Journal of rehabilitation research and development, 1986
Alignment of a prosthesis is defined as the position of the socket relative to the other prosthet... more Alignment of a prosthesis is defined as the position of the socket relative to the other prosthetic components of the limb. During dynamic alignment the prosthetist, using subjective judgment and feedback from the patient, aims to achieve the most suitable limb geometry for best function and comfort. Until recently it was generally believed that a patient could only be satisfied with a unique "optimum alignment." The purpose of this systematic study of lower-limb alignment parameters was to gain an understanding of the factors that make a limb configuration or optimum alignment, acceptable to the patient, and to obtain a measure of the variation of this alignment that would be acceptable to the amputee. In this paper, the acceptable range of alignments for 10 below- and 10 above-knee amputees are established. Three prosthetists were involved in the majority of the 183 below-knee and 100 above-knee fittings, although several other prosthetists were also involved. The effect...
Paper discussing the orthotic management of the foot of diabetic patients in the early stages by ... more Paper discussing the orthotic management of the foot of diabetic patients in the early stages by using a novel computer model.
Paper describing a preliminary study of the plantar pressure distribution on the sole of the foot... more Paper describing a preliminary study of the plantar pressure distribution on the sole of the foot of normal and diabetic subjects in Colombia.
Conventionally, patellar tendon-bearing (PTB) sockets, which need high dexterity of prosthetist, ... more Conventionally, patellar tendon-bearing (PTB) sockets, which need high dexterity of prosthetist, are widely used. Lack of chartered and experienced prosthetist has often led to painful experience of wearing prosthesis and this will in turn deter the patients to wear the prosthesis, which will further aggravate stump shrinkage. Thus, the hydrostatic socket which demands relatively lower level of fabricating skill is proposed to replace the PTB socket in order to produce the equivalent, if not better, quality of support to the amputee patients. Both sockets' pressure profiles are studied and compared using finite element analysis (FEA) software. Three-dimensional models of both sockets were developed using MIMICS software. The analysis results showed that hydrostatic socket did exhibit more uniform pressure profiles than that of PTB socket. PTB socket showed pressure concentration near the proximal brim of the socket and also at the distal fibula. It was also found that the pressu...
Paper investigating the degree of load sharing between the ischial brim and the rest of the socke... more Paper investigating the degree of load sharing between the ischial brim and the rest of the socket for the ischial containment (IC) and quadrilateral (Quad) socket designs.
Paper evaluating a commercial system for the measurement of socket/amputee interface pressure dis... more Paper evaluating a commercial system for the measurement of socket/amputee interface pressure distribution.
Paper discussing the application of a two part limb/socket finite element (FE) model to model soc... more Paper discussing the application of a two part limb/socket finite element (FE) model to model socket donning.
Paper examining modelling and pressure measurement technologies in the use of prosthetics for pat... more Paper examining modelling and pressure measurement technologies in the use of prosthetics for patients.
A review of prosthetic prescription practice reveals that in the United Kingdom about 85% of belo... more A review of prosthetic prescription practice reveals that in the United Kingdom about 85% of below and above-knee amputees are fitted with uniaxial feet, whereas in the United States about 80% are fitted with SACH feet. An evaluation method was developed to assess the performance of these two different types of feet. This included a subjective assessment procedure and a biomechanical evaluation of the function of the two feet and their effects on whole body gait kinematics and lower limb kinetics. Data were acquired by three Bolex H16 cine cameras and two Kistler force plates. This set-up allowed three-dimensional analysis on the prosthetic and contralateral sides of the subject. Investigations were undertaken in which an experimental prosthesis permitted the interchange of the ankle/foot while keeping the rest of the components the same. Altogether, six below knee and five above knee amputees were tested. No clear trend for preference for either type of foot was evident from the su...
During the last few years considerable attention has been given to the use of gait analysis as a ... more During the last few years considerable attention has been given to the use of gait analysis as a tool for clinical use. The instrumentation for measurement of the kinetics and kinematics of human locomotion was originally designed for research use. Extension of its use into the clinical field calls for simplified methodology and clearly defined protocols with precise identification of the relevant parameters for the analysis. Force platforms, TV-computer and pylon transducer systems were used for collection of kinetic and kinematic data of five normal subjects, 10 below-knee, 10 above-knee and one hip disarticulation amputee. The repeatability tests showed significant differences in the measured parameters. These variations are attributed to the methodology of the analysis and the step to step variation of the subjects' gait. Differences in the degree of step to step variation between various amputee and normal subjects are quantified. In this presentation the capability of pres...
A quantitative method was developed for defining manual socket modifications, averaging these mod... more 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 p...
Repetitive trauma and overuse of the plantar aponeurosis are believed to be causal factors of pla... more Repetitive trauma and overuse of the plantar aponeurosis are believed to be causal factors of plantar fasciitis. Therefore, it is important to know how an orthosis influences loading of the plantar aponeurosis. The aim of this study was to quantify strain in the plantar aponeurosis in cadaveric feet with the use of various combinations of orthotic wedges. An in vitro test that simulated static stance was used to determine the loading characteristics of the plantar aponeurosis. A differential variable reluctance transducer was operatively implanted into the plantar aponeurosis of nine fresh-frozen cadaveric lower limbs. Each specimen was mounted in an electromechanical testing machine that applied an axial load of as much as 900 newtons to the tibia. Eight different combinations of test conditions, in which wedges (each with a 6-degree incline) were or were not positioned under the medial and lateral aspects of the forefoot and hindfoot, were evaluated, with the plantigrade foot used as a neutral control. Each of the test conditions that involved a wedge under the forefoot resulted in strain that was significantly different from that in the neutral control. A wedge under the lateral aspect of the forefoot decreased strain in the plantar aponeurosis, and a wedge under the medial aspect increased strain (p < 0.05). The test conditions that involved a wedge under the hindfoot but not under the forefoot resulted in strains that were not significantly different from those in the neutral control (p > 0.05). A wedge under the lateral aspect of the forefoot transmits loads through the lateral support structures of the foot, locking the calcaneocuboid joint and decreasing strain in the plantar aponeurosis. A wedge under the medial aspect of the forefoot transmits loads through the medial support structures of the foot, which produces a truss-like action that increases strain in the plantar aponeurosis.
A clinical and laboratory evaluation programme of four commercially available above-knee prosthet... more A clinical and laboratory evaluation programme of four commercially available above-knee prosthetic systems has been undertaken at the University of Strathclyde. This chapter describes the philosophy and the methodology employed and discusses several aspects of the findings.
The new design, compared with conventional legs, aims at providing the amputee with greater stabi... more The new design, compared with conventional legs, aims at providing the amputee with greater stability, better function and proprioception by the elimination of the artificial knee joint. Ground clearance during swing phase is achieved by shortening the effective length of the limb, utilising a self-energising mechanism. Clinical trials have indicated that when patients wore this telescopic limb their gait improved and their confidence increased.
Adaptive seating has been defined as the customized prescription and application of sitting suppo... more Adaptive seating has been defined as the customized prescription and application of sitting support devices based on therapeutic principles. It is recognized that for children with neuromuscular disorders that result in poor postural control, a comfortable adaptive seating system that provides them with the support needed to maintain a sitting position can be essential for raising their overall level of well being. These systems are also used to try and prevent or to slow the progression of skeletal deformities. However, problems with current adaptive seating systems do exist. After extensive research into these problems we developed a novel adaptive seating system which aims to improve on current designs. It includes a number of innovative features including • Active dynamic supports: The backrest and headrest are mounted on gas springs, allowing them to move in order to accommodate the user's task induced movement or abnormal muscle tone. The forces applied to and the position...
Journal of rehabilitation research and development, 1986
Alignment of a prosthesis is defined as the position of the socket relative to the other prosthet... more Alignment of a prosthesis is defined as the position of the socket relative to the other prosthetic components of the limb. During dynamic alignment the prosthetist, using subjective judgment and feedback from the patient, aims to achieve the most suitable limb geometry for best function and comfort. Until recently it was generally believed that a patient could only be satisfied with a unique "optimum alignment." The purpose of this systematic study of lower-limb alignment parameters was to gain an understanding of the factors that make a limb configuration or optimum alignment, acceptable to the patient, and to obtain a measure of the variation of this alignment that would be acceptable to the amputee. In this paper, the acceptable range of alignments for 10 below- and 10 above-knee amputees are established. Three prosthetists were involved in the majority of the 183 below-knee and 100 above-knee fittings, although several other prosthetists were also involved. The effect...
Paper discussing the orthotic management of the foot of diabetic patients in the early stages by ... more Paper discussing the orthotic management of the foot of diabetic patients in the early stages by using a novel computer model.
Paper describing a preliminary study of the plantar pressure distribution on the sole of the foot... more Paper describing a preliminary study of the plantar pressure distribution on the sole of the foot of normal and diabetic subjects in Colombia.
Conventionally, patellar tendon-bearing (PTB) sockets, which need high dexterity of prosthetist, ... more Conventionally, patellar tendon-bearing (PTB) sockets, which need high dexterity of prosthetist, are widely used. Lack of chartered and experienced prosthetist has often led to painful experience of wearing prosthesis and this will in turn deter the patients to wear the prosthesis, which will further aggravate stump shrinkage. Thus, the hydrostatic socket which demands relatively lower level of fabricating skill is proposed to replace the PTB socket in order to produce the equivalent, if not better, quality of support to the amputee patients. Both sockets' pressure profiles are studied and compared using finite element analysis (FEA) software. Three-dimensional models of both sockets were developed using MIMICS software. The analysis results showed that hydrostatic socket did exhibit more uniform pressure profiles than that of PTB socket. PTB socket showed pressure concentration near the proximal brim of the socket and also at the distal fibula. It was also found that the pressu...
Paper investigating the degree of load sharing between the ischial brim and the rest of the socke... more Paper investigating the degree of load sharing between the ischial brim and the rest of the socket for the ischial containment (IC) and quadrilateral (Quad) socket designs.
Paper evaluating a commercial system for the measurement of socket/amputee interface pressure dis... more Paper evaluating a commercial system for the measurement of socket/amputee interface pressure distribution.
Paper discussing the application of a two part limb/socket finite element (FE) model to model soc... more Paper discussing the application of a two part limb/socket finite element (FE) model to model socket donning.
Paper examining modelling and pressure measurement technologies in the use of prosthetics for pat... more Paper examining modelling and pressure measurement technologies in the use of prosthetics for patients.
A review of prosthetic prescription practice reveals that in the United Kingdom about 85% of belo... more A review of prosthetic prescription practice reveals that in the United Kingdom about 85% of below and above-knee amputees are fitted with uniaxial feet, whereas in the United States about 80% are fitted with SACH feet. An evaluation method was developed to assess the performance of these two different types of feet. This included a subjective assessment procedure and a biomechanical evaluation of the function of the two feet and their effects on whole body gait kinematics and lower limb kinetics. Data were acquired by three Bolex H16 cine cameras and two Kistler force plates. This set-up allowed three-dimensional analysis on the prosthetic and contralateral sides of the subject. Investigations were undertaken in which an experimental prosthesis permitted the interchange of the ankle/foot while keeping the rest of the components the same. Altogether, six below knee and five above knee amputees were tested. No clear trend for preference for either type of foot was evident from the su...
During the last few years considerable attention has been given to the use of gait analysis as a ... more During the last few years considerable attention has been given to the use of gait analysis as a tool for clinical use. The instrumentation for measurement of the kinetics and kinematics of human locomotion was originally designed for research use. Extension of its use into the clinical field calls for simplified methodology and clearly defined protocols with precise identification of the relevant parameters for the analysis. Force platforms, TV-computer and pylon transducer systems were used for collection of kinetic and kinematic data of five normal subjects, 10 below-knee, 10 above-knee and one hip disarticulation amputee. The repeatability tests showed significant differences in the measured parameters. These variations are attributed to the methodology of the analysis and the step to step variation of the subjects' gait. Differences in the degree of step to step variation between various amputee and normal subjects are quantified. In this presentation the capability of pres...
A quantitative method was developed for defining manual socket modifications, averaging these mod... more 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 p...
Repetitive trauma and overuse of the plantar aponeurosis are believed to be causal factors of pla... more Repetitive trauma and overuse of the plantar aponeurosis are believed to be causal factors of plantar fasciitis. Therefore, it is important to know how an orthosis influences loading of the plantar aponeurosis. The aim of this study was to quantify strain in the plantar aponeurosis in cadaveric feet with the use of various combinations of orthotic wedges. An in vitro test that simulated static stance was used to determine the loading characteristics of the plantar aponeurosis. A differential variable reluctance transducer was operatively implanted into the plantar aponeurosis of nine fresh-frozen cadaveric lower limbs. Each specimen was mounted in an electromechanical testing machine that applied an axial load of as much as 900 newtons to the tibia. Eight different combinations of test conditions, in which wedges (each with a 6-degree incline) were or were not positioned under the medial and lateral aspects of the forefoot and hindfoot, were evaluated, with the plantigrade foot used as a neutral control. Each of the test conditions that involved a wedge under the forefoot resulted in strain that was significantly different from that in the neutral control. A wedge under the lateral aspect of the forefoot decreased strain in the plantar aponeurosis, and a wedge under the medial aspect increased strain (p < 0.05). The test conditions that involved a wedge under the hindfoot but not under the forefoot resulted in strains that were not significantly different from those in the neutral control (p > 0.05). A wedge under the lateral aspect of the forefoot transmits loads through the lateral support structures of the foot, locking the calcaneocuboid joint and decreasing strain in the plantar aponeurosis. A wedge under the medial aspect of the forefoot transmits loads through the medial support structures of the foot, which produces a truss-like action that increases strain in the plantar aponeurosis.
A clinical and laboratory evaluation programme of four commercially available above-knee prosthet... more A clinical and laboratory evaluation programme of four commercially available above-knee prosthetic systems has been undertaken at the University of Strathclyde. This chapter describes the philosophy and the methodology employed and discusses several aspects of the findings.
The new design, compared with conventional legs, aims at providing the amputee with greater stabi... more The new design, compared with conventional legs, aims at providing the amputee with greater stability, better function and proprioception by the elimination of the artificial knee joint. Ground clearance during swing phase is achieved by shortening the effective length of the limb, utilising a self-energising mechanism. Clinical trials have indicated that when patients wore this telescopic limb their gait improved and their confidence increased.
Adaptive seating has been defined as the customized prescription and application of sitting suppo... more Adaptive seating has been defined as the customized prescription and application of sitting support devices based on therapeutic principles. It is recognized that for children with neuromuscular disorders that result in poor postural control, a comfortable adaptive seating system that provides them with the support needed to maintain a sitting position can be essential for raising their overall level of well being. These systems are also used to try and prevent or to slow the progression of skeletal deformities. However, problems with current adaptive seating systems do exist. After extensive research into these problems we developed a novel adaptive seating system which aims to improve on current designs. It includes a number of innovative features including • Active dynamic supports: The backrest and headrest are mounted on gas springs, allowing them to move in order to accommodate the user's task induced movement or abnormal muscle tone. The forces applied to and the position...
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Papers by S. Solomonidis