Marlo Anatomical Socket® Studied for Coronal Plane Stability


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C a p a b i l i ti e s Communicating theScienceofProstheticsandOrthotics

Volume 21, Number 1, Winter 2013

Marlo Anatomical Socket® Studied for Coronal Plane Stability
R. J. Garrick, PhD, and Stefania Fatone, PhD, BPO(Hons)

[This work was funded by the National Institute on Disability and Rehabilitation Research (NIDRR) Grant H133E08009 of the US Department of Education. The opinions in this article are those of the grantee and do not reflect those of the US Department of Education. Grantees appreciate the use of the Jesse Brown Veterans Affairs Medical Center Motion Analysis Research Laboratory.]

Stefania Fatone, PhD,

Data were collected

BPO(Hons), Rebecca Stine,

from subjects walking

MS, and Robert Tillges,

at a comfortable, self-

CPO, have completed

selected speed on 6 force

data collection on the

plates (AMTI) embedded

NIDRR-funded research

in the center of a 12m

project, Effect of Socket

walkway and filmed by

Characteristics on Coronal

an 8 camera motion

Plane Stability during Gait

analysis system (Motion

in Persons with Unilateral Transfemoral Amputation. Patients who wear the Marlo Anatomical Socket

Figure 1. Socket conditions: a) intact MAS®, b) MAS® with one panel removed, c) MAS® with two panels removed, d) MAS® with ‘ear’ removed, e) ‘ear’ and one panel removed, f) ‘ear’ and both panels removed.

Analysis Corporation) while randomly wearing the MAS® in each of six modified conditions: 1)

(MAS®) report greater

intact MAS®; 2) MAS® with

range of hip motion, improved comfort, proprioception one medial panel removed; 3) MAS® with both medial

and cosmesis. Developed by Marlo Ortiz (Guadalajara, panels removed; 4) MAS® with medial ‘ear’ removed

Mexico) in 2004, the MAS® is thought to offer improved and both panels in place; 5) MAS® with medial ‘ear’

stability due to increased skeletal support along the and the first panel removed; and 6) MAS® with medial

medial ischial ramal complex (IRC) and volumetric ‘ear’ and both panels removed (See Figure 1). Other

distribution of the residuum’s soft tissue; however, data recorded Socket Comfort Score (0 denotes most

quantitative knowledge is lacking about the effect of uncomfortable and 10 denotes most comfortable),

the MAS® characteristics on the gait of persons with walking speed, stride width, coronal plane pelvic range

transfemoral amputation (TFA). This study quantifies of motion, maximum lateral trunk lean in prosthetic

gait characteristics for six persons with unilateral TFA stance and transverse plane prosthetic limb rotation

who now wear a MAS®; and examines self-reported during swing for each socket condition. Researchers

Socket Comfort Scores.

hypothesized that reports of comfort and stability for

Continued on page 2

INSIDE THIS ISSUE

MAS® Socket Studied for Coronal Plane Stability 1-2

How the MAS® Provides Comfort and Stability

2

NUPOC Appreciates Robert Tillges, CPO, FAAOP 2

Sara Koehler, PhD, Defends Dissertation

3

NUPOC Welcomes Brian Robillard, BS

4

NUPOC Hosts CLSHS Science Students

4-5

NUPOC Hosts FSM CCEP Educational Tour

5

Fatone Delivers Keynotes in Australia

6

Fatone and Caldwell Launch Collaborative Project

with Center for the Intrepid; Fatone Awarded

Supplemental Funding

6

NUPOC-IS Makes a Difference in Guatemala

7

NUPOC News

7

Craig Heckathorne, MS, Delivers Live Webinar

8

Northwestern University Prosthetics-Orthotics Center for Education and Research©

Capabilities/Winter 2013 1

Continued from page 1

increase in coronal plane pelvic ROM for sockets 1 to

sockets 1 to 6 would decrease incrementally.

6 (See Figure 2). Differences in length and firmness of

Analysis of data from the six

residuum may have affected the

socket conditions systematically

results. A subject with a very fleshy

demonstrates the contribution

residuum exhibited the largest

of ischial ramal containment and

variations in transverse plane

medial soft tissue compression to

rotation during swing with each

coronal plane stability for persons

socket. This study demonstrates a

with TFA while wearing a MAS®.

systematic relationship between

Results from six persons with TFA

socket comfort and stability; and

who walked successively in six

contributes to an understanding of

different MAS® socket conditions reported an incremental decrease in comfort and showed an

Figure 2. As supportive structure is incrementally removed in each of the 6 tested socket conditions, the Socket Comfort Score correspondingly declines.

socket design that will help address problems at the interface that are reported by persons with TFA.

How the MAS® Provides Comfort and Stability
R. J. Garrick, PhD
Wearers of prosthetic sockets rely on their prosthetist to create a socket with an intimate fit to provide comfort and stability. Persons with TFA who wear the MAS® report high satisfaction with comfort and stability. Structural features related to volume matching and proximal trim lines are thought to contribute to MAS® stability and comfort. Compared to other ischial containment designs, the MAS® contains without impinging on the ischial ramal complex; and by excluding the posterior aspect of the ischium provides coronal plane stability during mid-stance.
The posterior trim line located at the gluteal fold, obviates weight bearing by the gluteus maximus; the anterior trim line inferior to the anterior superior iliac spine allows nearly unrestricted range of hip motion; and the trim line of the lateral wall proximal to the greater trochanter maintains contact without gapping throughout the entire gait cycle.
Clinical fit aims for equilateral distribution of interior socket forces without local weight bearing pressures. Ortiz emphasizes that socket fit requires volumetric distribution of the residuum’s soft tissue, “Meticulous volume matching between the socket and the soft tissues of the thigh is critical to provide both quasihydrostatic weight bearing and excellent femoral stabilization” (Marlo Ortiz, M.A.S.® [Marlo Anatomical Socket], 2004). The MAS® holds the femur securely in a physiologically adducted position, enabling a narrow-based, ergonomically efficient gait without gapping or loss of suction in the socket.
Mr. Rob Rieckenberg participated as a subject in NUPOC’s MAS® research project. He said “I want to do whatever I can to benefit other amputees and help them get up and walk.” Rob likes wearing his MAS® fitted by prosthetist, Robert Tillges, CPO. “It feels like more a part of my body. It is lighter and I have more control. I trek, bike, hunt, ski and play softball.” Rob is a peer advocate of Wiggle Your Toes, the Minnesota-based non-profit organization that provides practical support and information for new amputees. The organization’s premise is “Recoup, recover, flourish!” Learn more at: www.wiggleyourtoes.org.

NUPOC Welcomes Research Collaboration with Robert Tillges, CPO, FAAOP
R. J. Garrick, PhD
NUPOC welcomes the research collaboration of Bob Tillges, CPO/L, FAAOP. Mr. Tillges is owner and president of Tillges Certified Orthotic Prosthetic Inc. (TCOP), founded in 1992. Tillges has more than 34 years of P&O experience and is a Fellow of the American Academy of Orthotists and Prosthetists. A recognized leader in MAS® socket fitting and fabrication, Mr. Tillges Robert Tillges, CPO has extended his expertise to collaborate with the NIDRR funded project, Effect of Socket Characteristics on Coronal Plane Stability during Gait in Persons with Unilateral Transfemoral Amputation (Principal Investigator Stefania Fatone, PhD). Collaboration with leading P&O professionals like Mr. Tillges enriches the process and outcome of the research project.
A native of St. Paul, MN, Mr. Tillges reflected on the impetus that led him to specialize in P&O, “From about sixth grade, I began working with my father who was a self-employed homebuilder. He was very meticulous in his work and I apply the same care to my own work in P&O. I maintain high standards and TCOP provides high quality products and services. I require excellence from my technicians, like my father expected from me.”
Seamlessly integrating family and work, Mr. Tillges and his two sons, also CPOs, work together at TCOP. Tillges adheres to a family-based philosophy of patient care. Mr. Tillges said, “I treat my patients like my family. I work for the satisfaction of my patients. If we can make their quality of life better, then we’ve got success. I feel satisfied when I see my patients who came in looking depressed leave my office smiling.”

Northwestern University Prosthetics-Orthotics Center for Education and Research©

Capabilities/Winter 2013 2

Sara Koehler, PhD, Successfully Defends Dissertation

Sara Rebecca Koehler, PhD,

persons with transfemoral amputation

successfully defended her doctoral

to systematic variations in prosthetic

dissertation, Neuromechanical

knee joint alignment during a level

Mechanisms of Prosthetic Knee Joint

walking task. She then investigated

Control: Associations with Prosthetic

the extent to which this response

Alignment, submitted in the field of

was exaggerated by the mechanical

Biomedical Engineering in the Robert

demands of sloped walking.

R. McCormick School of Engineering and Applied Science at Northwestern University on November 12, 2012. Steven A. Gard, PhD, served as her adviser and dissertation chair.

Overall, Dr. Koehler found that subjects responded to a destabilizing alignment perturbation by increasing their hip extension moment during early stance phase. In addition, subjects decreased

Dr. Koehler’s research, which was

the rate at which they loaded their

funded by a Merit Review grant (A7115R) through the Department

Sara Rebecca Koehler, PhD

prosthesis, decreased their step length, increased their trunk flexion, and

of Veterans’ Affairs and a fellowship

maintained their limb in a more vertical

through the Orthotics and Prosthetics Education Research posture at the time of opposite toe off. These findings

Foundation (OPERF), explored the control strategies used suggest that to overcome a reduction in knee-joint

by persons with transfemoral amputation to coordinate stability, amputees rely on a combination of both

the movement of a passive prosthetic knee joint during kinematic and kinetic control strategies. In contrast,

the stance phase of gait.

subjects were relatively insensitive to alignment

As part of her work, she cross-validated the performance perturbations that favored excessive knee-joint stability.

of an iPecs™ load cell (College Park Industries, Inc., Collectively, the findings from this research provide

Fraser, MI, USA), a wireless device designed to measure new insight into the control options of persons with

tri-axial forces and moments within a prosthesis, to transfemoral amputation, which may have important

that of a gold-standard motion analysis system. Using implications for the design and alignment of lower-

this load cell as part of a novel protocol to measure limb prostheses, as well as post-amputation training

joint kinematics, kinetics, and residual-limb muscle paradigms.

activity, she subsequently characterized the response of

Capabilities (ISSN 1055-7156) is published quarterly by the Northwestern University Rehabilitation Engineering Research Center for Prosthetics and Orthotics.

Director: Editor:

Steven A. Gard, PhD R. J. Garrick, PhD

This work is funded by the National Institute on Disability and Rehabilitation Research (NIDRR) of the Department of Education under grant number H133E080009. The opinions expressed in this publication are those of the grantee and do not necessarily reflect those of the Department of Education.

Subscription is free to all individuals and institutions interested in prosthetics and orthotics. Issues are archived on the NUPOC website, www.nupoc.northwestern.edu. Send subscription requests and address changes to: Capabilities, Northwestern University RERC, 680 North Lake Shore Drive, Suite 1100, Chicago, IL 60611.

©Copyright 2013 Northwestern University ProstheticsOrthotics Center. All rights reserved.

Dr. Koehler Accepts Position at Minneapolis VA Health Care System
After completing her doctoral degree, Dr. Koehler accepted a position as Research Health Scientist at the Minneapolis VA Health Care System (MVAHCS), where she is involved in a variety of research projects dedicated to improving the lives of veterans.
Together with Andrew Hansen,PhD, Director of the Rehabilitation Engineering Research Program at MVAHCS, she is currently working on a project to develop rocker shoes that can naturally immobilize the ankle and reduce chronic joint pain for persons with arthritis and rheumatism. She also is working on a project to assess the biomechanical contribution of adaptable prosthetic ankle joints for amputee gait.

Northwestern University Prosthetics-Orthotics Center for Education and Research©

Capabilities/Winter 2013 3

NUPOC Welcomes Brian Robillard, BS
R. J. Garrick, PhD

Brian Robillard, BS, has joined NUPOC as

majored in Mechanical Engineering. It

a Research Assistant on the Department

appeals to me as a discipline rooted in

of Defense-funded research project

classical engineering and acts as an entrée

(Principal Investigator, Stefania Fatone,

to all other areas. The design component

PhD), Development of Subischial Prosthetic

is most exciting.” Mr. Robillard is working

Sockets with Vacuum-Assisted Suspension

toward a Master of Science degree in

for Highly Active Persons with Transfemoral

Biomedical Engineering at Northwestern

Amputations. (See page 6.) This socket

University; he will integrate some of his

design aims to maximize flexibility without

work on the DoD project with his academic

sacrificing the rigidity necessary for force

work.

transmission between the user and

Interested in Prosthetics and Orthotics

prosthetic limb. The current socket design

(P&O) since high school, working with

is a three layer system that consists of

the DoD project team allows Mr. Robillard

a rigid frame sandwiched between two

to apply his skills in design and problem-

flexible layers. The potential benefits of

Brian Robillard, BS

solving to the field of P&O. “I love the

an automated fabrication technique over

design process, which is a combination

current hand fabrication of sockets are the

of problem-solving and team work. In the

ability to control flexibility of the frame through gradated future, I would like to focus on design and perhaps launch

thicknesses. Mr. Robillard plans to utilize NUPOC’s a medical device start-up company.”

Stratasys Fusion Deposition Modeling (FDM) 400mcTM, a rapid prototyping machine, as a novel way to develop transfemoral prosthetic sockets; and will help to develop an injection molding process to replicate and automate the socket fabrication process.

The third of four brothers, Mr. Robillard hails from Fresno, CA. He enjoys being outdoors and frequently hiked Half Dome in Yosemite National Park, located less than an hour from his home. He and his family enjoy frequent travel to Australia, Italy, Spain, Ireland

Reflecting on BME as a career choice, he said, “I am France, and Japan. He plays soccer for enjoyment and

attracted to the beauty of combining many fields into trains as a distance runner 5 days per week. He has

an overarching discipline. I always enjoyed math most completed international and domestic marathons and

as a subject, but I also read widely and had considered half-marathons. He plays acoustic and electrical guitar

pursuing medicine. I attended Notre Dame, where I and reads widely. Welcome to NUPOC, Brian!

NUPOC Hosts Crystal Lake South High School Science Students
R.J. Garrick, PhD

NUPOC Associate

Director, Edward

Grahn, BSME,

and R. J. Garrick,

PhD, facilitated an

educational tour for

more than 50 science

students from Crystal

Lake South High

School (CLSHS) who visited NUPOC on November 27, 2012

Science students and teachers from Crystal Lake South High School visited NUPOC to learn about rehabilitation engineering for Prosthetics and Orthotics.

with their science

instructors, Rich Marrano, Rene Kasischke, and others.

Students visited research stations where they learned about rehabilitation engineering for Prosthetics and Orthotics (P&O) and education and career opportunities. NUPOC Executive Director Steven A. Gard, PhD, provided an overview about NUPOC research
Continued on page 5

Northwestern University Prosthetics-Orthotics Center for Education and Research©

Capabilities/Winter 2013 4

NUPOC Hosts FSM Chicago Community Engagement Program Tour
R. J. Garrick, PhD

In conjunction with Northwestern University Family and Community Medicine’s Chicago Community Engagement Program (CCEP), the Family Medicine Interest Group (FMIG), and the T. K. Lawless Society, NUPOC hosted an educational tour for 11th-grade students from the Perspectives Charter High Schools (Chicago) on December 5, 2012. Acting in accord with their school motto, “Educating for college, preparing for life”, Perspectives Charter High School students toured NUPOC to learn about education, research, and career prospects in the field of Prosthetics and Orthotics.
CCEP engages FSM students to participate actively in community health activities and supports them with guidance and resources. Annually, FSM medical student

Students from the Perspectives Charter High Schools learned about Prosthetics, Orthotics and human motion analysis when they visited NUPOC. From left to right: Alejandra Jacobo-Cardenas, Loren Lowery, Ashley Adams, Tia Young, Hope Jernigan, Cynthia Botello, Romanus Hutchins, Noami Hernandez, Deion Caldwell, and Crystal Onate.

volunteers work with CCEP to organize and sponsor internships for high school students with the objective of introducing different aspects of the medical field. With CCEP, the high school student interns practice academic, professional, and social skills that are essential for success as university students and as employees in all occupations.
NUPOC hosted this tour as part of an annual commitment to public education. NUPOC appreciates the T. K. Lawless Society of the Feinberg School of Medicine, Mark Loafman, MD, MPH, Faculty Advisor; Amy Lu, 2nd year FSM student; Marynia Kolak, MFA, CCEP Coordinator; and NUPOC’s Ingrid Masterton, MPT, and R. J. Garrick, PhD, for developing this collaborative opportunity.

Continued from page 4

and education programs, current projects

before this trip. It is awesome to see what

and funding sources. Craig Heckathorne,

NUPOC is doing to help people who need

MS, explained and demonstrated how

prosthetic limbs. I learned about metabolic

upper limb prostheses work. Oluseeni

load and how difficult it can be to walk with

Komolafe, PhD, demonstrated human gait;

prosthetic limbs.”

and, with Rebecca Stine, MS, discussed

Another student remarked, “The motion

biomechanics and human motion analysis.

analysis lab was really impressive. The

Matty Major, PhD, presented Clinical

technology helps researchers to measure

Outcome Measures and instructed student

movements of different joints. Data

volunteers in performing several tests,

were detailed enough to solve issues

such as the Timed Up and Go, L-Test, Four

of energy loss for people who wear

Square Step Test, Functional Reach Test, and 10-M Walk Test.
A panel of NUPOC engineers, Kiki

Matty Major, PhD, instructed and supervised CLSHS students who performed Clinical Outcome

prostheses. I didn’t realize all the research and design that goes into giving someone a prosthetic limb.” Representative of

Zissimopoulos, MS, Oluseeni Komolafe, Measures, such as the Functional many CLSHS students’ experience was the

PhD, Matty Major, PhD, and Pranitha Reach Test.

comment, “NUPOC was great, relatable,

Gottipati, PhD, responded to students’

and interesting!”

questions about education, training, and career NUPOC sponsors annual learning opportunities for

opportunities in biomedical engineering and Prosthetics students who are interested in science, technology,

and Orthotics.

engineering and mathematics (STEM). Exposure to

Positive feedback from the CLSHS students indicated issues and concepts in biomedical engineering P&O

that their experience at NUPOC was fruitful. One student may motivate students to pursue these disciplines in

commented, “I didn’t know anything about prosthetics the future.

Northwestern University Prosthetics-Orthotics Center for Education and Research©

Capabilities/Winter 2013 5

Fatone Delivers Keynotes in Australia
R. J. Garrick, PhD

Stefania Fatone, PhD, BPO(Hons), was an invited keynote Using Outcome Measures to Assess the Effect of

speaker at the ISPO Australian

Ankle-Foot Orthoses on Gait. She

National Member Society Annual

demonstrated how to administer

General Meeting in Melbourne

stroke-specific outcome measures

where she presented The NIDRR

and how to use these data to

Rehabilitation Engineering Research

evaluate the effectiveness of orthotic

Center for Prosthetics & Orthotics at

interventions and adjustments. She

Northwestern University. Dr. Fatone

delivered keynotes and workshops

also presented two one-day, multi-

in Canberra on November 30 and

disciplinary instructional courses on

again in Melbourne on December 3.

the Orthotic Management of Stroke

Dr. Fatone has presented this well-

for the International Society for

received workshop to rehabilitation

Prosthetics and Orthotics, Australian Stefania Fatone, PhD, delivering Keynote s p e c i a l i s t s a n d a l l i e d h e a l t h

National Member Society. As part of Address at ISPO Australian National Member professionals in the Philippines,

the instructional course, Dr. Fatone Society Annual General Meeting.

Sweden and the USA.

also delivered a hands-on workshop,

Fatone and Caldwell Launch Collaborative Project with Center for the Intrepid (CFI); Fatone Awarded Supplemental Funding

As the final part of a 3-year project,

In December 2012, Dr. Fatone was awarded

Development of Subischial Prosthetic

supplemental funding through the Joint

Sockets with Vacuum Assisted Suspension

Warfighter Medical Research Program

for Highly Active Persons with Transfemoral

(JWMRP) to augment and accelerate high

Amputations, funded by the US Department

priority Department of Defense (DoD)

of Defense (Grant #W81XWH-10-1-0744) to

initiatives that imminently will achieve their

develop a flexible subischial prosthetic socket

objectives and yield a benefit to military

for highly active persons with transfemoral

medicine. This funding will supplement work

amputation, Principal Investigator Stefania

on the Development of Subischial Prosthetic

Fatone, PhD, BPO(Hons), and Ryan Caldwell,

Sockets with Vacuum-Assisted Suspension

CP/L, study prosthetist, visited the Center for

for Highly Active Persons with Transfemoral

the Intrepid at Brooke Army Medical Center in

Amputations.

San Antonio, TX, from October 29-31, 2012.
The CFI is a state-of-the-art facility for US military personnel who have sustained

Ryan Caldwell visited the CFI as part of Stefania Fatone’s DoD funded research

Vacuum-assisted suspension uses an active pump to create a negative pressure differential between the interior of a prosthetic socket

amputations, burns, or functional limb loss project.

and the surface of a residual limb. The original

during their service in Afghanistan and Iraq.

project developed plans and submitted

CFI offers cutting-edge technologies designed to be used patent applications for three hybrid, integrated

for rehabilitation, research, education, and training. Dr. electric/mechanical pump systems that require further

Fatone and Mr. Caldwell worked with CFI collaborators, development to achieve full maturity and deployment

Jason Wilken, PhD, and John Fergason, CP, to transition within the military environment. The objectives of this

the project socket technology for final performance supplemental funding are to prototype and test these

evaluation with military subjects. During the three day three hybrid vacuum pumps to create suitable vacuum

visit, Dr. Fatone and Mr. Caldwell enrolled three subjects; for prosthesis suspension in highly active persons with

cast, fabricated, and fit check sockets; reviewed the draft transfemoral amputation. Joining Dr. Fatone on this

instructional manual for socket fabrication; and finalized project are NUPOC postdoctoral fellow, Matthew Major,

details of the study protocol.

PhD, and NUPOC instrument maker, Dilip Thaker.

Northwestern University Prosthetics-Orthotics Center for Education and Research©

Capabilities/Winter 2013 6

NUPOC News
Publications­ Sensinger J, Intawachirarat N, Gard SA. “Contribution of Prosthetic Knee and Ankle Mechanisms to Swing-Phase Foot Clearance.” IEEE Transactions on Neural Systems and Rehabilitation Engineering, 21(1)7484, January 2013. Presentations Fatone S, Schweitzer J and Gard SA. Perceptions of Prosthetics and Orthotics Research within the Prosthetics and Orthotics Community. Poster Presentation, American Academy of Orthotists and Prosthetists (AAOP) 39th Annual Meeting and Scientific Symposium, Orlando, FL, February 20-23, 2013. Fatone S, Stine R, Tillges R. Effect of Socket Characteristics on Coronal Plane Stability during Gait in Persons with Unilateral Transfemoral Amputation. Paper presentation, American Academy of Orthotists and Prosthetists (AAOP) 39th Annual Meeting and Scientific Symposium, Orlando, FL, February 20-23, 2013. Fatone S, Howell J, Caldwell R, Komolafe O, Stine R. Role of Socket Design, Flexibility and Suspension in Transfemoral Sockets during Walking. Poster Presentation, American Academy of Orthotists and Prosthetists (AAOP) 39th Annual Meeting and Scientific Symposium, Orlando, FL, February 20-23, 2013. Wynne J, Fatone S, Bertram C, Coulter C, Kaluf B. Organized Session: Learn Patient Reported Outcomes for your Adult and Pediatric Patients. 39th Academy Annual Meeting and Scientific Symposium of the American Academy of Orthotists and Prosthetists, Orlando, FL, February

20-23, 2013. Grant Submissions Boutwell E. How Prosthesis Stiffness Influences Impact Forces during an In Vivo Impact and Level Walking. Fellowship Resubmission to the Orthotic and Prosthetics Education and Research Foundation (OPERF), January 18, 2013. Fatone S and Bjornson K. Orthotic Management of Gait in Cerebral Palsy: Effect of Footwear Modifications. R21 application submitted to NIH, February 16, 2013. Gard S. Effect of Prosthetic Foot and Ankle Stiffness on Standing and Walking. Submitted to Department of Veterans Affairs, Rehabilitation Research & Development Service, December 2012. Gard S and Casanova H. Evaluation of a Vacuum-Based Impression and Alignment Device (V-BIAD). Submitted to Department of Veterans Affairs, Rehabilitation Research & Development Service, December 2012. Gard S, Major M, Gottipati P. Estimating Post-Stroke Hemiplegic Gait Stability Using Nonlinear Dynamic Analyses. Submitted to NIH/NICHD on October 15, 2012. Major M. Sensory-Motor Mechanisms Underlying Fall Risk in Transtibial Amputees. Career Development Award (CDA-2) Application submitted to Department of Veterans Affairs, Rehabilitation Research & Development Service, December 2012. Wu Y and Gard S. Development and Evaluation of an Improved Method for Prosthetic Alignment. NIDRR Field Initiated Proposal, submitted the Department of Education, January 18, 2013. Letter of Intent Submissions Fatone S, Major M, Hansen A. Determining the Causes for Falling in Veterans with Lower Limb Amputations. VA Letter of Intent resubmitted for the March 15, 2013 due date.

NUPOC-IS Volunteers Improve Lives in Guatemala
R. J. Garrick, PhD

This is the fourth consecutive year that NUPOC International Service (NUPOC-IS) prosthetists and orthotists have volunteered their clinical skills at the Range of Motion Project-Chicago (ROMP) clinic in Zacapa, Guatemala. Melinda Thorpe, CPO, directs the NUPOC-IS outreach and Robert Lipschutz, CPO, served as the 2012 NUPOC-IS team leader.
Nine individuals (see photo) from NUPOC raised funds to cover their transportation, accommodations and other expenses. Some NUPOCIS participants also generated donations of prosthetic and orthotic components that they contributed to ROMP. Mr. Lipschutz and the NUPOC-IS group worked collaboratively with ROMP staff to custom design thermoplastic orthoses and prostheses for Guatemalan clients, many of whom traveled long distances to receive P&O treatment.
NUPOC-IS volunteers provide supervised services and products to Guatemalans who need prosthetic or orthotic treatment. Participants practice their P&O skills and observe immediate improvement in their ROMP clients’ quality of life. Larissa Conner, CO, a NUPOC graduate and participant in the 2012 service trip, fitted one transtibial and three transfemoral prostheses. Ms. Conner said that she enjoyed helping her clients regain mobility and independence. “This was a great experience. I felt thankful to see problems that I could address and improve people’s lives. I’d like to do it again.”

NUPOC-IS 2012 participants at the ROMP Clinic in Zacapa, Guatemala. Front row, from left: Elsa Orellana, Vivian Aragon, Karen Acevedo, Glendy Salguero, Jesse Albright; Larissa Conner; Liz Chabot, and Scott DeMelo (reclining); and Jessica Driscoll (seated front). Not shown is Kelly Simon. Back row, from left: Carlos Levi Larios, Robert Lipschutz (2012 team leader); Katie Antle-Johnson; Dave Krupa (ROMP co-founder); Nicholas Denroche, Vinicio Ortiz, Jonathan Naber (founder of Illini Prosthetic Technologies (IPT) and Open Socket-technology Prosthetic Arms), and Luis Aragon.

Northwestern University Prosthetics-Orthotics Center for Education and Research©

Capabilities/Winter 2013 7

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Craig Heckathorne, MS, Presents Live Webinar
R. J. Garrick, PhD

More than 30 individuals nationwide

problems using prostheses.”

attended a live webinar presented by Craig

Webinar participant Vicki Janisch inquired,

Heckathorne, MS, Research Engineer, on

“How might you deal with the survey tool

November 29, 2012. Mr. Heckathorne

distribution if internet is limited or if clients

presented Prosthetics for Farmers and

have no computer experience?”

Ranchers: What Is Used and What Is Needed for the AgrAbility Virtual National Training Workshop. Co-authors of the work are Kathryn Waldera, Margaret Parker, and Stefania Fatone. Paul Jones, National AgrAbility Project Manager, moderated the webinar, which attracted a national audience of participants from Maine to California. Attendees also tuned in from Wyoming, Colorado, Kansas, Utah, Missouri, West Virginia, Minnesota, North Carolina, Illinois and Indiana to attend Mr. Heckathorne’s webinar.

Mr. Heckathorne responded, “We will

make the survey available on SurveyMonkey®

and in printed form. Online, the survey is

automatically tailored to farmers or ranchers,

upper limb and lower limb amputations, and

unilateral and bilateral amputations. The

Craig Heckathorne, MS, presenting webinar for the AgrAbility Virtual National Training Workshop.

online survey is relatively compact and relates to the individual responder. The printed form is more cumbersome and is manually tailored to each individual.” Additional

interactions addressed questions of durability

for prostheses used in agricultural work and conditions of

An interactive question and answer session followed the material and device failure.

presentation. Mr. Jones asked, “How can the state AgrAbility Mr. Jones concluded the webinar, “Your talk has been projects assist you in expanding the pool of interviewees?” helpful and interesting. We will continue to work with you to

Mr. Heckathorne replied, “The state and regional get the word out to state and affiliated AgrAbility programs.”

AgrAbility Projects and their affiliated collaborators can help us by making the survey known to farmers and ranchers with amputations. Farmers and ranchers who participate in the survey can help to improve our understanding of their

This webinar is archived and accessible at: www. AgrAbility.org/Online-Training/archived/2012virtualntw. cfm.

Northwestern University Prosthetics-Orthotics Center for Education and Research©

Capabilities/Winter 2013 8

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Marlo Anatomical Socket® Studied for Coronal Plane Stability