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Mian SH, Abouel Nasr E, Moiduddin K, Saleh M, Abidi MH, Alkhalefah H. Assessment of consolidative multi-criteria decision making (C-MCDM) algorithms for optimal mapping of polymer materials in additive manufacturing: A case study of orthotic application. Heliyon 2024; 10:e30867. [PMID: 38770323 PMCID: PMC11103525 DOI: 10.1016/j.heliyon.2024.e30867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/16/2024] [Accepted: 05/07/2024] [Indexed: 05/22/2024] Open
Abstract
Objective The objectives of this research are twofold. The primary goal is to introduce, investigate, and contrast consolidative multi-criteria decision-making (C-MCDM) approaches. The second objective is the investigation of five alternative additive manufacturing materials. Methods It integrates the subjective and objective weights using the Bayes hypothesis in conjunction with a normal method. Chang's Extent Analysis Method under fuzzy logic is used to estimate subjective weights and the CRITIC approach is used for assessing objective weights. Ranking techniques, including the simple ranking process (SRP), multi-objective optimization based on ratio analysis (MOORA), measurement alternatives and ranking according to compromise solution (MARCOS), and technique for order preference by similarity to ideal solution (TOPSIS) are applied. It also encompasses sensitivity analysis based on Kendall's coefficient of concordance and rank reversal phenomenon analysis. Spearman's rank correlation coefficient, a weighted rank measure of correlation, and rank similarity coefficient are among the metrics used to evaluate agreement between different approaches. It entails gathering expert opinions regarding the importance of various criteria as well as conducting extensive experiments. Results The findings of the study indicate that polylactic acid is the best material to use for orthoses. When compared to the other MCDM approaches being discussed, SRP is the most reliable approach. It is also demonstrated that the SRP, MARCOS, and TOPSIS methods are rank reversal-free. Furthermore, SRP exhibits a very poor association with the TOPSIS technique but a strong correlation with the MOORA and MARCOS approaches. Conclusions To ensure results reliability, it is necessary to consider both the subjectivity and objectivity of weights as well as apply multiple MCDM methodologies in addition to sensitivity analysis.
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Affiliation(s)
- Syed Hammad Mian
- Advanced Manufacturing Institute, King Saud University, Riyadh, 11421, Saudi Arabia
| | - Emad Abouel Nasr
- Department of Industrial Engineering, College of Engineering, King Saud University, Riyadh, 11421, Saudi Arabia
| | - Khaja Moiduddin
- Advanced Manufacturing Institute, King Saud University, Riyadh, 11421, Saudi Arabia
| | - Mustafa Saleh
- Department of Industrial Engineering, College of Engineering, King Saud University, Riyadh, 11421, Saudi Arabia
| | - Mustufa Haider Abidi
- Advanced Manufacturing Institute, King Saud University, Riyadh, 11421, Saudi Arabia
| | - Hisham Alkhalefah
- Advanced Manufacturing Institute, King Saud University, Riyadh, 11421, Saudi Arabia
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Tan X, Ahmed-Kristensen S, Zhu Q, Han T, Zhu L, Chen W, Cao J, Nanayakkara T. Identification of excessive contact pressures under hand orthosis based on finite element analysis. Prosthet Orthot Int 2024:00006479-990000000-00249. [PMID: 38771762 DOI: 10.1097/pxr.0000000000000357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 03/15/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Implicit magnitudes and distribution of excessive contact pressures under hand orthoses hinder clinicians from precisely adjusting them to relieve the pressures. To address this, contact pressure under a hand orthosis were analysed using finite element method. METHODS This paper proposed a method to numerically predict the relatively high magnitudes and critical distribution of contact pressures under hand orthosis through finite element analysis, to identify excessive contact pressure locations. The finite element model was established consisting of the hand, orthosis and bones. The hand and bones were assumed to be homogeneous and elastic bodies, and the orthosis was considered as an isotropic and elastic shell. Two predictions were conducted by assigning either low (fat) or high (skin) material stiffness to the hand model to attain the range of pressure magnitudes. An experiment was conducted to measure contact pressures at the predicted pressure locations. RESULTS Identical pressure distributions were obtained from both predictions with relatively high pressure values disseminated at 12 anatomical locations. The highest magnitude was found at the thumb metacarpophalangeal joint with the maximum pressure range from 13 to 78 KPa. The measured values were within the predicted range of pressure magnitudes. Moreover, 6 excessive contact pressure locations were identified. CONCLUSIONS The proposed method was verified by the measurement results. It renders understanding of interface conditions underneath the orthosis to inform clinicians regarding orthosis design and adjustment. It could also guide the development of 3D printed or sensorised orthosis by indicating optimal locations for perforations or pressure sensors.
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Affiliation(s)
- Xinyang Tan
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | | | - Qian Zhu
- Department of Rehabilitation Medicine, The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, China
| | - Ting Han
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Zhu
- Dyson School of Design Engineering, Imperial College London, London, UK
| | - Wei Chen
- Department of Rehabilitation Medicine, The Affiliated Xuzhou Rehabilitation Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jiangang Cao
- Department of Assistive Technology, International University of Health and Welfare, Otawara, Japan
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Silva R, Silva B, Fernandes C, Morouço P, Alves N, Veloso A. A Review on 3D Scanners Studies for Producing Customized Orthoses. SENSORS (BASEL, SWITZERLAND) 2024; 24:1373. [PMID: 38474907 DOI: 10.3390/s24051373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/11/2024] [Accepted: 02/14/2024] [Indexed: 03/14/2024]
Abstract
When a limb suffers a fracture, rupture, or dislocation, it is traditionally immobilized with plaster. This may induce discomfort in the patient, as well as excessive itching and sweating, which creates the growth of bacteria, leading to an unhygienic environment and difficulty in keeping the injury clean during treatment. Furthermore, if the plaster remains for a long period, it may cause lesions in the joints and ligaments. To overcome all of these disadvantages, orthoses have emerged as important medical devices to help patients in rehabilitation, as well as for self-care of deficiencies in clinics and daily life. Traditionally, these devices are produced manually, which is a time-consuming and error-prone method. From another point of view, it is possible to use imageology (X-ray or computed tomography) to scan the human body; a process that may help orthoses manufacturing but which induces radiation to the patient. To overcome this great disadvantage, several types of 3D scanners, without any kind of radiation, have emerged. This article describes the use of various types of scanners capable of digitizing the human body to produce custom orthoses. Studies have shown that photogrammetry is the most used and most suitable 3D scanner for the acquisition of the human body in 3D. With this evolution of technology, it is possible to decrease the scanning time and it will be possible to introduce this technology into clinical environment.
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Affiliation(s)
- Rui Silva
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, 1499-002 Lisbon, Portugal
- CDRSP, Polytechnic University of Leiria, 2430-028 Marinha Grande, Portugal
| | - Bruna Silva
- CDRSP, Polytechnic University of Leiria, 2430-028 Marinha Grande, Portugal
| | | | - Pedro Morouço
- ESECS, Polytechnic University of Leiria, 2411 Leiria, Portugal
- CIDESD, Research Center in Sports Sciences, Health Sciences and Human Development, 6201-001 Covilhã, Portugal
| | - Nuno Alves
- CDRSP, Polytechnic University of Leiria, 2430-028 Marinha Grande, Portugal
| | - António Veloso
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada Dafundo, 1499-002 Lisbon, Portugal
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Madden VJ, Kamerman P, Leake HB, Catley MJ, Heathcote LC, Moseley GL. The Sensation and Pain Rating Scale: easy to use, clear to interpret, and responsive to clinical change. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.09.08.23295128. [PMID: 37732279 PMCID: PMC10508797 DOI: 10.1101/2023.09.08.23295128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Background The Sensation and Pain Rating Scale (SPARS) allows rating of non-painful as well as painful percepts. While it performs well in the experimental context, its clinical utility is untested. This prospective, repeated-measures study mixed qualitative and quantitative methods to examine the utility and performance of the SPARS in a clinical context, and to compare it with the widely used 11-point NRS for pain. Methods People presenting for outpatient physiotherapy (n = 121) provided ratings on the SPARS and NRS at first consultation, before and after sham and active clinical interventions, and at follow-up consultation. Clinicians (n = 9) reported each scale's usability and interpretability using Likert-type scales and free text, and answered additional questions with free text. Each data type was initially analysed separately: quantitative data were visualised and the ES II metric was used to estimate SPARS internal responsiveness; qualitative data were analysed with a reflexive inductive thematic approach. Data types were then integrated for triangulation and complementarity. Results The SPARS was well received and considered easy to use, after initial familiarisation. Clinicians favoured the SPARS over the NRS for clarity of interpretation and inter-rater reliability. SPARS sensitivity to change was good (ESII=0.9; 95%CI: 0.75-1.10). The greater perceptual range of the SPARS was deemed especially relevant in the later phases of recovery, when pain may recede into discomfort that still warrants clinical attention. Conclusion The SPARS is a promising tool for assessing patient percept, with strong endorsement from clinicians for its clarity and superior perceptual scope.
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Affiliation(s)
- Victoria J Madden
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town. IIMPACT in Health, University of South Australia, Adelaide, Australia
| | - Peter Kamerman
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, South Africa
| | - Hayley B Leake
- IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Kaurna Country, Adelaide, SA, Australia
| | - Mark J Catley
- IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Kaurna Country, Adelaide, SA, Australia
| | - Lauren C Heathcote
- Health Psychology Section, Department of Psychology, Institute of Psychiatry Psychology and Neuroscience, King's College London
| | - G Lorimer Moseley
- IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Kaurna Country, Adelaide, SA, Australia
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Danko M, Sekac J, Dzivakova E, Zivcak J, Hudak R. 3D Printing of Individual Running Insoles - A Case Study. Orthop Res Rev 2023; 15:105-118. [PMID: 37275301 PMCID: PMC10237191 DOI: 10.2147/orr.s399624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 05/03/2023] [Indexed: 06/07/2023] Open
Abstract
Purpose The study's starting point is to find a low-cost and best-fit solution for comfortable movement for a recreational runner with knee pain using an orthopedic device. It is a case study. The research aims to apply digitization, CAD/CAM tools, and 3D printing to create an individual 3D running insole. The objective is to incorporate flexible shape optimization would provide comfort reductions in foot plantar pressures in one subject with knee pain while running. The test hypothesis was if it is possible to make it from one material. For this purpose, we created a new digital workflow based on the Decision Tree method and analyzed pain and comfort scores during user testing of prototypes. Patient and Methods The input data were obtained during a professional examination by a specialist doctor in the orthopedic outpatient clinic in the motion laboratory (DIERS 4D Motion Lab, Germany) with the output of data on the proband's complex movement stereotype. Surface and volumetric data were obtained in the biomedical laboratory with the 3D scanner. We modified the digital 3D foot models in 3D mesh software, developed the design in SW Gensole (Gyrobot, UK), and finally incorporated the internal structure and the surface layer of the insole data of the knowledge from the medical examination, comfort analyses, and scientific studies findings. Results Four complete 3D-printed prototypes (n=4) with differences in density and correction elements were designed. All of them were fabricated on a 3D printer (Prusa i3 MK3S, Czech Republic) with flexible TPU material suitable for skin contact. The Participant tested each of them five times in the field during a workout and final insoles three months on the routine training. Conclusion A novel workflow was created for designing, producing, and testing full 3D-printed insoles. The product is fit for immediate use.
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Affiliation(s)
- Maria Danko
- Department of Biomedical Engineering and Measurement, Technical University of Kosice, Kosice, Slovak Republic
| | - Jan Sekac
- Department of Biomedical Engineering and Measurement, Technical University of Kosice, Kosice, Slovak Republic
| | - Eva Dzivakova
- Department of Biomedical Engineering and Measurement, Technical University of Kosice, Kosice, Slovak Republic
| | - Jozef Zivcak
- Department of Biomedical Engineering and Measurement, Technical University of Kosice, Kosice, Slovak Republic
| | - Radovan Hudak
- Department of Biomedical Engineering and Measurement, Technical University of Kosice, Kosice, Slovak Republic
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Ho M, Nguyen J, Heales L, Stanton R, Kong PW, Kean C. The biomechanical effects of 3D printed and traditionally made foot orthoses in individuals with unilateral plantar fasciopathy and flat feet. Gait Posture 2022; 96:257-264. [PMID: 35709609 DOI: 10.1016/j.gaitpost.2022.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 06/05/2022] [Accepted: 06/09/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Foot orthoses (FOs) are used to manage foot pathologies such as plantar fasciopathy. 3D printed custom-made FOs are increasingly being manufactured. Although these 3D-printed FOs look like traditionally heat-moulded FOs, there are few studies comparing FOs made using these two different manufacturing processes. RESEARCH QUESTION How effective are 3D-printed FOs (3D-Print) compared to traditionally-made (Traditional) or no FOs (Control), in changing biomechanical parameters of flat-footed individuals with unilateral plantar fasciopathy? METHODS Thirteen participants with unilateral plantar fasciopathy walked with shoes under three conditions: Control, 3D-print, and Traditional. 2 × 3 repeated measures analysis of variance (ANOVAs) with Bonferroni post-hoc tests were used to compare discrete kinematic and kinetic variables between limbs and conditions. Waveform analyses were also conducted using statistical parametric mapping (SPM). RESULTS There was a significant condition main effect for arch height drop (p = 0.01; ηp2 =0.54). There was 0.87 mm (95% CI [-1.84, -0.20]) less arch height drop in 3D-print compared to Traditional. The SPM analyses revealed condition main effects on ankle moment (p < 0.001) and ankle power (p < 0.001). There were significant differences between control condition and both 3D-print and Traditional conditions. For ankle moment and power, there were no differences between 3D-print and Traditional conditions. SIGNIFICANCE 3D-printed FOs are more effective in reducing arch height drop, whist both FOs lowered ankle plantarflexion moment and power compared to no FOs. The results support the use of 3D-printed FOs as being equally effective as traditionally-made FOs in changing lower limb biomechanics for a population of flat-footed individuals with unilateral plantar fasciopathy.
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Affiliation(s)
- Malia Ho
- Department of Podiatry, School of Health, Medical and Applied Sciences, CQUniversity Australia, Building 34, Bruce Highway, North Rockhampton, QLD 4701, Australia.
| | - Julie Nguyen
- Department of Podiatry, School of Health, Medical and Applied Sciences, CQUniversity Australia, Building 34, Bruce Highway, North Rockhampton, QLD 4701, Australia.
| | - Luke Heales
- Department of Physiotherapy, School of Health, Medical and Applied Sciences, CQUniversity Australia, Building 34, Bruce Highway, North Rockhampton, QLD 4701, Australia.
| | - Robert Stanton
- Department of Exercise and Sports Science, School of Health, Medical and Applied Sciences, CQUniversity Australia, Bruce Highway, North Rockhampton, QLD 4701, Australia.
| | - Pui W Kong
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore.
| | - Crystal Kean
- Department of Exercise and Sports Science, School of Health, Medical and Applied Sciences, CQUniversity Australia, Bruce Highway, North Rockhampton, QLD 4701, Australia.
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