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Lower Extremity

Are You Able to Manage Bright Ideas and Promote Innovation?

By Biodesigns, biomechanics, Food for thought, HiFi, Lower Extremity, Military, Orthotics, Prosthetics, Upper Extremity
By: Julie Alley
Recently saw a “Bight Ideas” post and cartoon on LinkedIn (thanks Brent) stating how we manage and encourage bright ideas will determine the future of O&P. I have thought about the question of product and technique adoption a lot, as one of our goals is to improve the standard of care in interface designs in O&P, but more generally, improve all limb device integration.
   
Over the years, I have seen it is easier to ignore bright ideas or new discoveries instead of embracing them quickly. Look at Edison. Few could understand the life-altering benefits of the light bulb. And we see this time and time again. Many products take years to gain traction or adoption. So why are we so slow to move and why would someone ignore a bright area or new discovery? For me, everything comes down to motivation and if you are personally motivated to do something. So what motivates someone to disregard or pass on a big idea? Now I’m no psychologist and I don’t claim to be one, but I believe there are many possible answers. Is it pure laziness, a good enough mentality, complacency, or I’ve done it this way for so long that I don’t want to change? Is it ego or not created it here syndrome? Is it not knowing enough about something or the inability to comprehend the idea? Is it seen as helping the competition? Is it insecurities? Is it easier to try and rip it off? Is it a fear of failing? Is it a bad manager or supervisor? Is it too many distractions, the belief that it would take too long to implement, perhaps a disbelief in the benefit of the new idea or product, one not seeing it as being valuable or worth the price or investment? Is it short term vs. long term thinking, is it distractions at work or home, is it not having stake in the new idea, is it tunnel vision, is it how or what you were taught in school the dictates your world view, is it not a priority, and the list goes on. Coming from outside the industry into this industry, I quickly noticed that the value of the prosthetist is minimized and the main focus is on the components, with the threshold for success being acceptance or delivery of the device at that one moment in time, even before the patient has had ample time to test and use the device. If this is the best we can achieve, then innovation, at least in the interface will never be achieved by the masses. If the industry can look at themselves and say our high risk of falls in femoral and tibial prostheses, and low acceptance rates in upper limb, is not acceptable, then maybe there is hope. For us, biodesigns will continue as a company to push for superior interfaces, as this is the platform or core for the whole system. And we will stand with the few also pushing for improved designs, with the hope that the industy will follow. If the role of the prosthetist and interface continues to be minimized, reimbursement will continue to fall. The schools/master programs can help push the change, but if they continue to focus on the past with very little emphasis on newer designs, outcome measures, biomechanical principles, gait analysis, functional range of performance, energy expenditure, alignment, soft tissue management, etc., the future O&P clinicians, will have much to learn. And if the prosthetist doesn’t learn how to fight for their place in the system, based on an experience and expertise few other allied health professionals have, then you will be replaced. Anyone can learn how to take a few measurements and send them to fabrication. But very few can make a patient who has lost a limb feel whole again.

The Importance of the Prosthetic Interface and Its Impact on Patient Management

By Lower Extremity, Socket Technology, Upper Extremity

The Interface or Socket that the Prosthetist provides has a profound impact on their patient’s ability to move forward with rehab and greatly impacts their life today and in the future. Read the recent article by Tricia West and Randall Alley. We must remember to think of our patients in the hear and now but maybe, and even more importantly, in the future.

https://www.aanlcp.org/wp-content/uploads/2020/10/Fall-2020.pdf

Randall Alley Hosts HiFi Overview Webinar 6/3

By Lower Extremity, Prosthetics, Upper Extremity

Randall Alley, HiFi Interface Inventor, is asking prosthetists to look to science not art when creating interface designs. It is well documented that current socket designs are plagued by inherent issues causing instability, rotational issues, pistoning, falls, skin issues, excessive energy expenditure, and the inability for wearers to sit up straight. Randall will be highlighting the research and benefits of his HiFi Interface System technology, including improved comfort, function, stability, faster walking speeds, improved gait symmetry and more. No more “buckets.” Time to step up to a better design. Time to step up for better science. Time to step up for our patients.

The Effect of Transfemoral Interface Design On Gait Speed and Risk of Falls

By HiFi, Knee Technology, Lower Extremity, Prosthetics, Socket Technology No Comments

 
By: Jason T. Kahle, Tyler D. Klenow, William J. Sampson, M. Jason Highsmith

September 2016, Technology and Innovations, Vol. 18, pgs. 167-173, The Effect of Transfemoral Interface Design On Gait Speed and Risk of Falls

The purpose of this study was to compare the effect of TFA interface design on walking capacity and balance confidence A retrospective cohort design was utilized involving unilateral TFA patients who used ischial ramus containment (IRC) and High-Fidelity (HiFi) interfaces. Falls and diminished walking capacity are impairments common in persons with transfemoral amputation (TFA). Reducing falls and optimizing walking capacity through such means as achieving a more normal gait speed and community ambulation should be considered when formulating the prosthetic prescription. Because walking capacity and balance confidence are compromised with TFA, these outcomes should be considered when evaluating interfaces for transfemoral prosthetic users. The purpose of this study was to compare the effect of TFA interface design on walking capacity and balance confidence A retrospective cohort design was utilized involving unilateral TFA patients who used ischial ramus containment (IRC) and High-Fidelity (HiFi) interfaces (independent variables). Dependent variables included the Activity-specific Balance Scale (ABC) and the two-minute walk test (2MWT). Complete records were available for 13 patients (n = 13). The age range was 26 to 58 years. Three patients functioned at the K4 activity level, whereas all others functioned at the K3 level. Mean ABC scores were significantly different (p ≤ 0.05) at 77.2 (±16.8; 35.6 to 96.9) for IRC and 90.7 (±5.7;77.5 to 98.7) for HiFi. The mean distance walked on the 2MWT was 91.8 m (±22.0, 58.3 to 124.7) for IRC compared to 110.4 m (±28.7; 64.7 to 171.1) for the HiFi socket (p ≤ 0.05). Alternative transfemoral interface design, such as the HiFi socket, can improve walking capacity and balance confidence in higher-functioning TFA patients.

Read Full Article Here

 

First Threadless Valves for Suction Sockets Sold to Otto Bock Healthcare

By Biodesigns, Lower Extremity, ottobock, Prosthetics, Upper Extremity
Randall Alley, BSc, CP, owner of biodesigns inc., Westlake Village, California, announced that the PushValve and MagValve, two threadless auto-expulsion valves for upper- and lower-extremity prosthetic suction sockets, have been sold to Otto Bock Healthcare, headquartered in Duderstadt, Germany.

Alley conceived the threadless valve concept, and with the help of tranfemoral amputee Adam Soss and engineer Dustin Bouch, created the world’s first threadless valve family for preparatory and definitive suction socket applications.

“Many of today’s valve designs haven’t changed significantly in their approach to providing suction suspension since they were conceived decades ago,” said Alley. “I wanted to create a valve that was an improvement over existing valves and ultimately one that is easier for patients to use–hence the idea for a threadless design.”

The PushValve is a latching, threadless auto-expulsion valve designed primarily for above-knee suction socket applications, Alley explained. The lower-profile MagValve is a magnetic threadless auto-expulsion valve suitable for both upper- and lower-extremity suction sockets.

“The main advantage of the threadless valve design is that it does not require any twisting, but instead can quickly and effortlessly push in and pull out,” according to a company statement. “In addition, audible feedback lets a patient know they are properly seated and secure: they just click into place. No special tools are required for tightening/loosening, and there is no threat of pulling hairs. The valves are also ideal for bilateral amputees and individuals with hand involvement who wouldn’t be able to easily manage existing screw-in valves. Both valves are also perfect for active individuals who have a need for speed.”

To purchase the valves for your patients’ prosthetic sockets visit ottobocks website.  https://shop.ottobock.us/Prosthetics/Lower-Limb-Prosthetics/Socket-Technologies-Liners/Valves/c/1606