https://online-publication.com/ojs/index.php/cpoj/issue/feed Canadian Prosthetics & Orthotics Journal 2019-03-17T23:05:32+00:00 CPOJ Editorial Office cpoj@online-publication.com Open Journal Systems <p><strong>Canadian Prosthetics &amp; Orthotics Journal (<span style="font-size: 11.0pt;">ISSN 2561-987X</span>)</strong> is an international peer-reviewed open-access&nbsp;journal established in Ottawa, Canada in 2017. CPOJ promotes&nbsp;unrestricted access to articles specifically for prosthetics and orthotics professionals, researchers, and global rehabilitation teams. <span style="font-family: Arial;">CPOJ encourages international scholars and researchers to submit their original and unpublished manuscripts,&nbsp;theses abstracts and/or research posters in order to disseminate internationally.</span></p> <p>At CPOJ, our strong partnership with highly qualified academic Editors and Reviewers permit our passion for promoting and disseminating knowledge. All articles published by CPOJ are permanently available online to the public without any restriction or subscription fees. All articles are free to be used, cited, and distributed with the appropriate acknowledgements. Authors are the copyright holders of their original contributions.</p> <p>&nbsp;</p> https://online-publication.com/ojs/index.php/cpoj/article/view/89 HOW INFILL PERCENTAGE AFFECTS THE ULTIMATE STRENGTH OF 3D-PRINTED TRANSTIBIAL SOCKETS DURING INITIAL CONTACT 2018-10-14T03:16:50+00:00 Leah Campbell leah.campbell4@gmail.com Adriel Lau lau.adriel@gmail.com Brittany Pousett brittany@barberprosthetics.com Ernie Janzen lau.adriel@gmail.com Silvia U Raschke Silvia_Raschke@bcit.ca <p><strong><em>BACKGROUND:</em> </strong>3D printing is becoming more popular across many industries. The first step to safely introducing 3D printed sockets in to prosthetics is to conduct strength testing on these sockets.</p> <p><em><strong>PURPOSE:</strong> </em>This study tests how changing the infill percentage (the percentage of material between the internal and external socket wall) affects the strength of 3D-printed transtibial sockets.</p> <p><strong><em>METHODS: </em></strong>A Fused Deposition Modelling (FDM) printer was used to print a total of nine transtibial (TT) sockets (three sockets at 30% infill, three sockets at 40% infill, and three sockets at 50%) using polylactic acid (PLA). A strength-testing apparatus measured, in Newtons (N), the maximum load the 3D-printed transtibial sockets could withstand at initial contact of the gait cycle.</p> <p><strong><em>RESULTS</em>:</strong> Based on the specific criteria outlined in this research project, all nine sockets exceeded the 4480N threshold set by ISO Standard 10328. Eight out of nine sockets failed at approximately double the force required with one socket (socket #2) failing at 5360N. Seven out of nine sockets failed at the medial popliteal region and two out of nine sockets failed at lateral mid socket region. Differences in infill percentage from 30%, 40%, 50% did not appear to influence strength of sockets.</p> <p><strong><em>CONCLUSION:</em></strong> Strength of 3D-printed TT sockets needs rigorous testing to be deemed safe for patient use. More definitive research and a higher number of samples are required to investigate how a larger range of infill percentage can affect strength. Until all the requirements of ISO Standard 10328 are satisfied, the safety of using 3D-printed TT sockets in clinical practice are uncertain.</p> <p><a href="https://jps.library.utoronto.ca/index.php/cpoj/article/view/30843/23262"><strong>Article PDF Link:</strong> https://jps.library.utoronto.ca/index.php/cpoj/article/view/30843/23262</a></p> <p><strong>LAYMAN’S ABSTRACT</strong></p> <p>3D printing is beginning to be used in prosthetics because it has the potential to be less expensive and more customizable to individual needs and styles. Unfortunately, there are companies using this technology to print prosthetic sockets for people without the proper education and training. Before people can start using this new technology safely, testing needs to be done to determine the strength of these 3D printed prosthetic sockets. Our project investigates how strong a 3D printed prosthetic socket is for an amputee below the knee. This is challenging because the entire weight will be put through the socket and it needs to be strong enough that it will not break. There is an international standard that gives instructions and information on testing the strength of a prosthetic socket. Our project will follow a part of these instructions and see how much weight can be put through a socket before it breaks. Our project printed nine identical prosthetic sockets, but the infill percentage of each socket was different. The infill percentage is the amount of material between the walls of an object. We put each socket in a machine and applied a compressive force until it broke and measured that force. Our tests showed the infill percentage did not change the strength of the sockets. They all passed the force measurement given by the international standard. Because our project only tested a part of the standard, there are many more tests that need to be done before the public can start using 3D-printed prosthetic sockets safely.</p> 2018-09-26T00:00:00+00:00 ##submission.copyrightStatement## https://online-publication.com/ojs/index.php/cpoj/article/view/95 DEVELOPMENT OF A GOVERNMENT CONTINUOUS QUALITY IMPROVEMENT PROCEDURE FOR ASSESSING THE PROVISION OF BONE ANCHORED LIMB PROSTHESIS: A PROCESS RE-DESIGN DESCRIPTIVE STUDY 2019-03-17T23:05:32+00:00 Laurent Frossard laurentfrossard@outlook.com Luciann Ferrada Luciann.Ferrada@health.qld.gov.au Tanya Quincey Tanya.Quincey@health.qld.gov.au Brendan Burkett BBurkett@usc.edu.au Debra Berg debra.berg@health.qld.gov.au <div class="item abstract"> <p><em>BACKGROUND:</em> Evidences of sustainable clinical benefits of bone-anchored prosthesis (BAP) using osseointegrated fixation over typical socket-suspended prostheses are becoming more probing. This influx of individuals to be fitted with BAP has pressed government organisations to adjust their policies. However, the appraisal of consumer’s experience for the provision of BAP founded by government organisation is yet to be developed. This descriptive study shares the experience gained by a government organisation, namely the Queensland Artificial Limb Service (QALS), while developing a specific BAP-inclusive continuous quality improvement (CQI) procedure.</p> <p><em>OBJECTIVE(S):</em> The primary objective was to present the methods and outcomes of key steps required to plan and create this CQI procedure. The secondary objective was to highlight key barriers and facilitators of the transition from a socket-focused to the proposed BAP-inclusive CQI procedure.&nbsp;</p> <p><em>METHODOLOGY:</em> The re-design process of the CQI procedure for 65 current QALS’s consumers with BAP involved a two-step process for the planning (e.g., case-mix, stakeholder) and creation (e.g., diagnosis, technical options, cost).</p> <p><em>FINDINGS:</em> Prosthetists labour toward CQI procedure represented 1.3 hrs out of 22 hrs and AUD$213 out of AUD$3,300 or 6% of the whole procedure for the provision of BAP. The time spent by a prosthetist, consumer and QALS staff represented 24%, 24% and 53% of the time of the CQI procedure, respectively. The cost of prosthetist and QALS staff labour represented 70% and 30% of the CQI procedure, respectively.</p> <p><em>CONCLUSIONS:</em> This descriptive study shares the workings and methodology that government organisations, such as QALS, can use to re-design a CQI procedure for comprehensive appraisal of the provision of prosthesis that could be inclusive of BAP and affordable while minimally time-consuming for prosthetists. The transition from a socket-focused to the proposed minimally disruptive BAP-inclusive CQI procedure was facilitated by prior knowledge of BAP treatment, early identification of the stakeholders and adaptation of current CQI procedure.</p> <p><strong>Article PDF Link:</strong> <a href="https://jps.library.utoronto.ca/index.php/cpoj/article/view/31326/24425">https://jps.library.utoronto.ca/index.php/cpoj/article/view/31326/24425</a></p> <p><strong>LAYMAN’S ABSTRACT</strong></p> <p>There is evidence supporting the long term clinical benefits of bone-anchored prosthesis (BAP) using an osseointegrated fixation over typical socket-suspended prostheses. The increasing number of individuals treated with osseointegrated fixation has pressed government organisations to adjust their policies for fair and equitable provision of prosthetic care. However, the appraisal of consumer’s experience for the provision of BAP by government organisation is yet to be developed.&nbsp; This descriptive study has fulfilled this need by sharing the experience gained by a QALS while developing a specific BAP-inclusive continuous quality improvement (CQI) procedure. This study revealed that government organisations can design a CQI procedure for comprehensive appraisal of the provision of prosthesis that could be inclusive of BAP and affordable while minimally time-consuming for prosthetists. The transition from a socket-focused to the proposed minimally disruptive BAP-inclusive CQI procedure was facilitated by prior knowledge of BAP treatment, early identification of the stakeholders and adaptation of current CQI procedure.</p> <p><strong>How to Cite:</strong> Frossard L, Ferrada L, Quincey T, Burkett B, Berg D. Development of a government continuous quality improvement procedure for assessing the provision of bone anchored limb prosthesis: a process re-design descriptive study. Canadian Prosthetics &amp; Orthotics Journal, Volume 1, Issue 2, No 4, 2018. DOI: <a href="https://doi.org/10.33137/cpoj.v1i2.31326"> https://doi.org/10.33137/cpoj.v1i2.31326 </a></p> </div> 2018-12-12T00:00:00+00:00 ##submission.copyrightStatement## https://online-publication.com/ojs/index.php/cpoj/article/view/91 GLOBAL STANDARDS FOR PROSTHETICS AND ORTHOTICS 2018-11-03T01:00:03+00:00 Edward D Lemaire elemaire@ohri.ca Terry J Supan elemaire@ohri.ca Marlo Ortiz elemaire@ohri.ca <p>Over the past decade, essential documents and agreements have emerged to help improve the lives of people with physical disabilities. These include Convention on the Rights of Persons with Disabilities (CRPD), ratified by more than 170 countries, and the World Health Organization (WHO) global disability action plan. While the principles in these broad agreements can be applied to people who would benefit from assistive technology, specific service standards are required to operationalize the CRPD and WHO objectives. Therefore, WHO, in partnership with the International Society for Prosthetics and Orthotics (ISPO) and the United States Agency for International Development (USAID), prepared global standards and an implementation manual to assist Member States in setting up, improving, or transforming their systems for delivering appropriate prosthetic and orthotic services.</p> <p><strong>Article PDF Link: </strong><a href="https://jps.library.utoronto.ca/index.php/cpoj/article/view/31371/23745">https://jps.library.utoronto.ca/index.php/cpoj/article/view/31371/23745</a></p> 2018-10-31T00:00:00+00:00 ##submission.copyrightStatement## https://online-publication.com/ojs/index.php/cpoj/article/view/82 THE IMPORTANCE OF ADDITIONAL MID SWING TOE CLEARANCE FOR AMPUTEES 2018-09-26T01:38:41+00:00 Knut Lechler klechler@ossur.com Kristleifur Kristjansson kkristjansson@ossur.com <p>Increased prosthetic hip to toe distance and insufficient mid swing toe clearance of a prosthetic foot is a well-recognized inadequacy for lower limb prosthesis users with wide and possible grave consequences on their ambulation capabilities.&nbsp; Most important are increased risk of falls and abnormal compensatory gait patterns with secondary unwanted physical effect like generally deceased mobility, muscular-skeletal pain and joint degeneration, i.e. osteoarthritis, with possible significant health economic effect.&nbsp; Even though insufficient toe clearance can be device related and technically or even intentionally induced for attaining equal length of the lower extremities in a neutral standing position or the stance phase, it is important to be aware of available technical solutions that can counteract the problem, like swing phase dorsiflexing feet, vacuum suspension systems, polycentric axis knees rather than single-axis knees and adequate knee flexion in early swing and swing-flexion assistance in the case of bionic knees.</p> <p><a href="http://online-publication.com/ojs/index.php/cpoj/article/view/82/27"><strong>Article PDF Link:</strong>http://online-publication.com/ojs/index.php/cpoj/article/view/82/27</a></p> 2018-09-26T00:00:00+00:00 ##submission.copyrightStatement##