Crossing barriers of rehabilitation through development of advanced prosthetic knees. Drikus Reinecke - Otto Bock South-Africa

Transcription

1 Crossing barriers of rehabilitation through development of advanced prosthetic knees. Drikus Reinecke - Otto Bock South-Africa

2 The different classifications of prosthetic knees. Three main Variation in prosthetic knees Polycentric Mechanical Single axis Mechanical Single axis Electronic Development of advanced prosthetic knees Drikus Reinecke, Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 2

3 What is a single axis knee. Rotation occurs around a single point Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 3

4 Prosthetic Knee Joints Single Axis Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 4

5 What is a Polycentric knee. Rotation occurs around multiple rotation point Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 5

6 Prosthetic Knee Joints Polisentric Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 6

7 The different classifications of prosthetic knees. Swing-phase control variations in prosthetic knees Single Axis Polycentric Swing control Mechanical Pneumatic Hydraulic Mechanical Pneumatic Hydraulic Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 7

8 The different classifications of prosthetic knees. Stance-phase control variation in prosthetic knees Single Axis Polycentric Stance control (Safety) Lock Brake Alignment Lock Alignment Electronic Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 8

9 Mechanical stance control of prosthetic knees. External / Environmental factors not recognized Single Axis Polycentric mechanical mechanical Stance control (Safety) Lock Brake Alignment Lock Alignment Cognitive control Alignment Foot selection Body powered (Muscle control) Weight dependant Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 9

10 Electronic stance control of prosthetic knees. External / Environmental factors are measured and compensated for. Single Axis Electronic Stance control (Safety) Micro processor Electronic sensors Alignment Axial load Linear accelerations Knee Angle Knee moment Ankle moment Shank inclination Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 10

11 Advanced prosthetics Why was it necessary to develop Microprocessor knees How does all of this really work. Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 11

12 Introduction to Micro Processor Knee Joints Milestones 1988 First prototype developed by Kelly James in Canada 1997 Market introduction of C- Leg 2004 Market introduction of C- Leg compact 2006 New generation of C-Leg 2008 New C-Leg compact introduced 2011 Introduction of the new C- Leg 2012 Introduction of Genium prosthetic system More than fittings around the world Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 12

13 Introduction to Micro Processor Knee Joints Who is a candidate for C-Leg or Genium? In addition to the Knee Disarticulation and Trans Femoral indications list: MOBIS 3-4 We have seen instances where bilateral above knee, hip disarticulation and hemipelvectomy patients have benefited from features of the C-Leg. The C-Leg is not intended for serious athletic training or high impact activities. Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 13

14 Introduction to Micro Processor Knee Joints What do C-Leg and Genium enable you to do? Walking with less concentration Reduced energy consumption while walking Feel more secure during ordinary walking Feel more stable walking on uneven surfaces Descend stairs and slopes step over step Walk with less compensations Have the prosthesis keep up with you when changing walking speeds Cycling, cross-country skiing, skating, riding Empty battery mode, improved stumble recovery Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 14

15 Introduction to Micro Processor Knee Joints Functionality Real time gait analysis The knee joint C-Leg measures 50 times per second Genium measures 100 times per second analyses the amputee s gait changes the hydraulic controls to prepare for the user s next movement (in real-time). - Gait cycle analysis in real-time - Leads to high safety Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 15

16 Introduction to Micro Processor Knee Joints Technology Technology Battery Hydraulics Gyroscope 2 axis accelerometer Electronics + Bluetooth Knee moment sensor Ankle moment / Axial load sensor Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 16

17 Introduction to Micro Processor Knee Joints Stumble recovery Joint can be loaded Improved stumble recovery If the joint detects a toe load during swing extension, it sets the flexion damping to a safe level (higher than normal flexion resistance but no locking) Because of this the joint can be loaded during swing extension (e.g. if prosthetic foot gets caught) This makes a stumble recovery easier and increases safety Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 17

18 Introduction to Micro Processor Knee Joints Knee flexion angle Optimized swing phase behavior Goal: A maximum of approx. 65 of knee flexion should be reached (independently of walking speed), coming as close as possible to natural gait. The damping control should act steadily increasing and as continuously as possible. 65 Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 18

19 Conclusion As a result of increase in diabetes the amputee age is increasing and it demands a higher form of security and stability of a prosthesis. Supporting high activity patient is the drive behind Ottobock developing microprocessor prosthetics systems. Prescribe according to clinical needs primarily and use financial constrains only as an additional indicator.

20 Development of advanced prosthetic knees Drikus Reinecke,Otto Bock South Africa 20 July 2013 Otto Bock HealthCare 20

21 Thank you very much for your attention!