Human-device interface pressure measurement in prosthetic, orthotic and exoskeleton applications: A systematic review

Armitage, Lucy; Turner, Shruti; Sreenivasa, Manish

doi:10.1016/j.medengphy.2021.09.008

Cited by 12 publications

(8 citation statements)

References 58 publications

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“…These human-machine coupling models with actuators are designed to replicate the neuromechanical elements of human movement [39]. The sensors can ascertain changes in task performance, muscle strength and fatigue, and environmental features, which may enable greater support for walking on diverse terrains [39,40]. Research is also expanding into the upper extremity, back, and ankle/foot exosystems [40,41], and more flexible systems with softer components than the traditional hard mechanical components of robotic devices [42].…”

Section: Technology Review and Efficacymentioning

confidence: 99%

“…The sensors can ascertain changes in task performance, muscle strength and fatigue, and environmental features, which may enable greater support for walking on diverse terrains [39,40]. Research is also expanding into the upper extremity, back, and ankle/foot exosystems [40,41], and more flexible systems with softer components than the traditional hard mechanical components of robotic devices [42]. Flexible systems are lighter and have less bulk, but it is not clear whether these systems can support the full weight of the lower extremities and body posture.…”

Section: Technology Review and Efficacymentioning

confidence: 99%

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Rehabilitation Technologies for Chronic Conditions: Will We Sink or Swim?

LaMarca,

Tse,

Keysor

2023

Healthcare

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Introduction: Chronic conditions such as stroke, Parkinson’s disease, spinal cord injury, multiple sclerosis, vestibular disorders, chronic pain, arthritis, diabetes, chronic obstructive pulmonary disease (COPD), and heart disease are leading causes of disability among middle-aged and older adults. While evidence-based treatment can optimize clinical outcomes, few people with chronic conditions engage in the recommended levels of exercise for clinical improvement and successful management of their condition. Rehabilitation technologies that can augment therapeutic care—i.e., exoskeletons, virtual/augmented reality, and remote monitoring—offer the opportunity to bring evidence-based rehabilitation into homes. Successful integration of rehabilitation techniques at home could help recovery and access and foster long term self-management. However, widespread uptake of technology in rehabilitation is still limited, leaving many technologies developed but not adopted. Methods: In this narrative review, clinical need, efficacy, and obstacles and suggestions for implementation are discussed. The use of three technologies is reviewed in the management of the most prevalent chronic diseases that utilize rehabilitation services, including common neurological, musculoskeletal, metabolic, pulmonary, and cardiac conditions. The technologies are (i) exoskeletons, (ii) virtual and augmented reality, and (iii) remote monitoring. Results: Effectiveness evidence backing the use of technology in rehabilitation is growing but remains limited by high heterogeneity, lack of long-term outcomes, and lack of adoption outcomes. Conclusion: While rehabilitation technologies bring opportunities to bridge the gap between clinics and homes, there are many challenges with adoption. Hybrid effectiveness and implementation trials are a possible path to successful technology development and adoption.

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Section: Technology Review and Efficacymentioning

confidence: 99%

Section: Technology Review and Efficacymentioning

confidence: 99%

Rehabilitation Technologies for Chronic Conditions: Will We Sink or Swim?

LaMarca,

Tse,

Keysor

2023

Healthcare

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“…Studies of musculoskeletal extremity region tissue remains important, as injury to these regions is common and the tissue layers interface with prosthetics and exo-skeleton devices [1][2][3]. Upper and lower limbs are the two most frequently injured regions during car crashes [4].…”

Section: Introductionmentioning

confidence: 99%

Role of multi-layer tissue composition of musculoskeletal extremities for prediction of in vivo surface indentation response and layer deformations

et al. 2023

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Emergent mechanics of musculoskeletal extremities (surface indentation stiffness and tissue deformation characteristics) depend on the underlying composition and mechanics of each soft tissue layer (i.e. skin, fat, and muscle). Limited experimental studies have been performed to explore the layer specific relationships that contribute to the surface indentation response. The goal of this study was to examine through statistical modeling how the soft tissue architecture contributed to the aggregate mechanical surface response across 8 different sites of the upper and lower extremities. A publicly available dataset was used to examine the relationship of soft tissue thickness (fat and muscle) to bulk tissue surface compliance. Models required only initial tissue layer thicknesses, making them usable in the future with only a static ultrasound image. Two physics inspired models (series of linear springs), which allowed reduced statistical representations (combined locations and location specific), were explored to determine the best predictability of surface compliance and later individual layer deformations. When considering the predictability of the experimental surface compliance, the physics inspired combined locations model showed an improvement over the location specific model (percent difference of 25.4 +/- 27.9% and 29.7 +/- 31.8% for the combined locations and location specific models, respectively). While the statistical models presented in this study show that tissue compliance relies on the individual layer thicknesses, it is clear that there are other variables that need to be accounted for to improve the model. In addition, the individual layer deformations of fat and muscle tissues can be predicted reasonably well with the physics inspired models, however additional parameters may improve the robustness of the model outcomes, specifically in regard to capturing subject specificity.

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“…Several sensors have been developed that can measure pressure at the socket-limb interface [ 8 , 9 ]; however, to date, these have been used to compare different prosthetics or activities, rather than to provide clinicians with information about fit during the socket design process. Furthermore, difficulties with cost, bulk, wires, and limitations in range or sensor performance have limited the translation of these systems into the clinical space for day-to-day use by prosthetists [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Validation of a Custom Interface Pressure Measurement System to Improve Fitting of Transtibial Prosthetic Check Sockets

Armitage

Cho

Sarıyıldız

et al. 2023

Sensors

Self Cite

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Achievement of fit between the residual limb and prosthetic socket during socket manufacture is a priority for clinicians and is essential for safety. Clinicians have recognised the potential benefits of having a sensor system that can provide objective socket-limb interface pressure measurements during socket fitting, but the cost of existing systems makes current technology prohibitive. This study will report on the characterisation, validation and preliminary clinical implementation of a low cost, portable, wireless sensor system designed for use during socket manufacture. Characterisation and benchtop testing demonstrated acceptable accuracy, behaviour at variable temperature, and dynamic response for use in prosthetic socket applications. Our sensor system was validated with simultaneous measurement by a commercial sensor system in the sockets of three transtibial prosthesis users during a fitting session in the clinic. There were no statistically significant differences between the sensor system and the commercial sensor for a variety of functional activities. The sensor system was found to be valid in this clinical context. Future work should explore how pressure data relates to ratings of fit and comfort, and how objective pressure data might be used to assist in clinical decision making.

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Human-device interface pressure measurement in prosthetic, orthotic and exoskeleton applications: A systematic review

Cited by 12 publications

References 58 publications

Rehabilitation Technologies for Chronic Conditions: Will We Sink or Swim?

Rehabilitation Technologies for Chronic Conditions: Will We Sink or Swim?

Role of multi-layer tissue composition of musculoskeletal extremities for prediction of in vivo surface indentation response and layer deformations

Validation of a Custom Interface Pressure Measurement System to Improve Fitting of Transtibial Prosthetic Check Sockets

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