Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 2, 2016
   Pages 207 — 218

Abstract — Registering a methodology for imaging and analysis of residual-limb shape after transtibial amputation

Alexander S. Dickinson, PhD;1* Joshua W. Steer, BEng;1 Christopher J. Woods, MSc;1 Peter R. Worsley, PhD2

1Bioengineering Science Research Group, Faculty of Engineering and the Environment, and 2Skin Health and Continence Technologies Research Group, Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom

Abstract — Successful prosthetic rehabilitation following lower-limb amputation depends upon a safe and comfortable socket-residual limb interface. Current practice predominantly uses a subjective, iterative process to establish socket shape, often requiring several visits to a prosthetist. This study ??proposes an objective methodology for residual-limb shape scanning and analysis by high-resolution, automated measurements. A 3-D printed "analog" residuum was scanned with three surface digitizers on 10 occasions. Accuracy was measured by the scan-height error between repeat analog scans and the computer-aided design (CAD) geometry and the scan versus CAD volume. Subsequently, 20 male residuum casts from ambulatory individuals with transtibial amputation were scanned by two observers, and 10 were repeat-scanned by one observer. The shape files were aligned spatially, and geometric measurements were extracted. Repeatability was evaluated by intraclass correlation, Bland-Altman analysis of scan volumes, and pairwise root-mean-square error ranges of scan area and width profiles. Submillimeter accuracy was achieved when scanning the analog shape using white light and laser scanning technologies. Scanning male residuum casts was highly repeatable within and between observers. The analysis methodology technique provides clinical researchers and prosthetists the capability to establish their own quantitative, objective, multipatient datasets. This could provide an evidence base for training, long-term follow-up, and interpatient outcome comparison, for decision support in socket design.

Key words: amputation, CAD/CAM, evidence-based prosthetics, prostheses, reliability, residual-limb shape, residuum volume, shape analysis, socket interface, surface scanning, validity.

View HTML ¦ View PDF ¦ Contents Vol. 53, No.2

This article and any supplementary material should be cited as follows:
Dickinson AS, Steer JW, Woods CJ, Worsley PR. Registering a methodology for imaging and analysis of residual-limb shape after transtibial amputation. J Rehabil Res Dev. 2016;53(2):207–18.

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