1. Doug Follmer Shubhra Kochar Lauren Levey Adam Zurmehly K-Air FOrce

2. Outline  Clinical evaluation  Initial design process  Design procedure  Device evaluation and testing  Device demonstration  Future recommendations  Acknowledgements

3. Spinal Cord Injuries  Affect neuromuscular and sensory function below level of injury  ~12,000 new injuries per year  Shorter life expectancy, higher cost of living

4. Rehabilitation  4-6 months of outpatient therapy  Maintaining and building muscle strength  Knee-Ankle-Foot Orthotics  T-6 injuries and below  Home mobility  Highly Customized  Acceptance Rate  2008 Article: 58-79% abandoned  40% of remaining users express dissatisfaction http://www.cascade- usa.com/products/ORTHOTICS/LOWER%20EXTREMITY%20ORTHOTICS/FRACTURE%20BRACES/MARAME D%20TIBIA%20FRACTURE%20BRACE%20S-SERIES.aspx

5. Project Definition  Adjustable KAFO for clinical diagnosis  Design Requirements  Leg size and height adjustments  Ankle Support  Ability for knee flexion  Comfort  Fatigue Resistance Image: Picture of KAFO padding

6. Design Idea Process

7. Initial Design  Thigh: three piece design  Shank: two piece design  Foot plate Thermoplastics straps thermoplastics Hard plastic

8. Initial Design  Telescoping- steel and Titanium rods  Knee and Ankle joints- Ultraflex

9. Design Process  Re-evaluation of components in terms of strength, stability, machinability, adjustability and weight.  More research  Limitations in available components  New ideas  Carbon fibers  Revisited the previous ideas  Improvisation of initial design

10. Final Design  Thigh and shank:  One piece design with air pockets and padding

11. Final Design  Knee and Ankle joints Knee-joint Orthoamerica Ankle-joint OTS Corp Carbon fiber foot Solid Stirrup

12. Final Design  Telescoping:  Continuous mechanism  Adjustment between knee and thigh and shank and ankle

13. Design Procedure

14. Thermoplastic Plaster Bandages Plaster of Paris Mold EWI Oven (~ 195 ˚ C ) Thermoplastic (~ 9 min) Positive Mold of the Thigh

15. Carbon Fiber Mold ReleaseEpoxy ResinHardener Assembly Carbon Fiber Feet: Left - First Attempt Right - Second Attempt

16. Metal Rods/Telescoping Aluminum Rod: Top View Aluminum Rod: Side View Machined Bracket for Telescoping

17. Air Pocket Fabrication Air Cast EWI: OSU Welding Engineering Division - Plastic Welding

18. Assembly Padding / VelcroAnkle JointVelcro Final KAFO - Side View Final KAFO - Front View

19. Device Evaluation and Testing

20. Review of Requirements What’s Important  Knee Joint  Ankle Joint  Height/Diameter Adjustment  Padding  Straps Key Areas  Support  Stability  Adjustability  Comfort  Weight  Cost

21. Patient #1: Ben Height: 6’1” Injury: L1 incomplete

22. Evaluation  Patient #2: Perry  Height: 5’9”  Injury: T10-T11 Complete

23. Demonstration Aircells Padding Carbon Fiber Foot Orthomerica Knee Joint OTS Orthotics Ankle Joint Thermoplastic

24. Future Recommendations  Non-riveted Velcro strap  Knee Joint alterations  Lock in extension  More strength in bolts  Shank adjustment  Carbon Fiber Foot  Screws Protruding  Tools  Orthotist

25. Acknowledgements  Dr. David Lee- Machine Shop, Mentor  Dr. Mark Ruegsegger- Mentor  Heather Loge- D.Physical Therapist, Clinician Mentor  Melissa Aston- Physical Therapist, Testing advisor  Rowan, Ben, and Perry- Patients, Test Subjects  North Sea Plastics- Thermoplastic Donation  OrthoMerica- Knee Joint Donation  Kirk Cooper, EWI- Thermoplastic forming  Dr. Avraham Benatar, OSU: MSE- Plastic Air Pocket Welding  Ryan- Scott Labs Machine Shop  Rowan, Ben, and Perry- Patients, test subjects  Jerry, Hanger Orthopaedics- Ankle Stirrup bending  Bruce Chase- Carbon Fiber advice  Rob Kapaku- Team Name Punnery

26. QUESTIONS?

27. Resources  Otto, Judith Phillipps. “The Stance Control Orthosis: Has Its Time Come?” The O&P Edge. Online article