Biomedical subjects

E D Lemaire

Publications and source records attributed to E D Lemaire.

9 recordsLinked to original sources

PubMed1998

Low-bandwidth telemedicine for remote orthotic assessment.

A model for performing remote orthotic assessments using low-bandwidth computer communication technology (video conferencing) was developed, tested, and evaluated. System evaluation involved comparing a series of remote assessments with on-site assessments. While most on-site and on-line results were similar, discrepancies which occurred were attributed to between-clinician differences, measurement technique differences, technical and learning obstacles at the start of the project, and within subject variations during the day. On-line assessment efficiency improved with each on-line session and corresponded with increased confidence in the system, easier system use, and better overall satisfaction. An on-line debriefing session was held with all project clinicians. These clinicians supported continued use of the communication system for rehabilitation consultation and education. Clinically. preliminary face-to-face meetings and a regular practice schedule were recommended. Technically, the system was considered good; however, suggested improvements included using a high quality speaker-phone system, streamlining the video capture process, and providing more reliable telecommunication connections.

Computers↗

PubMed1996

A quantitative method for comparing and evaluating manual prosthetic socket modifications.

Manually designed prosthetic sockets are difficult to evaluate since the hand-sculpting modification process does not retain the initial shape for comparison. A quantitative method for defining and comparing manual socket modifications was developed and integrated into the CADVIEW software package. The numerical comparison procedure consisted of a) digitizing premodification and post-modification models of a prosthetic socket, b) aligning these two shapes to a common axis (calculate cross section centroids, determine line of best fit through the centroids, rotate and move the line of best fit to a common axis), and c) displaying the differences in shape both numerically and using a color-coded three dimensional image. Alignment technique testing showed a between-radial-point average error of 2.5 mm using automatic alignment and 1.4 mm after further manual alignment adjustment. The between socket difference values were used to outline individual modifications and save these outlines to disk. Modification outlines from a series of patients were averaged to determine a prosthetist's general modification style. Averaged results from two prosthetists qualitatively supported the effectiveness of this procedure. This alignment and comparison system should help transfer hand-sculpting skills to prosthetic CAD/CAM systems, clinical research, and education for new clinicians.

Amputation Stumps↗

PubMed1996

A CAD CAM digitizing adapter for spinal casts.

An adapter was designed to hold a negative cast of a torso in position for mechanical digitization. Once a spinal shape is digitized, the data file can be loaded into a CAD CAM system for modification and manufacturing of a positive model for an orthosis. The adapter currently fits a Seattle Digitizer (M+IND, Seattle, WA); however, the interface unit can be changed to accommodate other commercial digitizers. By using this adapter, current lower limb prosthetic CAD CAM systems can be used to design and manufacture spinal orthoses.

Anthropometry↗

PubMed1996

Clinical analysis of a CAD/CAM system for custom seating: a comparison with hand-sculpting methods.

A CAD/CAM system for manufacturing custom seating inserts was evaluated within a moderately to severely disabled population. Using the Otto Bock Shape System, 25 CAD/CAM seats were manufactured at a remote facility and compared to 9 seats manufactured using hard-sculpting techniques. Clinician and client questionnaires were completed for each seat to assess satisfaction, fitting/manufacturing times, and to collect demographic data. The CAD/CAM method was significantly better (p < 0.05) than the hand-sculpting method in terms of on-site fabrication time. No significant differences were found for initial fitting time, final fitting time, clinician insert rating, and client satisfaction. These results support the CAD/CAM method as an effective and clinically efficient technique for making custom wheelchair seats.

Adult↗

PubMed1994

Osteoarthritis and elderly amputee gait.

The hypothesis that an increased load on the nonamputated leg of long-term prosthetic users leads to an increased risk of developing osteoarthritis was investigated using physical examinations and gait analysis. Based on the clinical results from an elderly group of experienced trans-tibial amputees and a similar control group of nonamputees, the amputee group experienced a significantly greater incidence of osteoarthritis (p < 0.05) in the knee of their nonamputated leg. The amputee group had consistently larger knee joint reaction forces, joint impulses, net joint moments, and net joint powers. Significantly higher results (p < 0.05) were found for amputee vertical impulse and net joint power during the double support phase of gait. These results support the hypothesis that elderly, trans-tibial amputees have a higher risk of developing osteoarthritis and experience larger forces at the knee of their nonamputated limb than people without lower extremity amputations.

Aged↗

PubMed1994

A trans-femoral brim adapter for CAD CAM measurements.

A computer aided design/computer aided manufacture (CAD CAM) brim measurement adapter was designed for use with a Berkeley casting stand. This measurement adapter accommodates all IPOS/CANFIT-PLUS transfemoral brim sizes and shapes, allows brim positioning, provides adequate stability, and provides a substantial cost saving by using existing, functional hardware as a base.

Anthropometry↗

PubMed1993

Gait patterns of elderly men with trans-tibial amputations.

Gait patterns for the non-amputated leg of eight elderly men with trans-tibial amputations were assessed using kinematic and kinetic measures. Kinematically, the subject's walking speed was faster than expected but less than normative non-amputee data. The stride length was also less than non-amputee norms. Net joint moment and power analyses showed various discrepancies between the amputee subjects and non-amputees. The amputees required a concentric ankle dorsiflexor moment just after heel-strike to help move the lower leg into mid-stance position. The concentric plantarflexor moment at push-off was much larger than comparative data. A large eccentric flexor moment was also found at the hip during late mid-stance. Most of these discrepancies could be explained by the lack of an ankle moment generator on the amputated side of the body.

Age Factors↗

PubMed1991

A technique for the determination of center of gravity and rolling resistance for tilt-seat wheelchairs.

A balance platform setup was defined for use in the determination of the center of gravity in the sagittal plane for a wheelchair and patient. Using the center of gravity information, measurements from the wheelchair and patient (weight, tire coefficients of friction), and various assumptions (constant speed, level-concrete surface, patient-wheelchair system is a rigid body), a method for estimating the rolling resistance for a wheelchair was outlined. The center of gravity and rolling resistance techniques were validated against criterion values (center of gravity error = 1 percent, rolling resistance root mean square error = 0.33 N, rolling resistance Pearson correlation coefficient = 0.995). Consistent results were also obtained from a test dummy and five subjects. Once the center of gravity is known, it is possible to evaluate the stability of a wheelchair (in terms of tipping over) and the interaction between the level of stability and rolling resistance. These quantitative measures are expected to be of use in the setup of wheelchairs with a variable seat angle and variable wheelbase length or when making comparisons between different wheelchairs.

Biomechanical Phenomena↗

PubMed1990

Force-time data acquisition system for sprint starting.

A device for the acquisition of horizontal forces in the sprint start was designed and tested on the basis of linearity, hysteresis, and the force-time curves. The force measuring device was built to resemble and function as a regular starting block while measuring the reaction force from the push off. The linearity test produced a correlation coefficient of 0.99; the hysteresis was 1.0% of the full scale force block output; and the frequency response test displayed an average error of 6% in terms of amplitude and no discernable phase shift effect at a 6 Hz loading frequency. The force-time curves produced were consistent with previous results and did not differ greatly upon comparison with a force plate. All these results were within acceptable limits.

Biomechanical Phenomena↗