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Short Report from AOPA Meeting in Chicago
Due to a prior commitment in England, I could only attend the first day of this year's AOPA meeting. But, from all reports this was one of the most successful AOPA meetings that anyone could recall. I spotted a couple of new developments on the first day.
New Carbon Fiber Feet
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The anterior cant of the pylon gives this Freedom Innovations foot some vertical compliance, in addition to the familiar dynamic response in the sagittal plane.
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One of the surprises of the meeting was the debut of three new high performance carbon fiber feet, from a new company called Freedom Innovations. They are being designed and produced by Roland Christensen, PhD who has been quietly creating Flex-Foot products in his rural Utah company for many years.
I was impressed with the thinking behind these feet, which should theoretically be easier to walk on at slow cadences and yet quickly stiffen at a higher pace to allow jogging or running. Reactions from transtibial amputees who participated in the preliminary clinical trials confirmed that the feet seem to perform this way in the real world, although the lower initial spring resistance felt too soft to some folks until they became accustomed to it.
One interesting wrinkle I noted was that the pylon of their high profile foot is inclined anteriorly about fifteen degrees or so. This seems to add a certain amount of vertical compliance and should make this foot feel very "springy".
They have a web site at www.freedom-innovations.com that is still under construction but has some good basic information about the company and their feet. Check out the "two-view" digital photos of their feet: when you move the cursor over the image, it rotates to provide a different perspective
Electronic "Smart Knee" & DA Ankle Adapter for SCOKJ
The folks from Horton's Technologies showed two examples of stance control KAFOs that were electronically operated, using a slightly modified version of their mechanically actuated joints. Basically, they retrofitted electric solenoids onto the joints where the mechanical push rod is normally attached. A heel switch combined with eight standard AA batteries automatically engaged and disengaged the flexion locks.
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Electronic version of Horton's SCOKJ uses AA batteries, electric solenoids, and a heel switch to create a "Smart Knee".
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They had a patient model walking on both the mechanical and electronic versions during their workshop. The electronic version seemed to work fine, and the patient could easily switch back and forth between both systems. They are beginning clinical trials with their "Smart Knee", and reportedly the final version will have micro-solenoids integrated inside the standard joint housings.
Horton's also developed a small adapter kit that connects their control rods to the posterior channel of a Becker Double Action Ankle Joint. The standard Becker spring provides a dorsiflexion assist; two degrees of motion are sufficient to trigger the stance control knee joints. This should be one of the simplest methods to control these joints.
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Left: Kit adapts Becker DA ankle to control Horton's Stance Control Orthotic Knee Joint. Right: Two degrees of ankle motion are sufficient to trigger the stance control joints.
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Stance Phase Lock KAFO
Fillauer showed Basko's SPL KAFO and had a patient model walking at their booth. As anticipated, this is a gravity-actuated stance control orthosis, so there is no need to fabricate any ankle controls. The angle when the pendulum lock engages and disengages is adjusted on the joint head itself.
The joints are used in pairs. The lateral joint locks in full extension. The medial is designed to snub heel rise, and this is also adjustable. They are sleek and attractive looking, and connect to standard Bock side bars. There is also a clever remote release, mounted either on the orthosis or on the patient's belt, to select free motion, manual lock, or automatic lock.
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Left: Lateral joint locks in full extension. Center: Medial joint limits heel rise. Right: Remote release can be mounted on orthosis, or on patient's belt.
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This is the third mechanical approach to creating a stance control orthosis released in North America since January, and more variations are on the way. There is little doubt now that stance control will become more and more common in the future, and will gradually change the way we practice as orthotists.
The fabrication manual is available as a PDF file online at www.fillauer.com/customfab/pdfs/splmanual.pdf. Kudos to Fillauer for posting this information so soon after introducing this technology to the US.
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speech at Texas Scottish Rite Hospital for Crippled Children
Hi!
I was in the audience when you gave your speech at the review course for orthopaedic residents at Texas Scottish Rite Hospital and just wanted to offer you praise for your professional representation of orthotics and prosthetics. In a... read more
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Re: speech at Texas Scottish Rite Hospital for Crippled Children
Thanks for your words of encouragement, Sherryl. I try to accept as many invitations to lecture to physician residents as my schedule will permit because they are interested in P&O at that stage in their training. I'm always hoping to piq... read more
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Ertl Procedure
John, Thank you for your response. You are a thorough reviewer of topics, so I offer the following with respect for your thoroughness. You are correct, there is little known literature. There is, actually, considerable scientific support ... read more
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Re: Ertl Procedure
Thanks for these additional details, Jan. I agree with your comments that there is support in the literature for the Ertl, and particularly that Phil Deffer's work after WW II generated interest in the US which continues to this day in som... read more
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Error en la descripcion del contenido de Noviembre.
Ciudad de Mexico 7 Noviembre, 2002.
Estimado John Michael, CPO, FAAOP:
leyendo la descripcion del contenido de La Esquina de John Michael de Noviembre, no coincide con los articulos publicados en Espanol.Le agradeceremos cambiar esta de... read more
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Re: Error en la descripcion del contenido de Noviembre.
Thanks for this heads up; I'll ask Jon to cut and paste the correct intro. --John Michael CPO
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Re: Re: Error en la descripcion del contenido de Noviembre.
Ciudad de Mexico 8 de Noviembre, 2002.
John Michael, C. P. O.
gracias por la respuesta y correccion inmediata de la introduccion en Español de La Esquina de John Michael edicion de Noviembre.
Los felicitamos por su eficiente y profesiona... read more
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Re: Re: Re: Error en la descripcion del contenido de Noviembre.
Happy to respond promptly! --John Michael CPO
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Bibliografía sobre Prótesis y Ortésis.
Ciudad de México 9 de Noviembre, 2002.
Estimado John Michael, C. P. O. FAAOP, FISPO.
La Sociedad Mexicana de Ortesistas y Protesistas tiene planeado elaborar una lista de los Libros de Texto básicos que debe adquirir y estudiar un pract... read more
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Re: Bibliografía sobre Prótesis y Ortésis.
I will try to remember to let you know when new resources in P&O become available. I put together a basic list back in January that is available at http://www.oandp.com/news/jmcorner/2002-01/2.asp?searchquery=basic+texts. Best regards. -... read more
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Re: Re: Bibliografía sobre Prótesis y Ortésis.
Ciudad de Mexico 11 de Noviembre, 2002.
Estimado John Michael, CPO, FAAOP: en el portal de la Sociedad Mexicana de Ortesistas y Protesistas, www.smopac.org.mx/ se puede encontrar una Lista de Libros de Texto que pueden ser adquiridos po... read more
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Re: Re: Re: Bibliografía sobre Prótesis y Ortésis.
Very happy to help in this task. --John Michael CPO
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Sistema CAD CAM.
Ciudad de Mexico 15 de Noviembre, 2002.
Estimado John Michael, C. O. FAAOP: en la ciudad de Santiago de Chile Sudamerica, el Laboratorio Ortopedico de Teleton Chile (organizacion no lucrativa) desea informacion acerca de los sistemas CAD C... read more
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Re: Sistema CAD CAM.
Unfortunately, I have not kept up with the state of the art in CADCAM so I cannot provide any authoritative information on this topic. The Academy has a CADCAM society, and their members will be much more current in this area. You can con... read more
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¿Existe una ortesis llamada JUSTO?
Ciudad de Mexico 20 Noviembre, 2002.
Estimado John Michael, CPO, FAAOP: Judy Hettinga de O & P Edge nos pregunta si conocemos un producto comercial o una ortesis llamada JUSTO. No podemos recordar haber escuchado este nombre aplicado a a... read more
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Re: ¿Existe una ortesis llamada JUSTO?
Sorry for the delay in responding, but I haven't heard of such an orthosis and cannot find it on any databases. --John Michael CPO
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Re: Re: ¿Existe una ortesis llamada JUSTO?
Sorry for the delay in responding. I am not familiar with such an orthosis and couldn't find it listed in any of the standard databases. --John Michael CPO
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Codigo de Etica Universal para Ortesistas y Protesistas?
Ciudad de Mexico 28 de Noviembre, 2002.
Estimado John Michael, C. P. O. FAAOP: algunos practicantes en Ortesis y Protesis nos preguntan si existe un Codigo de Etica qpe puede ser aplicado al servicio profesional de protesis y ortésis. ¿Exi... read more
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Re: Codigo de Etica Universal para Ortesistas y Protesistas?
I'm not aware of a universal code of ethics, but the ABC Code is posted online at http://www.abcop.org/Canons_of_Ethics.asp and the BOC code is at http://www.bocusa.org/code.htm. --John Michael CPO
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Re: Codigo de Etica Universal para Ortesistas y Protesistas?
Very interesting question. I'm not aware of an "universal code of ethics" for prosthetist-orthotists. The Code by the American Board for Certification in the US is one of the most comprehensive that I am aware of, and is posted at www.abc... read more
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¿Que sucede con la Edicion de Diciembre de La Esquina de John Michael?
Ciudad de Mexico 3 de Diciembre, 2002.
Estimado John Michael, CPO. FAAOP, FISPO: varios practicantes en ortesis y protesis me preguntan cuando aparece la edición de Diciembre, de La Esquina de John Michael?
Existe algun problema para su p... read more
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Re: ¿Que sucede con la Edicion de Diciembre de La Esquina de John Michael?
I don't know why the delay, since I submitted the December Corner well in advance of the deadline. I'll ask the folks at OANDP.COM why there has been a delay. --John Michael CPO
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