Selecting Appropriate 3D Scanning Technologies for Prosthetic Socket Design and Transtibial Residual Limb Shape Characterization
Selecting Appropriate 3D Scanning Technologies for Prosthetic Socket Design and Transtibial Residual Limb Shape Characterization
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DOI：
10.1097/jpo.0000000000000350
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发表时间：
2022-01-01
影响因子：
0.6
通讯作者：
Worsley, Peter R.
中科院分区：
文献类型：
--
作者：
Dickinson, Alexander S.;Donovan-Hall, Maggie K.;Worsley, Peter R.
导言：石膏铸造法和人工矫正法代表了基准假体接受腔的设计方法。3D技术在假肢设计和制造方面的潜力越来越大，特别是在低资源环境下增强这些服务的可获得性。然而，社区有责任验证这些新数字技术的有效性。这项研究的动机是建立基准数据来评估数字形状捕获技术，特别是针对临床相关的残肢形状和里程碑捕获，用于肢体测量和插座设计。因此，目的是评估体内石膏铸型的可重复性，并将其与三种临床使用的3D扫描仪进行比较。材料和方法：对11名经胫骨截肢的参与者进行铸型和3D扫描的可靠性比较评估。对于每个参与者，两个正模由修复师铸造，并使用白光3D表面扫描仪进行数字化。在铸型之间，每个参与者的残肢都被扫描了。结果：95%的临床相关眼窝形状表面积与人工铸型之间的偏差小于2.87 mm(SD，0.44 mm)，平均偏差为0.18 mm(SD，1.72 mm)。铸型的重复性系数体积为46.1ml(3.47%)，周长为9.6 mm(3.53%)。在所有有临床意义的测量中，Omega扫描仪的可靠性更高，而Sense和iSense扫描仪的可靠性更差，尽管观察到Sense扫描仪的性能与铸型相当(95%的形状一致性)。结论：本研究提供了一个平台，在手动石膏铸造的最佳实践的背景下评估新的临床形状捕获技术，并开始讨论哪种3D扫描设备最适合不同类型的临床应用。这些方法和基准结果可以支持修复师获得和应用他们的临床经验，作为他们持续专业发展的一部分。
Introduction: Plaster casting and manual rectification represent the benchmark prosthetic socket design method. 3D technologies have increasing potential for prosthetic limb design and fabrication, especially for enhancing access to these services in low-resource settings. However, the community has a responsibility to verify the efficacy of these new digital technologies. The motivation for this study was to establish benchmarking data to assess digital shape capture technologies, specifically for clinically relevant residual limb shape and landmark capture for limb survey and socket design. The objective was therefore to assess the repeatability of plaster casting in vivo and to compare this with three clinically used 3D scanners.Materials and Methods: A comparative reliability assessment of casting and 3D scanning was conducted in 11 participants with established transtibial amputation. For each participant, two positive molds were cast by a prosthetist and digitized using a white-light 3D surface scanner. Between casts, each participant's residual limb was scanned. The deviation among scan volumes, cross-sections, and shapes was calculated.Results: A total of 95% of the clinically relevant socket shape surface area had a deviation between manual casts of less than 2.87 mm (SD, 0.44 mm), and the average deviation was 0.18 mm (SD, 1.72 mm). The repeatability coefficient of casting was 46.1 ml (3.47%) for volume and 9.6 mm (3.53%) for perimeters. For all clinically meaningful measures, greater reliability was observed for the Omega scanner and worse for the Sense and iSense scanners, although it was observed that the Sense scanner performance was comparable to casting (95th percentile shape consistency).Conclusions: This study provides a platform to appraise new clinical shape capture technologies in the context of best practice in manual plaster casting and starts the conversation of which 3D scanning devices are most appropriate for different types of clinical use. The methods and benchmark results may support prosthetists in acquiring and applying their clinical experience, as part of their continuing professional development.