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Buis AWP, McGarry A, Kamyab M , Murray KD, Hillman S

Hands Free Hydro Cast – Optimising Trans-femoral Socket Design and Maximising Rehabilitation Potential. Buis AWP, McGarry A, Kamyab M , Murray KD, Hillman S Biomedical Engineering, University of Strathclyde, Glasgow, UK. Introduction. Statement of problem (Why)

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Buis AWP, McGarry A, Kamyab M , Murray KD, Hillman S

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  1. Hands Free Hydro Cast – Optimising Trans-femoral Socket Design and Maximising Rehabilitation Potential Buis AWP, McGarry A, Kamyab M, Murray KD, Hillman S Biomedical Engineering, University of Strathclyde, Glasgow, UK

  2. Introduction • Statement of problem (Why) • Implementation of a “good” fit • Methodology (What & How) • Results • conclusion

  3. Statement of problem • The purpose of a socket is to provide a mechanical connection between the skeleton and the rigid structure of the prosthesis. • The dominating concepts are the Quad and Ischial cont. • How stabilising are those sockets? • Are they reproducible? • Can we do better?

  4. Implementation of a “good” fit • Socket fit criteria: • As “stiff” as possible coupling • No tissue damage • Minimum discomfort Implementation tools; • Surface matching • Volume matching • Is it possible to distribute the load to the different transmission elements in a controlled way? • Yes, if the force flow distributes itself proportionally to the stiffness of the available path!

  5. Implementation of a “good” fit Rubber Block MetalBlock Rubber Block “Let nature deform the soft tissues in such a way that the stiffest path principle is achieved”

  6. Methodology • Copy of the existing Ischial containment socket. • Pressure cast socket according the Hydro cast principle.

  7. Methodology (work packages) • Dynamic interface pressure (ideally shear) • Femoral stability • User performance outcome measures • Kinetic (forces) • Kinematic (position in space and time)

  8. Methodology • Dynamic interface pressure • Validated Tekscan™ pressure • measurement system

  9. Methodology • Femoral stability

  10. User performance outcome measures • Kinetic (forces) • Kinematic (position in space and time) Methodology

  11. Results • Dynamic interface pressure A M P L Ischial containment Hydro

  12. Sensor Results Ultrasound Anterior Video X section socket Medial

  13. Results Lateral Lateral A A P P Medial Medial Ischial Containment Hydro Cast

  14. Results • User performance outcome measures • Summary • Speed slightly higher with the old socket, but it was noted that the subject’s speed increased as she became more accustomed to the new socket. • Stride length slightly longer with the old socket, effected via increased step length bilaterally. • Cadence and double support time much the same for both conditions. • Single support time on the right a little decreased with the new socket. • Clear differences between pistoning and gapping were observed. Indicating that the Hydro concept is more stable.

  15. Conclusion • No significant pressure distribution differences. • Shear should be investigated! • No significant Kinetic and kinematic differences. • Significant stability differences in direction, pistoning and gapping in favour of the Hydro concept prosthesis.

  16. Thank you!

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