Biomedical subjects

E D Lemaire

Publications and source records attributed to E D Lemaire.

15 recordsLinked to original sources

PubMed2001

Low-bandwidth, Internet-based videoconferencing for physical rehabilitation consultations.

Low-bandwidth, Internet-based videoconferencing was used to provide physical rehabilitation consultation services for eight community hospitals. Videoconferencing and file transmission used a PC and modem. A separate telephone line was used for voice. Over 21 months, 47 physical rehabilitation consultations were completed for communication disorders, foot care, gait problems, orthotics, prosthetics, arm weakness and wheelchair prescription. Consultations were approximately 40 min long. Clinician questionnaires were completed by 47 individuals. While more than 80% of the questionnaire responses supported the telemedicine approach, remote clinicians rated their satisfaction higher than did the specialists. Client questionnaires were completed by 24 individuals (a response rate of 51%). All clients were comfortable with and had confidence in the teleconsultations.

Attitude of Health Personnel↗

PubMed2000

Gait evaluation of a transfemoral prosthetic simulator.

OBJECTIVE: To test a prosthetic simulator developed to allow persons without amputation to walk like a person with a transfemoral (TF) amputation. PATIENTS: Five able-bodied subjects; comparison with data from the literature on persons with TF amputations. SETTING: Motion analysis laboratory. DESIGN: Two 45- to 60-minute gait training sessions before subjects walked along a 10-meter walkway. There were 6 trials: 3 walking with a cane, 3 without a cane. MAIN OBJECTIVE MEASURES: Sagittal plane kinematic and kinetic analysis of ankle, knee, and hip: angular velocity, joint moment, and power. RESULTS: Kinematic and kinetic analyses showed that joint mechanics during walking were similar between the test subjects and comparative results from persons with TF amputations (reported in the literature). Test subjects walked slower and moved their hip and knee joints faster (higher angular velocity values during the terminal swing) than the TF amputee subjects, although these results were not statistically significant (p < .05). These findings were consistent with new prosthetic users who are more tentative during gait training. However, a perfect simulation would show no difference in kinematic results. CONCLUSION: These results support the use of a TF prosthetic simulator to help health care professionals experience the process of fitting the prosthesis from the client's perspective.

Adult↗

PubMed2000

Technical evaluation of a low-bandwidth, Internet-based system for teleconsultations.

A low-bandwidth telemedicine system was evaluated in eight community hospitals connected to a central hospital via the Internet. PCs were used with videoconferencing software and modem connections to the telephone network. The average data connection rates, still-image transfer times and live-video transmission rates were determined. The time to send 640 x 480, 320 x 240 and 160 x 120 pixel, 24-bit still images ranged from 29 s to 411 s. The average file transfer times for a 10 s MPEG video-clip was 8.6 min. The average live video frame rate was 1 frame/s (at the best image quality), with an average latency of 3 s. The results suggest that Internet-based videoconferencing is acceptable for certain telemedicine applications.

Canada↗

PubMed1999

Analysis of assisted-gait characteristics in persons with incomplete spinal cord injury.

UNLABELLED: Ambulatory assistive device use can improve functional independence following spinal cord injury and, potentially, quality of life. However, the interaction between aids and user in this population is poorly understood. OBJECTIVES: To determine the influence of walkers, crutches and canes on assisted-gait following incomplete spinal cord injury. STUDY DESIGN/METHODS: Outcome parameters evaluated in ten individuals included orthogonal forces exerted on instrumented assistive devices, walking speed, cadence, step length, trunk and thigh angles, as well as knee and ankle joint angles. Kinetic data included axial compressive force, and medio/lateral and antero/posterior bending forces. SETTING: Canada. RESULTS: Results indicated that walkers (n= 5) provided the greatest vertical support (up to 100% body weight), but resulted in slow gait with a forward flexed posture. Elbow crutch users (n = 3) walked faster (greater step length and cadence) and had a more upright posture than the walker users. Crutches supported up to 50% of the subject's body weight, granted lateral stability, and provided restraint in the antero/posterior direction. Canes (n = 2) offered restraining and propulsive assistance, some lateral stability, and the least amount of vertical support. CONCLUSION: Ambulatory devices affected posture and walking speed while fulfilling various assistive functions during locomotion. The conclusion drawn is that rehabilitation specialists are advised to match device characteristics to user needs when prescribing walking aids. SPONSORSHIP: Natural Sciences and Engineering Research Council of Canada (NSERC).

Adult↗

PubMed1999

Validation of a quantitative method for defining CAD/CAM socket modifications.

A quantitative method was developed for defining manual socket modifications, averaging these modifications over a series of amputees, and using the average modifications as a template in commercial CAD/CAM systems. The CADVIEW programme (i.e. software for viewing and analysing CAD sockets) was rewritten to provide comparison functions for aligning sockets to a common axis, visualising the differences between sockets, generating modification outlines, assigning apex point values, and averaging the modification outlines. A CAD template generated in this manner should be the best general representation of a prosthetist's modification style. To test this hypothesis, 13 people with trans-tibial amputations were fitted with both a manual and a CAD/CAM socket. Questionnaires were completed by the subjects and by the prosthetist to obtain information on prosthetic comfort, function, and overall satisfaction. Ground reaction force and stride parameter data were also collected for each prosthesis during gait laboratory testing. No significant differences were found between the manually designed socket and the CAD/CAM designed socket for all data except the vertical peak forces on the amputated side. These results support the clinical application of this quantitative technique for making the transition from manual to CAD/CAM prosthetic modification procedures.

Adult↗

PubMed1998

Low-bandwidth telemedicine for remote orthotic assessment.

A model for performing remote orthotic assessments using low-bandwidth computer communication technology (video conferencing) was developed, tested, and evaluated. System evaluation involved comparing a series of remote assessments with on-site assessments. While most on-site and on-line results were similar, discrepancies which occurred were attributed to between-clinician differences, measurement technique differences, technical and learning obstacles at the start of the project, and within subject variations during the day. On-line assessment efficiency improved with each on-line session and corresponded with increased confidence in the system, easier system use, and better overall satisfaction. An on-line debriefing session was held with all project clinicians. These clinicians supported continued use of the communication system for rehabilitation consultation and education. Clinically. preliminary face-to-face meetings and a regular practice schedule were recommended. Technically, the system was considered good; however, suggested improvements included using a high quality speaker-phone system, streamlining the video capture process, and providing more reliable telecommunication connections.

Computers↗

PubMed1996

A quantitative method for comparing and evaluating manual prosthetic socket modifications.

Manually designed prosthetic sockets are difficult to evaluate since the hand-sculpting modification process does not retain the initial shape for comparison. A quantitative method for defining and comparing manual socket modifications was developed and integrated into the CADVIEW software package. The numerical comparison procedure consisted of a) digitizing premodification and post-modification models of a prosthetic socket, b) aligning these two shapes to a common axis (calculate cross section centroids, determine line of best fit through the centroids, rotate and move the line of best fit to a common axis), and c) displaying the differences in shape both numerically and using a color-coded three dimensional image. Alignment technique testing showed a between-radial-point average error of 2.5 mm using automatic alignment and 1.4 mm after further manual alignment adjustment. The between socket difference values were used to outline individual modifications and save these outlines to disk. Modification outlines from a series of patients were averaged to determine a prosthetist's general modification style. Averaged results from two prosthetists qualitatively supported the effectiveness of this procedure. This alignment and comparison system should help transfer hand-sculpting skills to prosthetic CAD/CAM systems, clinical research, and education for new clinicians.

Amputation Stumps↗

PubMed1996

A CAD CAM digitizing adapter for spinal casts.

An adapter was designed to hold a negative cast of a torso in position for mechanical digitization. Once a spinal shape is digitized, the data file can be loaded into a CAD CAM system for modification and manufacturing of a positive model for an orthosis. The adapter currently fits a Seattle Digitizer (M+IND, Seattle, WA); however, the interface unit can be changed to accommodate other commercial digitizers. By using this adapter, current lower limb prosthetic CAD CAM systems can be used to design and manufacture spinal orthoses.

Anthropometry↗

PubMed1996

Clinical analysis of a CAD/CAM system for custom seating: a comparison with hand-sculpting methods.

A CAD/CAM system for manufacturing custom seating inserts was evaluated within a moderately to severely disabled population. Using the Otto Bock Shape System, 25 CAD/CAM seats were manufactured at a remote facility and compared to 9 seats manufactured using hard-sculpting techniques. Clinician and client questionnaires were completed for each seat to assess satisfaction, fitting/manufacturing times, and to collect demographic data. The CAD/CAM method was significantly better (p < 0.05) than the hand-sculpting method in terms of on-site fabrication time. No significant differences were found for initial fitting time, final fitting time, clinician insert rating, and client satisfaction. These results support the CAD/CAM method as an effective and clinically efficient technique for making custom wheelchair seats.

Adult↗

PubMed1994

Osteoarthritis and elderly amputee gait.

The hypothesis that an increased load on the nonamputated leg of long-term prosthetic users leads to an increased risk of developing osteoarthritis was investigated using physical examinations and gait analysis. Based on the clinical results from an elderly group of experienced trans-tibial amputees and a similar control group of nonamputees, the amputee group experienced a significantly greater incidence of osteoarthritis (p < 0.05) in the knee of their nonamputated leg. The amputee group had consistently larger knee joint reaction forces, joint impulses, net joint moments, and net joint powers. Significantly higher results (p < 0.05) were found for amputee vertical impulse and net joint power during the double support phase of gait. These results support the hypothesis that elderly, trans-tibial amputees have a higher risk of developing osteoarthritis and experience larger forces at the knee of their nonamputated limb than people without lower extremity amputations.

Aged↗

PubMed1994

A trans-femoral brim adapter for CAD CAM measurements.

A computer aided design/computer aided manufacture (CAD CAM) brim measurement adapter was designed for use with a Berkeley casting stand. This measurement adapter accommodates all IPOS/CANFIT-PLUS transfemoral brim sizes and shapes, allows brim positioning, provides adequate stability, and provides a substantial cost saving by using existing, functional hardware as a base.

Anthropometry↗

PubMed1993

Gait patterns of elderly men with trans-tibial amputations.

Gait patterns for the non-amputated leg of eight elderly men with trans-tibial amputations were assessed using kinematic and kinetic measures. Kinematically, the subject's walking speed was faster than expected but less than normative non-amputee data. The stride length was also less than non-amputee norms. Net joint moment and power analyses showed various discrepancies between the amputee subjects and non-amputees. The amputees required a concentric ankle dorsiflexor moment just after heel-strike to help move the lower leg into mid-stance position. The concentric plantarflexor moment at push-off was much larger than comparative data. A large eccentric flexor moment was also found at the hip during late mid-stance. Most of these discrepancies could be explained by the lack of an ankle moment generator on the amputated side of the body.

Age Factors↗

PubMed1991

A technique for the determination of center of gravity and rolling resistance for tilt-seat wheelchairs.

A balance platform setup was defined for use in the determination of the center of gravity in the sagittal plane for a wheelchair and patient. Using the center of gravity information, measurements from the wheelchair and patient (weight, tire coefficients of friction), and various assumptions (constant speed, level-concrete surface, patient-wheelchair system is a rigid body), a method for estimating the rolling resistance for a wheelchair was outlined. The center of gravity and rolling resistance techniques were validated against criterion values (center of gravity error = 1 percent, rolling resistance root mean square error = 0.33 N, rolling resistance Pearson correlation coefficient = 0.995). Consistent results were also obtained from a test dummy and five subjects. Once the center of gravity is known, it is possible to evaluate the stability of a wheelchair (in terms of tipping over) and the interaction between the level of stability and rolling resistance. These quantitative measures are expected to be of use in the setup of wheelchairs with a variable seat angle and variable wheelbase length or when making comparisons between different wheelchairs.

Biomechanical Phenomena↗

PubMed1990

Force-time data acquisition system for sprint starting.

A device for the acquisition of horizontal forces in the sprint start was designed and tested on the basis of linearity, hysteresis, and the force-time curves. The force measuring device was built to resemble and function as a regular starting block while measuring the reaction force from the push off. The linearity test produced a correlation coefficient of 0.99; the hysteresis was 1.0% of the full scale force block output; and the frequency response test displayed an average error of 6% in terms of amplitude and no discernable phase shift effect at a 6 Hz loading frequency. The force-time curves produced were consistent with previous results and did not differ greatly upon comparison with a force plate. All these results were within acceptable limits.

Biomechanical Phenomena↗

PubMedDate not supplied

Effectiveness of various materials in reducing plantar shear forces. A pilot study.

Vertical plantar forces are known to be a major precipitating factor in the development of foot pathology. It is also postulated that shear forces are important in the pathogenesis of foot ulcers in patients with diabetes mellitus. Various materials are used in insoles designed to reduce forces on the foot. While many foam materials have been tested for their ability to dissipate vertical forces, few studies have tested the effect of these materials on shear forces. This study assessed the effectiveness of five different materials in reducing plantar shear forces and compared two new gel materials with three of the more conventional foam materials. Four subjects were tested while walking over a force platform with one of the five materials taped to the surface. Peak force, impulse, and resultant shear force data were analyzed. The gel materials were significantly better than the foam materials at reducing shear forces. Thus the use of gel materials in insoles may be indicated for the reduction of plantar shear forces on the diabetic foot.

Adult↗