Sound Side Research Articles

PHILOSOPHY AND POETRY: THE UNITY AND DIFFERENCE OF DIMENSIONS (Marginalia to E.K. Sobolevskaja’s article “Yearning – homeland – rowan...”)

The poetic dimension of philosophical thought is the central problem of this paper. Poetry and philosophy have different tasks, but both poetry and philosophy are concerned with the word as an instrument – knowledge (for philosophy) and expression (for poetry). Philosophy uses the word in its semantic constituents, abstracting from its external form. For poetry, the external sound side is inseparable from meaning and its various semantic aspects. In some cases, however, these typological attitudes and tenets are reversed. In philosophy, such cases can be considered as the work with language in its poetic dimension. Heraclitus worked in this way in antiquity, Heidegger works with language and with the word similarly in modern times. In poetry, we can consider the work of M. Tsvetaeva as such a case. Poeticizing, as represented by Tsvetaeva, is a cardinal linguistic shift, determined by the inner experience: distancing from any national language, or cardinal defamiliarization of the language in the constitutive centres of its conventional symbolic coordination, recognizing it every time and, accordingly, recognizing, renaming, defamiliarizing of the world. More than anybody else poets are immersed in the world, in search of the names, in giving meanings to things. When considering the poet’s work from the perspective of poetic dimensions of philosophical thought, the author relies on an article by Elena Sobolevskaya “Yearning – homeland – rowan...”, which uses both philological and philosophical approaches to the analysis and interpretation of Marina Tsvetaeva’s poetic work.

Measurement of Sigma Level from Consumer Sound Side in Fried Oil Product

The industry of goods and services is inseparable and is highly related to customers, so customer satisfaction is always the main goal. A company will be able to continue to survive in the market as long as it can maintain good quality in order to satisfy customers. To find out which cooking oil products on the market are in accordance with the wishes of the customer or the voice of customer, a customer satisfaction survey or questionnaire was conducted which was distributed to mothers in Griya Asri housing complex, Purwosari - Pasuruan, by comparing 3 brands of cooking oil which were all made from oil palm, namely: brands A, B and C. From the questionnaire will be known what is needed or desired by the customer so the company can determine CTQ (critical to quality) based on the voice of customer. The questionnaire that has been distributed is then calculated sigma level and also made a comparison between the level of importance with the level of customer satisfaction. The results show that the lowest level of sigma for brand A cooking oil in CTQ is not turbid fast and cheap price is 1.86, with the position in quadrant A (Attention) while for B brand low level sigma cooking oil is in CTQ for low price, namely 1.83 with a position in quadrant A (Attention) and finally the lowest level of sigma for C brand cooking oil is in CTQ Not quickly cloudy, that is 1.97 with a position in quadrant A (Attention). So it can be concluded that the CTQ that needs to be improved and considered both from the sigma level and the quadrant position for the three types of cooking oil products is not turbid fast and cheap prices.

Evaluating the Ability of Congenital Upper Extremity Amputees to Control a Multi-Degree of Freedom Myoelectric Prosthesis

To determine whether children and adults with unilateral congenital upper limb amputation can control myoelectric prostheses with multiple degrees of freedom (DOF) using pattern recognition (PR) technology. Seven participants (age 9-62 years) with unilateral congenital transradial amputation were tested on both their residual and sound side limbs to determine proficiency in controlling a virtual prosthesis using electromyographic signals captured by an array of surface electrodes that were processed using PR technology. Proficiency was measured through a virtual environment game called the target achievement control test, in which the testing protocol asked participants to match increasingly complex prosthesis postures with 1,2, and 3 DOF. All the participants successfully created a PR calibration at 1, 2, and 3 DOF with their residual limb during testing, and no differences in calibration accuracy were observed when comparing the residual versus sound upper limbs. No differences were noted in the mean completion rate on the target achievement control test between the residual and sound limbs. Participants with a congenital upper limb amputation achieved PR control calibration of multi-DOF prostheses with proficiency and quality results of PR calibration that were comparable to those of their sound limb. This capability was observed in children as well as in adults. This demonstrates the potential for children and adults with a unilateral congenital transradial amputation to benefit from myoelectric prostheses with PR control. The results from this study highlight the potential for patients in this population to benefit from myoelectric prostheses with PR control. Persons with unilateral congenital upper limb amputations can be considered for provision of this technology andenrollment in future research activities.

Sound side trunk muscles contribute to trunk control during prosthetic gait in persons with unilateral transfemoral amputation

The incidence of knee and hip joint osteoarthritis in subjects with below knee amputation (BK) appears significantly higher compared to unimpaired subjects, especially in the intact side. However, it is controversial if constant higher loads on the sound side are one of the major factors for an increased osteoarthritis (OA) incidence in subjects with BK, beside other risk factors, e.g. with respect to metabolism. The aim wasto investigate joint contact forces (JCF) calculated by a musculoskeletal model in the intact side and to compare it with those of unimpaired subjects and to further elucidate in how far increased knee JCF are associated with increased frontal plane knee moments. A group of seven subjects with BK amputation and a group of ten unimpaired subjects were recruited for this study. Gait data were measured by 3D motion capture and force plates. OpenSim software was applied to calculate JCF. Maximum joint angles, ground reaction forces, and moments as well as time distance parameters were determined and compared between groups showing no significant differences, with some JCF components of knee and hip even being slightly smaller in subjects with BK compared to the reference group. This positive finding may be due to the selected ESAR foot. However, other beneficial factors may also have influenced this positive result such as the general good health status of the subjects or the thorough and proper fitting and alignment of the prosthesis.

Land cover changes on a barrier island: Yearly changes, storm effects, and recovery periods

Ecosystems on barrier islands provide socio-ecological services to terrestrial and aquatic endangered species, as well as human inhabitants. The management of these coastal ecosystems is challenged by changes in annual and storm time scales driven by atmospheric, oceanographic, geologic, and human processes. Thus, the need for data and methods to accurately quantify and assess ecosystem and land cover evolution to inform stakeholders is on the rise. A dataset of high-resolution color infrared images of a U.S. National Wildlife Refuge is used to quantify annual land cover changes at a barrier island scale and to identify the effects of hurricanes and their recovery periods. Geospatial analysis and change matrices depict the interconnection between 13 land cover classes. Vegetation growth over regions of bare sand formed by storms leads to the creation of successional habitats, while the loss of bare sand dune to beach, and beach to water are indicators of erosional processes. Storms passing along the ocean and sound side of a barrier island result in different land cover changes that can last anywhere from 4 to more than 7 years, respectively. Management practices for coastal regions and the presence of infrastructure partially control the expansion of marshes, bare sand, maritime brush, and dunes.

Efficacy Evaluation of Temporomandibular Arthroscopic-Assisted Masseter Nerve Avulsion on Hemimasticatory Spasm

Hemimasticatory spasm (HMS) is a masticatory muscle disorder without an effective treatment approach at present. This retrospective analysis aims to investigate the clinical efficacy of temporomandibular arthroscope-assisted masseteric nerve avulsion on HMS and thereby further determine a more effective therapeutic strategy for HMS patients. Four patients with HMS receiving temporomandibular arthroscope-assisted masseteric nerve avulsion in the neurology department of oral surgery of our hospital from April 2017 to April 2018 were recruited in this study. Through a clinical follow-up period of 36 months, the comprehensive efficacy of arthroscope-assisted masseteric nerve avulsion was evaluated combined with an electrophysiological electromyogram. Furthermore, the maximum muscle strength and masticatory efficiency of the sound and affected sides were measured to determine whether there were complications. The morphology of the myelin sheath of the masseteric nerve avulsed in the operation was observed under the transmission electron microscope. The 3 years of follow-up showed that complete remission of HMS was seen in 4 patients with the score reduced to grade 0, showing satisfactory clinical efficacy. Electrophysiological electromyogram demonstrated an absence of obvious high-frequency group discharge potential in the 4 patients within 3 years after the operation, and the overall efficacy combined with the clinical efficacy was considered satisfactory. The maximum masseter strength of the sound side had no significant change, but that of the affected side was slightly decreased. The masticatory efficiency of the affected side was slightly decreased immediately after the operation but returned to the preoperative level 1 year after the operation, suggesting that this operation did not affect the masticatory function of the patients. No obvious demyelination was found in the avulsed nervous tissues. Temporomandibular arthroscope-assisted masseteric nerve avulsion yielded satisfactory and stable overall efficacy on the treatment of HMS. The masticatory efficiency of the affected side was optimally preserved, while the maximum masseter muscle strength of the affected side was partially decreased.

Toward Phase-Variable Control of Sit-to-Stand Motion with a Powered Knee-Ankle Prosthesis.

This paper presents a new model and phase-variable controller for sit-to-stand motion in above-knee amputees. The model captures the effect of work done by the sound side and residual limb on the prosthesis, while modeling only the prosthetic knee and ankle with a healthy hip joint that connects the thigh to the torso. The controller is parametrized by a biomechanical phase variable rather than time and is analyzed in simulation using the model. We show that this controller performs well with minimal tuning, under a range of realistic initial conditions and biological parameters such as height and body mass. The controller generates kinematic trajectories that are comparable to experimentally observed trajectories in non-amputees. Furthermore, the torques commanded by the controller are consistent with torque profiles and peak values of normative human sit-to-stand motion. Rise times measured in simulation and in non-amputee experiments are also similar. Finally, we compare the presented controller with a baseline proportional-derivative controller demonstrating the advantages of the phase-based design over a set-point based design.

Spatial Hearing Difficulties in Reaching Space in Bilateral Cochlear Implant Children Improve With Head Movements.

The aim of this study was to assess three-dimensional (3D) spatial hearing abilities in reaching space of children and adolescents fitted with bilateral cochlear implants (BCI). The study also investigated the impact of spontaneous head movements on sound localization abilities. BCI children (N = 18, aged between 8 and 17) and age-matched normal-hearing (NH) controls (N = 18) took part in the study. Tests were performed using immersive virtual reality equipment that allowed control over visual information and initial eye position, as well as real-time 3D motion tracking of head and hand position with subcentimeter accuracy. The experiment exploited these technical features to achieve trial-by-trial exact positioning in head-centered coordinates of a single loudspeaker used for real, near-field sound delivery, which was reproducible across trials and participants. Using this novel approach, broadband sounds were delivered at different azimuths within the participants' arm length, in front and back space, at two different distances from their heads. Continuous head-monitoring allowed us to compare two listening conditions: "head immobile" (no head movements allowed) and "head moving" (spontaneous head movements allowed). Sound localization performance was assessed by computing the mean 3D error (i.e. the difference in space between the X-Y-Z position of the loudspeaker and the participant's final hand position used to indicate the localization of the sound's source), as well as the percentage of front-back and left-right confusions in azimuth, and the discriminability between two nearby distances. Several clinical factors (i.e. age at test, interimplant interval, and duration of binaural experience) were also correlated with the mean 3D error. Finally, the Speech Spatial and Qualities of Hearing Scale was administered to BCI participants and their parents. Although BCI participants distinguished well between left and right sound sources, near-field spatial hearing remained challenging, particularly under the " head immobile" condition. Without visual priors of the sound position, response accuracy was lower than that of their NH peers, as evidenced by the mean 3D error (BCI: 55 cm, NH: 24 cm, p = 0.008). The BCI group mainly pointed along the interaural axis, corresponding to the position of their CI microphones. This led to important front-back confusions (44.6%). Distance discrimination also remained challenging for BCI users, mostly due to sound compression applied by their processor. Notably, BCI users benefitted from head movements under the "head moving" condition, with a significant decrease of the 3D error when pointing to front targets (p < 0.001). Interimplant interval was correlated with 3D error (p < 0.001), whereas no correlation with self-assessment of spatial hearing difficulties emerged (p = 0.9). In reaching space, BCI children and adolescents are able to extract enough auditory cues to discriminate sound side. However, without any visual cues or spontaneous head movements during sound emission, their localization abilities are substantially impaired for front-back and distance discrimination. Exploring the environment with head movements was a valuable strategy for improving sound localization within individuals with different clinical backgrounds. These novel findings could prompt new perspectives to better understand sound localization maturation in BCI children, and more broadly in patients with hearing loss.

Idiopathic Facial Nerve Paralysis &amp; Response to Physiotherapy in Pregnant Woman; A Case Report

Facial nerve palsy is a common condition affecting both genders and all age group. However, its incidence in pregnant females needs greater care. It may affect only lower half of the face or full one side of the face or in extreme condition bilateral sides. Symptoms include deviation of angle of mouth towards sound side, flattening of nasolabial folds, loss of forehead wrinkles and inability to completely close the eyelid along with loss of taste on anterior two third of tongue. Here we present a rare case report of facial nerve palsy in a pregnant woman in third trimester of pregnancy. She was offered an evidence based physiotherapy treatment regime along with pharmacological treatment and she recovered; however late complication of “Ptosis” was reported.

ФОРМУВАННЯ КОМУНІКАТИВНОЇ КОМПЕТЕНТНОСТІ ЯК СКЛАДОВОЇ ПІДГОТОВКИ ДІТЕЙ З МОВЛЕННЄВИМИ ПОРУШЕННЯМИ ДО ШКІЛЬНОГО НАВЧАННЯ

The problem of the effectiveness of the correctional work of students with children who have speech impairments before school education is investigated. Theoretical analysis of the problem has shown that speech and communication are the most important factors of personality formation, because in the process of communicating with the community the child experiences the world, gains experience, and learns knowledge. The basic component of preschool education requires the child to have a certain level of verbal proficiency, i.e. competence, The objective is to teach children different types of verbal competence from an early age so that by the end of preschool age the child has acquired the appropriate knowledge, skills and abilities needed to communicate. It was found that verbal competence is a system of practical knowledge about the sound, lexical, and grammatical sides of speech, which an individual must master in order to take part in acts of verbal communication. It was stated that the solution of the problem will be the implementation by the students of a correctional and developmental program aimed at the formation of speech and language competence as a component of readiness of children with speech impairments to school education. The students of Dnipro National University named after Oles Gonchar under our supervision conducted the research. The study of the level of formation of communicative competence of children with language disorders before school education was implemented. The research involved 32 preschool children: 16 children in the Experimental Group (EG), 16 children in the Control Group (CG). The results of the study allowed the students to conclude that the formation of communicative competence of children with verbal impairments to school education can be successful under the conditions of specially organized, systematized and regular lessons for the correctional and developmental program “Home to school”. The results obtained show the effectiveness of the students’ correctional work with children who have mental impairments before school.

Evaluation of Donor Ankle Function after Harvesting Peroneus Longus Tendon Graft for Anterior Cruciate Ligament Reconstruction- A Prospective Cohort Study

Introduction: Primary full thickness Peroneus Longus Tendon Graft (PLTG) for Anterior Cruciate Ligament Reconstruction (ACLR) has been used with good clinical outcome. Recently, it is designated as a promising graft option for ACLR. The effect of harvesting PLTG on donor ankle function is still not completely understood. Peroneus Longus Tendon (PLT) is thought to play a major role in proprioceptive regulation of the ankle joint. All the studies till date did cross-sectional assessments of ankle and foot function at or after 6 months that might have overlooked the timely detection of donor site morbidities. Aim: To evaluate the ankle function and compare the affected and sound limb function in subjects with an ACLR with autologous PLTG starting at an early postoperative visit upto six months. Materials and Methods: A prospective cohort study was conducted at a tertiary rehabilitation centre from March 2019 to March 2021 including the follow-up evaluation. As per the inclusion criteria, 63 participants after ACLR with PLTG were considered for assessment using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hind foot scale and Foot and Ankle Ability Measure (FAAM) scale at 6 weeks, 3 months and 6 months post-ACLR follow-up. Comparison between sound and affected limbs was done during all follow-ups. The statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 18.0. Both FAAM and AOFAS ankle and foot scores were analysed with non parametric tests. Results: Mean age of 63 participants were 29.25 years. Median of AOFAS and FAAM score at 6 week, 3 month, and 6 month post- ACLR follow-ups were (88, 98 and 100) and (97.22, 98.80 and 100), respectively. Statistically significant increase in AOFAS and FAAM scores were observed at 3 month and 6 month as compared to 6 week follow-ups with p=0.001 and p-value=0.001 respectively. The group comparison between the affected and sound side functional scores at different study visits showed statistically significant greater values for the sound ankle than the affected ankle (FAAM: 6 week: p-value=0.001; 3 month: p-value=0.001; 6 month: p-value=0.001 and AOFAS p-value=0.001; p-value=0.001; p-value=0.001, respectively). Conclusion: The evaluation of functional outcomes showed gradual and linear improvement at subsequent postoperative visits and restores fully to 100% at 6 month indicating a near- normal to normal donor ankle function following ACLR with PLTG by 6 months. The group comparison showed only marginal but significant difference between affected and sound ankle function.

Comparison of Knee Muscle Strength and Ankle Dorsiflexion Range of Motion Between Standing Workers With and Without Patellofemoral Pain Syndrome

Background: Prolonged standing during work causes a lower extremity pain and disorders. Patellofemoral pain syndrome (PFPS) is one of the common diagnoses of the knee pain. Although the etiology of PFPS is not completely understood, it is considered to be multifactorial. Objects: The purpose of this study was to investigate difference in strength of knee muscles, quadriceps:hamstring muscles strength ratio (Q:H ratio), asymmetry ratio of knee muscles strength and dorsiflexion range of motion (ROM) between standing workers with and without PFPS. Methods: Twenty-eight standing workers with PFPS and 26 age-, height-, and weightmatched standing workers without PFPS participated in this study. A tension sensor measured knee muscle strength, and motion sensor measured dorsiflexion ROM. The asymmetry ratio of knee muscles was calculated by a specific formula using the knee muscles strength of the dominant side and the sound side. An independent t-test was used to identify significant differences in the strength, ROM, Q:H ratio, and asymmetry ratio between the PFPS and normal groups. Results: The standing worker with PFPS have significantly lower dorsiflexion ROM (p < 0.000) and higher asymmetry ratio of the hamstring muscles strength (p < 0.000) compare to the standing worker without PFPS. No significant differences were seen in the strength of quadriceps muscle and hamstring muscles, Q:H ratio, and asymmetry ratio of quadriceps muscle strength. Conclusion: There was a significant difference in the asymmetry ratio of the isometric hamstring muscle strength. This finding suggests that the asymmetry ratio of isometric hamstring muscle strength may be more important than measuring only the hamstring muscle strength of the PFPS side. Furthermore, the results of this study showed a significant difference in dorsiflexion ROM between the standing industrial workers with and without PFPS. Dorsiflexion ROM and isometric hamstring muscle strength should be considered when evaluating the subjects with PFPS.

Effects on ankle power and sound limb load with an active prosthetic foot

Abstract The performance of conventional prosthetic feet depends on material and construction principles. Certain powered feet can even generate net positive mechanical work in order to provide an active push-off. The aim of this study was to evaluate the influence of ankle power on the gait of transfemoral amputees. For this purpose level walking of six transfemoral amputees was analysed with a basic and an active foot and three different power settings of the latter. The results show clear advantages of the active foot in comparison with a basic foot. However, a strong relation of the sound side knee loading parameters with the varied ankle power outputs of the active foot couldn’t be shown.

Reliability and Criterion-Related Validity of the activPAL™ Accelerometer When Measuring Physical Activity and Sedentary Behavior in Adults With Lower Limb Absence

Introduction: Accurate measurement of physical behavior in adults with lower limb absence is essential to report true patterns of physical behavior and the effectiveness of interventions. The effect of placing accelerometers on prostheses may also affect the reliability and validity.Purpose: To assess reliability and criterion-related validity of the activPAL for measuring incidental and purposeful stepping, and reclining and stepping time in adults with unilateral lower limb absence.Methods: 15 adults with unilateral lower limb absence completed simulated lifestyle activities in a laboratory setting that were retrospectively scored via video analysis. Objective data were obtained simultaneously from two activPAL monitors placed on the sound and prosthetic side. Data were analyzed using one-way intraclass correlation coefficients (ICC), pairedt-tests and Cohen’sd.Results: Reliability (prosthetic side vs. sound side) was poor for incidental steps (ICC = .05,d = 0.48) but acceptable for all other measures (ICC = .77–.88;d = .00–.18). Mean activPAL measures, although highly related to the criterion, underestimated, on average, stepping and time-related variables. Differences were large for all stepping variables (d = .38–.96).Conclusions: The activPAL is a reliable measurement tool in adults with lower limb absence when used in a laboratory setting. Placement of the monitor on the sound side limb is recommended for testing. The activPAL shows evidence of relative validity, but not absolute validity. Further evaluation is needed to assess whether similar evidence is found in free-living activity and sedentary contexts.

Design and optimization of a hip disarticulation prosthesis using the remote center of motion mechanism.

Hip disarticulation prostheses (HDPs) are not routinely seen in clinical practice, and traditional hip prostheses rotate around an axis at the front side of the pelvic socket. This study proposes a mechanism to restore the rotation center to the acetabulum of the amputated side and uses comparative experiments with traditional HDP to verify the validity of the novel design. A double parallelogram design of HDP based on a remote center of motion (RCM) mechanism was presented in this paper. Optimization was achieved by a genetic algorithm with the maximal integral size and minimal driving force of the mechanism. The prototype was developed by final optimal results and tested by a hip disarticulated amputee. Testing results revealed that the RCM-HDP improved the range of motion of the hip prosthesis by 78%. The maximal flexion of the assorted prosthetic knee was closer to the sound side than a traditional HDP by 15%. The proposed RCM-HDP promoted the kinematic performance and symmetry of the hip prosthesis compared to the traditional design.

Asymmetry of mass and motion affects the regulation of whole-body angular momentum in individuals with upper limb absence

BackgroundThere is a high fall prevalence in individuals with upper limb absence, which may be related to a momentum imbalance resulting from the loss of all or part of one arm. The purpose of this study was to characterise whole-body angular momentum in individuals with upper limb absence during walking, and determine the effect of restoring the mass and inertial properties of the impaired side with a mock prosthesis. MethodsTen individuals with unilateral upper limb absence walked at self-selected speeds, with and without a mock prosthesis. For each condition, whole-body angular momentum range was computed during ten strides; in the first 50% of the stride bilaterally, and over the whole stride. Two-way repeated measures ANOVAs were used to assess the main effect of side and the interaction effect with prosthesis condition on the 50% range, and paired t-tests to determine the effect of prosthesis condition on the whole stride range (α = 0.05). FindingsSagittal plane 50% range was greater for the sound compared to the impaired side stride (P = .003), with no difference in the coronal or transverse planes (P ≥ .8). Coronal plane whole stride range was lower when wearing the mock prosthesis (P = .021), with no change in the sagittal or transverse planes (P ≥ .5). InterpretationUse of a prosthesis does not reduce a sagittal plane imbalance. There may be a greater risk of loss of balance in people with upper limb absence following a perturbation, particularly when it occurs during the sound side stance phase, during which whole-body angular momentum is elevated.

Biomechanical analysis of stair ascent in persons with Chopart amputation.

Compared to walking on level ground, ascending stairs requires a large range of motion not only of the hip and knee joint, but also of the ankle joint. The prosthesis often worn by persons with partial foot amputation largely prevents the ankle motion needed during stair ascent. Aim of this study was to assess subjects with a Chopart amputation utilizing a clamshell device during stair ascent to identify potential biomechanical deficits. Cross-sectional study with reference group. Six subjects with unilateral Chopart amputation and 17 unimpaired subjects underwent three-dimensional motion analysis while ascending stairs in a step-over-step manner. During weight acceptance, the involved side showed increased external hip-flexing and reduced knee-flexing moments and the sound side a higher ankle power than in the control group. The sound side showed higher external knee-flexing, dorsi-flexing, and hip-adducting moments than the controls during weight acceptance. The mechanism observed on the involved side differs from that in controls, but is comparable to the mechanisms used by subjects with transtibial amputation reported in the literature. However, compensatory movements on the sound side take place at the ankle and knee joint, differing from subjects with more proximal amputations. This study underpins the importance of adequate foot leverage and ankle function in cases of partial foot amputation, particularly in transfer situations such as stair ascent. If ankle range of motion is adequate, prosthetic/orthotic devices combining shank leverage with a hinged spring mechanism at the ankle may be promising.

The Influence of Hydraulic Ankles and Microprocessor-control on the Biomechanics of Trans-tibial Amputees During Quiet Standing on a 5° Slope.

Lower limb amputees have a high incidence of comorbidities, such as osteoarthritis, which are believed to be caused by kinetic asymmetries. A lack of prosthetic adaptation to different terrains requires kinematic compensations, which may influence these asymmetries. Six SIGAM grade E-F trans-tibial amputees (one bilateral) wore motion capture markers while standing on force plates, facing down a 5° slope. The participants were tested under three prosthetic conditions; a fixed attachment foot (FIX), a hydraulic ankle (HYD) and a microprocessor foot with a 'standing support' mode (MPF). The resultant ground reaction force (GRF) and support moment for prosthetic and sound limbs were chosen as outcome measures. These were compared between prosthetic conditions and to previously captured able-bodied control data. The distribution of GRF between sound and prosthetic limbs was not significantly affected by foot type. However, the MPF condition required fewer kinematic compensations, leading to a reduction in sound side support moment of 59% (p=0.001) and prosthetic side support moment of 43% (p=0.02) compared to FIX. For the bilateral participant, only the MPF positioned the GRF vector anterior to the knees, reducing the demand on the residual joints to maintain posture. For trans-tibial amputees, loading on lower limb joints is affected by prosthetic foot technology, due to the kinematic compensations required for slope adaptation. MPFs with 'standing support' might be considered reasonable and necessary for bilateral amputees, or amputees with stability problems due to the reduced biomechanical compensations evident.

Gait Characteristics of Transtibial Amputees on Level Ground in a Cohort of 53 Amputees - Comparison of Kinetics and Kinematics With Non-amputees.

Retrospective analysis. The gait characteristics of transtibial amputees (TTs) have been described many times. In general, the literature reported nearly consistent results for the kinematic and kinetic parameters of the prosthetic side. However, the literature revealed inconsistent findings on kinetic parameters for determining the risk of developing knee osteoarthritis, such as the peak knee adduction moment, knee flexion moment and vertical ground reaction forces. The objective of our study was to describe the sagittal kinetic and kinematic gait characteristics of the ankle and residual knee joint of the prosthetic limb and the knee loading parameters of the sound side of unilateral TTs. This specific consideration may contribute to resolving the controversy of these parameters in the literature. We analysed our database containing gait analyses from 53 unilateral TTs and compared data to a control group (CG), also taken from our database. The sagittal kinetic and kinematic gait characteristics of the ankle and residual knee joint of the prosthetic limb, and selected knee loading parameters of the sound side (the peak knee adduction moment, knee flexion moment and vertical ground reaction forces) were evaluated. Beside these parameters we reported typical spatiotemporal gait parameters as gait velocity, step length, step length asymmetry, stance phase duration and asymmetry of stance phase duration. The TTs walked slower and more asymmetrically than the CG. The kinematic pattern of the prosthetic ankle differed from that found in the CG. The largest difference was observed for the range of motion of the plantarflexion at push-off, which was significantly reduced for the prosthetic foot. The residual knee joint was generally affected with respect to decreased moments and reduced knee flexion during stance phase. The peaks of the vertical ground reaction forces and knee adduction moments showed no differences between the sound side of amputees and the CG. The peak knee flexion moment at midstance was significantly reduced for the sound side of amputees in comparison with the CG. The biomechanical data measured for the prosthetic side in a cohort of 53 unilateral TT amputees conformed with the literature. The parameters determining the risk of developing knee osteoarthritis investigated in our retrospective analysis were not increased on the sound side in comparison with non-amputees. We deem it reasonable to assume that an appropriate prosthesis will reduce the likelihood of overloading the knee on the sound side during normal walking.

Analysis and Evaluating of Flexible Ankle Foot Orthosis for Drop Foot Deformity

This work involved two major parts: the first Part is the experimental part included manufacturing ankle foot orthotics, measure the (the reaction force of the ground, pressure distribution) for both normal (healthy) and sound side (intake) legs in two case, the first measurement when the patient walking without orthosis while the second test when the patient dressed up the flexible (AFO). The pressure generated between leg and calf part is measured by F-Socket devise. The experimental part also consist test the mechanical properties of a suggestion composite material. The second Part is the (FEM) finite element analysis for numerical simulation part during which the stresses are calculated using ANSYS 14.5 software. Experimental work was done on a case study suffering from low level spinal cord trauma he has good control of the trunk muscles but the muscle weakness and nerve damage for right leg. The patient with age, weight of 30years, 75kg, respectively. The Results show the parameters of test for both legs (left and right) in two cases. The results show that the data of the gait cycle in the case of the patient wearing the brace is more acceptable and we notice improvement in the performance of walking steps and reduce the difference between the infected leg and natural and this indicates the good evaluation of this orthosis. Max pressure obtained is 1.53*10^5MPa from F .Socket at calf region .Max stress Calculated at Posterior ankle joint because it is flexible Position The equivalent Von-Mises stress and the safety factor for fatigue of the composite material gave good results this led to the longer life design.