3r60 knee manual
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3r60 knee manualThe 3R60’s EBS securely provides up to 15 degrees of knee flexion at heel strike. This helps avoid hip hiking and other compensatory movements during the gait cycle. The knee is easily adjusted to suit the user’s individual needs. An innovative hydraulic system controls the behavior of the knee joint during swing phase. The dampening values of the hydraulic system are based on gait analysis investigations. For the user, this mainly means that he or she can easily initiate swing phase and use a wide range of walking speeds. Flexion and extension dampening can be individually adapted to fit the user. The new generation of the 3R60 is smaller and at just 845 grams, also lighter than its predecessor. Four proximal connections are available for the knee so that you can easily fit different amputation levels. To work properly, this page requires JavaScript to be enabled.This flexion not only results in more comfortable foot placement, but also improves knee safety. High-performance swing phase hydraulics that are straightforward to adjust enable easy initiation of the swing phase, optimum progressive damping for natural movement patterns and comfortable end position damping for a wide range of walking speeds. It also increases ground clearance in the swing phase. This supports the easy initiation of the swing phase and enables the user to walk at a wider range of speeds. This flexion not only results in more comfortable foot placement, but also improves knee safety. High-performance swing phase hydraulics that are straightforward to adjust enable easy initiation of the swing phase, optimum progressive damping for natural movement patterns and comfortable end position damping for a wide range of walking speeds. Therefore, please contact your local Otto Bock office or representative for more information.http://nv-tel.ru/public/4-thread-overlocker-manual.xml
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Links to social media sites are intended to facilitate communications between Otto Bock users and they may contain information that is not in accordance with the Australian regulations. Furthermore, Otto Bock makes no representation that the materials on the Websites are legally appropriate for use in Australia. To work properly, this page requires JavaScript to be enabled.What’s more, the knee joint dampens forces acting on the residual limb, pelvis and spine during heel strike. Thanks to progressive stance phase damping, including in the flexion direction, the 3R60 Pro supports the user in a wide variety of everyday activities. The knee joint is lightweight, compact and suitable for users up to 75 kg.It also increases ground clearance in the swing phase. This supports the easy initiation of the swing phase and enables the user to walk at a wider range of speeds. What’s more, the knee joint dampens forces acting on the residual limb, pelvis and spine during heel strike. The knee joint is lightweight, compact and suitable for users up to 75 kg.Therefore, please contact your local Otto Bock office or representative for more information. Stance phase flexion takes place against the Stance phase extension is dampened by hydraulics. An ischial containment prosthetic socket and The seal of the prosthetic socket should begin as This ensures optimum control of residual Approved for a body weight of up to 125 kg. The gait pattern should be as similar as possible to a physiologically healthy model. With the 3R60 EBS Knee Joint, users are well on their way. This device helps you to individually adjust knee flexion during stance phase for every type of gait, which relieves the residual limb, hips, and spine of the prosthesis wearer and results in additional stability. Lower Extremities 334 Pages Prosthetics. They exclude delivery charges and customs duties and do not include additional charges for installation or activation options.http://scro.ru/pic/4-way-manual-ball-valve.xml Prices are indicative only and may vary by country, with changes to the cost of raw materials and exchange rates. By using our site, you consent to the placing of cookies on your computer or device. Further information is provided in our data privacy statement. See our separate pages on the C-Leg: Many models are available on the market, including 4, 6 or 7 bar linkage designs. Advantages include: See Knee Disarticulation - A Whirlwind Tour for more detail on polycentric knees. Capable of adapting to a user's pattern of walking over time. Coming in several models: 1900, 2000, 2100, and Junior. In the swing phase, the joint reduces the length of the prosthesis by more than 25 mm depending on the flexion angle. This gives the prosthesis wearer much more ground clearance in the swing phase. This sophisticated design allows for two different modes of operation: Swing phase mode and stance phase flexion mode. We are frequently called upon for product testing and development and are proud to partner with our suppliers to continue to develop creative solutions for individual needs. It also facilitates an easy kneeling action. Mid-swing shortening allows the prosthesis to swing more easily through each step and helps prevent hip hiking. This short video presents how easy it is for practitioners to set up and adjust the knee to each individual user's cadence. This short video presents how easy it is for practitioners to set up and adjust the knee to each individual user's cadence. This is the go-to knee for superior shock absorption, increased comfort and a more natural gait. Mid-swing shortening offers increased toe clearance during swing to prevent hip-hiking and the 3-phase hydraulic swing control accommodates changes in walking speed. Plus, the adjustable stance flexion feature mimics the knee flexion that occurs during early stance, reducing shock and stress on the residual limb.http://www.drupalitalia.org/node/67629 With a weight limit of 125kg (275lbs) and 25 increased fluid capacity over Model 2000, the Total Knee 2100 offers the ultimate in stability, control, efficiency and durability. Whereas low K3 users place a premium on stance stability, high K3 users desire a more responsive knee for a dynamic walking experience. Delivering powered extension when standing up, controlled resistance when descending, and active flexion and extension during walking, POWER KNEE facilitates symmetrical weight distribution and natural gait. POWER KNEE has been demonstrated to significantly reduce rehabilitation time for new transfemoral amputees. POWER KNEE, the only motor powered knee joint, provides active motion and superior powered stance stability to replace lost muscle function, enabling users to go further and new amputees to rehabilitate faster. In this inspiring video Neal tells us about the attack, what happened immediately afterwards and how the rehabilitation process progressed. You must have JavaScript enabled in your browser to utilize the functionality of this website. The final responsibility for correct coding is the sole responsibility of the practitioner submitting the claim. Prosthesis users want to be able to walk safely, comfortably, and in a natural manner. This device helps you to individually adjust knee flexion during stance phase for every type of gait, which relieves the residual limb, hips, and spine of the prosthesis wearer and results in additional stability.Change content default valueIs the worst over? Have patients most at risk already been affected.COVID-19 poses several challenges and has made it difficult to measure.According to the International Agency for Research on Cancer, in 2018.We hope this finds you, your family, your staff, patientsPlease select channelAffidea, the leading European providerAccess the future of healthcare While healthcare organizations across.According to the International Agency for Research on Cancer, in 2018.http://charlottemarquardt.com/images/3pk-nt007-manual.pdfInternational experts treating COVID-19 patients have concluded that.Questions to Wolfgang Heimsch, President Customer Service at Siemens HealthineeThe team at Breakthrough Genomics is contributing to the fight against.The 175th president of the American Medical Association (AMA). As of May 4, Oliver Reichardt isDr. Sebastian Krolop, M.D., Ph.D., M. Sc. has recently been appointed the.The American Society for Parenteral and Enteral Nutrition (ASPEN) has.The 2017 Ethica Award, the highest honour of the European cardiovascular.Gamma Medica, a leader in molecular breast imaging (MBI) technology, announced.Please select channelPlease select channel. Twelve users completed the OC twice with each joint, once without and once with a mental loading task (MLT). The performance was objectively assessed using time measurement from digital video recordings, and the Total Heart Beat Index was used to estimate movement efficiency. A 1 mo familiarization period was provided for each knee joint before data collection. It took longer to complete the OC with the 3R60 compared with either the SNS or the C-Leg. No significant time differences were found between the C-Leg and the SNS, but differences between the 3R60 and the SNS (slalom and rock sections) and between the 3R60 and the C-Leg (rock section) were observed. Within the simulated sand section, two participants fell with the C-Leg, one with the 3R60, and none with the SNS. Movement efficiency without MLT was similar between all joints, but with an MLT a significant decrease in movement efficiency was observed with the C-Leg. Previous experience using an SNS had no influence on the results. Overview of obstacle course (OC) setup within laboratory. Time differences exist only between 3R60 and C-Leg and between 3R60 and SNS. Participants maneuvering OC with C-Leg had similar time as when they were maneuvering OC with SNS. Download full-text PDF Other full-text sources Content available from Margrit R Meier: 53fec6c20cf21edafd152225.pdf 53fec6c20cf23bb019be5d12.pdf Content uploaded by Margrit R Meier Author content All content in this area was uploaded by Margrit R Meier on Aug 28, 2014 Content may be subject to copyright. Download full-text PDF Other full-text sources Content available from Margrit R Meier: 53fec6c20cf21edafd152225.pdf 53fec6c20cf23bb019be5d12.pdf The perfo rmance was ob jectively assessed using time measurement from di gital video recordings, and the T otal Heart Beat Index was used to estimate movement efficiency. It took lo nger to complete the OC with the 3R60 compared with either the SNS or the C-Leg. No si gnificant time differences were found between the C-Leg and the SNS, but dif- ferences between the 3R 60 and the SNS (slalom a nd rock sec- tions) and between the 3R60 and the C-Leg (rock section) were observed. W ithin the simulated sand section, two participants fell with the C-Leg, one with the 3 R60, and none with the SNS. Movement efficiency without ML T was similar between all joints, but with an ML T a significant decrease in movemen t effi- ciency was observed with the C- Leg. Previous ex perience using an SNS had no influence on the results. Key words: 3R60, C-Leg, maneuverability, mental loading task, movement efficiency, obstacle course, prosthetic knee joint, SNS, T otal Heart Beat Index, walking. INTRODUCTION More and more research is now available that demon- strates the ef fect of micropr ocessor-controlled prosthetic knee joints on user performance, satisfaction, and experi- ences. Meier, PhD; Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences, Departme nt of Occupational Therapy and Prosthetics and Orthotics, Postboks 4, S t Olavs plass, 0130 Oslo, Norway.In addi- tion, indoor stairs made from dif ferent materials with di f - ferent raiser heights and configurations nee d to be handled, such as single flight stairs, corner stairs with multiple flights, or spiral st airs. Once outside the home, the variety of surfaces increases: in addition to man-made sur- faces, such as walkways, natural surfaces need to be tra- versed to participate fully in life activities. W alkways come in a variety of compositions, su ch as cobblestones, concrete slabs, or pebble stones of different sizes, to name a few. W alkways can be level, inclined, or side-wise elevated, and their characteristic may cha nge frequently over relatively short distances. Thus, studying maneuverability on non- level surfaces is important to many daily activities of pros- thesis users and can add signi ficantly to the understanding of possible interactions betw een walking surfaces and the performance characteristics of different prosthetic compo- nents. Clinical experiences st rongly suggest that prosthesis users are sensitive to surface features during walking and standing. Given microprocesso r-controlled knee joints’ range of possible settings and their adaptation to walking speed, uneven terrain may be a domain where they pro- vide superior maneuverability than passive, mechanically- controlled prosthetic knee jo ints. In particular, we were interested in determining ho w one of the microprocessor- controlled prosthetic kn ee jo ints available on the market, the C-Leg, performed when prosthesis users walked over uneven surfaces. Because different surfaces may have different ef fects on maneuverability, an OC was devel- oped with a number of dif ferent independent sections. Such a setup allowed for an analysis of possible interac- tions between walking surface and maneuverability in each section. W e only fo und a sing le published study that carefully analyzed the performance of users of transfemoral pros- theses while they traversed an OC with different walking surfaces. At the start of the SWOC, the participant sat in a chair with arms, then stood up, walked several feet straight ahead, turned right, stepped over an axillary crutch, continued walking, turned left, a nd walked acro ss a multicolored mat. A right-turn followed, after wh ich the participant navigated around a lar ge kitchen trash can, followed by a walk across a heavy shag rug. The SWOC was completed when the participant sat down on an armless chair placed at the end of the course. Stu dy participants completed the SWOC under two conditions: (1) hands free and (2) with a weighted laundry basket (4.5 kg) using their previ ous nonmicroprocessor knee joints and their current C-Legs. Under the hands-free conditi on, the participants com- pleted the SWOC significantly faster with the C-L eg than with the previous knee joint, taking significantly fewer steps and producing signifi cantly fewer step-offs. No stumbles were recorded with either knee joint. Under the weighted laundry basket condition, no differences were observed between the knee joints except in one variable: total time taken to complete the SWOC was shorter with the C-Leg than with the nonmicroproc essor knee joints. Perhaps more differences betw een the knee joints would have been observed if the considerably different dura- tions of prior experience with the C-Leg had been con- trolled for. Prior experien ce with the C-Leg varied between 2 and 44 months. The purpose of our study was to evaluate the maneu- verability and movement effici ency of transfemoral pros- thesis users traversing an OC with defined su rface characteristics while wearing th ree different prosthetic knee joints: the C-Leg, the SNS unit (CaT ech; Dayton, Ohio), and the 3R60 prosthetic knee joint (Otto Bock). METHODS Participants’ Eligibility Criteria Persons with transfemoral amputation, between 40 and 60 years old, with a body mass less than 125 kg Individuals whose prostheses demonstrated a poor socket fit were excluded from the study. Fitting of T est Prosthesis and S tudy Design A test prosthesis was fabric ated for ea ch participant using a duplication of his or her current prosthetic socket and a Dynamic Plus foot (Otto Bock), a foot approved by the manufacturer to be used in combination with the C- Leg. The study had a crossover design; after ea ch testing session, the cur- rent prosthetic test knee joint was exchanged with the next test knee joint and aligned by an experienced prosthetist before the participant was se nt home for the next accom- modation period. Throughout the d ynamic alignment ses- sion, participants r eceived verbal instruction on how to use the current test joint appropriately. For the C-Leg, how- ever, the participants receiv ed additional written instruc- tions in the form of an information brochure from Otto Bock about the C-Leg. All pa rticipants received the same information. Dynamic alignmen t was carried out on a level walking surface using observa tional gait analysis, as is common in general clinical practice. Dynamic alignment and instructions were given by the same prosthetist and continued until both the par ticipant and the prosthetist were confident that the knee could be used dynamically and without undue anxiety by the subject. For the duration of the accommodation period, study participants were encouraged to contact the pr osthetist any time for addi- tional fine-tuning. None of th e study participants requested additional fine-tuning sessions. The sequence of fitting the three knee joints was randomized. The time to complete the OC was used as a measure of performance for the dif ferent prosthetic knee joints. In addition, any falls were recorded. T he THBI is a validated index of mo vement efficiency in children with ce rebral palsy. This index was chosen for its strength of measuring movement efficiency without the need to reach a plat eau heart beat as is required, for example, with the Physio logical Cost Index (PCI). In our case, completing the OC required a relatively short time, a period that was insu fficient for subjects to reach steady heart rate and thus excl uded the use of the PCI. The THBI is calculated by dividing the total number of heart beats measured over a specified time period by the total dis- tance traveled during that tim e. As THBI increases, move- ment efficiency decreases. Experimental Protocol Study participants were asked to complete the OC twice: first without a mental loading task (ML T) and then with an ML T. For safety reas ons, all participants started without the ML T. The OC was set up in the Department of V eterans Affairs (V A) Chic ago Motion Analysis Research Laboratory (V ACMARL). A handrail on the left-hand side was p resent for both the ramp and the step section. The OC measured a total length of 23.2 m from start to finish ( Figur e 1 ). The ML T consisted of an arithmetic calculation in which the participant was required to count vocally back- ward in 3-step de crements us ing the first knee joint during the first visit, in 7-step decrements using the second knee joint during the second visit, and in 3-step decrements using the third knee joint during the third visit. As previously mentioned, the knee joints were rando mly assigned. The three-digit ML T starting numbe r was specifically selected The ML T for visits 1 and 3 had the same starting number; the ML T for visit 2 started with a higher number because of the lar ger arithmetic step de crement required during this visit. All participants receiv ed the same st arting numbers. No specific information was give n to the participants other than to perform the ML T wh ile tr aversing the OC. T ime was objectively determined fr om a digi tized vi deotape recording (Sony Super S teadyshot miniDV Handycam V ision; T okyo, Japan) of the participants navigating the OC, allowing for time assessment of the different section s as well as the entire OC (r esolution of 0.033 s between video frames). No familiariza tion run was allowed and no encouragement was given, nor were the participants informed that their traverse time was being measured. The instructions given were simply to complete the OC. T o demonstrate the navigation pa th, the lead investigator walked the OC onc e as the participant watched. However, she did not walk ov er the bean bag section in order to avoid any visual feedback to the participants prior to their own experience. During the ML T run, the numbers spoken by the participants were record ed manually. Participants were aware that their answer s were noted. Each participant’ s heart ra te was monitored using a Polar S610 heart rate moni tor (Lake Success, New Y o rk). For heart rate analysis, the da ta were transferred from the receiver unit (wrist watch) to a computer and proces sed to extract the relevant heart rate. The heart rate monitor did not allow remote adding of tags into the data stream to delineate particular OC seg ments. Hence, the heart rate over the entire OC was analyzed instead of over the indi- vidual OC sections. S tatistical Analysis A two-factor repeated measures ana lysis of variance (ANOV A) was used with task ( w i t h o u t M L T, w i t h M L T ) and joints (3R60, SNS, C-Le g) as fixed factors and sub- jects as a rando m factor. The diagnostics for this paramet- ric ANOV A model we re satisfa ctory for all parameters. The dependent “time taken” variables durin g the beanbag and rock sections of the OC were determined to have skewed distributions; hence, a logarithmic (base 10) trans- formation was carried out and one (same su bject) of the three outliers was removed in order to satisfy the paramet- ric model. An outlier was regard ed as a data point that lay beyond three standard devi ations of the mean. The variable “total time” to complete the OC satisfied the model with- out transformation once the outliers were disregarded. Where necessary, post hoc anal yses were performed using Bonferroni corrections to account for multiple compari- sons. Because 50 percent of the participants had used an SNS unit prior to study entry, we decided to test if previous experience with the SNS unit had an influence on th e Figure 1. Overview of obstacle course (OC) se tup within laboratory. T wo video cameras were set up in such a way that entire OC could be filmed, allowing time measurements for each section. Data were regrouped into two g roups: previ- ous SNS experience (pSNS) and non-pS NS users (persons who did not have previous experience with the SNS). T o test for any significance of this new variable, a third factor was added to the previous model and the analysis was repeated, this time as a three-fa ctor repeated measures ANOV A. This reana lysis redu ced the significant level to 0.02. Paired comparisons between no-ML T and with-ML T within each joint type were assessed using W ilcoxon signed rank tests given th e skewed distrib utions of the variables. All tests were completed using the statistical software SPSS 15.0 (Chicago, Illinois). RESUL TS A total of 24 participants were enrolled in the study. However, eight did not come in for either their initial appointment or the first tes ting session, two participants dropped out, and two asked to be withdrawn from the study. Participants’ characteristics are summarized in Ta b l e 1. Participants used a variety of different prosthetic componen ts, with the CaT ech SNS the most commonly used prosthetic knee joint in this study sample ( Ta b l e 2 ).No falls occurred when participants walked with the SNS unit. Pa rticipants who fell previously did not fall during the second round when the ML T was applied. The same applie s for the corner an d step sections ( Figure 5, Ta b l e 3 ). Based on prior use of the SNS unit (50 of the study participants had an SNS prior to study entry, Ta b l e 2 ), the variable pSNS was crea ted by splitting the sample into two groups based on evaluation of participants’ previous expe- riences. There were no statistically signific ant effects of pSNS on any of the OC sections or on total time. Also, all interactions of pSNS with ta sk and pSNS with joint were statistically insignificant. T hus, previous experiences with an SNS unit did not appear to have had an influence on the measured outcomes ( Ta b l e 4 ). Time differences exist on ly between 3R60 and C-Leg and between 3R60 and SNS. Participants maneuvering OC with C-Leg had similar time as when they w ere maneuvering OC with SNS.Th at is, pa rticipants completed the OC equally fast while walking with the SNS and the C-Leg. A substantial ambulation challenge was observed within the beanbag section of the OC. Three falls occurred during the participants’ firs t round of the OC (without ML T): two falls occurred in participants wearing the C- Leg, one with the 3R60, and none with the SNS. The falls occurred in three subjects: tw o who were 54 years old and one who was 62 years old. All three had different etiologies of amputations (1 traumatic, 1 peripheral vascular disease, 1 infection), and had their am putations 3, 28, and 6 years prior to testing, respectively. W e concluded that the falls were not due to the participan ts’ characteristics, but were likely elicited by a combination of the particular knee joint they were using during that trial and the challenges imposed by the compliant surface they were traversing at that time. This finding is in contrast with other previously reported data. Hafner et al. obtained subjective feedback from prosthesis users who perceived a reduction in stum- bles and falls while walking with the C-Leg compared with Figure 3. Beanbag section—Infl uence of task on performance. All participant s completed this sectio n significantly faster when mental load ing task (ML T) was appl ied.Actual and not transformed data are shown. But this required loading appears to be difficult to ach ieve on sur- faces that have higher comp liance (i.e., lower stif fness), such as in the case of the beanbag section of the OC. When prosthesis users walk on rela tively compliant surfaces, the C-Leg may remain extended in late stance phase when the knee joint should begin flexing in preparation for swing, leading to stumbles or falls. There fore, the compliance is believed to have been the primary contributing factor to why the participants’ falls occurred in the beanbag section. Frame-by-frame analysis of the video recording as those subjects traversed the beanbag section indicated that the ini- tiation of the C-Leg’ s swing phase either did not occur o r occurred at an inappropriate ti me, thus directly contributing to the falls. Although the manuf acturer ’ s specified require- ment for knee break to occur in late stance is at a minimum of 66 percent body weight loading on the “forefoot,” the C- Leg actually monitors an external dorsiflexion torque on the pylon. Even though the participants likely placed full body weight on their prosth esis when traversing the bean- bag section, the compliant su rface may not have permitted the center of pressure of th e ground reaction force to suf fi- ciently progress anterior unde r the prosthetic foot and cre- ate a sufficient lever arm to enable the ankle joint torque to reach the minimum threshold. In spite of our observations, it is possible that subjects in the Hafner et al. Therefore, we acknowledge that the C-Leg may improve stability in par - ticular situations that would normally cause stumbles or falls with some mec hanical knees. Nonethe less, our study provides additional information that is relevant for clinical use. If a patient routinely encounters c ompliant surfaces during his or her everyday use of his o r her prosthesis, a Figure 4. Rock section—Influence of joint on performanc e. Only joint had sign ificant influence o n participants’ performance during this s ection; significant differences were found betwee n 3R60 and SNS an d be tween 3R60 and C-Leg, but not betwee n C-Leg and SNS.The absence of falls during the ML T (the second trial across the OC) is most likely attributable to the learning effect by the subjects. The fa lls experienced by the users during their first trials on the OC may have ma de them par - ticularly wary and cued them on how to react to t hese sec- tions on subsequent trials to prevent additional falls. It could be ar gued that the beanbag section is not rep- resentative of walking surfac es encountered in real life. However, the authors have heard anecdotal first-hand accounts from prosthesis users of stumbles occurring on soft terrains while walking with the C-Leg because of the inability of the knee to flex in late stance phase for swing. Similarly, manufacturers are encouraged to care- fully review and evaluate the control algorithms pro- grammed into their microp rocessor-controlled knees and consider the effect of surface stiffness and uneven ter- rains on knee function an d performance. The time differences in the ro ck section were attribut- able only to the different knee joints. When participants were walking with the C-Leg, they were able to complete this section fastest, although there was not a significant dif- ference in times between the C-Leg and the SNS. It could Ta b l e 3. Ne ither joint, task, nor interaction had sign ificant in fluence on particip ants’ performance du ring these three sections (see Ta b l e 3 for details). Ta b l e 4. Effect of previous SNS experience (pSNS) and interactions on OC. See text for further details.