Coefficient of Friction Measurements on Transfemoral Amputees

Impact of Indenter Size and Microrelief Anisotropy on the Tribological Behavior of Human Skin

Everyday, we interact with screens, sensors, and many other devices through contact with the skin. Experimental efforts have increased our knowledge of skin tribology but are challenged by the fact that skin has a complex structure, undergoes finite deformations, has nonlinear material response, and has properties that vary with anatomical location, age, sex, and environmental conditions. Computational models are powerful tools to dissect the individual contribution of these variables to the overall frictional response. Here, we present a three-dimensional high-fidelity multilayer skin computational model including a detailed surface topography or skin microrelief. Four variables are explored: local coefficient of friction (COF), indenter size, mechanical properties of the stratum corneum, and displacement direction. The results indicate that the global COF depends nonlinearly on the local COF, implying a role for skin deformation on the friction response. The global COF is also influenced by the ratio of the indenter size to the microrelief features, with larger indenters smoothing out the role of skin topography. Changes in stiffness of the uppermost layer of skin associated with humidity have a substantial effect on both the contact area and the reaction forces, but the overall changes in the COF are small. Finally, for the microrelief tested, the response can be considered isotropic. We anticipate that this model and results will enable the design of materials and devices for a desired interaction against skin.

Investigation of Orthopedic Prosthesis Socket Management after Transfemoral Amputation by Expert Survey

Prosthesis treatment requires the close interaction of different actors. In fitting prostheses to patients, special attention is given to the manufacturing of the socket. The continuous development of the technologies involved in the fitting and optimization of prostheses is shown in the literature. The assessment of orthopedic technicians and their influence in the process is thus far largely unexplored. Ten orthopedic technicians were interviewed about the socket fitting process after transfemoral amputation. The research goal was to clarify the socket treatment process with regards to the German context. The results showed that the orthopedic technicians focussing on the patient during the fitting process. This study underlines the importance of interaction and empathy. Volume fluctuations are decisive within the treatment process and are interactively influenced by various factors. Furthermore, the research emphasizes the need for appropriate assistive technologies and the potential for the further development of existing systems.

Lower limb prosthetic interfaces: Clinical and technological advancement and potential future direction

The human-prosthesis interface is one of the most complicated challenges facing the field of prosthetics, despite substantive investments in research and development by researchers and clinicians around the world. The journal of the International Society for Prosthetics and Orthotics, Prosthetics and Orthotics International, has contributed substantively to the growing body of knowledge on this topic. In celebrating the 50th anniversary of the International Society for Prosthetics and Orthotics, this narrative review aims to explore how human-prosthesis interfaces have changed over the last five decades; how research has contributed to an understanding of interface mechanics; how clinical practice has been informed as a result; and what might be potential future directions. Studies reporting on comparison, design, manufacturing and evaluation of lower limb prosthetic sockets, and osseointegration were considered. This review demonstrates that, over the last 50 years, clinical research has improved our understanding of socket designs and their effects; however, high-quality research is still needed. In particular, there have been advances in the development of volume and thermal control mechanisms with a few designs having the potential for clinical application. Similarly, advances in sensing technology, soft tissue quantification techniques, computing technology, and additive manufacturing are moving towards enabling automated, data-driven manufacturing of sockets. In people who are unable to use a prosthetic socket, osseointegration provides a functional solution not available 50 years ago. Furthermore, osseointegration has the potential to facilitate neuromuscular integration. Despite these advances, further improvement in mechanical features of implants, and infection control and prevention are needed.