Universitat Internacional de Catalunya
Treatment Methods in Orthoprosthetics
Other languages of instruction: Catalan, English,
Teaching staff
Email Mariano Fernández mfernandezfa@uic.es
Introduction
The subject makes available to students the knowledge of the currently existing procedures to correct organic deficiencies, anomalies and alterations of the locomotor system through the indication and preparation of external correction devices (orthoses) or the replacement of organic segments using prostheses. The topics will introduce techniques used in the study of gait and limb movements in human beings as well as the methods of functional stimulation, reinnervation and neuroprosthesis.
The subject will have a high practical content where students can train skills related to orthotic and prosthetic engineering. In the same way, they will access specialized clinical facilities in orthopedic practice where they will be guided by specialists in this area of medicine. Students will work in the orthotics laboratory regarding the design and implementation of the different types of orthotics and prostheses with which to make these procedures available to the patient. Working side by side with renowned professionals in this field will lead to the understanding and completion of the theoretical knowledge acquired, introducing students to the real world of ortho-prosthetic technique.
Pre-course requirements
To have passed the following subjects of the First Year of Bioengineering: Anatomy and Physiology, and Biomaterials and Biocompatibility, and of the Second Year: Fundamental Biomechanics, Applied Pathology, and Fundamentals and Electronic Systems.
Complementary subjects
Neurosciences Applied to Orthotics, Computation, Robotics and Bionics, and Design and Image Diagnosis.
Objectives
To know the existing types of orthotics and prostheses.
To know their biomechanics and performance.
To know their indications.
To know and be able to assess the complementary means for diagnosing the deficiencies to be treated.
To know their design and customisation.
To know the materials used in their manufacture.
To know the electronic systems used in these products.
To know the manufacturing procedures and processes.
3D in design and manufacture of orthotics and prostheses.
Applied bionics.
To know how to adapt orthotics and prostheses to each patient.
Assessment of the different products in view of their functional capacity and results.
Competences/Learning outcomes of the degree programme
- CB3 - Students must have the ability to bring together and interpret significant data (normally within their area of study) and to issue judgements that include a reflection on important issues that are social, scientific or ethical in nature.
- CB5 - Students have developed the necessary learning skills to undertake subsequent studies with a high degree of autonomy.
- CE11 - To evaluate manufacturing, metrological and quality control systems and processes.
- CE13 - To identify, understand and use the principles behind electronics, sensors, air conditioners and systems that acquire biomedical signals
- CE9 - To apply the basic foundations of elasticity and the resistance of materials to the behaviour of actual volumes.
Learning outcomes of the subject
Presentation: Transmitting knowledge and activating cognitive processes in the student, involving their participation, through lessons on each of the topics.
Cooperative learning: Develop active learning through cooperative work strategies among students and fostering shared responsibility to achieve group goals.
Practical learning: The students will attend an Orthotics clinic and laboratory where they will acquire the necessary practical knowledge to indicate an orthosis or prosthesis according to the patient's needs. They will know the different options that exist to solve the different problems presented and will become familiar with the design, preparation, adaptation and repair of the aforementioned elements.
Problem-Based Learning:
From the statement, analysis, processing and solution of real problems
Promoting in the student the responsibility for their own learning
Developing a relevant knowledge base
Developing skills for critical evaluation and the acquisition of new knowledge
Developing skills to address complex problems and possible solutions
Develop skills for interpersonal relationships
Involve the students by encouraging their initiative and enthusiasm
Developing their cognitive, integrative, expression and communication skills
Syllabus
Theoretical contents
Module 0: Signature Introduction
Presentation of the signature. Evaluation methods. General orientation of the practices in the collaborating clinic.
Module I: Orthesis and Prosthesis
Theme 1. Ortesis extremidad superior, inferior and rachis
Upper end: Hombro, Codo, Muñeca, Mano
Lower end: Chair, Rodilla, Tobillo, Pie
Rachis: Cervical, Dorsal, Lumbar
Theme 2. Upper and lower extremity prostheses
Superior extremity: Disarticulation Hombro, Brazo, Forebrazo, Mano
Lower end: Disarticulation chair, Muslo, Pierna, Tobillo and pie
Theme 3. Medical and clinical aspects of prosthesis and orthoprosthesis
Complementary methods for diagnosis.
Clinical criteria for the indications of prosthesis and orthoprosthesis.
Module II: Modeling and Simulation Applied to Prostheses
Theme 4: Orthosis and lower limb prosthesis
Transfemoral and Transtibial Orthoprosthesis
Components
Shafted orthosis
Theme 5: Materials for orthesis
Suitable properties and materials
Polymers and Metals
Rigid and flexible orthosis
Theme 6: Orthoprosthesis modeling
numerical simulation
examples
Module III: Neuroprosthesis
Theme 7. Introduction to Orthesis and Exoskeletons
Types of exoskeletons
Exoskeleton-user interaction for assistance and recovery
Energy generation (Harvesting)
Theme 8. Neuroprosthetic control theory
Introduction to Control Theory
Controllers for postural control and human gait
Bio-inspired controllers
Theme 9. Reinervation and electrostimulation
Muscle reinnervation and patient cases, recording and control using EMG
Electroneurography (ENG), types of electrodes, recording and control by ENG
Sensory replacement mechanisms (sensory feedback)
FES (Functional Electrical Stimulation), current waveforms, Therapeutic effects.
practical contents
Module IV: Clinical Practices
Stay in an orthopedic clinic specializing in prosthesis.
Module V: Laboratory Practices
Ergonomic and functional adaptation of an upper limb prosthesis.
Additive manufacturing and rapid prototype applied to the design of orthesis and prosthesis
Processing and interpretation of biomedical signs of the human march.
Printing, fabrication, assembly and programming of the control of an upper limb exoskeleton.
Virtual reality for training and functional rehabilitation with exoskeleton.
Teaching and learning activities
In person
Totally participatory.
Expositive: Transmitting knowledge and activating cognitive processes in the student, involving their participation, through lessons on each of the topics.
Cooperative learning: Developing active learning through cooperative work strategies among students and promoting shared responsibility to achieve group goals.
Practical learning: The students will attend an Orthotoprosthetic clinic and laboratory where they will acquire the practical knowledge necessary to indicate an orthosis or prosthesis based on the patient's needs. They will know the different options that exist to solve the different problems presented, and they will become familiar with the design, preparation, adaptation and repair of such elements.
Problem Based Learning:
• From the statement, analysis, processing and solution of real problems
• Promoting in the student responsibility for their own learning
• Developing a relevant knowledge base
• Developing skills for critical evaluation and the acquisition of new knowledge
• Developing skills to pose complex problems and possible solutions
• Develop skills for interpersonal relationships
• Involve the student by increasing their initiative and enthusiasm
• Developing their cognitive, integrative, expression and communication skills.
Evaluation systems and criteria
In person
The evaluation will consist of the following elements:
A) Report on clinical practices (20%)
B) Partial examination (test type) (30%)
C) Laboratory Practices and Final Project (50%)
Important considerations:
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Plagiarism, copying or any other action that may be considered cheating will score zero in that evaluation section. Moreover, plagiarism during exams will mean the immediate failure of the whole subject.
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In the second-sitting exams, the maximum mark students will be able to obtain is "Excellent" (a mark with honours distinction will not be possible).
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Changes of the calendar, exam dates or the evaluation system will not be accepted.
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Exchange students (Erasmus and others) or students resitting will be subject to the same conditions as the rest of the students.
Bibliography and resources
Bibliographic resources, images and videos inserted in the class
Complementary basic bibliography:
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J. Webster, D. Murphy, Atlas of Orthoses and Assistive Devices, 5th Edition. Elsevier 2018. ISBN: 9780323483230.
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J. Hsu, J. Michael, J. Fisk, AAOS Atlas of Orthoses and Assistive Devices, 4th Ed, Mosby 2008
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EduExo - The Robotic Exoskeleton Kit. Handbook and Tutorial. Beyond Robotics GmbH, 2019.
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Farina, D., Jensen, W. and Akay, M. eds., 2013. Introduction to neural engineering for motor rehabilitation (Vol. 40). John Wiley & Sons.
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Kuiken, T.A., Feuser, A.E.S. and Barlow, A.K. eds., 2013. Targeted muscle reinnervation: a neural interface for artificial limbs. Taylor & Francis.