| Summary: | 博士 === 國立成功大學 === 醫學工程研究所碩博士班 === 90 === Amputations not only caused the loss of limb but also accompanied with inconvenience of physical mobility for the patients. The newly developed prosthetic designs make possible the replacement of amputated limbs, thus greatly improve the body mobility and life independence of the patients. However, the real manifestation of the prosthetic gait and the discrepancy between the prosthetic and normal gaits needs further investigations, especially the effects of walking speeds and on walking surfaces.
In Taiwan, the sockets of most prosthetic devices are made of resin. The ventilation of this type of socket is poor. In the summer time, the air temperature in Taiwan can rise to 34℃ or higher at humidity levels of 60 % or higher, the kind of weather called muggy or steamy. Heavy sweating is a typical condition in such a climate. For amputees, heavy sweating is a major problem since the socket becomes wet and fill with sweat. Consequently, prosthetic socket devices have a tendency to come loose or fall off during locomotion. Moreover, the constant moisture can cause skin complications such as eczema, blisters, dermatitis, ulcers or infection in the residual limb. Some amputees may have to be hospitalized because of these complications. Some patients even require further amputation. However, to date, there are very few studies in this subject. In last decades many researchers have tried to improve socket material. Although these new prosthesis materials can improve the feeling of comfort, they cannot solve the sweating problem. Therefore it is very important to develop a socket system to facilitate ventilation, cooling and the elimination of sweat. In our study a new prosthesis design equipped with an electric automatic air ventilation system have been tested and the sweat due to high temperature and humidity inside the socket can be reduced. The total AVS, including fan and battery, weighted only about 95g.
New prosthetic materials and designs have broadened the range of availability in artificial feet. As a result, it is becoming more difficult for prosthetists and clinic physicians to select the best foot for individual amputees. Much of the research evaluating the dynamics of prosthetic feet is subjective. Quantitative research on below-knee amputee gait has been performed in the following areas : dynamic evaluation of the foot through motion analysis, evaluation of forces created by and acting on the body while wearing a prosthetic foot, and amputees’ energy consumption with various foot designs
The purposes of this thesis are to scientifically measure the dynamic gait characteristics of the amputee by using motion analysis and to measure the energy consumption for the below-knee amputee when wearing the SACH, single-axis and multiple-axis prosthetic feet on ground, slopes and stairs.
First, the walking condition for patient with below-knee amputees is analyzed. Twenty patients who severed the shank are selected and divide into two groups to wear three different types of prosthetic foot : SACH foot (traditional type), single-axis foot, and multiple-axis foot, These patients on ground, slopes (5, 10 and 16 degrees) and stairs. These research results provide an objective for clinic physicians to select the proper type of prosthetic feet for the individual patient.
Second, the energy consumption of three different types of prosthetic foot is conducted for the same twenty subjects. These subjects walk at speeds of 1 mile per hour, 1.5 mile per hour and 2 mile per hour on slope of 0, 3 and 6 degrees. Energy consumption is detected while walking by metabolic measurement cart and heavy-duty treadmill. Subjective results are additionally determined via questionnaire after testing. A survey is conducted to determine the comfort level of prosthetic foot with patients after the experiment. The records provide a objective and subjective records for physician’s prescription for amputees.
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