Development of an artificial foot enabling the simulation of the natural behaviour of the human unroll of the foot during walking and running

From 3rd Congress of the International Foot and Ankle Biomechanics Community Sydney, Australia. 11-13 April 201

Treatment of forefoot problems in older people: study protocol for a randomised clinical trial comparing podiatric treatment to standardised shoe advice

<p>Abstract</p> <p>Background</p> <p>Foot problems in general and forefoot problems in particular can lead to a decrease in mobility and a higher risk of falling. Forefoot problems increase with age and are more common in women than in men. Around 20% of people over 65 suffer from non-traumatic foot problems and 60% of these problems are localised in the forefoot. Little is known about the best way to treat forefoot problems in older people. The aim of this study is to compare the effects of two common modes of treatment in the Netherlands: shoe advice and podiatric treatment. This paper describes the design of this study.</p> <p>Methods</p> <p>The study is designed as a pragmatic randomised clinical trial (RCT) with 2 parallel intervention groups. People aged 50 years and over who have visited their general practitioner (GP) with non traumatic pain in the forefoot in the preceding year and those who will visit their GP during the recruitment period with a similar complaint will be recruited for this study. Participants must be able to walk unaided for 7 metres and be able to fill in questionnaires. Exclusion criteria are: rheumatoid arthritis, neuropathy of the foot or pain caused by skin problems (e.g. warts, eczema). Inclusion and exclusion criteria will be assessed by a screening questionnaire and baseline assessment. Those consenting to participation will be randomly assigned to either a group receiving a standardised shoe advice leaflet (n = 100) or a group receiving podiatric treatment (n = 100). Primary outcomes will be the severity of forefoot pain (0-10 on a numerical rating scale) and foot function (Foot Function 5-pts Index and Manchester Foot Pain and Disability Index). Treatment adherence, social participation and quality of life will be the secondary outcomes. All outcomes will be obtained through self-administered questionnaires at the start of the study and after 3, 6, 9 and 12 months. Data will be analysed according to the "intention-to-treat" principle using multilevel level analysis.</p> <p>Discussion</p> <p>Strength of this study is the comparison between two common primary care treatments for forefoot problems, ensuring a high external validity of this trial.</p> <p>Trial registration</p> <p>Netherlands Trial Register (NTR): <a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2212">NTR2212</a></p

RESEARCH IN ORTHOPAEDIC SHOE TECHNOLOGY BACHELOR LEVEL EDUCATION. NEEDED AND INEVITABLE?

This article discusses the importanceof fully integrated research activities into bachelor level programs in orthopeadic shoe technology. To work accoording evidence based principles and acquire the competences tot do so it is neseccary for students to engage in research activities from within the educational programe as soon as possible

Research in prosthetics and orthotics bachelor level education. needed and inevitable?

This article discusses the importance of fully integrating research activities into the Bachelor level programs (undergraduate programs) in orthopaedic engineering / prosthetics and orthotics. To work according to evidence based principles and acquire the competences to do so it is necessary for students to engage in research activities from within the educational programme as soon as possible. Involvement in research not only creates more insight in what research means and what the effects are, but also generates a number of cross links with the stakeholders involved in P&O education (see fig 1) which were not apparent before for the student. Also, the interaction with orthopaedic companies is stimulated in a broader context than is traditionally the case. A structure enhancing the interaction of educational institution, companies, research groups and institutions is presented which operates at the intersection of these stakeholders. A whole new world is therefore coming into range which will generate all kinds of new and unexplored opportunities

Functional evaluation of ankle foot orthoses by finite element simulations

status: publishe

Design of an active orthosis controlling spasticity and contractures

Abstract During the project ACTOR an active orthosis to control spasticity and prevent contractures at the elbow joint in patients with stroke is developed. With an annual incidence of 200 to 300 per 100.000 inhabitants, stroke is the commonest cause of severe disability in Western countries.1 80% to 95% of patients with stroke do not show complete functional recovery of the hemiplegic arm and 38% of the patients develop spasticity in the first year.2,3 In addition to pain and contractures, spasticity is a major barrier for efficient rehabilitation and has an unfavourable impact on numerous activities of daily life. The increasing amount of patients and the relative decrease of therapists create a need for technological innovations compensating this imbalance and resulting in an increase in therapy time, repetitions and task specificity.4 The project ACTOR examines how an active assisted angular mobilisation therapy can be performed in an autonomous working system. EMG signals from m. biceps brachii and m. triceps brachii are used as input signals for the actuator control algorithm to guide the elbow flexion and extension movement, respectively. For each patient, an EMG threshold is defined that has to be exceeded during the whole range of motion (ROM) in order that the device assists the movement at a constant speed (10°/sec). In this way, active training of the patient can be ensured and, by increasing the threshold, training progression can be made. The ROM during this therapy is based on the passive ROM measured by a therapist. After proving the feasibility, the effectiveness of the device will be assessed by means of a clinical trial in which the effect on spasticity, active and passive ROM, muscle force and functional activities is investigated. This project will lead to a prototype preceding the development of a user-friendly, comfortable, safe and affordable rehabilitation device. Future potential can lie in the possibility to become a complement to traditional, labour- and time-intensive neurological rehabilitation to achieve a faster functional recovery of patients with stroke.status: publishe

Finite element analysis of ankle foot orthoses

status: publishe

A new robot-assisted training device unsing EMG signals for upper limb treatment after stroke

status: publishe