Browsing by Author "Fey, Nicholas P."
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Item Effect of Medial Thighplasty on Oxygen and Metabolic Consumption Rates in a Transfemoral Amputee during Sustained Overground Walking Bouts(Institute of Electrical and Electronics Engineers Inc.) Kunnappally, Jamie R.; Fey, Nicholas P.; Kunnappally, Jamie R.; Fey, Nicholas P.Energy expenditure during daily physical activity is notably higher for amputees, even when using a lower limb prosthetic device, due in part to the constraints surrounding the patient-device interface. This case study tracks changes in minute by minute metabolic data during a six minute walking test pre and post-medial thighplasty in a transfemoral amputee in order to gain a better understanding of how the procedure changes the metabolic rates and energy expenditure involved in overground walking for the amputee by altering the physical relationship between the patient and the prosthetic socket. Post medial-thighplasty, the subject is able to expend less metabolic energy and consume less O₂ which is reflected in the lower cost of transport when either metric is normalized to body weight.Item Metabolic and Kinematic Effects of Medial Thighplasty and Myofascial Lengthening on Gait of Adults with Limb Loss and Children with Cerebral Palsy(2019-08) Kunnappally, Jamie; Fey, Nicholas P.In the treatment and management of certain physical and neurological conditions affecting gait and quality of life, surgical intervention plays a key role in changing the foundation of the body in a way that can ultimately make it a better, more efficient ‘machine’ in terms of physical activity and the abilities of the patient. Certain conditions such as amputation and cerebral palsy place the patient’s body in a position that is in many ways compromised in its ability to handle day to day tasks in a way that an able-bodied person would function. However, when we consider ‘functionality,’ it is important to recognize that attempting to make changes to merely make the patient physically similar to an unaffected person may not actually result in the best possible outcome for the patient. Instead, we must look towards quantifiable measures that provide better, more solid insight into how a person’s body may function post procedure while still possessing the prior condition (e.g., amputation or cerebral palsy). In Chapter 1, we examined an obese woman amputated unilaterally above the knee. Following long term use of a leg prosthesis, she received medial thighplasty limb revision surgery consisting of medial excision and circumferential liposuction of subcutaneous adipose tissue, of her residual limb to attempt to optimize socket fit and distal device function. We assessed whether various measures of physical function (metabolic cost and gait velocity) improved post surgery. In Chapter 2, we examined a series of three children with cerebral palsy who received a musculotendon lengthening through a surgical procedure known as selective percutaneous myofascial lengthening (SPML). The surgery was performed in an effort to increase knee joint range of motion, to reduce the presence of crouch gait, and to improve other spatiotemporal parameters of gait. By exploring these foundational cases in surgical intervention, future decisions concerning management of physical and neurological conditions may be better informed, and ultimately improve quality of life of these individuals.Item Reducing Residual Limb Adipose Tissue via Surgery Alters Foursquare Stepping Mechanics of a Transfemoral Amputee(Institute of Electrical and Electronics Engineers Inc.) Levy, Emily T.; Fey, Nicholas P.; Levy, Emily T.; Fey, Nicholas P.As prosthetic technology advances, performance improvement is expected for persons with amputation to accomplish their daily activities. However, prosthesis research often overlooks the interface between the residual limb of the user and the prosthetic socket. This case study analyzed the influence of the local mechanical properties of the residual limb on biomechanics during non-steady movements. Before and after a unique surgery removing excess adipose tissue in the residual limb, an obese transfemoral amputee performed foursquare step tests. Post-surgery, the subject moved more fluidly. The increased maneuverability is characterized by increased stepping speed, less sharp direction changes, and more efficient movement path, and these movement qualities were quantified by task completion time, radius of curvature, and distance travelled, respectively. © 2017 IEEE.