Search results for: Knee Arthroplasty

Authors: Ahmed R. Z. Baghdadi, Amira A. A. Abdallah

Abstract:

Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel un-satisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much.

Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA) and uni-compartmental knee arthroplasty (UKA) on dynamic balance, pain and functional performance following rehabilitation.

Methods: Fifteen patients with CRTKA (group I), fifteen with PSTKA (group II), fifteen with UKA (group III) and fifteen indicated for arthroplasty but weren’t operated on yet (group IV) participated in the study. The mean age was 54.53±3.44, 55.13±3.48, 52.8±1.93 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99, 35.6±1.88 and 35.73±1.03 kg/m² for group I, II, III and IV respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four and eight weeks pre- and post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1^st week), home-based (2^nd-4^th weeks), and outpatient clinic (5^th-8^th weeks) programs.

Results: The Mixed design MANOVA revealed that group III had significantly higher BBS scores, and lower pain scores and TUG and SC time than groups I and II four and eight weeks post-operatively. In addition, group I had significantly lower pain scores and SC time compared with group II eight weeks post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly eight weeks post-operatively compared with the three other assessments in group I, II and III with the opposite being true four weeks post-operatively.

Interpretation/Conclusion: CRTKA is preferable to PSTKA with UKA being generally superior to TKA, possibly due to the preserved human proprioceptors in the un-excised compartmental articular surface.

Keywords: Dynamic Balance, Functional Performance, Knee Arthroplasty, Pain.

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Authors: Ahmed R. Z. Baghdadi, Mona H. Gamal Eldein

Abstract:

Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel un-satisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much. Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA on dynamic balance, pain and functional performance following rehabilitation. Methods: Thirty patients with CRTKA (group I), thirty with PSTKA (group II) and fifteen indicated for arthroplasty but weren’t operated on yet (group III) participated in the study. The mean age was 54.53±3.44, 55.13±3.48 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99 and 35.73±1.03 kg/m2 for groups I, II and III respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four weeks preand post-operatively, three, six and twelve months post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-12th weeks) programs, follow-up to all groups for twelve months. Results: The Mixed design MANOVA revealed that group I had significantly lower pain scores and SC time compared with group II three, six and twelve months post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly six months post-operatively compared with four weeks pre- and post-operatively and three months postoperatively in groups I and II with the opposite being true four weeks post-operatively. But no significant differences in BBS scores, pain scores and TUG and SC time between six and twelve months postoperatively in groups I and II. Interpretation/Conclusion: CRTKA is preferable to PSTKA, possibly due to the preserved human proprioceptors in the un-excised PCL.

Keywords: Dynamic Balance, Functional Performance, Knee Arthroplasty, Long-Term.

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Authors: M.Somjarod, V. Tanawat, l. Weerawat

Abstract:

The understanding of knee movement during swing importance for golf swing improving and preventing injury. Thirty male professional and amateur golfers were assigned to swing time by time for 3 times. Data from a vedio-based motion capture were used to compute knee joint movement variables. The results showed that professional and amateur golfers were significantly in left knee flexion angle at the impact point and mid follow through phase. Nevertheless, left knee external rotation in both groups was also significant. The right knee were no significant different in all variable. However, pattern of knee joint movement are also likely between professional and amateur golfers.

Keywords: Golfer, Knee joint, Movement, Swing

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Authors: S. Hirokawa, M. Fukunaga, M. Mawatari

Abstract:

Knee joint forces are available by in vivo measurement using an instrumented knee prosthesis for small to moderate knee flexion but not for high flexion yet. We created a 2D mathematical model of the lower limb incorporating several new features such as a patello-femoral mechanism, a thigh-calf contact at high knee flexion and co-contracting muscles' force ratio, then used it to determine knee joint forces arising from high knee flexions in four kneeling conditions: rising with legs in parallel, with one foot forward, with or without arm use. With arms used, the maximum values of knee joint force decreased to about 60% of those with arms not used. When rising with one foot forward, if arms are not used, the forward leg sustains a force as large as that sustained when rising with legs parallel.

Keywords: Knee joint force, kneeling, mathematical model, biomechanics.

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Authors: Jobin Varghese, V. M. Akhil, P. K. Rajendrakumar, K. S. Sivanandan

Abstract:

The major contributor to the human locomotion is the knee flexion and extension. During heel strike, a huge amount of energy is transmitted through the leg towards knee joint, which in fact is damped at heel and leg muscles. During high shocks, although it is damped to a certain extent, the balance force transmits towards knee joint which could damage the knee. Due to the vital function of the knee joint, it should be protected against damage due to additional load acting on it. This work concentrates on the development of spring mass damper system which exactly replicates the stiffness at the heel and muscles and the objective function is optimized to minimize the force acting at the knee joint. Further, the data collected using force plate are put into the model to verify its integrity and are found to be in good agreement.

Keywords: Spring, mass, damper, impact, knee joint.

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Authors: Alexander Hendricks, Sean Nevin, Clayton Wikoff, Melissa Dougherty, Jacob Orlita, Rafiqul Noorani

Abstract:

Knee orthotics play an important role in aiding in the recovery of those with knee injuries, especially athletes. However, structural knee orthotics is often very expensive, ranging between $300 and $800. The primary reason for this project was to answer the question: can 3D printed orthotics represent a viable and cost-effective alternative to present structural knee orthotics? The primary objective for this research project was to design a knee orthotic for athletes with knee injuries for a low-cost under $100 and evaluate its effectiveness. The initial design for the orthotic was done in SolidWorks, a computer-aided design (CAD) software available at Loyola Marymount University. After this design was completed, finite element analysis (FEA) was utilized to understand how normal stresses placed upon the knee affected the orthotic. The knee orthotic was then adjusted and redesigned to meet a specified factor-of-safety of 3.25 based on the data gathered during FEA and literature sources. Once the FEA was completed and the orthotic was redesigned based from the data gathered, the next step was to move on to 3D-printing the first design of the knee brace. Subsequently, physical therapy movement trials were used to evaluate physical performance. Using the data from these movement trials, the CAD design of the brace was refined to accommodate the design requirements. The final goal of this research means to explore the possibility of replacing high-cost, outsourced knee orthotics with a readily available low-cost alternative.

Keywords: Knee Orthotics, 3D printing, finite element analysis.

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Authors: N. Zhang, J. S. Kuang, S. Mogili

Abstract:

To investigate seismic performance of beam-column knee joints, four full-scale reinforced concrete beam-column knee joints, which were fabricated to simulate those in as-built RC frame buildings designed to ACI 318-14 and ACI-ASCE 352R-02, were tested under reversed cyclic loading. In the experimental programme, particular emphasis was given to the effect of horizontal reinforcement (in format of inverted U-shape bars) on the shear strength and ductility capacity of knee joints. Test results are compared with those predicted by four seismic design codes, including ACI 318-14, EC8, NZS3101 and GB50010. It is seen that the current design codes of practice cannot accurately predict the shear strength of seismically designed knee joints.

Keywords: Large-scale tests, RC beam-column knee joints, seismic performance, shear strength.

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Authors: C. Copilusi, C. Ploscaru

Abstract:

This paper addresses attention to a research regarding the design of a knee orthosis in a modular form used on children walking rehabilitation. This research is focused on the human lower limb kinematic analysis which will be used as input data on virtual simulations and prototype validation. From this analysis, important data will be obtained and used as input for virtual simulations of the knee modular orthosis. Thus, a knee orthosis concept was obtained and validated through virtual simulations by using MSC Adams software. Based on the obtained results, the modular orthosis prototype will be manufactured and presented in this article.

Keywords: Human lower limb, children orthoses, kinematic analysis, knee orthosis.

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Authors: Oleksandr Poliakov, Olena Chepenyuk, Yevgen Pashkov, Mykhaylo Kalinin, Vadym Kramar

Abstract:

In one of the prosthesis designs for lower limb transfemoral amputations artificial knee joints with polycentric mechanisms are used. Such prostheses are characterized by high stability during the stance phase of the movement. The existing variety of polycentric mechanisms indicates the possibility of finding the optimal prosthesis design satisfying several quality criteria.In this paper we present a multicriteria method for the synthesis of the artifical polycentric knee mechanism based on the uniform systematic study of the design parameters space and on the analysis of Pareto optimal solutions.

Keywords: Optimalcriteria, polycentric knee, prosthesis, synthesis, transfemoral amputee.

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Authors: Mahmoud Miri, Abdolreza Zare, Hossein Abbas zadeh

Abstract:

The knee bracing steel frame (KBF) is a new kind of energy dissipating frame, which combines excellent ductility and lateral stiffness. In this framing system, a special form of diagonal brace connected to a knee element instead of beam-column joint, is investigated. Recently, a similar system was proposed and named as chevron knee bracing system (CKB) which in comparison with the former system has a better energy absorption characteristic and at the same time retains the elastic nature of the structures. Knee bracing can provide a stiffer bracing system but reduces the ductility of the steel frame. Chevron knee bracing can be employed to provide the desired ductility level for a design. In this article, relation between seismic performance and structural parameters of the two above mentioned systems are investigated and compared. Frames with similar dimensions but various heights in both systems are designed according to Iranian code of practice for seismic resistant design of building, and then based on a non-linear push over static analysis; the seismic parameters such as behavior factor and performance levels are compared.

Keywords: Seismic behaviour, ordinary knee bracing frame, Chevron knee brace, behaviour factor, performance level.

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Authors: Amal E. Shehata, Manal E. Fareed

Abstract:

Osteoarthritis (OA) is the most prevalent and far common debilitating form of arthritis which can be defined as a degenerative condition affecting synovial joint. Patients suffering from osteoarthritis often complain of dull ache pain on movement. Physical agents can fight the painful process when correctly indicated and used such as heat or cold therapy Aim. This study was carried out to: Compare the effect of cold, warm and contrast therapy on controlling knee osteoarthritis associated problems. Setting: The study was carried out in orthopedic outpatient clinics of Menoufia University and teaching Hospitals, Egypt. Sample: A convenient sample of 60 adult patients with unilateral knee osteoarthritis. Tools: three tools were utilized to collect the data. Tool I : An interviewing questionnaire. It comprised of three parts covering  sociodemographic data, medical data and adverse effects of the treatment protocol. Tool II : Knee Injury and Osteoarthritis Outcome Score (KOOS) It consists of five main parts. Tool II1 : 0-10 Numeric pain rating scale. Results: reveled that the total knee symptoms score was decreased from moderate symptoms pre intervention to mild symptoms after warm and contrast method of therapy, but the contrast therapy had significant effect in reducing the knee symptoms and pain than the other symptoms. Conclusions: all of the three methods of therapy resulted in improvement in all knee symptoms and pain but the most appropriate protocol of treatment to relive symptoms and pain was contrast therapy.

Keywords: Knee Osteoarthritis, Cold, Warm and Contrast Therapy.

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Authors: S. Mogili, J. S. Kuang, N. Zhang

Abstract:

Knee joints, the beam column connections found at the roof level of a moment resisting frame buildings, are inherently different from conventional interior and exterior beam column connections in the way that forces from adjoining members are transferred into joint and then resisted by the joint. A knee connection has two distinct load resisting mechanisms, each for closing and opening actions acting simultaneously under reversed cyclic loading. In spite of many distinct differences in the behaviour of shear resistance in knee joints, there are no special design provisions in the major design codes available across the world due to lack of in-depth research on the knee connections. To understand the relative importance of opening and closing actions in design, it is imperative to study knee joints under varying shear stresses, especially at higher opening-to-closing shear stress ratios. Three knee joint specimens, under different input shear stresses, were designed to produce a varying ratio of input opening to closing shear stresses. The design was carried out in such a way that the ratio of flexural strength of beams with consideration of axial forces in opening to closing actions are maintained at 0.5, 0.7, and 1.0, thereby resulting in the required variation of opening to closing joint shear stress ratios among the specimens. The behaviour of these specimens was then carefully studied in terms of closing and opening capacities, hysteretic behaviour, and envelope curves to understand the differences in joint performance based on which an attempt to suggest design guidelines for knee joints is made emphasizing the relative importance of opening and closing actions. Specimens with relatively higher opening stresses were observed to be more vulnerable under the action of seismic loading.

Keywords: Knee-joints, large-scale testing, opening and closing shear stresses, seismic performance.

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Authors: Rakkrit Duangsoithong, Jermphiphut Jaruenpunyasak, Alba Garcia

Abstract:

The use of foot recognition can be applied in many medical fields such as the gait pattern analysis and the knee exercises of patients in rehabilitation. Generally, a camera-based foot recognition system is intended to capture a patient image in a controlled room and background to recognize the foot in the limited views. However, this system can be inconvenient to monitor the knee exercises at home. In order to overcome these problems, this paper proposes to use the deep learning method using Convolutional Neural Networks (CNNs) for foot recognition. The results are compared with the traditional classification method using LBP and HOG features with kNN and SVM classifiers. According to the results, deep learning method provides better accuracy but with higher complexity to recognize the foot images from online databases than the traditional classification method.

Keywords: Convolutional neural networks, deep learning, foot recognition, knee rehabilitation.

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Authors: A. Vairis, M. Petousis, B. Kandyla, C. Chrisoulakis

Abstract:

The human knee joint has a three dimensional geometry with multiple body articulations that produce complex mechanical responses under loads that occur in everyday life and sports activities. To produce the necessary joint compliance and stability for optimal daily function various menisci and ligaments are present while muscle forces are used to this effect. Therefore, knowledge of the complex mechanical interactions of these load bearing structures is necessary when treatment of relevant diseases is evaluated and assisting devices are designed. Numerical tools such as finite element analysis are suitable for modeling such joints in order to understand their physics. They have been used in the current study to develop an accurate human knee joint and model its mechanical behavior. To evaluate the efficacy of this articulated model, static load cases were used for comparison purposes with previous experimentally verified modeling works drawn from literature.

Keywords: biomechanics, finite element modeling, knee joint

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Authors: Dimitar Karastoyanov, Vladimir Monov

Abstract:

The paper is concerned with the state examination as well as the problems during the post surgical (orthopedic) rehabilitation of the knee and ankle joint. An observation of the current appliances for a passive rehabilitation devices is presented. The major necessary and basic features of the intelligent rehabilitation devices are considered. An approach for a new intelligent appliance is suggested. The main advantages of the device are: both active as well as passive rehabilitation of the patient based on the human - patient reactions and a real time feedback. The basic components: controller; electrical motor; encoder, force – torque sensor are discussed in details. The main modes of operation of the device are considered.

Keywords: Ankle, knee, rehabilitation, computer control.

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Authors: Jing Fang, Yao Cui, Mingming Wang, Shengli She, Jianping Yuan

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Wearable robotics is a potential solution in aiding gait rehabilitation of lower limbs dyskinesia patients, such as knee osteoarthritis or stroke afflicted patients. Many wearable robots have been developed in the form of rigid exoskeletons, but their bulk devices, high cost and control complexity hinder their popularity in the field of gait rehabilitation. Thus, the development of a portable, compliant and low-cost wearable robot for gait rehabilitation is necessary. Inspired by Chinese traditional folding fans and balloon inflators, the authors present an inflatable, foldable and variable stiffness knee exosuit (IFVSKE) in this paper. The pneumatic actuator of IFVSKE was fabricated in the shape of folding fans by using thermoplastic polyurethane (TPU) fabric materials. The geometric and mechanical properties of IFVSKE were characterized with experimental methods. To assist the knee joint smartly, an intelligent control profile for IFVSKE was proposed based on the concept of full-cycle energy management of the biomechanical energy during human movement. The biomechanical energy of knee joints in a walking gait cycle of patients could be collected and released to assist the joint motion just by adjusting the inner pressure of IFVSKE. Finally, a healthy subject was involved to walk with and without the IFVSKE to evaluate the assisting effects.

Keywords: Biomechanical energy management, gait rehabilitation, knee exosuit, wearable robotics.

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Authors: M. Tahani, G. Karimi

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In this paper after reviewing some previous studies, in order to optimize the above knee prosthesis, beside the inertial properties a new controlling parameter is informed. This controlling parameter makes the prosthesis able to act as a multi behavior system when the amputee is opposing to different environments. This active prosthesis with the new controlling parameter can simplify the control of prosthesis and reduce the rate of energy consumption in comparison to recently presented similar prosthesis “Agonistantagonist active knee prosthesis". In this paper three models are generated, a passive, an active, and an optimized active prosthesis. Second order Taylor series is the numerical method in solution of the models equations and the optimization procedure is genetic algorithm. Modeling the prosthesis which comprises this new controlling parameter (SEP) during the swing phase represents acceptable results in comparison to natural behavior of shank. Reported results in this paper represent 3.3 degrees as the maximum deviation of models shank angle from the natural pattern. The natural gait pattern belongs to walking at the speed of 81 m/min.

Keywords: Above knee prosthesis, active controlling parameter, ballistic motion, swing phase.

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Authors: Shaival Dalal, Nilesh Shah, Dinshaw Pardiwala, David Rajan, Satyen Sanghavi, Charul Bhanji

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Autologous Chondrocyte Implantation (ACI) is used worldwide since 1998 to treat cartilage defect. GEL based ACI is a new tissue-engineering technique to treat full thickness cartilage defect with fibrin and thrombin as scaffold for chondrocytes. Purpose of this study is to see safety and efficacy of gel based ACI for knee cartilage defect in multiple centres with different surgeons. Gel-based Autologous Chondrocyte Implantation (GACI) has shown effectiveness in treating isolated cartilage defect of knee joint. Long term results are still needed to be studied. This study was followed-up up to two years and showed benefit to patients. All enrolled patients with a mean age of 28.5 years had an average defect size of3 square centimeters, and were grade IV as per ICRS grading. All patients were followed up several times and at several intervals at 6th week, 8th week, 11th week, 17th week, 29th week, 57th week after surgery. The outcomes were measured based on the IKDC (subjective and objective) and MOCART scores.

Keywords: Knee, chondrocyte, autologous chondrocyte implantation, gel.

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Authors: Farzan Namvari, Panam Zarfam

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Nowadays use of a new structural bracing system called 'Knee Bracing System' have taken the specialists attention too much. On the other hand nonlinear static analysis procedures in estimate structures performance in earthquake time have taken attention too much. One of these procedure is modal pushover analysis (MPA) procedure. The accuracy of MPA procedure for simple steel moment resisting frame has been verified and considered in Chintanapakdee and Chopra-s article in 2003. Since the accuracy of MPA procedure has not verified for semi-rigid steel frames with knee bracing, we are going to get through with this matter in this study. For this purpose, the selected structures are four frames with different heights, 5 to 20 stories, will be designed according to AISC criteria. Then MPA procedure is used for the same frames with different rigidity percentiles of connections. The results of seismic responses are compared with dynamic nonlinear response history analysis as exact procedure and accuracy of MPA procedure is evaluated. It seems that MPA procedure accuracy will come down by reduction of the rigidity percentiles of semi-rigid connections.

Keywords: Knee Bracing, Modal Pushover Analysis, SeismicBehavior, Semi-Rigid Connections.

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Authors: Gabriel Sitler, Yousef Sardahi, Asad Salem

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This paper presents an optimal and robust sliding mode controller (SMC) to regulate the position of the knee joint angle for patients suffering from knee injuries. The controller imitates the role of active orthoses that produce the joint torques required to overcome gravity and loading forces and regain natural human movements. To this end, a mathematical model of the shank, the lower part of the leg, is derived first and then used for the control system design and computer simulations. The design of the controller is carried out in optimal and multi-objective settings. Four objectives are considered: minimization of the control effort and tracking error; and maximization of the control signal smoothness and closed-loop system’s speed of response. Optimal solutions in terms of the Pareto set and its image, the Pareto front, are obtained. The results show that there are trade-offs among the design objectives and many optimal solutions from which the decision-maker can choose to implement. Also, computer simulations conducted at different points from the Pareto set and assuming knee squat movement demonstrate competing relationships among the design goals. In addition, the proposed control algorithm shows robustness in tracking a standard gait signal when accounting for uncertainty in the shank’s parameters.

Keywords: Optimal control, multi-objective optimization, sliding mode control, wearable knee exoskeletons.

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Authors: Alò Roberta, Bottiglione Francesco, Mantriota Giacomo

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The efficiency of the actuation system of exoskeletons and active orthoses for lower limbs is a significant aspect of the design of such devices because it affects their efficacy. The F-IVT is an innovative actuation system to power artificial knee joint with energy recovery capabilities. Its key and non-conventional elements are a flywheel that acts as a mechanical energy storage system, and an Infinitely Variable Transmission (IVT). The design of the F-IVT can be optimized for a certain walking condition, resulting in a heavy reduction of both the electric energy consumption and of the electric peak power. In this work, by means of simulations of level ground walking at different speeds, it is demonstrated that the F-IVT is still an advantageous actuator which permits to save energy consumption and to downsize the electric motor even when it does not work in nominal conditions.

Keywords: Active orthoses, actuators, lower extremity exoskeletons, knee joint.

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Authors: Chirawat Wattanapanich, Hong Wei

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This study presents new gait representations for improving gait recognition accuracy on cross gait appearances, such as normal walking, wearing a coat and carrying a bag. Based on the Gait Energy Image (GEI), two ideas are implemented to generate new gait representations. One is to append lower knee regions to the original GEI, and the other is to apply convolutional operations to the GEI and its variants. A set of new gait representations are created and used for training multi-class Support Vector Machines (SVMs). Tests are conducted on the CASIA dataset B. Various combinations of the gait representations with different convolutional kernel size and different numbers of kernels used in the convolutional processes are examined. Both the entire images as features and reduced dimensional features by Principal Component Analysis (PCA) are tested in gait recognition. Interestingly, both new techniques, appending the lower knee regions to the original GEI and convolutional GEI, can significantly contribute to the performance improvement in the gait recognition. The experimental results have shown that the average recognition rate can be improved from 75.65% to 87.50%.

Keywords: Convolutional image, lower knee, gait.

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Authors: Zeinab A.Hussein, Manal S. Abd El-Wahab, Shorouk A. W. El-Shennawy

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Children with hemiplgic cerebral palsy often walk with diminished reciprocal arm swing so the purpose of this study was to describe kinematic characteristics in children with hemiplegic cerebral palsy (CP) during the gait suphases, and find if there is a correlation between upper(shoulder and elbow) and lower(hip, knee, and ankle) limb joints either in involved or uninvolved.48 children with hemiplegic cerebral palsy (18boys, 30girls) with an average age of (5.1±0.87) years were selected randomly to evaluate joint angles during gait by 3D motion analysis system with 6 pro reflex cameras in a sagittal plane for both sides of the body. The results showed increased shoulder and elbow flexion, increased hip angular displacement, decreased knee and ankle arcs during gait cycle, also there is correlation between shoulder and elbow to hip, knee, and ankle joints during various subphases of gait.

Keywords: Cerebral palsy, Gait, Hemiplegia, Motion analysis.

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Authors: Chih-I. Tsai, Yu-Chien. Lin

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Through experiences of clinical practices, it is discovered that locations on the body at a level of four fingerbreadth above and below the joints are the points at which muscles connect to tendons, and since the muscles and tendons possess opposite characteristics, muscles are full of blood but lack qi, while tendons are full of qi but lack blood, these points on our body become easily blocked. It is proposed that through doing acupuncture or creating localized pressure to the areas four fingerbreadths above and below our joints, with an elastic bandage, we could help the energy, also known as qi, to flow smoothly in our body and further improve our health. Based on the Four Fingers Theory, we understand that human height is 22 four fingerbreadths. In addition, qi and blood travel through 24 meridians, 50 times each day, and they flow through 6 cun with every human breath. We can also understand the average number of human heartbeats is 75 times per minute. And the function of qi-blood circulation system in Traditional Chinese Medicine is the same as the blood circulation in Western Medical Science. Informed by Four Fingers Theory, this study further examined its applications in acupuncture practices. The research question is how Four Fingers Theory proves what has been mentioned in Nei Jing that there are 66 acupoints under a human’s elbow and knee. In responding to the research question, there are 66 acupoints under a human’s elbow and knee. Four Fingers Theory facilitated the creation of the acupuncture naming and teaching system. It is expected to serve as an approachable and effective way to deliver knowledge of acupuncture to the public worldwide.

Keywords: Four Fingers theory, Meridians circulation, 66 Acupoints under a human’s elbow and knee, acupuncture.

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Authors: Nazim Mir-Nasiri, Hudyjaya Siswoyo Jo

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The paper describes conceptual design, control strategies, and partial simulation for a new fully autonomous lower limb wearable exoskeleton system for human motion enhancement that can support its weight and increase strength and endurance. Various problems still remain to be solved where the most important is the creation of a power and cost efficient system that will allow an exoskeleton to operate for extended period without batteries being frequently recharged. The designed exoskeleton is enabling to decouple the weight/mass carrying function of the system from the forward motion function which reduces the power and size of propulsion motors and thus the overall weight, cost of the system. The decoupling takes place by blocking the motion at knee joint by placing passive air cylinder across the joint. The cylinder is actuated when the knee angle has reached the minimum allowed value to bend. The value of the minimum bending angle depends on usual walk style of the subject. The mechanism of the exoskeleton features a seat to rest the subject’s body weight at the moment of blocking the knee joint motion. The mechanical structure of each leg has six degrees of freedom: four at the hip, one at the knee, and one at the ankle. Exoskeleton legs are attached to subject legs by using flexible cuffs. The operation of all actuators depends on the amount of pressure felt by the feet pressure sensors and knee angle sensor. The sensor readings depend on actual posture of the subject and can be classified in three distinct cases: subject stands on one leg, subject stands still on both legs and subject stands on both legs but transit its weight from one leg to other. This exoskeleton is power efficient because electrical motors are smaller in size and did not participate in supporting the weight like in all other existing exoskeleton designs.

Keywords: Energy efficient system, exoskeleton, motion enhancement, robotics.

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Authors: Chang, Chun-Lang, Liu, Chun-Kai

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This study, for its research subjects, uses patients who had undergone total knee replacement surgery from the database of the National Health Insurance Administration. Through the review of literatures and the interviews with physicians, important factors are selected after careful screening. Then using Cross Entropy Method, Genetic Algorithm Logistic Regression, and Particle Swarm Optimization, the weight of each factor is calculated and obtained. In the meantime, Excel VBA and Case Based Reasoning are combined and adopted to evaluate the system. Results show no significant difference found through Genetic Algorithm Logistic Regression and Particle Swarm Optimization with over 97% accuracy in both methods. Both ROC areas are above 0.87. This study can provide critical reference to medical personnel as clinical assessment to effectively enhance medical care quality and efficiency, prevent unnecessary waste, and provide practical advantages to resource allocation to medical institutes.

Keywords: Total knee replacement, Case Based Reasoning, Cross Entropy Method, Genetic Algorithm Logistic Regression, Particle Swarm Optimization.

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Authors: Seddeq E. Ghrare, Salahaddin M. Shreef

Abstract:

Medical image modalities such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), X-ray are adapted to diagnose disease. These modalities provide flexible means of reviewing anatomical cross-sections and physiological state in different parts of the human body. The raw medical images have a huge file size and need large storage requirements. So it should be such a way to reduce the size of those image files to be valid for telemedicine applications. Thus the image compression is a key factor to reduce the bit rate for transmission or storage while maintaining an acceptable reproduction quality, but it is natural to rise the question of how much an image can be compressed and still preserve sufficient information for a given clinical application. Many techniques for achieving data compression have been introduced. In this study, three different MRI modalities which are Brain, Spine and Knee have been compressed and reconstructed using wavelet transform. Subjective and objective evaluation has been done to investigate the clinical information quality of the compressed images. For the objective evaluation, the results show that the PSNR which indicates the quality of the reconstructed image is ranging from (21.95 dB to 30.80 dB, 27.25 dB to 35.75 dB, and 26.93 dB to 34.93 dB) for Brain, Spine, and Knee respectively. For the subjective evaluation test, the results show that the compression ratio of 40:1 was acceptable for brain image, whereas for spine and knee images 50:1 was acceptable.

Keywords: Medical Image, Magnetic Resonance Imaging, Image Compression, Discrete Wavelet Transform, Telemedicine.

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Authors: Pirutchada Musigapong, Wantanee Phanprasit

Abstract:

The intention of this study to design the probability optimized sewing sack-s workstation based on ergonomics for productivity improvement and decreasing musculoskeletal disorders. The physical dimensions of two workers were using to design the new workstation. The physical dimensions are (1) sitting height, (2) mid shoulder height sitting, (3) shoulder breadth, (4) knee height, (5) popliteal height, (6) hip breadth and (7) buttock-knee length. The 5th percentile of buttock knee length sitting (51 cm), the 50th percentile of mid shoulder height sitting (62 cm) and the 95th percentile of popliteal height (43 cm) and hip breadth (45 cm) applied to design the workstation for sewing sack-s operator and the others used to adjust the components of this workstation. The risk assessment by RULA before and after using the probability optimized workstation were 7 and 7 scores and REBA scores were 11 and 5, respectively. Body discomfort-abnormal index was used to assess muscle fatigue of operators before adjustment workstation found that neck muscles, arm muscles area, muscles on the back and the lower back muscles fatigue. Therefore, the extension and flexion exercise was applied to relief musculoskeletal stresses. The workers exercised 15 minutes before the beginning and the end of work for 5 days. After that, the capability of flexion and extension muscles- workers were increasing in 3 muscles (arm, leg, and back muscles).

Keywords: Animal feed, anthropometry, ergonomics, sewing sack, workstation design.

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Authors: Dabiri Y, Najarian S, Eslami M R., Zahedi S, Moser D, Shirzad E, Allami M

Abstract:

The effect of muscle loss due to transfemoral amputation, on energy expenditure of hip joint and individual residual muscles was simulated. During swing phase of gait, with each muscle as an ideal force generator, the lower extremity was modeled as a two-degree of freedom linkage, for which hip and knee were joints. According to results, muscle loss will not lead to higher energy expenditure of hip joint, as long as other parameters of limb remain unaffected. This finding maybe due to the role of biarticular muscles in hip and knee joints motion. Moreover, if hip flexors are removed from the residual limb, residual flexors, and if hip extensors are removed, residual extensors will do more work. In line with the common practice in transfemoral amputation, this result demonstrates during transfemoral amputation, it is important to maintain the length of residual limb as much as possible.

Keywords: Amputation Level, Simulation, Transfemoral Amputee.

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Authors: Binnur Sagbas

Abstract:

Artificial joint replacements such as total knee and total hip prosthesis have been applied to the patients who affected by osteoarthritis. Although different material combinations are used for these joints, biopolymers are most commonly preferred materials especially for acetabular cup and tibial component of hip and knee joints respectively. The main limitation that shortens the service life of these prostheses is wear. Wear is complicated phenomena and it must be considered with friction and lubrication. In this study, micro wave (MW) induced argon+oxygen plasma surface modification were applied on ultra-high molecular weight polyethylene (UHMWPE) and vitamin E blended UHMWPE (VE-UHMWPE) biopolymer surfaces to improve surface wettability and wear resistance of the surfaces. Contact angel measurement method was used for determination of wettability. Ball-on-disc wear test was applied under 25% bovine serum lubrication conditions. The results show that surface wettability and wear resistance of both material samples were increased by plasma surface modification.

Keywords: Artificial joints, plasma surface modification, UHMWPE, vitamin E, wear.

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