e30 SOFMER 2016 / Annals of Physical and Rehabilitation Medicine 59S (2016) e25–e33
The factors of good compliance are continence and auton-
omy regarding the introduction of the catheter. Nevertheless,
self-catheterization can be difficult because of the usual short-
comings associated with bladder and sphincter disorders (motor,
sensory...).
We found only one study about one adaptive equipment to facilitate
the gesture for monoplegic patients.
Observations This case report concerns a 53-years-old man, left
brachial amputated in 1987 because of a motorbike accident asso-
ciated with primitive progressive multiple sclerosis since 1996. He
has an overactive bladder syndrome and dysuria because of a detru-
sor sphincter dyssynergia and overactive detrusor. Treatments by
alpha bloquants then TENS on the tibial posterior nerve and finally
neuromodulation of the posterior sacral roots did not succeed.
The indication of self-catheterization was chosen and the patient’s
education was organized in Physical Medicine and Rehabilitation
unit in University Hospital of Rangueil.
The team of therapists has manufactured adaptive equipment to
enable the learning of intermittent self-catheterization despite his
amputation. It consists in the realization of a thermo-formed plastic
penile support, with a central channel to support the penis and a
curved base on both sides for holding the device between the thighs.
It was a success and the patient was able to independently urinary
catheterism with one hand while the device correctly maintained
his penis.
Discussion/Conclusion Three months later, he no longer needed
this assistance.
To conclude, it can be conclude that a multidisciplinary
management allowed a monoplegic patient to acquire the self-
catheterization technique, avoiding him to undergo surgical
treatment.
Disclosure of interest The authors declare that they have no com-
peting interest.
http://dx.doi.org/10.1016/j.rehab.2016.07.069
PO06
Articulated vs. fixed carbon-fiber
prosthesis in individual with partial
foot amputation: Study case
Marie Laberge-Malo
1,*
, Reggie C. Hamdy
4
, Laurent Ballaz
3
,
Audrey Parent
2
, Annie Pouliot
3
1
CHU Sainte-Justine, Médecine Physique et Réadaptation, Montréal,
Canada
2
École Polytechnique, Département de Génie Biomédical, Montréal,
Canada
3
Université du Québec à Montréal, UQAM, Montréal, Canada
4
Hôpital Shriners pour Enfants, Montréal, Canada
*
Corresponding author.
E-mail address: marie laberge@ssss.gouv.qc.ca (M. Laberge-Malo)
Objective Toe filler combined to ankle-foot orthosis (AFO) can
be used to improve gait after a partial foot amputation. The AFO
supports the plantar aspect of the foot, and the toe filler gives a
longer lever arm that helps for pivoting over the lost metatarsals.
However, the AFO type can influence gait parameters.
The objective of this study case was to evaluate the effect of pros-
thesis with toe filler combined to:
– an articulated AFO;
– a fixed carbon-fiber AFO on gait.
Patients and methods A gait analysis was practiced on a 20-year-
old male with a partial foot amputation.
Kinematic and kinetic data during walking, gait efficiency (Energy
Expenditure Index), and postural control were evaluated in both
conditions.
Results An improved ankle power was observed at toe-off with
the fixed carbon-fiber AFO. Moreover, spatiotemporal gait param-
eters were more symetrical with the fixed carbon-fiber AFO. Gait
efficiency was higher with the fixed carbon-fiber AFO compared to
the articulated one.
Discussion/Conclusion The fixed carbon-fiber AFO improves ankle
kinematic and kinetic during walking and results in an improve-
ment of walking efficiency in this participant with partial foot
amputation.
Disclosure of interest The authors declare that they have no com-
peting interest.
http://dx.doi.org/10.1016/j.rehab.2016.07.070
PO07
Modelisation of the action of
compression bandages on the lower
limb
Fanette Chassagne
1,*
, Pierre Badel
1
, Reynald Convert
2
,
Pascal Giraux
3
, Jérôme Molimard
1
1
École des Mines, Centre Ingénierie Santé, Saint-Étienne, France
2
Thuasne, Levallois-Perret, France
3
CHU, Médecine Physique et de Réadaptation, Saint-Étienne, France
*
Corresponding author.
E-mail address: fanette.chassagne@emse.fr (F. Chassagne)
Objective Compression bandages are commonly used in the
treatment of some venous or lymphatic pathologies. The success
of the treatment relies on the applied pressure, which depends
on several parameters, especially the bandage properties but also
patients’ morphology.
A previous experimental study showed that considering only
patient’s morphology and bandage elastic properties were not suffi-
cient to explain interface pressure distribution. However, these two
parameters are the only one taken into account in Laplace’s Law,
current standard method to explain interface pressure distribution.
The objective of the study is to characterize and model compression
bandages pressure generation mechanisms.
Material and methods A patient-specific numerical simulation
of 4 bandages application [Biflex
®
16 and Biflex
®
17 (Thuasne)
applied with 2 and 3 layers on the leg] was developed for 5 sub-
jects. The inputs of this simulation are the subjects’ morphology,
the bandage’s and soft tissues’ elastic properties and the application
technique.
The results of this simulation were then confronted to the experi-
mental results and pressure values computed with Laplace’s Law:
P = nT/r, with P the pressure [N/mm
2
], n the number of layers, T the
bandage tension [N/mm] and r the local radius of curvature [mm].
Results The numerical simulation provides the complete pres-
sure distribution over the leg but also considers the deformations
of the leg, induced by bandage application. The comparison with the
results given by Laplace’s law highlighted the influence of these leg
geometry changes on the applied pressure.
However, the 4 parameters considered in this simulation (leg
morphology and deformations, bandage elastic properties and
application technique) are not sufficient to completely explain
pressure generation, and differences with the experiments still per-
sist.
Discussion/Conclusion Numerical simulation still needs to be
enriched to consider other parameters which may impact interface
pressure such as bandage to bandage interaction for example.
Disclosure of interest The authors declare that they have no com-
peting interest.
http://dx.doi.org/10.1016/j.rehab.2016.07.071
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