Registering a methodology for imaging and analysis of residual-limb shape after transtibial amputation
Registering a methodology for imaging and analysis of residual-limb shape after transtibial amputation
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DOI：
10.1682/jrrd.2014.10.0272
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发表时间：
2016-01-01
影响因子：
--
通讯作者：
Worsley, Peter R.
中科院分区：
文献类型：
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作者：
Dickinson, Alexander S.;Steer, Joshua W.;Worsley, Peter R.
下肢截肢后成功的假肢康复取决于一个安全、舒适的接受腔-残肢界面。目前的实践主要使用主观的、迭代的过程来建立接受腔形状，通常需要多次访问修复师。本研究提出了一个客观的方法，残肢形状扫描和分析的高分辨率，自动测量。一个3D打印的“模拟”残留物用三个表面数字化仪扫描了10次。通过重复模拟扫描与计算机辅助设计（CAD）几何结构之间的扫描高度误差以及扫描与CAD体积之间的扫描高度误差来测量准确度。随后，20名男性残留铸件从走动的个人与经胫骨截肢进行了扫描，由两名观察员，和10个重复扫描由一名观察员。形状文件在空间上对齐，并提取几何测量。通过组内相关性、扫描体积的Bland-Alttuan分析以及扫描面积和宽度轮廓的成对均方根误差范围来评价重复性。当使用白色光和激光扫描技术扫描模拟形状时，实现了亚毫米精度。扫描男性残留铸件内和观察员之间的可重复性很高。分析方法技术为临床研究人员和修复师提供了建立自己的定量，客观，多患者数据集的能力。这可以为培训、长期随访和患者间结局比较提供证据基础，为插座设计提供决策支持。
Successful prosthetic rehabilitation following lower-limb amputation depends upon a safe and comfortable socket-residual limb interface. Current practice predominantly uses a subjective, iterative process to establish socket shape, often requiring several visits to a prosthetist. This study proposes an objective methodology for residual-limb shape scanning and analysis by high-resolution, automated measurements. A 3-D printed "analog" residuum was scanned with three surface digitizers on 10 occasions. Accuracy was measured by the scan-height error between repeat analog scans and the computer-aided design (CAD) geometry and the scan versus CAD volume. Subsequently, 20 male residuum casts from ambulatory individuals with transtibial amputation were scanned by two observers, and 10 were repeat-scanned by one observer. The shape files were aligned spatially, and geometric measurements were extracted. Repeatability was evaluated by intraclass correlation, Bland-Alttuan analysis of scan volumes, and pairwise root-mean-square error ranges of scan area and width profiles. Submillimeter accuracy was achieved when scanning the analog shape using white light and laser scanning technologies. Scanning male residuum casts was highly repeatable within and between observers. The analysis methodology technique provides clinical researchers and prosthetists the capability to establish their own quantitative, objective, multipatient datasets. This could provide an evidence base for training, long-term follow-up, and interpatient outcome comparison, for decision support in socket design.