion process were made to undergo tensile testing. The specimens were also inspected by differential scanning calorimetry and photomicrographs. Finally, the specimen showing the best performance from the thermomechanical viewpoint has been selected to extrude the filament for the fused deposition modelling process.
  6. Mohd Sharif NA, Usman J, Wan Safwani WKZ, Siew Li G, Abdul Karim S, Mohamed NA, et al.
    Proc Inst Mech Eng H, 2019 Nov;233(11):1132-1140.
    PMID: 31597554 DOI: 10.1177/0954411919874614
    Knee sleeves are often prescribed to alleviate pain in people with early knee osteoarthritis. However, the biomechanics underlying their pain-relieving effect are still not well understood. This pre-post study aims at evaluating and comparing the effects of two different types of knee sleeves on knee adduction moment. Patients with clinically diagnosed knee osteoarthritis were recruited from the University of Malaya Medical Centre and were randomly assigned to two test groups using (1) a simple knee sleeve and (2) a simple sleeve with patella cutout. Knee adduction moment was collected using the Vicon motion capture system with two Kistler force plates. Pain, stiffness and physical functions were recorded using the Western Ontario and McMaster Universities Osteoarthritis Index. All measurements were taken before, immediately after and at the completion of 6 weeks of application (primary time point). In total, 17 participants with early unilateral knee osteoarthritis (47.7 (9.7) years) completed the study. Overall results show significant reduction in pain, early stance and late stance knee adduction moment and increased walking speed after 6 weeks of both knee sleeves application. This study results suggest that knee sleeves can reduce knee adduction moments in early unilateral knee osteoarthritis by 14.0% and 12.1% using the simple sleeve and the sleeve with patella cutout, respectively, and can potentially delay disease progression. In addition, knee sleeve with patella cutout does not provide additional benefits when compared to the simple knee sleeve.
  7. Ahmad A, Abu Osman NA, Mokhtar H, Mehmood W, Kadri NA
    Proc Inst Mech Eng H, 2019 Sep;233(9):901-908.
    PMID: 31244368 DOI: 10.1177/0954411919856144
    The Chêneau brace has proven its effectiveness in treating the adolescent idiopathic scoliosis patients. However, no studies reported on the analysis of interface pressure in double-curve adolescent idiopathic scoliosis patients. In this study, we evaluated the interface pressure of the Chêneau brace action in double-curve adolescent idiopathic scoliosis patient treatment. A total of 72 (60 girls and 12 boys) patients aged 10 years and above participated in the study. The F-Socket transducers (9811E) were used to evaluate the pressure on the right thoracic and left thoracolumbar curves between normal and maximum strap tension and variation in these interface pressures with other tasks. Each patient was asked to do nine different tasks corresponding to daily activities, and the interface pressures for each activity were recorded for both normal and maximum tension. The resultant mean peak pressure in double-curve adolescent idiopathic scoliosis was higher for right thoracic curves than left thoracolumbar curves in all tasks. The pressure significantly increased at the task of maximal inspiration (p 
  8. Ali Akhbar MF, Yusoff AR
    Proc Inst Mech Eng H, 2019 Feb;233(2):207-218.
    PMID: 30572787 DOI: 10.1177/0954411918819113
    Bone-drilling operation necessitates an accurate and efficient surgical drill bit to minimize thermal damage to the bone. This article provides a methodology for predicting the bone temperature elevation during surgical bone drilling and to gain a better understanding on the influences of the point angle, helix angle and web thickness of the drill bit. The proposed approach utilized the normalized Cockroft-Latham damage criterion to predict material cracking in the drilling process. Drilling simulation software DEFORM-3D is used to approximate the bone temperature elevation corresponding to different drill bit geometries. To validate the simulation results, bone temperature elevations were evaluated by comparison with ex vivo bone-drilling process using bovine femurs. The computational results fit well with the ex vivo experiments with respect to different drill geometries. All the investigated drill bit geometries significantly affect bone temperature rise. It is discovered that the thermal osteonecrosis risk regions could be reduced with a point angle of 110° to 140°, a helix angle of 5° to 30° and a web thickness of 5% to 40%. The drilling simulation could accurately estimate the maximum bone temperature elevation for various surgical drill bit point angles, web thickness and helix angles. Looking into the future, this work will lead to the research and redesign of the optimum surgical drill bit to minimize thermal insult during bone-drilling surgeries.
  9. Mehmood W, Abd Razak NA, Lau MS, Chung TY, Gholizadeh H, Abu Osman NA
    Proc Inst Mech Eng H, 2019 Feb;233(2):181-192.
    PMID: 30518308 DOI: 10.1177/0954411918816124
    Transtibial prosthetic sockets can be fabricated either by the conventional way, which involve using plaster of Paris bandages for casting. This will include modifications through hand, scanning and digital imaging of software. The aim of this study is to determine the circumferential profiles and conduct a volumetric analysis of a conventional socket that has fabrication using biosculptor technology. In doing this, a male transtibial amputee, age 28 years old with stable health condition was studied, where circumferential measurements were taken at intervals of 1 cm from the distal end of the residual limb to the medial tibial plateau level. Furthermore, the interior volume of both sockets and residuum were determined directly using water displacement method. A comparative value for the calculation of volume was also carried out using engineering mathematical equations. From these measurements, a total surface bearing transtibial sockets was fabricated to compare the changes of circumferential values of both sockets. The finding shows a percentage of the difference between the volume of the residual limb and conventional sockets to be 6.09%, whereas the biosculptor fabrication socket was 7.84% using the water displacement method. A comparison of circumferential profiles and volumetric analysis findings on the contrary showed that socket fabricated using the biosculptor technology is interchangeable with the conventional socket with more advantages, where biosculptor technology produces cheaper sockets and faster process with digital function in the procedure, unlike the conventional manual technique.
  10. Genisa M, Shuib S, Rajion ZA, Arief EM, Hermana M
    Proc Inst Mech Eng H, 2018 Oct 11.
    PMID: 30309283 DOI: 10.1177/0954411918806333
    The aim of this study is to investigate the estimation of density from the Hounsfield unit of cone beam computed tomography data in dental imaging, especially for dental implant application. A jaw phantom with various known densities of anatomical parts (e.g. soft tissue, cortical bone, trabecular bone, tooth enamel, tooth dentin, sinus cavity, spinal cord and spinal disc) has been used to test the accuracy of the Hounsfield unit of cone beam computed tomography in estimating the mechanical density (true density). The Hounsfield unit of cone beam computed tomography data was evaluated via the MIMICS software using both two-dimensional and three-dimensional methods, and the results showed correlation with the true density of the object. In addition, the results revealed that the Hounsfield unit of cone beam computed tomography and bone density had a logarithmic relation, rather than a linear one. To this end, the correlation coefficient of logarithmic correlation (R2 = 0.95) is higher than the linear one (R2 = 0.77).
  11. Khan SJ, Khan SS, Usman J, Mokhtar AH, Abu Osman NA
    Proc Inst Mech Eng H, 2018 Feb;232(2):163-171.
    PMID: 29283019 DOI: 10.1177/0954411917750409
    This study aims to investigate the effects of varying toe angles at different platform settings on Overall Stability Index of postural stability and fall risk using Biodex Balance System in healthy participants and medial knee osteoarthritis patients. Biodex Balance System was employed to measure postural stability and fall risk at different foot progression angles (ranging from -20° to 40°, with 10° increments) on 20 healthy (control group) and 20 knee osteoarthritis patients (osteoarthritis group) randomly (age: 59.50 ± 7.33 years and 61.50 ± 8.63 years; body mass: 69.95 ± 9.86 kg and 70.45 ± 8.80 kg). Platform settings used were (1) static, (2) postural stability dynamic level 8 (PS8), (3) fall risk levels 12 to 8 (FR12) and (4) fall risk levels 8 to 2 (FR8). Data from the tests were analysed using three-way mixed repeated measures analysis of variance. The participant group, platform settings and toe angles all had a significant main effect on balance ( p ≤ 0.02). Platform settings had a significant interaction effect with participant group F(3, 144) = 6.97, p 
  12. Hashim NA, Abd Razak NA, Abu Osman NA, Gholizadeh H
    Proc Inst Mech Eng H, 2018 Jan;232(1):3-11.
    PMID: 29199518 DOI: 10.1177/0954411917744585
    Body-powered prostheses are known for their advantages of cost, reliability, training period, maintenance, and proprioceptive feedback. This study primarily aims to analyze the work related to the improvement of upper limb body-powered prostheses prior to 2016. A systematic review conducted via the search of the Web of Science electronic database, Google Scholar, and Google Patents identified 155 papers from 1921 to 2016. Sackett's initial rules of evidence were used to determine the levels of evidence, and only papers categorized in the design and development category and patents were analyzed. A total of 40 papers in the sixth level of "Design and Development" of an upper limb body-powered prosthesis were found. Approximately 81% were categorized under mechanical alteration. Most papers were patent-type documents (48%), with the Journal of Rehabilitation Research and Development publishing most of the articles related to the design and development of body-powered prostheses. Papers in the scope of the study were published once every 3 years in almost a century, proving that only a few studies were conducted to improve body-powered arms compared with myoelectric technology. Further research should be carried out mainly in areas that have received less attention.
  13. Pirouzi G, Abu Osman NA, Ali S, Davoodi Makinejad M
    Proc Inst Mech Eng H, 2017 Dec;231(12):1127-1132.
    PMID: 28985696 DOI: 10.1177/0954411917735082
    Prosthetic alignment is an essential process to rehabilitate patients with amputations. This study presents, for the first time, an invented device to read and record prosthesis alignment data. The digital device consists of seven main parts: the trigger, internal shaft, shell, sensor adjustment button, digital display, sliding shell, and tip. The alignment data were read and recorded by the user or a computer to replicate prosthesis adjustment for future use or examine the sequence of changes in alignment and its effect on the posture of the patient. Alignment data were recorded at the anterior/posterior and medial/lateral positions for five patients. Results show the high level of confidence to record alignment data and replicate adjustments. Therefore, the device helps patients readjust their prosthesis by themselves, or prosthetists to perform adjustment for patients and analyze the effects of malalignment.
  14. Ngadiman NHA, Noordin MY, Idris A, Kurniawan D
    Proc Inst Mech Eng H, 2017 Jul;231(7):597-616.
    PMID: 28347262 DOI: 10.1177/0954411917699021
    The potential of electrospinning process to fabricate ultrafine fibers as building blocks for tissue engineering scaffolds is well recognized. The scaffold construct produced by electrospinning process depends on the quality of the fibers. In electrospinning, material selection and parameter setting are among many factors that contribute to the quality of the ultrafine fibers, which eventually determine the performance of the tissue engineering scaffolds. The major challenge of conventional electrospun scaffolds is the nature of electrospinning process which can only produce two-dimensional electrospun mats, hence limiting their applications. Researchers have started to focus on overcoming this limitation by combining electrospinning with other techniques to fabricate three-dimensional scaffold constructs. This article reviews various polymeric materials and their composites/blends that have been successfully electrospun for tissue engineering scaffolds, their mechanical properties, and the various parameters settings that influence the fiber morphology. This review also highlights the secondary processes to electrospinning that have been used to develop three-dimensional tissue engineering scaffolds as well as the steps undertaken to overcome electrospinning limitations.
  15. Thompson MS, Bajuri MN, Khayyeri H, Isaksson H
    Proc Inst Mech Eng H, 2017 May;231(5):369-377.
    PMID: 28427319 DOI: 10.1177/0954411917692010
    Tendons are adapted to carry large, repeated loads and are clinically important for the maintenance of musculoskeletal health in an increasing, actively ageing population, as well as in elite athletes. Tendons are known to adapt to mechanical loading. Also, their healing and disease processes are highly sensitive to mechanical load. Computational modelling approaches developed to capture this mechanobiological adaptation in tendons and other tissues have successfully addressed many important scientific and clinical issues. The aim of this review is to identify techniques and approaches that could be further developed to address tendon-related problems. Biomechanical models are identified that capture the multi-level aspects of tendon mechanics. Continuum whole tendon models, both phenomenological and microstructurally motivated, are important to estimate forces during locomotion activities. Fibril-level microstructural models are documented that can use these estimated forces to detail local mechanical parameters relevant to cell mechanotransduction. Cell-level models able to predict the response to such parameters are also described. A selection of updatable mechanobiological models is presented. These use mechanical signals, often continuum tissue level, along with rules for tissue change and have been applied successfully in many tissues to predict in vivo and in vitro outcomes. Signals may include scalars derived from the stress or strain tensors, or in poroelasticity also fluid velocity, while adaptation may be represented by changes to elastic modulus, permeability, fibril density or orientation. So far, only simple analytical approaches have been applied to tendon mechanobiology. With the development of sophisticated computational mechanobiological models in parallel with reporting more quantitative data from in vivo or clinical mechanobiological studies, for example, appropriate imaging, biochemical and histological data, this field offers huge potential for future development towards clinical applications.
  16. Sia SF, Zhao X, Li R, Zhang Y, Chong W, He L, et al.
    Proc Inst Mech Eng H, 2016 Nov;230(11):1051-1058.
    PMID: 28095764 DOI: 10.1177/0954411916671752
    BACKGROUND: Internal carotid artery stenosis requires an accurate risk assessment for the prevention of stroke. Although the internal carotid artery area stenosis ratio at the common carotid artery bifurcation can be used as one of the diagnostic methods of internal carotid artery stenosis, the accuracy of results would still depend on the measurement techniques. The purpose of this study is to propose a novel method to estimate the effect of internal carotid artery stenosis on the blood flow based on the concept of minimization of energy loss.

    METHODS: Eight internal carotid arteries from different medical centers were diagnosed as stenosed internal carotid arteries, as plaques were found at different locations on the vessel. A computational fluid dynamics solver was developed based on an open-source code (OpenFOAM) to test the flow ratio and energy loss of those stenosed internal carotid arteries. For comparison, a healthy internal carotid artery and an idealized internal carotid artery model have also been tested and compared with stenosed internal carotid artery in terms of flow ratio and energy loss.

    RESULTS: We found that at a given common carotid artery bifurcation, there must be a certain flow distribution in the internal carotid artery and external carotid artery, for which the total energy loss at the bifurcation is at a minimum; for a given common carotid artery flow rate, an irregular shaped plaque at the bifurcation constantly resulted in a large value of minimization of energy loss. Thus, minimization of energy loss can be used as an indicator for the estimation of internal carotid artery stenosis.

  17. Ngadiman NH, Mohd Yusof N, Idris A, Kurniawan D
    Proc Inst Mech Eng H, 2016 Aug;230(8):739-49.
    PMID: 27194535 DOI: 10.1177/0954411916649632
    Electrospinning is a simple and efficient process in producing nanofibers. To fabricate nanofibers made of a blend of two constituent materials, co-axial electrospinning method is an option. In this method, the constituent materials contained in separate barrels are simultaneously injected using two syringe nozzles arranged co-axially and the materials mix during the spraying process forming core and shell of the nanofibers. In this study, co-axial electrospinning method is used to fabricate nanofibers made of polyvinyl alcohol and maghemite (γ-Fe2O3). The concentration of polyvinyl alcohol and amount of maghemite nanoparticle loading were varied, at 5 and 10 w/v% and at 1-10 v/v%, respectively. The mechanical properties (strength and Young's modulus), porosity, and biocompatibility properties (contact angle and cell viability) of the electrospun mats were evaluated, with the same mats fabricated by regular single-nozzle electrospinning method as the control. The co-axial electrospinning method is able to fabricate the expected polyvinyl alcohol/maghemite nanofiber mats. It was noticed that the polyvinyl alcohol/maghemite electrospun mats have lower mechanical properties (i.e. strength and stiffness) and porosity, more hydrophilicity (i.e. lower contact angle), and similar cell viability compared to the mats fabricated by single-nozzle electrospinning method.
  18. Noordin MY, Jiawkok N, Ndaruhadi PY, Kurniawan D
    Proc Inst Mech Eng H, 2015 Nov;229(11):761-8.
    PMID: 26399875 DOI: 10.1177/0954411915606169
    There are millions of orthopedic surgeries and dental implantation procedures performed every year globally. Most of them involve machining of bones and cartilage. However, theoretical and analytical study on bone machining is lagging behind its practice and implementation. This study views bone machining as a machining process with bovine bone as the workpiece material. Turning process which makes the basis of the actually used drilling process was experimented. The focus is on evaluating the effects of three machining parameters, that is, cutting speed, feed, and depth of cut, to machining responses, that is, cutting forces and surface roughness resulted by the turning process. Response surface methodology was used to quantify the relation between the machining parameters and the machining responses. The turning process was done at various cutting speeds (29-156 m/min), depths of cut (0.03 -0.37 mm), and feeds (0.023-0.11 mm/rev). Empirical models of the resulted cutting force and surface roughness as the functions of cutting speed, depth of cut, and feed were developed. Observation using the developed empirical models found that within the range of machining parameters evaluated, the most influential machining parameter to the cutting force is depth of cut, followed by feed and cutting speed. The lowest cutting force was obtained at the lowest cutting speed, lowest depth of cut, and highest feed setting. For surface roughness, feed is the most significant machining condition, followed by cutting speed, and with depth of cut showed no effect. The finest surface finish was obtained at the lowest cutting speed and feed setting.
  19. Arifin N, Abu Osman NA, Ali S, Gholizadeh H, Wan Abas WA
    Proc Inst Mech Eng H, 2015 Jul;229(7):491-8.
    PMID: 26019139 DOI: 10.1177/0954411915587595
    In recent years, computerized posturography has become an essential tool in quantitative assessment of postural steadiness in the clinical settings. The purpose of this study was to explore the ability of the Biodex(®) Stability System (BSS) to quantify postural steadiness in below-knee amputees. A convenience sample of 10 below-knee amputees participated in the study. The overall (OSI), anterior-posterior (APSI) and medial-lateral (MLSI) stability indexes as well as the percentage of time spent in left and right quadrants and four concentric zones were measured under altered sensory conditions while standing with solid ankle cushion heel (SACH), single-axis (SA) and energy storage and release (ESAR) feet. Significant difference was found between sensory conditions in SACH and ESAR feet for OSI (SACH, p = 0.002; ESAR, p = 0.005), APSI (SACH, p = 0.036; ESAR, p = 0.003) and MLSI (SACH, p = 0.008; ESAR, p = 0.05) stability indexes. The percentage of time spent in Zone A (0°-5°) was significantly greater than the other three concentric zones (p < 0.01). The loading time percentage on their intact limb (80%-94%) was significantly longer than the amputated limb (20%-6%) in all conditions for all three prosthetic feet. Below-knee amputees showed compromised postural steadiness when visual, proprioceptive or vestibular sensory input was altered. The findings highlight that the characteristics of postural stability in amputees can be clinically assessed by utilizing the outcomes produced by the BSS.
  20. Khalid YM, Gouwanda D, Parasuraman S
    Proc Inst Mech Eng H, 2015 Jun;229(6):452-63.
    PMID: 25979442 DOI: 10.1177/0954411915585597
    Ankle rehabilitation robots are developed to enhance ankle strength, flexibility and proprioception after injury and to promote motor learning and ankle plasticity in patients with drop foot. This article reviews the design elements that have been incorporated into the existing robots, for example, backdrivability, safety measures and type of actuation. It also discusses numerous challenges faced by engineers in designing this robot, including robot stability and its dynamic characteristics, universal evaluation criteria to assess end-user comfort, safety and training performance and the scientific basis on the optimal rehabilitation strategies to improve ankle condition. This article can serve as a reference to design robot with better stability and dynamic characteristics and good safety measures against internal and external events. It can also serve as a guideline for the engineers to report their designs and findings.
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