A digital patient for computer-aided prosthesis design

This article concerns the design of lower limb prosthesis, both below and above knee. It describes a new computer-based design framework and a digital model of the patient around which the prosthesis is designed and tested in a completely virtual environment. The virtual model of the patient is the backbone of the whole system, and it is based on a biomechanical general-purpose model customized with the patient's characteristics (e.g. anthropometric measures). The software platform adopts computer-aided and knowledge-guided approaches with the goal of replacing the current development process, mainly hand made, with a virtual one. It provides the prosthetics with a set of tools to design, configure and test the prosthesis and comprehends two main environments: the prosthesis modelling laboratory and the virtual testing laboratory. The first permits the three-dimensional model of the prosthesis to be configured and generated, while the second allows the prosthetics to virtually set up the artificial leg and simulate the patient's postures and movements, validating its functionality and configuration. General architecture and modelling/simulation tools for the platform are described as well as main aspects and results of the experimentation.

[1]  D H Cotter,et al.  Artificial limbs. , 1988, British medical journal.

[2]  Joseph Bray Vision.  Markerless Based Human Motion Capture : A Survey , 2000 .

[3]  O Parodi,et al.  Visualization and simulated surgery of the left ventricle in the virtual pathological heart of the Virtual Physiological Human , 2011, Interface Focus.

[4]  Stella Gabbiadini,et al.  Knowledge-based design of lower limb prosthesis , 2011 .

[5]  A F Mak,et al.  State-of-the-art research in lower-limb prosthetic biomechanics-socket interface: a review. , 2001, Journal of rehabilitation research and development.

[6]  M Edwards,et al.  Chapter 18 – Lower Limb Prosthetics , 2002 .

[7]  Smith Dg,et al.  Atlas Of Amputations and Limb Deficiencies : Surgical, Prosthetic, and Rehabilitation Principles , 2004 .

[8]  L J Marks,et al.  Science, medicine, and the future: Artificial limbs. , 2001, BMJ.

[9]  Daniel P. Huttenlocher,et al.  Efficient Graph-Based Image Segmentation , 2004, International Journal of Computer Vision.

[10]  Caterina Rizzi,et al.  Knowledge-based system for guided modelling of sockets for lower limb prostheses , 2010 .

[11]  Klaas Postema,et al.  Use of the Delphi Technique for developing national clinical guidelines for prescription of lower-limb prostheses. , 2005, Journal of rehabilitation research and development.

[12]  Marco Viceconti,et al.  Are spontaneous fractures possible? An example of clinical application for personalised, multiscale neuro-musculo-skeletal modelling. , 2012, Journal of biomechanics.

[13]  J C H Goh,et al.  Development of an integrated CAD-FEA process for below-knee prosthetic sockets. , 2005, Clinical biomechanics.

[14]  Ergin Tönük,et al.  Nonlinear viscoelastic material property estimation of lower extremity residual limb tissues. , 2004, Journal of biomechanical engineering.

[15]  Ming Zhang,et al.  Pressure distribution at the stump/socket interface in transtibial amputees during walking on stairs, slope and non-flat road. , 2006, Clinical Biomechanics.

[16]  Marco Viceconti,et al.  The Virtual Physiological Human , 2011, Interface Focus.

[17]  J. Bowker,et al.  Atlas of Limb Prosthetics: Surgical, Prosthetic, and Rehabilitation Principles , 1992 .

[18]  G. Tomassini,et al.  Atlas of amputations and limb deficiencies: Surgical, prosthetic, and rehabilitation principles , 2005 .

[19]  A. Mak,et al.  Regional differences in pain threshold and tolerance of the transtibial residual limb: including the effects of age and interface material. , 2005, Archives of physical medicine and rehabilitation.

[20]  Angus McFadyen,et al.  Dynamic interface pressure distributions of two transtibial prosthetic socket concepts. , 2009, Journal of rehabilitation research and development.

[21]  Mario C Faustini,et al.  The quasi-static response of compliant prosthetic sockets for transtibial amputees using finite element methods. , 2006, Medical engineering & physics.

[22]  黄亚明.  MedScape , 2009 .

[23]  Caterina Rizzi,et al.  The role of simulation tools to innovate the prosthesis socket design process , 2007 .

[24]  R. Seymour.  Prosthetics and orthotics : lower limb and spinal , 2002 .

[25]  J. Geertzen,et al.  Literature review of the possible advantages of silicon liner socket use in trans-tibial prostheses , 2005, Prosthetics and orthotics international.

[26]  Chih-Han Chang,et al.  A proposal for the pre‐evaluation protocol of below‐knee socket design - integration pain tolerance with finite element analysis , 2003 .