Displaying publications 1 - 20 of 22 in total

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  1. Histomorphometric changes in the vessel wall at the site of amputation in diabetic patients--do they influence healing of the stump?
    Naidu SV, Sengupta S
    J Orthop Surg (Hong Kong), 2005 Apr;13(1):3-7.
    PMID: 15872394
    To predict healing of the stump by assessing the microscopic vascular changes at the amputation site.
    Matched MeSH terms: Amputation Stumps/blood supply*; Amputation Stumps/physiopathology
  2. Interface pressure profile analysis for patellar tendon-bearing socket and hydrostatic socket
    Moo EK, Osman NA, Pingguan-Murphy B, Abas WA, Spence WD, Solomonidis SE
    Acta Bioeng Biomech, 2009;11(4):37-43.
    PMID: 20405814
    Conventionally, patellar tendon-bearing (PTB) sockets, which need high dexterity of prosthetist, are widely used. Lack of chartered and experienced prosthetist has often led to painful experience of wearing prosthesis and this will in turn deter the patients to wear the prosthesis, which will further aggravate stump shrinkage. Thus, the hydrostatic socket which demands relatively lower level of fabricating skill is proposed to replace the PTB socket in order to produce the equivalent, if not better, quality of support to the amputee patients. Both sockets' pressure profiles are studied and compared using finite element analysis (FEA) software. Three-dimensional models of both sockets were developed using MIMICS software. The analysis results showed that hydrostatic socket did exhibit more uniform pressure profiles than that of PTB socket. PTB socket showed pressure concentration near the proximal brim of the socket and also at the distal fibula. It was also found that the pressure magnitude in hydrostatic socket is relatively lower than that of PTB socket.
    Matched MeSH terms: Amputation Stumps/physiopathology; Amputation Stumps/surgery
  3. The patellar tendon bar! Is it a necessary feature?
    Abu Osman NA, Spence WD, Solomonidis SE, Paul JP, Weir AM
    Med Eng Phys, 2010 Sep;32(7):760-5.
    PMID: 20678997 DOI: 10.1016/j.medengphy.2010.04.020
    The purpose of this investigation was to vary the load on the patellar tendon bar and to study the subsequent effect this has on the pattern of the pressure distribution at the stump-socket interface. Ten male subjects from the Southern General Hospital in Glasgow, UK participated in this study. Measuring systems utilising strain gauge and electrohydraulic technologies were designed, developed and constructed to enable pressure measurements to be conducted. One transducer, the patellar tendon (PT) transducer, was attached to the patellar tendon bar of the socket such that the patellar tendon bar was capable of being translated by +/-10 mm towards or away from the tendon. The results of this study showed that the position of the patellar tendon bar had no significant effect on the pressure distribution around the socket indicating that it is an unnecessary feature, which, we propose, may be eliminated during manufacture of a trans-tibial socket.
    Matched MeSH terms: Amputation Stumps/physiopathology*; Amputation Stumps/surgery*
  4. Transtibial prosthetic socket pistoning: static evaluation of Seal-In(®) X5 and Dermo(®) Liner using motion analysis system
    Gholizadeh H, Osman NA, Kamyab M, Eshraghi A, Abas WA, Azam MN
    Clin Biomech (Bristol, Avon), 2012 Jan;27(1):34-9.
    PMID: 21794965 DOI: 10.1016/j.clinbiomech.2011.07.004
    The method of attachment of prosthesis to the residual limb (suspension) and socket fitting is a critical issue in the process of providing an amputee with prosthesis. Different suspension methods try to minimize the pistoning movement inside the socket. The Seal-In(®) X5 and Dermo(®) Liner by Ossur are new suspension liners that intend to reduce pistoning between the socket and liner. Since the effects of these new liners on suspension are unclear, the objective of this study was to compare the pistoning effect of Seal-In(®) X5 and Dermo(®) Liner by using Vicon Motion System.
    Matched MeSH terms: Amputation Stumps/physiopathology*
  5. Clinical evaluation of two prosthetic suspension systems in a bilateral transtibial amputee
    Gholizadeh H, Abu Osman NA, Kamyab M, Eshraghi A, Lúvíksdóttir AG, Wan Abas WA
    Am J Phys Med Rehabil, 2012 Oct;91(10):894-8.
    PMID: 22173083
    The effects of Seal-In X5 and Dermo liner (Össur) on suspension and patient's comfort in lower limb amputees are unclear. In this report, we consider the case of a 51-yr-old woman with bilateral transtibial amputation whose lower limbs were amputated because of peripheral vascular disease. The subject had bony and painful residual limbs, especially at the distal ends. Two prostheses that used Seal-In X5 liners and a pair of prostheses with Dermo liners were fabricated, and the subject wore each for a period of 2 wks. Once the 2 wks had passed, the pistoning within the socket was assessed and the patient was questioned as to her satisfaction with both liners. This study revealed that Seal-In X5 liner decreased the residual limb pain experienced by the patient and that 1-2 mm less pistoning occurred within the socket compared with the Dermo liner. However, the patient needed to put in extra effort for donning and doffing the prosthesis. Despite this, it is clear that the Seal-In X5 liner offers a viable alternative for individuals with transtibial amputations who do not have enough soft tissue around the bone, especially at the end of the residual limb.
    Matched MeSH terms: Amputation Stumps
  6. Fulltext Traumatic hemipelvectomy with free gluteus maximus fillet flap covers: a case report
    Faisham W, Azman W, Muzaffar T, Muslim D, Azhar A, Yahya M
    Malays Orthop J, 2012 Nov;6(3):37-9.
    PMID: 25279054 MyJurnal DOI: 10.5704/MOJ.1207.002
    Traumatic hemipelvectomy is an uncommon and life threatening injury. We report a case of a 16-year-old boy involved in a traffic accident who presented with an almost circumferential pelvic wound with wide diastasis of the right sacroiliac joint and symphysis pubis. The injury was associated with complete avulsion of external and internal iliac vessels as well as the femoral and sciatic nerves. He also had ipsilateral open comminuted fractures of the femur and tibia. Emergency debridement and completion of amputation with preservation of the posterior gluteal flap and primary anastomosis of the inferior gluteal vessels to the internal iliac artery stump were performed. A free fillet flap was used to close the massive exposed area.
    Matched MeSH terms: Amputation Stumps
  7. Clinical investigation of the interface pressure in the trans-tibial socket with Dermo and Seal-In X5 liner during walking and their effect on patient satisfaction
    Ali S, Osman NA, Mortaza N, Eshraghi A, Gholizadeh H, Wan Abas WA
    Clin Biomech (Bristol, Avon), 2012 Nov;27(9):943-8.
    PMID: 22795863 DOI: 10.1016/j.clinbiomech.2012.06.004
    The interface pressure between the residual limb and prosthetic socket has a significant effect on an amputee's satisfaction and comfort. Liners provide a comfortable interface by adding a soft cushion between the residual limb and the socket. The Dermo and the Seal-In X5 liner are two new interface systems and, due to their relative infancy, very little are known about their effect on patient satisfaction. The aim of this study was to compare the interface pressure with these two liners and their effect on patient satisfaction.
    Matched MeSH terms: Amputation Stumps/physiopathology*
  8. Quantitative and qualitative comparison of a new prosthetic suspension system with two existing suspension systems for lower limb amputees
    Eshraghi A, Abu Osman NA, Karimi MT, Gholizadeh H, Ali S, Wan Abas WA
    Am J Phys Med Rehabil, 2012 Dec;91(12):1028-38.
    PMID: 23168378 DOI: 10.1097/PHM.0b013e318269d82a
    The objectives of this study were to compare the effects of a newly designed magnetic suspension system with that of two existing suspension methods on pistoning inside the prosthetic socket and to compare satisfaction and perceived problems among transtibial amputees.
    Matched MeSH terms: Amputation Stumps
  9. Transtibial prosthetic suspension: less pistoning versus easy donning and doffing
    Gholizadeh H, Abu Osman NA, Eshraghi A, Ali S, Sævarsson SK, Wan Abas WA, et al.
    J Rehabil Res Dev, 2012;49(9):1321-30.
    PMID: 23408214
    Poor suspension increases slippage of the residual limb inside the socket during ambulation. The main purpose of this article is to evaluate the pistoning at the prosthetic liner-socket interface during gait and assess patients' satisfaction with two different liners. Two prostheses with seal-in and locking liners were fabricated for each of the 10 subjects with transtibial amputation. The Vicon motion system was used to measure the pistoning during gait. The subjects were also asked to complete a Prosthesis Evaluation Questionnaire. The results revealed higher pistoning inside the socket during gait with the locking liner than with the seal-in liner (p < 0.05). The overall satisfaction with the locking liner was higher (p < 0.05) because of the relative ease with which the patients could don and doff the device. As such, pistoning may not be the main factor that determines patients' overall satisfaction with the prosthesis and other factors may also contribute to comfort and satisfaction with prostheses. The article also verifies the feasibility of the Vicon motion system for measuring pistoning during gait.
    Matched MeSH terms: Amputation Stumps
  10. An experimental study of the interface pressure profile during level walking of a new suspension system for lower limb amputees
    Eshraghi A, Abu Osman NA, Gholizadeh H, Ali S, Sævarsson SK, Wan Abas WA
    Clin Biomech (Bristol, Avon), 2013 Jan;28(1):55-60.
    PMID: 23157843 DOI: 10.1016/j.clinbiomech.2012.10.002
    Different suspension systems that are used within prosthetic devices may alter the distribution of pressure inside the prosthetic socket in lower limb amputees. This study aimed to compare the interface pressure of a new magnetic suspension system with the pin/lock and Seal-In suspension systems.
    Matched MeSH terms: Amputation Stumps
  11. Satisfaction and problems experienced with transfemoral suspension systems: a comparison between common suction socket and seal-in liner
    Gholizadeh H, Abu Osman NA, Eshraghi A, Ali S, Yahyavi ES
    Arch Phys Med Rehabil, 2013 Aug;94(8):1584-9.
    PMID: 23262380 DOI: 10.1016/j.apmr.2012.12.007
    To compare a seal-in liner with the common suction socket with regards to patient satisfaction and problems experienced with the prosthesis.
    Matched MeSH terms: Amputation Stumps*
  12. Fulltext The capability of fiber Bragg grating sensors to measure amputees' trans-tibial stump/socket interface pressures
    Al-Fakih EA, Osman NA, Eshraghi A, Adikan FR
    Sensors (Basel), 2013 Aug 12;13(8):10348-57.
    PMID: 23941909 DOI: 10.3390/s130810348
    This study presents the first investigation into the capability of fiber Bragg grating (FBG) sensors to measure interface pressure between the stump and the prosthetic sockets of a trans-tibial amputee. FBG element(s) were recoated with and embedded in a thin layer of epoxy material to form a sensing pad, which was in turn embedded in a silicone polymer material to form a pressure sensor. The sensor was tested in real time by inserting a heavy-duty balloon into the socket and inflating it by using an air compressor. This test was conducted to examine the sensitivity and repeatability of the sensor when subjected to pressure from the stump of the trans-tibial amputee and to mimic the actual environment of the amputee's Patellar Tendon (PT) bar. The sensor exhibited a sensitivity of 127 pm/N and a maximum FSO hysteresis of around ~0.09 in real-time operation. Very good reliability was achieved when the sensor was utilized for in situ measurements. This study may lead to smart FBG-based amputee stump/socket structures for pressure monitoring in amputee socket systems, which will result in better-designed prosthetic sockets that ensure improved patient satisfaction.
    Matched MeSH terms: Amputation Stumps/physiopathology*
  13. Fulltext Interface pressure in transtibial socket during ascent and descent on stairs and its effect on patient satisfaction
    Ali S, Abu Osman NA, Eshraghi A, Gholizadeh H, Abd Razak NA, Wan Abas WA
    Clin Biomech (Bristol, Avon), 2013 Nov-Dec;28(9-10):994-9.
    PMID: 24161521 DOI: 10.1016/j.clinbiomech.2013.09.004
    Transtibial amputees encounter stairs and steps during their daily activities. The excessive pressure between residual limb/socket may reduce the walking capability of transtibial prosthetic users during ascent and descent on stairs. The purposes of the research were to evaluate the interface pressure between Dermo (shuttle lock) and Seal-In X5 (prosthetic valve) interface systems during stair ascent and descent, and to determine their satisfaction effects on users.
    Matched MeSH terms: Amputation Stumps/physiopathology*
  14. Fulltext Balance control in lower extremity amputees during quiet standing: a systematic review
    Ku PX, Abu Osman NA, Wan Abas WA
    Gait Posture, 2014 Feb;39(2):672-82.
    PMID: 24331296 DOI: 10.1016/j.gaitpost.2013.07.006
    Postural control has been widely evaluated for the normal population and different groups over the past 20 years. Numerous studies have investigated postural control in quiet standing posture among amputees. However, a comprehensive analysis is lacking on the possible contributing factors to balance. The present systematic review highlights the current findings on variables that contribute to balance instability for lower extremity amputees. The search strategy was performed on PubMed, Web of Science, Medline, Scopus, and CINAHL and then followed by additional manual searching via reference lists in the reviewed articles. The quality of the articles was evaluated using a methodological quality assessment tool. This review included and evaluated a total of 23 full-text articles. Despite the inconsistencies in the methodological design of the studies, all articles scored above the acceptable level in terms of quality. A majority of the studies revealed that lower extremity amputees have increased postural sway in the standing posture. Asymmetry in body weight, which is mainly distributed in the non-amputated leg, was described. Aside from the centre of pressure in postural control, sensory inputs may be a related topic for investigation in view of evidence on their contribution, particularly visual input. Other balance-related factors, such as stump length and patients' confidence level, were also neglected. Further research requires examination on the potential factors that affect postural control as the information of standing postural is still limited.
    Matched MeSH terms: Amputation Stumps/physiopathology*
  15. Transfemoral prosthesis suspension systems: a systematic review of the literature
    Gholizadeh H, Abu Osman NA, Eshraghi A, Ali S
    Am J Phys Med Rehabil, 2014 Sep;93(9):809-23.
    PMID: 24743451 DOI: 10.1097/PHM.0000000000000094
    The purpose of this study was to find the scientific evidence pertaining to various transfemoral suspension systems to provide selection criteria for clinicians. To this end, databases of PubMed, Web of Science, and ScienceDirect were explored. The following key words, as well as their combinations and synonyms, were used for the search: transfemoral prosthesis, prosthetic suspension, lower limb prosthesis, above-knee prosthesis, prosthetic liner, transfemoral, and prosthetic socket. The study design, research instrument, sampling method, outcome measures, and protocols of articles were reviewed. On the basis of the selection criteria, 16 articles (11 prospective studies and 5 surveys) were reviewed. The main causes of reluctance to prosthesis, aside from energy expenditure, were socket-related problems such as discomfort, perspiration, and skin problems. Osseointegration was a suspension option, yet it is rarely applied because of several drawbacks, such as extended rehabilitation process, risk for fracture, and infection along with excessive cost. In conclusion, no clinical evidence was found as a "standard" system of suspension and socket design for all transfemoral amputees. However, among various suspension systems for transfemoral amputees, the soft insert or double socket was favored by most users in terms of function and comfort.
    Matched MeSH terms: Amputation Stumps
  16. Fulltext Gait biomechanics of individuals with transtibial amputation: effect of suspension system
    Eshraghi A, Abu Osman NA, Karimi M, Gholizadeh H, Soodmand E, Wan Abas WA
    PLoS One, 2014;9(5):e96988.
    PMID: 24865351 DOI: 10.1371/journal.pone.0096988
    Prosthetic suspension system is an important component of lower limb prostheses. Suspension efficiency can be best evaluated during one of the vital activities of daily living, i.e. walking. A new magnetic prosthetic suspension system has been developed, but its effects on gait biomechanics have not been studied. This study aimed to explore the effect of suspension type on kinetic and kinematic gait parameters during level walking with the new suspension system as well as two other commonly used systems (the Seal-In and pin/lock). Thirteen persons with transtibial amputation participated in this study. A Vicon motion system (six cameras, two force platforms) was utilized to obtain gait kinetic and kinematic variables, as well as pistoning within the prosthetic socket. The gait deviation index was also calculated based on the kinematic data. The findings indicated significant difference in the pistoning values among the three suspension systems. The Seal-In system resulted in the least pistoning compared with the other two systems. Several kinetic and kinematic variables were also affected by the suspension type. The ground reaction force data showed that lower load was applied to the limb joints with the magnetic suspension system compared with the pin/lock suspension. The gait deviation index showed significant deviation from the normal with all the systems, but the systems did not differ significantly. Main significant effects of the suspension type were seen in the GRF (vertical and fore-aft), knee and ankle angles. The new magnetic suspension system showed comparable effects in the remaining kinetic and kinematic gait parameters to the other studied systems. This study may have implications on the selection of suspension systems for transtibial prostheses. Trial registration: Iranian Registry of Clinical Trials IRCT2013061813706N1.
    Matched MeSH terms: Amputation Stumps
  17. Interface stress in socket/residual limb with transtibial prosthetic suspension systems during locomotion on slopes and stairs
    Eshraghi A, Abu Osman NA, Gholizadeh H, Ali S, Abas WA
    Am J Phys Med Rehabil, 2015 Jan;94(1):1-10.
    PMID: 24919079 DOI: 10.1097/PHM.0000000000000134
    This study aimed to compare the effects of different suspension methods on the interface stress inside the prosthetic sockets of transtibial amputees when negotiating ramps and stairs.
    Matched MeSH terms: Amputation Stumps/physiopathology*
  18. The effect of Dermo and Seal-In X5 prosthetic liners on pressure distributions and reported satisfaction during ramp ambulation in persons with transtibial limb loss
    Ali S, Osman NA, Razak A, Hussain S, Wan Abas WA
    Eur J Phys Rehabil Med, 2015 Feb;51(1):31-7.
    PMID: 24963603
    Lower limb amputee's are greatly affected in dealing with the environmental barriers such as ramps and stairs and reported high interface pressure between the residual limb and socket/liner. Interface pressure between the residual limb and socket/liner can affect the satisfaction and use of the prosthesis. Until now, little attention has been paid to interface pressure between socket and stump during ramp negotiation and its effect on amputee's satisfaction.
    Matched MeSH terms: Amputation Stumps
  19. Fulltext Techniques for Interface Stress Measurements within Prosthetic Sockets of Transtibial Amputees: A Review of the Past 50 Years of Research
    Al-Fakih EA, Abu Osman NA, Mahmad Adikan FR
    Sensors (Basel), 2016 Jul 20;16(7).
    PMID: 27447646 DOI: 10.3390/s16071119
    The distribution of interface stresses between the residual limb and prosthetic socket of a transtibial amputee has been considered as a direct indicator of the socket quality fit and comfort. Therefore, researchers have been very interested in quantifying these interface stresses in order to evaluate the extent of any potential damage caused by the socket to the residual limb tissues. During the past 50 years a variety of measurement techniques have been employed in an effort to identify sites of excessive stresses which may lead to skin breakdown, compare stress distributions in various socket designs, and evaluate interface cushioning and suspension systems, among others. The outcomes of such measurement techniques have contributed to improving the design and fitting of transtibial sockets. This article aims to review the operating principles, advantages, and disadvantages of conventional and emerging techniques used for interface stress measurements inside transtibial sockets. It also reviews and discusses the evolution of different socket concepts and interface stress investigations conducted in the past five decades, providing valuable insights into the latest trends in socket designs and the crucial considerations for effective stress measurement tools that lead to a functional prosthetic socket.
    Matched MeSH terms: Amputation Stumps
  20. A comparison of pressure distributions between two types of sockets in a bulbous stump
    Gholizadeh H, Abu Osman NA, Eshraghi A, Arifin N, Chung TY
    Prosthet Orthot Int, 2016 Aug;40(4):509-16.
    PMID: 25583929 DOI: 10.1177/0309364614564022
    BACKGROUND: This article describes a total surface bearing prosthetic socket for a patient (25-year-old female) with a bulbous stump.

    CASE DESCRIPTION AND METHODS: The subject had unstable excessive soft tissue at the distal end of the residuum. After 2 years of prosthetic use, she experienced several problems, including pain in the residual limb and knee joint. Pressure distribution was evaluated during ambulation. We also designed a total surface bearing socket with Velcro as suspension system to distribute the load evenly on the residual limb, and to facilitate donning procedure.

    FINDINGS AND OUTCOMES: The main site of weight bearing in the old prosthesis (patellar tendon bearing) was anterior proximal region of the residual limb, especially the patellar tendon. The pressure was almost 10 times higher than the distal region during level walking. Pressures were distributed more evenly with the total surface bearing socket design, and the donning was much easier.

    CONCLUSION: Pressure distribution within the socket could be affected by socket design and suspension system. Using the total surface bearing socket and Velcro as suspension system might facilitate donning of prosthesis and reduce traction at the end of residual limb during the swing phase of gait.

    CLINICAL RELEVANCE: Proper socket design and suspension system based on the amputees' need can facilitate rehabilitation process and lead to the amputee's satisfaction. The pressure is distributed more uniformly over the residual limb by the total surface bearing socket compared to the patellar tendon bearing socket for lower limb amputees with unusual stump shape.

    Matched MeSH terms: Amputation Stumps
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