Translartion. Region: Russians Fedetion –
Source: Novosibirsk State University – Novosibirsk State University –
The research group on biomechanics and medical engineering, created on the basis of Mathematical center in Akademgorodok, with the support of the Russian Science Foundation (project no. 24-71-00069) is conducting a kinematics data survey of the gait of patients with lower limb amputations at the Novosibirsk branch of the Moscow Prosthetic and Orthopedic Enterprise using its own software. The new development allows for the assessment of the rehabilitation of amputees and the correct use of the prosthesis, as well as the accuracy of its selection and adjustment. The first patients have already undergone this procedure and were satisfied with the result. Its effectiveness has also been assessed by prosthetists, who are to become the main users of this software.
— To record the kinematics of the amputee’s gait, we use an inertial sensor system — it is easy to use and more affordable. To work with it, the staff does not need special skills, and therefore, there is no need for training. The prosthetist only needs to install numbered sensors on the patient’s body, calibrate and record the patient’s readings while walking. The entire procedure takes an average of 15-20 minutes. Then the data is processed, based on its results it becomes known whether the prosthesis is optimally adjusted, whether the GOST requirements are met during rehabilitation, how much the patient’s gait corresponds to the gait of a healthy person, — said the head of the research group, candidate of physical and mathematical sciences Vladimir Serdyukov.
The research team includes students from the School of Engineering Faculty of Mechanics and Mathematics of NSU And Institute of Medicine and Medical Technologies NSU. They are currently working on capturing gait kinematics data from amputees. They work with servicemen who were injured during the SVO. Participation in these studies is voluntary.
— Patients of the Novosibirsk branch of the Moscow Prosthetic and Orthopedic Enterprise do not refuse the offer to work with us. Many are interested in having their gait filmed; they are interested in looking at it from the outside — on a system that reproduces movements. For us, this work provides an opportunity to identify the connection between different levels of amputation and the designs of optimally suitable prostheses. This is very important when selecting a prosthesis that would allow the patient to lead a full life, move comfortably and avoid musculoskeletal disorders that can result from improper selection or adjustment of the prosthesis, — explained Daria Korostovskaya, a 3rd-year student of the Mechanics and Mathematics Faculty of NSU.
The experts of the scientific group note that lower limb prostheses are now produced so perfect that, with the correct settings, the patient’s gait is visually almost indistinguishable from the gait of an ordinary person, which is confirmed by the graphs constructed using this software product. The graphs of the kinematics of users of modern prostheses are similar to those obtained as a result of filming the kinematics of the gait of ordinary people. But it will still not be possible to achieve absolute coincidence – even the most perfect prosthesis will not be able to repeat the exact kinematics of a healthy foot, but it is quite possible to achieve maximum approximation.
— Modern lower limb prostheses allow their users to lead an active lifestyle, play sports, travel, but this is all provided that the prosthesis is correctly selected and the patient has learned to use it correctly. It is important to teach a person to walk correctly on a prosthesis, because often the patient does not understand how to properly control the joint or place the foot. All this is taught during rehabilitation, and our development helps to assess how well the patient has mastered the necessary skills, — explained Tatyana Shashkina, a second-year student of the Mechanics and Mathematics Faculty of NSU.
The procedure for capturing gait kinematics data is simple: sensors are attached to the patient’s body, then he or she assumes a T-pose, spreading his or her arms to the sides, and operators calibrate the equipment. Then an automatic sound signal is given about its completion, and the patient should walk in a straight line. Significant gait defects and incorrect prosthesis placement are visible visually, but some violations can only be detected by high-precision equipment. The procedure is performed several times. It is important that the recordings can be made not only in a hospital setting. If necessary, data can be collected outdoors. This makes it possible to assess the correctness of the gait at different times of the day and in any conditions. Sometimes it is necessary to assess a person’s gait at the end of the day, when he or she gets tired and stops constantly monitoring the placement of the amputated limb. In this case, the product and gait settings need to be adjusted. And after that, a new data capture is taken, allowing prosthetists to make sure that the gait defect has been eliminated.
— In the near future, we will present a program that will allow automatic data processing via a web interface. It works as follows: the prosthetist uploads a file with data obtained during filming of the patient’s gait kinematics into the program and receives information on how much it corresponds to the correct anatomical one. The compliance of the performed prosthetics with the GOST requirements is also assessed. The indicators of three films are compared: at the beginning of prosthetics, during rehabilitation and upon discharge from the hospital. All changes are recorded and analyzed. The attending physician will also be able to add his recommendations to this data package. We hope that our software product will ultimately be appreciated by representatives of the prosthetic and orthopedic industry of Russia and we will soon be able to present it to potential customers — prosthetic and rehabilitation centers, as well as prosthetic developers, — Vladimir Serdyukov specified.
Specialists from the Novosibirsk branch of the Moscow Prosthetic Plant highly appreciate the development of NSU specialists.
– Cooperation with NSU for us is very important in terms of objectifying the results of prosthetics. The tracking of the technical quality of the prostheses themselves does not represent a problem, it is more difficult to assess the quality of prosthetics in relation to the patient’s life and find out how much the established prosthesis meets his patient’s requirements and whether he uses it correctly. We need to see the whole process of rehabilitation – from start to discharge – in dynamics: the moment when a person takes the first steps on the prosthesis, when he learns to walk and prior to develop a confident gait. Only in this way can we evaluate the result of rehabilitation. This can only be done visually and from the words of the patient, but his assessment is subjective and not always true. Sometimes the patient thinks that it is convenient for him to walk on a prosthesis, but in fact this is not entirely true, because the user does not yet know how the perfectly selected and adjusted prosthesis should “work” correctly. Meanwhile, for example, incorrectly selected height of the product can negatively affect the condition of the musculoskeletal system. We can only visually determine it, which is quite difficult and in this part we are not safe from inaccuracies. The development of NSU employees will allow us at any stage to see how much the technical tool that we offer the patient meets his needs. He must leave us full-fledged technically the user of this product, ”said Anton Kamenev, manager of the Novosibirsk JSC, Moscow Prosthetic-Orthopedic Enterprise.
The branch manager noted that software for studying the biomechanics of lower limb amputees, similar to what was developed by NSU specialists, is being created all over the world, but so far not a single system that is convenient for use has been created.
— It is obvious that NSU employees have created a product that is convenient both for us, as the main consumers, and for our patients. Now it takes much less time to adjust the prosthesis, not to mention the accuracy of this manipulation. The significance of this development is great. Initially, we decided to test it on a person who had been using a prosthesis for five years. When testing using the software product from NSU specialists, we noticed that the subject fell forward while walking, which created additional stress on the spine. Guided by the data obtained, we changed the design of the prosthesis and the patient, who was previously sure that everything was fine and the prosthesis was adjusted perfectly, was surprised: “This is how it should really be! Even my back stopped hurting!” This is the value of this development for the end user, — Anton Kamenev summed up.
More information about this and other projects of the Biomechanics and Medical Engineering group can be found in group channel.
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