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Fulltext Development and performance of a new prosthesis system using ultrasonic sensor for wrist movements: a preliminary study

Abd Razak NA, Abu Osman NA, Gholizadeh H, Ali S

Biomed Eng Online, 2014 Apr 23;13:49.
PMID: 24755242 DOI: 10.1186/1475-925X-13-49

BACKGROUND: The design and performance of a new development prosthesis system known as biomechatronics wrist prosthesis is presented in this paper. The prosthesis system was implemented by replacing the Bowden tension cable of body powered prosthesis system using two ultrasonic sensors, two servo motors and microcontroller inside the prosthesis hand for transradial user.
METHODS: The system components and hand prototypes involve the anthropometry, CAD design and prototyping, biomechatronics engineering together with the prosthetics. The modeler construction of the system develop allows the ultrasonic sensors that are placed on the shoulder to generate the wrist movement of the prosthesis. The kinematics of wrist movement, which are the pronation/supination and flexion/extension were tested using the motion analysis and general motion of human hand were compared. The study also evaluated the require degree of detection for the input of the ultrasonic sensor to generate the wrist movements.
RESULTS: The values collected by the vicon motion analysis for biomechatronics prosthesis system were reliable to do the common tasks in daily life. The degree of the head needed to bend to give the full input wave was about 45°-55° of rotation or about 14 cm-16 cm. The biomechatronics wrist prosthesis gave higher degree of rotation to do the daily tasks but did not achieve the maximum degree of rotation.
CONCLUSION: The new development of using sensor and actuator in generating the wrist movements will be interesting for used list in medicine, robotics technology, rehabilitations, prosthetics and orthotics.
Satisfaction and problems experienced with wrist movements: comparison between a common body-powered prosthesis and a new biomechatronics prosthesis

Abd Razak NA, Abu Osman NA, Kamyab M, Wan Abas WA, Gholizadeh H

Am J Phys Med Rehabil, 2014 May;93(5):437-44.
PMID: 24429510 DOI: 10.1097/PHM.0b013e3182a51fc2

This report compares wrist supination and pronation and flexion and extension movements with the common body-powered prosthesis and a new biomechatronics prosthesis with regard to patient satisfaction and problems experienced with the prosthesis. Fifteen subjects with traumatic transradial amputation who used both prosthetic systems participated in this study. Each subject completed two questionnaires to evaluate their satisfaction and problems experienced with the two prosthetic systems. Satisfaction and problems with the prosthetic's wrist movements were analyzed in terms of the following: supination and pronation; flexion and extension; appearance; sweating; wounds; pain; irritation; pistoning; smell; sound; durability; and the abilities to open a door, hold a cup, and pick up or place objects. This study revealed that the respondents were more satisfied with the biomechatronics wrist prosthesis with regard to supination and pronation, flexion and extension, pain, and the ability to open a door. However, satisfaction with the prosthesis showed no significant differences in terms of sweating, wounds, irritation, pistoning, smell, sound, and durability. The abilities to hold a cup and pick up or place an object were significantly better with the body-powered prosthesis. The results of the survey suggest that satisfaction and problems with wrist movements in persons with transradial amputation can be improved with a biomechatronics wrist prosthesis compared with the common body-powered prosthesis.
Fulltext Design and development of potential tissue engineering scaffolds from structurally different longitudinal parts of a bovine-femur

Pramanik S, Pingguan-Murphy B, Cho J, Abu Osman NA

Sci Rep, 2014 Jul 28;4:5843.
PMID: 25068570 DOI: 10.1038/srep05843

The complex architecture of the cortical part of the bovine-femur was examined to develop potential tissue engineering (TE) scaffolds. Weight-change and X-ray diffraction (XRD) results show that significant phase transformation and morphology conversion of the bone occur at 500-750°C and 750-900°C, respectively. Another breakthrough finding was achieved by determining a sintering condition for the nucleation of hydroxyapatite crystal from bovine bone via XRD technique. Scanning electron microscopy results of morphological growth suggests that the concentration of polymer fibrils increases (or decreases, in case of apatite crystals) from the distal to proximal end of the femur. Energy-dispersive analysis of X-ray, Fourier transform infrared, micro-computer tomography, and mechanical studies of the actual composition also strongly support our microscopic results and firmly indicate the functionally graded material properties of bovine-femur. Bones sintered at 900 and 1000°C show potential properties for soft and hard TE applications, respectively.
New method for the isolation of endothelial cells from large vessels

Ataollahi F, Pingguan-Murphy B, Moradi A, Wan Abas WA, Chua KH, Abu Osman NA

Cytotherapy, 2014 Aug;16(8):1145-52.
PMID: 24831838 DOI: 10.1016/j.jcyt.2014.01.010

Numerous protocols for the isolation of bovine aortic endothelial cells have been described in the previous literature. However, these protocols prevent researchers from obtaining the pure population of endothelial cells. Thus, this study aimed to develop a new and economical method for the isolation of pure endothelial cells by introducing a new strategy to the enzymatic digestion method proposed by previous researchers.
Treatment stability of Milwaukee brace in idiopathic hyperkyphosis

Mehdikhani M, Behtash H, Ganjavian MS, Abu Osman NA, Khalaj N

Prosthet Orthot Int, 2014 Aug;38(4):316-20.
PMID: 23950552 DOI: 10.1177/0309364613499063

The Milwaukee brace is an efficient method for correcting hyperkyphosis before skeletal maturity. However, loss of correction in long-term follow-up is inevitable.
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.
Are the spatio-temporal parameters of gait capable of distinguishing a faller from a non-faller elderly?

Mortaza N, Abu Osman NA, Mehdikhani N

Eur J Phys Rehabil Med, 2014 Dec;50(6):677-91.
PMID: 24831570

Fall is a common and a major cause of injuries. It is important to find elderlies who are prone to falls. The majority of serious falls occur during walking among the older adults. Analyzing the spatio-temporal parameters of walking is an easy way of assessment in the clinical setting, but is it capable of distinguishing a faller from a non-faller elderly? Through a systematic review of the literature, the objective of this systematic review was to identify and summarize the differences in the spatio-temporal parameters of walking in elderly fallers and non-fallers and to find out if these parameters are capable of distinguishing a faller from a non-faller. All original research articles which compared any special or temporal walking parameters in faller and non-faller elderlies were systematically searched within the Scopus and Embase databases. Effect size analysis was also done to standardize findings and compare the gait parameters of fallers and non-fallers across the selected studies. The electronic search led to 5381 articles. After title and abstract screening 30 articles were chosen; further assessment of the full texts led to 17 eligible articles for inclusion in the review. It seems that temporal measurements are more sensitive to the detection of risk of fall in elderly people. The results of the 17 selected studies showed that fallers have a tendency toward a slower walking speed and cadence, longer stride time, and double support duration. Also, fallers showed shorter stride and step length, wider step width and more variability in spatio-temporal parameters of gait. According to the effect size analysis, step length, gait speed, stride length and stance time variability were respectively more capable of differentiating faller from non-faller elderlies. However, because of the difference of methodology and number of studies which investigated each parameter, these results are prone to imprecision. Spatio-temporal analysis of level walking is not sufficient and cannot act as a reliable predictor of falls in elderly individuals.
Fulltext Piezoelectric bimorphs' characteristics as in-socket sensors for transfemoral amputees

El-Sayed AM, Hamzaid NA, Abu Osman NA

Sensors (Basel), 2014;14(12):23724-41.
PMID: 25513823 DOI: 10.3390/s141223724

Alternative sensory systems for the development of prosthetic knees are being increasingly highlighted nowadays, due to the rapid advancements in the field of lower limb prosthetics. This study presents the use of piezoelectric bimorphs as in-socket sensors for transfemoral amputees. An Instron machine was used in the calibration procedure and the corresponding output data were further analyzed to determine the static and dynamic characteristics of the piezoelectric bimorph. The piezoelectric bimorph showed appropriate static operating range, repeatability, hysteresis, and frequency response for application in lower prosthesis, with a force range of 0-100 N. To further validate this finding, an experiment was conducted with a single transfemoral amputee subject to measure the stump/socket pressure using the piezoelectric bimorph embedded inside the socket. The results showed that a maximum interface pressure of about 27 kPa occurred at the anterior proximal site compared to the anterior distal and posterior sites, consistent with values published in other studies. This paper highlighted the capacity of piezoelectric bimorphs to perform as in-socket sensors for transfemoral amputees. However, further experiments are recommended to be conducted with different amputees with different socket types.
Fulltext A comparison in mechanical properties of cermets of calcium silicate with Ti-55Ni and Ti-6Al-4V alloys for hard tissues replacement

Ataollahi Oshkour A, Pramanik S, Shirazi SF, Mehrali M, Yau YH, Abu Osman NA

ScientificWorldJournal, 2014;2014:616804.
PMID: 25538954 DOI: 10.1155/2014/616804

This study investigated the impact of calcium silicate (CS) content on composition, compressive mechanical properties, and hardness of CS cermets with Ti-55Ni and Ti-6Al-4V alloys sintered at 1200°C. The powder metallurgy route was exploited to prepare the cermets. New phases of materials of Ni16Ti6Si7, CaTiO3, and Ni31Si12 appeared in cermet of Ti-55Ni with CS and in cermet of Ti-6Al-4V with CS, the new phases Ti5Si3, Ti2O, and CaTiO3, which were emerged during sintering at different CS content (wt%). The minimum shrinkage and density were observed in both groups of cermets for the 50 and 100 wt% CS content, respectively. The cermets with 40 wt% of CS had minimum compressive Young's modulus. The minimum of compressive strength and strain percentage at maximum load were revealed in cermets with 50 and 40 wt% of CS with Ti-55Ni and Ti-6Al-4V cermets, respectively. The cermets with 80 and 90 wt% of CS showed more plasticity than the pure CS. It concluded that the composition and mechanical properties of sintered cermets of Ti-55Ni and Ti-6Al-4V with CS significantly depend on the CS content in raw cermet materials. Thus, the different mechanical properties of the cermets can be used as potential materials for different hard tissues replacements.
Fulltext Investigation of CPD and HMDS sample preparation techniques for cervical cells in developing computer-aided screening system based on FE-SEM/EDX

Jusman Y, Ng SC, Abu Osman NA

ScientificWorldJournal, 2014;2014:289817.
PMID: 25610902 DOI: 10.1155/2014/289817

This paper investigated the effects of critical-point drying (CPD) and hexamethyldisilazane (HMDS) sample preparation techniques for cervical cells on field emission scanning electron microscopy and energy dispersive X-ray (FE-SEM/EDX). We investigated the visualization of cervical cell image and elemental distribution on the cervical cell for two techniques of sample preparation. Using FE-SEM/EDX, the cervical cell images are captured and the cell element compositions are extracted for both sample preparation techniques. Cervical cell image quality, elemental composition, and processing time are considered for comparison of performances. Qualitatively, FE-SEM image based on HMDS preparation technique has better image quality than CPD technique in terms of degree of spread cell on the specimen and morphologic signs of cell deteriorations (i.e., existence of plate and pellet drying artifacts and membrane blebs). Quantitatively, with mapping and line scanning EDX analysis, carbon and oxygen element compositions in HMDS technique were higher than the CPD technique in terms of weight percentages. The HMDS technique has shorter processing time than the CPD technique. The results indicate that FE-SEM imaging, elemental composition, and processing time for sample preparation with the HMDS technique were better than CPD technique for cervical cell preparation technique for developing computer-aided screening system.
Fulltext Comparison of various functionally graded femoral prostheses by finite element analysis

Oshkour AA, Talebi H, Shirazi SF, Bayat M, Yau YH, Tarlochan F, et al.

ScientificWorldJournal, 2014;2014:807621.
PMID: 25302331 DOI: 10.1155/2014/807621

This study is focused on finite element analysis of a model comprising femur into which a femoral component of a total hip replacement was implanted. The considered prosthesis is fabricated from a functionally graded material (FGM) comprising a layer of a titanium alloy bonded to a layer of hydroxyapatite. The elastic modulus of the FGM was adjusted in the radial, longitudinal, and longitudinal-radial directions by altering the volume fraction gradient exponent. Four cases were studied, involving two different methods of anchoring the prosthesis to the spongy bone and two cases of applied loading. The results revealed that the FG prostheses provoked more SED to the bone. The FG prostheses carried less stress, while more stress was induced to the bone and cement. Meanwhile, less shear interface stress was stimulated to the prosthesis-bone interface in the noncemented FG prostheses. The cement-bone interface carried more stress compared to the prosthesis-cement interface. Stair climbing induced more harmful effects to the implanted femur components compared to the normal walking by causing more stress. Therefore, stress shielding, developed stresses, and interface stresses in the THR components could be adjusted through the controlling stiffness of the FG prosthesis by managing volume fraction gradient exponent.
Fulltext Effect of intra-articular hyaluronic injection on postural stability and risk of fall in patients with bilateral knee osteoarthritis

Khalaj N, Abu Osman NA, Mokhtar AH, George J, Abas WA

ScientificWorldJournal, 2014;2014:815184.
PMID: 25136689 DOI: 10.1155/2014/815184

Knee osteoarthritis is a common cause of disability which influences the quality of life. It is associated with impaired knee joint proprioception, which affects postural stability. Postural stability is critical for mobility and physical activities. Different types of treatment including nonsurgical and surgical are used for knee osteoarthritis. Hyaluronic acid injection is a nonsurgical popular treatment used worldwide. The aim of this study was to demonstrate the effect of hyaluronic acid injections on postural stability in individuals with bilateral knee osteoarthritis. Fifty patients aged between 50 and 70 years with mild and moderate bilateral knee osteoarthritis participated in our study. They were categorized into treatment (n = 25) and control (n = 25) groups. The treatment group received five weekly hyaluronic acid injections for both knees, whereas the control group did not receive any treatment. Postural stability and fall risk were assessed using the Biodex Stability System and clinical "Timed Up and Go" test. All the participants completed the study. The treatment group showed significant decrease in postural stability and fall risk scores after five hyaluronic acid injections. In contrast, the control group showed significant increase. This study illustrated that five intra-articular hyaluronic acid injections could significantly improve postural stability and fall risk in bilateral knee osteoarthritis patients. This trial is registered with: NCT02063373.
Fulltext Comparative study between Dermo, Pelite, and Seal-In X5 liners: effect on patient's satisfaction and perceived problems

Ali S, Abu Osman NA, Arifin N, Gholizadeh H, Abd Razak NA, Abas WA

ScientificWorldJournal, 2014;2014:769810.
PMID: 25184154 DOI: 10.1155/2014/769810

This study aimed to compare the effect of satisfaction and perceived problems between Pelite, Dermo with shuttle lock, and Seal-In X5 liners on the transtibial amputees.
Fulltext Intelligent screening systems for cervical cancer

Jusman Y, Ng SC, Abu Osman NA

ScientificWorldJournal, 2014;2014:810368.
PMID: 24955419 DOI: 10.1155/2014/810368

Advent of medical image digitalization leads to image processing and computer-aided diagnosis systems in numerous clinical applications. These technologies could be used to automatically diagnose patient or serve as second opinion to pathologists. This paper briefly reviews cervical screening techniques, advantages, and disadvantages. The digital data of the screening techniques are used as data for the computer screening system as replaced in the expert analysis. Four stages of the computer system are enhancement, features extraction, feature selection, and classification reviewed in detail. The computer system based on cytology data and electromagnetic spectra data achieved better accuracy than other data.
Fulltext Development of an air pneumatic suspension system for transtibial prostheses

Pirouzi G, Abu Osman NA, Oshkour AA, Ali S, Gholizadeh H, Abas WA

Sensors (Basel), 2014;14(9):16754-65.
PMID: 25207872 DOI: 10.3390/s140916754

The suspension system and socket fitting of artificial limbs have major roles and vital effects on the comfort, mobility, and satisfaction of amputees. This paper introduces a new pneumatic suspension system that overcomes the drawbacks of current suspension systems in donning and doffing, change in volume during daily activities, and pressure distribution in the socket-stump interface. An air pneumatic suspension system (APSS) for total-contact sockets was designed and developed. Pistoning and pressure distribution in the socket-stump interface were tested for the new APSS. More than 95% of the area between each prosthetic socket and liner was measured using a Tekscan F-Scan pressure measurement which has developed matrix-based pressure sensing systems. The variance in pressure around the stump was 8.76 kPa. APSS exhibits less pressure concentration around the stump, improved pressure distribution, easy donning and doffing, adjustability to remain fitted to the socket during daily activities, and more adaptability to the changes in stump volume. The volume changes were adjusted by utility of air pressure sensor. The vertical displacement point and reliability of suspension were assessed using a photographic method. The optimum pressure in every level of loading weight was 55 kPa, and the maximum displacement was 6 mm when 90 N of weight was loaded.
Fulltext Effect of layer thickness and printing orientation on mechanical properties and dimensional accuracy of 3D printed porous samples for bone tissue engineering

Farzadi A, Solati-Hashjin M, Asadi-Eydivand M, Abu Osman NA

PLoS One, 2014;9(9):e108252.
PMID: 25233468 DOI: 10.1371/journal.pone.0108252

Powder-based inkjet 3D printing method is one of the most attractive solid free form techniques. It involves a sequential layering process through which 3D porous scaffolds can be directly produced from computer-generated models. 3D printed products' quality are controlled by the optimal build parameters. In this study, Calcium Sulfate based powders were used for porous scaffolds fabrication. The printed scaffolds of 0.8 mm pore size, with different layer thickness and printing orientation, were subjected to the depowdering step. The effects of four layer thicknesses and printing orientations, (parallel to X, Y and Z), on the physical and mechanical properties of printed scaffolds were investigated. It was observed that the compressive strength, toughness and Young's modulus of samples with 0.1125 and 0.125 mm layer thickness were more than others. Furthermore, the results of SEM and μCT analyses showed that samples with 0.1125 mm layer thickness printed in X direction have more dimensional accuracy and significantly close to CAD software based designs with predefined pore size, porosity and pore interconnectivity.
Fulltext Postural stability characteristics of transtibial amputees wearing different prosthetic foot types when standing on various support surfaces

Arifin N, Abu Osman NA, Ali S, Gholizadeh H, Abas WA

ScientificWorldJournal, 2014;2014:856279.
PMID: 25003155 DOI: 10.1155/2014/856279

This study aimed to evaluate the effects of prosthetic foot types on the postural stability among transtibial amputees when standing on different support surfaces.
Fulltext Technology efficacy in active prosthetic knees for transfemoral amputees: a quantitative evaluation

El-Sayed AM, Hamzaid NA, Abu Osman NA

ScientificWorldJournal, 2014;2014:297431.
PMID: 25110727 DOI: 10.1155/2014/297431

Several studies have presented technological ensembles of active knee systems for transfemoral prosthesis. Other studies have examined the amputees' gait performance while wearing a specific active prosthesis. This paper combined both insights, that is, a technical examination of the components used, with an evaluation of how these improved the gait of respective users. This study aims to offer a quantitative understanding of the potential enhancement derived from strategic integration of core elements in developing an effective device. The study systematically discussed the current technology in active transfemoral prosthesis with respect to its functional walking performance amongst above-knee amputee users, to evaluate the system's efficacy in producing close-to-normal user performance. The performances of its actuator, sensory system, and control technique that are incorporated in each reported system were evaluated separately and numerical comparisons were conducted based on the percentage of amputees' gait deviation from normal gait profile points. The results identified particular components that contributed closest to normal gait parameters. However, the conclusion is limitedly extendable due to the small number of studies. Thus, more clinical validation of the active prosthetic knee technology is needed to better understand the extent of contribution of each component to the most functional development.
Fulltext Review of the socket design and interface pressure measurement for transtibial prosthesis

Pirouzi G, Abu Osman NA, Eshraghi A, Ali S, Gholizadeh H, Wan Abas WA

ScientificWorldJournal, 2014;2014:849073.
PMID: 25197716 DOI: 10.1155/2014/849073

Socket is an important part of every prosthetic limb as an interface between the residual limb and prosthetic components. Biomechanics of socket-residual limb interface, especially the pressure and force distribution, have effect on patient satisfaction and function. This paper aimed to review and evaluate studies conducted in the last decades on the design of socket, in-socket interface pressure measurement, and socket biomechanics. Literature was searched to find related keywords with transtibial amputation, socket-residual limb interface, socket measurement, socket design, modeling, computational modeling, and suspension system. In accordance with the selection criteria, 19 articles were selected for further analysis. It was revealed that pressure and stress have been studied in the last decaeds, but quantitative evaluations remain inapplicable in clinical settings. This study also illustrates prevailing systems, which may facilitate improvements in socket design for improved quality of life for individuals ambulating with transtibial prosthesis. It is hoped that the review will better facilitate the understanding and determine the clinical relevance of quantitative evaluations.
Fulltext The effects of suction and pin/lock suspension systems on transtibial amputees' gait performance

Gholizadeh H, Abu Osman NA, Eshraghi A, Ali S

PLoS One, 2014;9(5):e94520.
PMID: 24827560 DOI: 10.1371/journal.pone.0094520

The suction sockets that are commonly prescribed for transtibial amputees are believed to provide a better suspension than the pin/lock systems. Nevertheless, their effect on amputees' gait performance has not yet been fully investigated. The main intention of this study was to understand the potential effects of the Seal-in (suction) and the Dermo (pin/lock) suspension systems on amputees' gait performance.

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