CAOC

Real-life story about a little girl's battle against Blount's disease.
Click here to read more about Mckenzie Upton.


12/02/2015 

During the past week, our group had been trying to do research and find a mentor who will help us along the way. We are waiting to hear from Dr. Jan Grudziak, a pediatric orthopedic specialist at Children’s Hospital of Pittsburgh. 

Information about a newly designed KAFO brace with a different mechanism will be updated under "Types of KAFO". 

Tomorrow, we are heading to TechShop for our first vacuum forming class. Hopefully, the class will inform and inspire us to create a brace with the help of the vacuum forming machine. 


12/03/2015 TechShop Update

Today we took a vacuum forming class at TechShop. The vacuum forming machine is widely used in commercial packaging and mass production. We wanted to compare vacuum forming to 3D printing and see which technique is more effective and also more efficient at producing a brace off of a leg model. We wanted to use the prosthetic leg Emma made last year for her project as a mold, but they couldn't find us plastic sheets big enough for the leg (although the leg fit perfectly fine on the machine). Therefore, we decided to use a small cylindrical 3D printed object as a mold just to see how the machine worked.
Here is a picture of the mold on the machine:



A closer look at the mold and the vacuum-formed product (clear plastic): 



We couldn't get the plastic off of the mold so we had to cut open the sides in order to pull it off...



Our biggest takeaway from this class is that vacuum forming may not work for our project because we would need plastic far thicker and sturdier than the one given to us in this class, and we also learned that it's hard to vacuum form certain shapes because the plastic would pop, and it's also incredibly hard to get the vacuum-formed plastic off of the mold. However, if we ever need to produce several models of the leg brace in a short period of time, we might come back to vacuum forming for help.
Click here to watch a video about vacuum forming.

12/11/2015
Today we took an Arduino class at TechShop. Each of us obtained a set of materials needed including breadboard, switch, sensors, motor, LEDs and various electronic components. We learned some basic Arduino programming skills and may further apply them onto the leg brace to collect data. 
 

12/15/2015
Today we had a meeting with Peggy Giesen, a pediatric physical therapist from the Learning Institute. 

Some thoughts and considerations we learned through the meeting are as following:

• Gait Pattern

• Medial/Lateral metal bar

• No quantitative data; redness & marking

• Locking the hinge

• Room for growth; easy adjustments

• both sides of ankle and knee; bony prominences-->soft padding

• foot plate; foot position

• orthosis inside the shoe

• Bilateral/unilateral-->leg length discrepancy; add height to shoe

• Compliance

01/29/2016
We had a very nice and informative meeting with Sean Greer from DeLaTorre Orthotics. 

He is a Certifed Orthotist with DeLaTorre Orthotics and Prosthetics. He specializes in pediatric bracing, especially body remolding devices such as cranial remolding helmets, scoliosis braces, and Blount's braces.

Notes from the meeting: 

Goals: build a theoretical model which allows the following:

1. safe, quick digital image capture; require a minimal amount of time for the baby to hold still in order to get a clear image of the leg

2. make the brace more appealing to parents-->increase compliance

• thickness of the brace
• fits inside the pant and shoe; “invisible”
• aesthetically appealing design
• room for growth→ less frequent visits, no need to make newer braces and thus reduce cost, avoid ?? nerve (beneath: where corrective force is exerted; above: better); however, more space means less control and less fitting

3. take technician out of the equation→ reduce medical expertise required in the fabrication process and thus lower the cost

• expertise needed for scanning and making adjustments to make sure the brace is working appropriately
• now: the shells are contoured to the shape of the bones and the upright is bent in order to align the shells
• metal bending is becoming a dying art; adds to cost→ off-the-shelf components (esp. straight aluminum upright) are to be attached directly to the customized shells while maintaining the straight alignment of the brace→ protruding rectangular platform

4. appropriate material to maximize comfortability

• 90% polypropylene (rigidity) and 10% polyethylene (flexibility)
• light, portable, doesn’t cause skin breakdown
• conditionally malleable? 4D printing: becomes bendable when heat is applied→ change shape to accommodate growth   click

5. 3-point pressure system

• Davis’ and Wolff’s laws of tissue adaptation and bone remodeling: inhibited growth where pressure is exerted
• exert pressure on the proximal, lateral side of tibia
• pressure sensor & alert system
• How tight should the straps be pulled? → make the call based on feeling (loosen the straps when a bruise/blister/open wound results)
• design a longitudinal study to investigate…

-How much pressure is required to correct the Q angle formed by the axises of the femur and the tibia?
-What is the threshold pressure value below which the kafo is no longer effective?
-Does this pressure correlate with age (critical window: 18-30 months) ?

• place a pressure sensor on lateral side of tibial shell to measure much pressure is applied when the strap below the knee is pulled this tight
• color lights indicating how tight the strap is pulled:

-red light signals too little pressure→ pull tighter
-green→ within the pressure range
-yellow→ too tight