Good morning Doug,
Apparently, OandP list chose not to forward the below comments to the respondents. In a nutshell, if you decide to assemble prosthetic feet attached to post-acute fracture braces for demonstration and empathy training purposes you can use a “click” ball point pen as a simple and immediately available neurocorrelagraphy device. I’ll be happy to discuss any aspects of developing and measuring the clients ability to acquire kinematic sensorimotor skills when connected to and operating an O&P or Robotics device.
The following is a brief list of initial musts.
1. Try this exercise on yourself before demonstrating the neurocorrelating effects of various biomechanical designs on other people.
2. Use low profile adjustable prosthetic feet and keep the build height to an absolute minimum.
3. When walking, deprive yourself of somatosensory and proprioception in your anatomical feet and ankles by not using any muscles below the knees. Walking on bi-lateral TT prosthesis is initially challenging, so brace yourself against a solid wall or have an assistant securely hold a safety belt around waist.
4. Hold a click pen in one of your hands (I usually use my dominant or right hand because I have more sensorimotor skills corresponding to my dominant hand).
5. Press the click pen in when you think the right prosthetic heel is going to make contact with the ground and click a second time when you think the left heel is going to make contact.
The closer you can hear and feel the click sensation in your hand and fingers (stereognosis) with the perceived sensation of prosthetic heel contact, the more proficient you will become at operating the pseudo- prosthetics (enhanced sense of balance, generally more self confident in your ability to safely, constantly and predictably stand and walk and greater personal interests in what you’re doing).
This is where things start to get really interesting. If you can learn to reduce the elapsed time between the perceived clink and heel contact to 30 milliseconds or less, body sensations and propriocpetion normally attribute to your anatomical feet and ankle will drift to the prosthetic feet. You don’t have to record timing; you will know you have reduced the elapsed time to 30 ms. or less precisely when the perceived drift begins to occur. In my opinion, facilitating this neurocorrelating drift is the primary clinical purpose of applied biomechanical engineering.
I hope you can find the time to give the potential O&P and robotics technological contribution in functional restoration and physical rehabilitation science additional thought. On a more personal note, I hope your intimate experience will blow your mind! Keep in mind that any alteration of perceptual reality is immediately reversible simply by removing yourself from the pseudo-prosthetics. Ideally, the altered perception would eventually become self sustaining in you clients even when they are not wearing their prosthetics. This is one of many mechanical neurobiological engineering facets of clinical O&P that we could further discuss in the future if you are interested.
Again, I look forward to your thoughts, comments and ideas,
Michael
> ———- Original Message ———-
> From: “MANUFACTURING,DYCOR #”
> To: [email protected]
> Cc: [email protected], CBlondes
> Date: November 18, 2019 at 1:03 PM
> Subject: Fwd: Extracoropreal orthotics, prosthetics and robotics
>
> Good morning List served,
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> I would like to thank those individuals for their interesting responses to the below inquiry. First and foremost as a fellow beleaguered O&P clinical practitioner, I am deeply moved by the energy, dedication and enthusiasm demonstrated in the responses. It’s reassuring to know that O&P is populated by such a caliber of professional colleagues.
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> Topics that were brought up by the respondents include the use of outcome measurements, application of advanced technologies with an emphases on semi-autonomous micro-processing mechanical kinematics, expansion of the O&P knowledge base and direct O&P clinical involvement of wholesale manufactures and allied health professionals. I would also like to thank Daniel Heitzmann for providing a link to compendia, a reviewed paper and a poster abstract that briefly explains how applied mechanical engineering might positively influence active and voluntary or enactive and volitional control and manipulation strategies of the extracorporeal orthotics, prosthetics and robotics device. ( https://urldefense.proofpoint.com/v2/url?u=https-3A__www.dycormfg.com_content_research-2Ddevelopment.html&d=DwICaQ&c=sJ6xIWYx-zLMB3EPkvcnVg&r=KmuawjwNpT9A2bnhzaNVjw8wO7L_TDosEXIk33h_tlw&m=VDHy6ZAy0C6GuEdh_RPZ66RbEOxqaQ7j-wNKSbsbHFU&s=XNCV5umnktP1TIqk5MFVhFVXAvdry5VuxRcWV4p7OYg&e= ). If you are interested, I recommend that the poster abstract be reviewed first and then the first compendium.
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> Enactive and volitional control and manipulation of mechanical extracorporeal devices can best be demonstrated with empathy training by the attending clinical prosthetist using low profile prosthetic feet attached to lower limb post acute fracture braces or boots. This mode of empathy training is inexpensive and effective in helping interested parties understand and appreciate the greater value to clinical O&P and Robotics technological intervention. Interesting, the attending prosthetists can initially practice empathy training on themselves using this mechanical kinematic device. It’s quite an eye opener to experience somatosensory and proprioception in the prosthetic foot itself rather than the receptor mediation modality being substituted and reveals a whole new dimension to physical rehabilitation science. If the O&P profession doesn’t take the initiative in demonstrating this seemingly critical area of physical rehabilitation, some other professional group eventually will.
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> I look forward to your thoughts and comments,
>
> Michael Wilson LP/CPO
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> > > ———- Original Message ———-
> > From: “MANUFACTURING,DYCOR #”
> > To: [email protected]
> > Cc: [email protected]
> > Date: November 2, 2019 at 12:19 PM
> > Subject: Extracoropreal orthotics, prosthetics and robotics
> >
> > Good morning list served,
> >
> > I know you are all very busy so I will ask only for a brief moment of your limited time.
> >
> > Is anybody interested in how the mechanical design and clinical application of extracorporeal othothics, prosthetics and robotics might directly influence voluntary and active control and manipulation of the OPR device and how this mechanical influence might be physically measured? I my opinion, these physical measurements influence the potential in O&P and robotics applied technological science and have an immediate and positive social, political and economical effect on both private and institutional O&P and robotics clinical practice. This influence is easily experienced and demonstrated and can be a useful tool in promoting your professional and business interests.
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> > Michael Wilson LP/CPO
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