The Biomechanics Issues Relating to Amputees - Coursework Example

The Biomechanics Issues Relating to ‘Amputees’ Name of Student Student Number Institution Course Code Name of Lecturer Date of Submission Introduction This report evaluates the concepts of biomechanics as applied in the process of ensuring amputees gain mobility. The aspect of biomechanics use in correcting loss of limbs has greatly gained prominence in the 21st century (Enderle, Bronzino and Blanchard 2005). The initial trauma that is associated with amputation and medical disorders that follows it have been studied under the concept of biomechanics. In context, there are problems that emanate from limbs replacement via utilisation of prosthetic devices (Burkley 2000). The problems are complex and but interrelated, and this study approach looks into the concept of biomechanics issues that relate to amputees. This report will critically analyse the whole concept and consequently bring to focus relevant issues within the clinical management touching on biomechanical perspectives like the limitations associated to prosthetic designs. Generally, this report outlines the literature review pertaining to biomechanics issues relating to amputees, followed by an outline of disabilities and prognosis touching on to functional outcomes and rehabilitation goals. Consequently, an outline of medical or surgical management will be looked into coupled with biomechanical basis of the disability. To fully comprehend the issues, biomechanical analysis of disability and remaining function will be assessed, as well as the application of biomechanics in assessment, treatment and provision of aids. Finally, future trends in the management with an emphasis on the role of biomechanics and biomedical engineering will be examined and highlight relevant case materials made out in the study. Literature on Biomechanics Issues Relating to Amputees The great and intense developments in the past decades that has been observed in respect to design and clinical implementation of attachable joint prosthesis have created the desire for greater knowledge on biomechanics of the muscoskeletal system (Sagawa et al. 2011). Studies on biomechanics relating to amputation has been on going with interesting findings being made out in respect to gaining the capacity to use artificial limbs after losing natural ones (Segal, et al. 2011). The most outstanding feature of ‘Biomechanics of Lower limb Prosthetics’ regards the demonstration of the biomechanics practicality whenever applied to lower prosthetics (Petkin 2010). A number of technologies have been utilised to enhance the biomechanics concept to aid amputees gain mobility. This is achieved with the inclusion of body physiology and utilising the mechanical aspect of artificial materials to acquire new limbs (Smith and Berke 2004). Various original concepts have been described in the past with a good example being the ‘rolling technology’ which has been implemented in prosthetic devices (O’Sullivan, Schmitz and Fulk 2014). Consequently, the principle of ‘reciprocal anti-resonance in locomotion’ looked into the future studies. According to Pitkin (2010), anthropomorphicity is a key tool utilised in planning the design of an artificial limb, or its components. This tool is a concept utilising the human forms attributes or other forms of traits to come up with artificial parts that can be used for replacement purposes (Enderle, Bronzino and Blanchard 2005). In order to use joints movements as design parameters to come up with new lower limbs, effective methodologies aimed at recording and analysing are put in place. Technology has greatly improved and currently, implementation of computerised motion analysis has been initiated with examples of Vicon, Peak among others (Hirsch 2000 cited in Pitkin 2010). However, prior to this; computation of joint movements was carried out with great efforts and consumed extensive time to come up with workable findings. The current terns of motion analysis and gait analysis have a relation to the specialised hardware and software for gathering, processing and analysing kinematic and flexible constraints of movement (Pitkin 2009). Physical Disabilities and Prognosis Physical disability is termed as the limitation on an individual’s physical functioning, mobility, stamina and dexterity (Simon 2004). They can be temporally, short-term or long term in respect to the extent of damage caused to the body part. A number of conditions may proceed to remission as others arise and vanish with no specific pattern, whereas there could be gradual deterioration (Segal, et al. 2011). Further, individuals may have inborn disabilities or acquire them in their later stages of life due to illness, accident or side effects emanating from medication (Pitkin 2009). This report has greater interest in the movement dysfunction that occurs within an uninjured healthy person resulting to injury, as well as those dysfunctions that occur after injury or hinder effective results in rehabilitation. Consequently, locomotive dysfunction may arise due to neurological ailments among people like spinal cord injury, stroke or Parkinson’s disease (Simon 2004). Biomechanical methods are crucial in quantifying movement, as well as contribute effectively to a comprehensive approach towards comprehending the effects brought about by rehabilitation interventions (O’Sullivan, Schmitz and Fulk 2014). Clinical procedures conducted as rehabilitation therapies to restore locomotive or physical functioning of an individual dwells greatly upon biomechanical aspects to understand progress, as well as evaluate how effectively the procedures can be improved (Simon 2004). Laboratory settings are put in place to ensure to study both the upper and lower extremity movements with platforms of force, motion capture systems and electromyography (Smith and Berke 2004). Electromyography refers to a diagnostic procedure that assesses muscles health, as well as nerve cells that control them (Enderle, Bronzino and Blanchard 2005). By understanding the concept of bone modelling, locomotive physical functioning and the biomechanical aspects; effective prosthetics are made with less complications and improves mobility of the disabled persons. This is highly crucial in the realisation of rehabilitation goals as regards to achieving functional outcomes of disabled limbs. Surgical Management Amputation is usually the last of a long series of procedures applied by surgeons after medication proves ineffective and the result is defeat leading to loss of limbs (Macdonald, et al. 2009). Nerveless, the surgical process and management ensures that the limbs are enhanced for artificial replacement by ensuring the nervous system and bone sockets are spared. Loosing or removal of the limb is a last result and becomes inevitable rest the patient gets worse or even end up dead (Sagawaet al. 2011). In this regard, surgical management of amputation ensures that restoration of as much as possible of the previous normal functioning is achieved. The processes under consideration involve both mechanical and biological processes and must be in coordination with the rest of the body. Over the years, surgeons have resulted to ensuring amputation stumps that are functional and efficient to enhance mobility (Pitkin 2009). This aids in the artificial use of prosthetics. Surgeons of amputation ensure high degree of saving the foot mobility capability (Buckley 2000). Any mistake that would result to altered biomechanics of the foot can result to focal pressure keratosis. Thus, amputation procedures ensure that care is taken not to cause post-operative disorders (Smith and Berke 2004). However, care and periodical check-ups are made to ensure that hygiene is maintained, as well as detection of any infection made out at the early stages to prevent complications. Biomechanical Basis of the Disability Various aspects of life results to loss of limbs; either partially or wholly and thus, the mobility of an individual is compromised (WHO 2004). The success or failure of the total joint replacement is dependent upon the design of prosthetic that has been created. This is in respect to the concept of biomechanics and the ability of the design to absorb and transmit without failure to the tissues supporting it, as well as, causing no harm (Enderle, Bronzino and Blanchard 2005). In regard to this, the lack of such knowledge renders the prosthetic designs to be arbitrary and the performance of the total joint replacement becomes a process having no biomechanical basis. Biomechanical concepts are assessed and made effective with comparative experiments of normal people with patients having limb disabilities (Pitkin 2010). Time-distance parameters are taken and ground reaction force recorded in respect to walking speed and evaluates the viability of the proposed designs. It is evident that observed parameters over a given range of walking speeds can be crucial indicators of gait abnormalities connected to limb disability (Pitkin 2009). For instance, it is evident that clinical improvements after medication is consistent with any changes observed with walk parameters. Therefore, in respect to biomechanical basis towards understanding and rectification of disability, this concept shows the usefulness and importance of taking into consideration parameters of walk in respect to walking speed (Sagawa et al. 2011). Biomechanical Analysis of Disability and Remaining Function and Provision of Aids Biomechanical analysis is useful in the scientific assessment of causes of movement problems, as well as in measuring the rehabilitation progress and outcomes (Enderle, Bronzino and Blanchard 2005). Nevertheless, present concepts of biomechanics are being utilised explicitly in small number of specialist rehabilitation cases. According to World Health Organisation cited in Pitkin (2010), approximately 7-10% of human beings possess some degree of impairment or disability. Further, close to 80% of the affected live in developing nations with only less than 5% having the capacity to access rehabilitation services (O’Sullivan, Schmitz and Fulk 2014). The past three decades have experienced significant and controversial developments bringing changes in the transfemoral prosthetics (Pitkin 2009). Improvements in the health care facilities, as well as new materials and components still are on the making to ensure coming up with effective solutions. The fundamental goal of biomechanics as far as disability is concerned, aims at ensuring comfort, maintaining cosmesis and designs (Macdonald, et al. 2009). With new material utilisation, components and designs, biomechanics of amputee can realise higher activity standard than before. With respect to continual functioning, measures are being put in place to look into improving the closed environment of prosthetics and bone connections which result to micro-abrasions and macerations emanating from sweating and movements within the socket (Sagawa et al. 2011). Further, accumulation of bacterial flora, as well as normal skin flora can enhance the rate of infection. Thus, with improved biomechanics features, these hitches will be addressed. Current Issues in Clinical Management from a Biomechanical Perspective There have been sensitive issues pertaining to biomechanics of disability with experts trying to critically come with effective concepts to understand how to enhance locomotion among the amputees (O’Sullivan, Schmitz and Fulk 2014). Diverse studies have been carried out to critically assess the concept of biomechanics and biomechanical engineering. In context to the expenditure of energy in the process of movement with or without devices of aid, as well as in therapeutic exercises, it is evident that crutch-walking has been found to be metabolically of higher cost for an amputee in comparison to walking with the suction-pocket prosthesis (Pitkin 2009). With progress of these studies, it will be possible to come up with criteria for maximum workloads in respect to the disabled people. Skin problems have been documented in respect to prosthetic use. Studies conducted in the field of dermatology indicate that albeit the lingering unresolved problems, there have been successful modes of treatments for some bacterial and fungal infections, diseases emanating from oedema and contact dermatitides (Macdonald, et al. 2009). Bone structure has a great contribution in the success of artificial limbs use. Microstructural simulations of bone remodelling are specifically significant within the clinical management of osteoporosis (Macdonald, et al. 2009). Prior to application of any given model in the clinics, there is need for a validation to carry out against in vivo data. However, it clear to note that simulations indicate accurate effects of treatment with adaptations made in respect to human data favouring use of the same in clinics (Buckley 2000). Future Trends in the Management on the Role of Biomechanics and Biomechanical Engineering and Relevant Case Materials The future trends in the clinical management are geared towards ensuring reduction in complications of prosthetics on human bodies. Biomechanical methods have been utilised in the rehabilitation processes to quantify locomotion (O’Sullivan, Schmitz and Fulk 2014). Further, improvement of the coordination of the artificial limbs is expected to be studied in respect to how the artificial limbs can effectively be enhanced with respect to electrical aspects of the body (Pitkin 2009). The concept of biomechanics and biomedical engineering has gained prominence even with respect to athletics. Studies have been on the rise evaluating how effective to ensure speed and functionality of the legs is restored after amputation, as well as ensure that speed of running is achieved lie in normal circumstances (Buckley 2000). On the same note, development of improved prosthetic controls has been floated for development which will be like man-machine interface. This is one development in the field of biomechanics and biomechanical engineering that will greatly improve on the locomotion aspect among the disabled persons (Macdonald, et al. 2009; Simon 2004). Incorporating biological concepts and technology is a complex venture, but any breakthroughs made give rise to solutions of daunting problems in nature. Within the areas of amputation operations, it is imperative that specific osteoplastic and myoplastic techniques, incorporated with nerve stump protection, as well as measures, create maximum circulatory conditions necessary to restore biological and mechanical function (Segal, et al. 2011). This is in respect to greater degree of functioning than the prevailing present procedures. Effective materials pertaining to biomechanics and biomechanical engineering concepts touching on amputation are well documented in sites of biomechanical laboratories (Pitkin 2010). In respect to rehabilitation processes, cases have been observed aimed at ensuring that recovery is realised aided with findings made out from uninjured persons and related to locomotive data given by designed prosthetics. Reference List Buckley, J., 2000. Biomechanical Adaptations of Transtibial Amputee Sprinting in Athletics Using Dedicated Prosthesis. Clinical Biomechanics, Vol. 15, pp. 352-358. Enderle, J., Bronzino, J. and Blanchard, S. (Eds.), 2005. Introduction to Biomedical Engineering, 2nd ed. Burlington, MA: Elsevier Academic Press. Macdonald, A. S., Loudon, D., Docherty, C. and Miller, E. (2009). Project Findings: Innovation in envisioning dynamic biochemical data to inform healthcare and design guidelines and strategy. New Dynamics of Ageing programme, Sheffield. O’Sullivan, S., Schmitz, T., and Fulk, G., 2014. Physical Rehabilitation, 6th ed. Philadelphia: F.A. Davis Company. Pitkin, M., 2009. Regular and International Generation of Propulsion in Normal Gait as Prototype for Prosthetic design. IEEE Eurocon 2009 International Conference. St. Petersburg, Russia. Pp. 18-23. Pitkin, M., 2010. Biomechanics of Lower Limb Prosthetics, Berlin: Springer. Doi:10.1007/978-3-642-03016-1_2. Sagawa Jr., Y., Turcot, K., Armand, S., Thevenon, A., Vuillerme, N. and Waterlain, E., 2011. Biomechanics and Physiological Parameters during Gait in Lower Limb Amputees: A Systematic review. Gait Posture. doi:10.1016/j.gaitpost.2011.02.003 Segal, A. D, Orenduff, M. S., Czernicki, J. M., Schoen, J. and Klute, G. K., 2011. Comparison of Transtibial Amputee and Non-Amputee Biomechanics during Common Turning Task. Gait Posture, Vol. 33, no. 1, pp. 41-47. Simon, S., 2004. Quantification of Human Motion: Gait Analysis- Benefits and Limitations to its Application to Clinical Problems. Journal of Biomechanics. Vol. 31, pp. 1869-1880. Smith, D. and Berke, G., 2004. Post-operative Management of the Lower Extremity Amputee. Journal of prosthetics and Orthotics, 16(3S). World Health Organisation (WHO) 2004. The Rehabilitation of People with Amputations. WHO United States Department of Defense MossRehab Amputee Rehabilitation Program, USA. Read More