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Article
Publication date: 15 February 2008

A.G. Bache

The present field of prosthetics/orthotics is an erratic agglomerate of vague guidelines, skills and knowledge. The author conceived prosthotology to clarify, expand and…

Abstract

Purpose

The present field of prosthetics/orthotics is an erratic agglomerate of vague guidelines, skills and knowledge. The author conceived prosthotology to clarify, expand and enlighten prosthetics/orthotics into a science with a solid foundation and clear framework. This paper seeks to present itself as an introduction to the field and its relationship with cybernetics and systems.

Design/methodology/approach

Prosthotology achieves this by disregarding the established barriers between the human body, mind and environment. This traditional scheme is replaced by focusing on goals and goal systems instead. A goal system consists of a goal former and a goal achiever. When a goal achiever cannot achieve a goal, it can be amended. If a goal achiever cannot initialise, a prosthesis may provide amendment. If a goal achiever cannot propagate, an orthosis may provide amendment.

Findings

This perspective enables one to focus on a person's needs, what exactly is inhibiting these needs, and how best to permit the needs to be granted. It does not assume that, in order to achieve a goal, only the human body can be used.

Practical implications

Prosthotology provides direction and advancement for prosthetics and orthotics. It also enhances integration of prosthetics and orthotics with other engineering disciplines.

Originality/value

So far one has only scratched the surface of the potential of prosthetics and orthotics, using prosthotology, this potential is obvious and a step closer.

Details

Kybernetes, vol. 37 no. 2
Type: Research Article
ISSN: 0368-492X

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Article
Publication date: 2 August 2011

Jairo Chimento, M. Jason Highsmith and Nathan Crane

The purpose of this paper is to evaluate the performance of 3D printed materials for use as rapid tooling (RT) molds in low volume thermoforming processes such as in…

Abstract

Purpose

The purpose of this paper is to evaluate the performance of 3D printed materials for use as rapid tooling (RT) molds in low volume thermoforming processes such as in manufacturing custom prosthetics and orthotics.

Design/methodology/approach

3D printed specimens of different materials were produced using the Z‐Corp process. The parts were post processed using both standard and alternative methods. Material properties relevant to the 3D printed parts such as pneumatic permeability, flexural strength and wear rate were measured and compared to standard plaster compositions commonly used.

Findings

Three‐dimensional printing (3DP) can replicate the performance of the plaster materials traditionally used in prosthetic/orthotic applications by using modified post process techniques. The resulting 3D printed molds can still be modified and adjusted using traditional methods. The results show that 3D printed molds are feasible for thermoforming prosthetic and orthotic devices such as prosthetic sockets while providing new flexibility.

Originality/value

The proposed method for RT of a mold for prosthetic/orthotic manufacturing provides great flexibility in the manufacturing and fitting process while maintaining proven materials in the final device provided to patients. This flexibility increases the value of digital medical records and efforts to develop model‐based approaches to prosthetic/orthotic device design by providing a readily available process for recreating molds. Depending on the needs of the practitioners and patients, 3DP can be incorporated at a variety of points in the manufacturing process.

Details

Rapid Prototyping Journal, vol. 17 no. 5
Type: Research Article
ISSN: 1355-2546

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Article
Publication date: 27 April 2010

Douglas Cook, Vito Gervasi, Robert Rizza, Sheku Kamara and Xue‐Cheng Liu

The purpose of this paper is to determine the most‐practical means of transforming computer‐aided‐design models of custom clubfoot pedorthoses into functional pedorthoses…

Abstract

Purpose

The purpose of this paper is to determine the most‐practical means of transforming computer‐aided‐design models of custom clubfoot pedorthoses into functional pedorthoses for testing on patients in a clinical trial.

Design/methodology/approach

The materials used in conventional orthosis fabrication are not yet available for solid free‐form fabrication; therefore, to fabricate the pedorthoses, several approaches were considered, including direct manufacturing, additive‐based moulding, laser cutting of foam and combinations of several of these approaches.

Findings

The chosen approach of additively manufacturing the custom hard shell, and moulding the polyurethane‐foam insert, resulted in accurate, durable and effective pedorthoses that fit well, and could be adjusted as needed. The pedorthoses that were produced are currently being tested on the respective patients for their improvement in mobility and degree of clubfoot correction, and will continue through early 2010.

Practical implications

Additive manufacturing provides an ideal approach for generating the custom, end‐use hard‐ and soft‐layer patterns: each pedorthosis is truly unique; and the soft layer has regions of variable thickness. The advantage of this approach is the reduction in labour and the increase in degrees of design freedom available, compared to conventional methods of fabricating orthotic devices. Replacement inserts can be moulded in a matter of hours using this silicone‐moulding approach.

Originality/value

Several new approaches for fabricating custom orthotic devices were explored, and the related results are discussed. The goal of this paper is to convey the potential of the fabrication procedure used and lessons learned on this project to the rapid prototyping and orthotic communities.

Details

Rapid Prototyping Journal, vol. 16 no. 3
Type: Research Article
ISSN: 1355-2546

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Article
Publication date: 4 December 2017

Lu Lu, Kit-Lun Yick, Sun Pui Ng, Joanne Yip and Chi Yung Tse

The purpose of this paper is to quantitatively assess the three-dimensional (3D) geometry and symmetry of the torso for spinal deformity and the use of orthotic bracewear…

Abstract

Purpose

The purpose of this paper is to quantitatively assess the three-dimensional (3D) geometry and symmetry of the torso for spinal deformity and the use of orthotic bracewear by using non-invasive 3D body scanning technology.

Design/methodology/approach

In pursuing greater accuracy of body anthropometric measurements to improve the fit and design of apparel, 3D body scanning technology and image analysis provide many more advantages over the traditional manual methods that use contact measurements. To measure the changes in the torso geometry and profile symmetry of patients with adolescent idiopathic scoliosis, five individuals are recruited to undergo body scanning both with and without wearing a rigid brace during a period of six months. The cross-sectional areas and profiles of the reconstructed 3D torso models are examined to evaluate the level of body symmetry.

Findings

Significant changes in the cross-sectional profile are found amongst four of the patients over the different visits for measurements (p < 0.05), which are consistent with the X-rays results. The 3D body scanning system can reliably evaluate changes in the body geometry of patients with scoliosis. Nevertheless, improvements in the symmetry of the torso are found to be somewhat inconsistent among the patients and across different visits.

Originality/value

This pilot study demonstrates a practical and safe means to measure and analyse the torso geometry and symmetry so as to allow for more frequent evaluations, which would result in effective and optimal treatment of spinal deformation.

Details

Research Journal of Textile and Apparel, vol. 21 no. 4
Type: Research Article
ISSN: 1560-6074

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Article
Publication date: 1 March 2005

Andrew Cox, Dan Chicksand and Paul Ireland

This paper demonstrates, using empirical cases from the National Health Services (NHS), how existing practices in demand specification, procurement and supply management…

Abstract

This paper demonstrates, using empirical cases from the National Health Services (NHS), how existing practices in demand specification, procurement and supply management fail to address the significant problems caused by the misalignment of demand and supply. When examining internal demand management a number of problems arise including: product overspecification, premature establishment of design and specification, frequent changes in specification, poor demand information, fragmentation of spend, maverick buying, inter-departmental power and politics, and the risk-averse nature and culture of the organisation. It is argued that unless these problems are addressed and eliminated the NHS will not be in a position to select the most appropriate reactive or proactive approach from the range of sourcing options available. An improvement path that NHS Trusts might follow to achieve more efficient and effective procurement and supply management is outlined.

Details

Journal of Public Procurement, vol. 5 no. 1
Type: Research Article
ISSN: 1535-0118

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Article
Publication date: 12 March 2018

Harish Kumar Banga, Rajendra M. Belokar, Parveen Kalra and Rajesh Kumar

Ankle–foot orthoses (AFOs) are assistive devices prescribed for a number of physical and neurological disorders affecting the mobility of the lower limbs. Additive…

Abstract

Purpose

Ankle–foot orthoses (AFOs) are assistive devices prescribed for a number of physical and neurological disorders affecting the mobility of the lower limbs. Additive manufacturing has been explored as an alternative process; however, it has proved to be inefficient cost-wise. This work aims to explore the possibilities of generating modular AFO elements, namely, calf, shank and footplate, with the localized composite reinforcement that aids in the optimization of the device in terms of functionality, aesthetics, rigidity and cost.

Design/methodology/approach

The conventional lower leg–foot orthosis configuration depends on thermoforming a polymer sheet around a mortar cast with a trademark firmness relying upon the trim-line with the inalienable plan restrictions. In manufacturing of AFO the expert, i.e. orthotist's, guidance is used. Polypropylene and polyethylene material is used in fabrication of AFO to complete all-round reported points of interest over the ordinary outlines, yet their mechanical conduct under administration conditions cannot be effectively anticipated.

Findings

AFOs made of polypropylene and polyethylene material are available in the market, which are used by children of age 3-5 years. With the existing AFO design, patients are facing excessive heating and sweating problems during long-term usage. After feedback from patients and orthotists (who prescribed AFO to patients), an attempt has been made to solve the problem with a new and improved AFO design of AFO by using finite element modelling and stress analysis. Also, the results indicate that the new design is similar to the actual product design.

Originality/value

This work introduces the low-cost 3D printing with reinforcement approach as an alternative route for the designing and manufacturing of orthotic devices with complex shapes. It is expected that new applications add-up to increase the body of knowledge about the behaviour of such products which will mix both areas, composite theory and additive manufacturing. This study investigated the fields related to 3D scanning, 3D printing and computer-aided designing for the manufacturing of a customized AFO.

Details

Rapid Prototyping Journal, vol. 24 no. 2
Type: Research Article
ISSN: 1355-2546

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Article
Publication date: 17 October 2017

Miguel Fernandez-Vicente, Ana Escario Chust and Andres Conejero

The purpose of this paper is to describe a novel design workflow for the digital fabrication of custom-made orthoses (CMIO). It is intended to provide an easier process…

Abstract

Purpose

The purpose of this paper is to describe a novel design workflow for the digital fabrication of custom-made orthoses (CMIO). It is intended to provide an easier process for clinical practitioners and orthotic technicians alike. It further functions to reduce the dependency of the operators’ abilities and skills.

Design/methodology/approach

The technical assessment covers low-cost three-dimensional (3D) scanning, free computer-aided design (CAD) software, and desktop 3D printing and acetone vapour finishing. To analyse its viability, a cost comparison was carried out between the proposed workflow and the traditional CMIO manufacture method.

Findings

The results show that the proposed workflow is a technically feasible and cost-effective solution to improve upon the traditional process of design and manufacture of custom-made static trapeziometacarpal (TMC) orthoses. Further studies are needed for ensuring a clinically feasible approach and for estimating the efficacy of the method for the recovery process in patients.

Social implications

The feasibility of the process increases the impact of the study, as the great accessibility to this type of 3D printers makes the digital fabrication method easier to be adopted by operators.

Originality/value

Although some research has been conducted on digital fabrication of CMIO, few studies have investigated the use of desktop 3D printing in any systematic way. This study provides a first step in the exploration of a new design workflow using low-cost digital fabrication tools combined with non-manual finishing.

Details

Rapid Prototyping Journal, vol. 23 no. 6
Type: Research Article
ISSN: 1355-2546

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Article
Publication date: 1 December 2004

Andrew Cox, Glyn Watson, Chris Lonsdale and Joe Sanderson

This paper reports the findings of a two‐year EPSRC funded research project into relationship and performance strategies in power regimes. The findings from 12 very…

Abstract

This paper reports the findings of a two‐year EPSRC funded research project into relationship and performance strategies in power regimes. The findings from 12 very different industrial and service sector cases studies demonstrate that there is a correlation between the ability to improve the performance of suppliers and the power circumstances that exist between the buyers and suppliers. Buyers appear to be able to achieve improved performance from suppliers in situations of buyer dominance or interdependence. The research also demonstrates that whatever the objective power circumstance managers often subjectively misperceive the appropriate sourcing choices available to them. As a result business relationships can be aligned, but they are often misaligned. Furthermore, misaligned relationships may be “remediable” but they may not.

Details

Supply Chain Management: An International Journal, vol. 9 no. 5
Type: Research Article
ISSN: 1359-8546

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Article
Publication date: 14 January 2014

David Palousek, Jiri Rosicky, Daniel Koutny, Pavel Stoklásek and Tomas Navrat

– The purpose of this paper is to describe a manufacturing methodology for a wrist orthosis. The case study aims to offer new approaches in the area of human orthoses.

Abstract

Purpose

The purpose of this paper is to describe a manufacturing methodology for a wrist orthosis. The case study aims to offer new approaches in the area of human orthoses.

Design/methodology/approach

The article describes the utilization of rapid prototyping (RP), passive stereo photogrammetry and software tools for the orthosis design process. This study shows the key points of the design and manufacturing methodology. The approach uses specific technologies, such as 3D digitizing, reverse engineering and polygonal-surface software, FDM RP and 3D printing.

Findings

The results show that the used technologies reflect the patient's requirements and also they could be an alternative solution to the standard method of orthosis design.

Research limitations/implications

The methodology provides a good position for further development issues.

Practical implications

The methodology could be usable for clinical practice and allows the manufacturing of the perfect orthosis of the upper limb. The usage of this methodology depends on the RP system and type of material.

Originality/value

The article describes a particular topical problem and it is following previous publications in the field of human orthoses. The paper presents the methodology of wrist orthosis design and manufacturing. The paper presents an alternative approach applicable in clinical practice.

Details

Rapid Prototyping Journal, vol. 20 no. 1
Type: Research Article
ISSN: 1355-2546

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Article
Publication date: 1 April 2014

Damon Burn and Elaine Beeson

The purpose of this paper is to investigate cost effectiveness, diagnostic rates, surgical percentage and appropriateness for orthopaedic referrals and number of patients…

Abstract

Purpose

The purpose of this paper is to investigate cost effectiveness, diagnostic rates, surgical percentage and appropriateness for orthopaedic referrals and number of patients able to be seen in orthopaedic triage from GP orthopaedic referrals.

Design/methodology/approach

The study involved triaging paper referrals for orthopaedic outpatients to an interface service, orthotics or continue normal route. Data were collected on outcome of the interface appointment and outcomes for those patients referred to orthopaedics from the appointment.

Findings

The study demonstrated a 27.3 per cent cost saving from the normal orthopaedic route with 86.1 per cent of patients able to be managed by an extended scope physiotherapist (ESP) without requiring orthopaedic assessment. Appropriateness of onward orthopaedic referrals was 80.5 per cent with surgery conversion rate of 75 per cent.

Originality/value

Although triage and ESP positions have been studied before, this is the first known study to look at cost effectiveness across the patient pathway despite this being a large reason for the creation of these positions. Further larger studies are required to build upon this base in terms of demonstrating the cost effectiveness of the value of these positions.

Details

Clinical Governance: An International Journal, vol. 19 no. 2
Type: Research Article
ISSN: 1477-7274

Keywords

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