@article{2c5270dd7f8547ada4403a2c583787cc,
title = "Below-knee residual limb shape change measurement and visualization",
abstract = "Objective: The ability to measure and visualize shape change (deformation) of a residual limb within and between prostheses is an important step toward improved prosthetic fit assessment. The objective was to develop measurement and visualization methods for below-knee residual limb soft tissue shape change after donning and loading a prosthesis to detect small shape changes (30mm or less). Design: Spiral X-ray computed tomography imaging was utilized to acquire 3D volumetric data of the below-knee residual limb and prosthesis in situ from poor- and a good-fitting prostheses without and with a load. A new sum projection depth-shaded cylindrical mapping technique to measure and visualize small changes in shape was developed. From the volumetric data, the relative displacement of small lead markers placed on the residual limb's skin surface were measured using multiplanar reconstruction images and cylindrical maps. Displacement measurements averaging 15mm or less were obtained. Results: The precision and accuracy was 1mm and 2mm, respectively, when measuring the shape change or deformation of the skin surface from the sum projection cylindrical maps. The skin surface deformation was at least 7mm or greater when comparing marker locations between scans with the prostheses in situ. Conclusion: These new image-based measurement and visualization methods provide a feasible means for measuring and displaying lower extremity residual limb shape change within and between different prostheses with and without loading.",
author = "Commean, {Paul K.} and Brunsden, {Barry S.} and Smith, {Kirk E.} and Vannier, {Michael W.}",
note = "Funding Information: BJECTIVE MEASUREMENT of prosthesis fit requires O detailed geometric knowledge of the soft tissue envelope surface location as well as the underlying skeletal framework. The residual lower limb consists of a bony substructure, fibrous and cartilaginous investments, and soft tissue (muscle, fat, and From the MallinekrodtI nstitute of Radiology,W ashingtonU niversityS chool of Medicine, St. Louis, MO (Mr. Commean, Mr. Brunsden, Mr. Smith), and The Departmento f Radiology,U niversityo f IowaC ollegeo f Medicine,I owaC ity,I A (Dr. Vannier). Submittedf or publicationS eptember3 , 1997. Acceptedi n revisedf orm November 17, 1997. Supported in part by the NationalI nstituteso f Health, NationalI nstituteo f Child Health and Human Development, N~tional Center for Medical RehabilitationR e-search grantR O1 HD30169. No commercialp artyh aving a directf inanciali nteresti n the results of the research supporting this article has or will confer a benefit upon the authors or upon any organizationw ithw hicht he authorsa re associated. Reprint requests to MichaelW . Vannier,D epartmento f Radiology,U niversityo f Iowa Collegeo f Medicine,2 00 HawkinsD rive3 966AJ PR IowaC ity,I A 52242-1077 {\textcopyright} 1998 by the AmericanC ongresso f RehabilitationM edicinea nd the American Academyo f PhysicalM edicinea nd Rehabilitation 0003-9993/98/7907-463053.00/0 skin). The soft tissue is subject to both short-and long-term changes caused by edema, venous pooling, exercise, weight gain or loss, muscle contraction, and atrophy. In addition, the soft tissue is continuously deformable. Lower leg volume measurement methods have been developed to quantify and help understand the effects of edema and atrophy. 1-6 In addition, residual lower limb volumes and straight line distances between markers using a spiral x-ray computed tomography (SXCT) scanner have been measured. 7-15 In vivo skin displacement measurements within the prosthesis with and without a load applied to the prosthesis have not been reported. A comprehensive volumetric imaging technique, such as an SXCT scanner, is needed to visualize and measure the residual lower limb within the prosthesis. The effects of weight gain or loss, edema, atrophy, and soft tissue displacement for poor-and good-fitting prostheses within subjects and across subjects can then be studied to show how shape change relates to fit.",
year = "1998",
month = jul,
doi = "10.1016/S0003-9993(98)90355-0",
language = "English",
volume = "79",
pages = "772--782",
journal = "Archives of Physical Medicine and Rehabilitation",
issn = "0003-9993",
number = "7",
}