1St International Conference on Orthotics and Prosthetics (Icop 2019) 20Th -21St November 2019 UOW Malaysia KDU, Utropolis, Glenmarie Shah Alam

st 1 International Conference on

Orthotics and Prosthetics (iCOP 2019)

“Empowering Disability Through Technology”

20th -21st November 2019 Auditorium, UOW Malaysia KDU Utropolis, Glenmarie

In Partnership with

Sponsored by Supported by

1st International Conference on Orthotics and Prosthetics (iCOP 2019) 20th -21st November 2019 UOW Malaysia KDU, Utropolis, Glenmarie Shah Alam

Contents

Welcome Message ...... 2 Committees ...... 3 Information ...... 4 Conference Programme ...... 5 Keynote Speakers ...... 7 Invited Speakers ...... 12 Abstracts ...... 17 Sponsor ...... 33 Exhibitors ...... 34

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 1

Welcome Message

The 1st International Conference on Orthotics and Prosthetics (iCOP 19) is a collaboration between reputable universities such as Universiti Putra Malaysia (UPM), University of Malaya (UM), KDU University College (KDUUC), Universiti Teknologi MARA (UITM), University of Bath and International Society for Prosthetics and Orthotics (ISPO) that aims to create a platform to share experiences, build partnerships and explore innovative solutions for the benefit of patients and the key players of engineering, technologies and industry in the field of Orthotics and Prosthetics (O & P).

The conference is themed Empowering Disability through Technology. This event will host an exhibition from industry and medicals partners which will open our eyes to new technologies, new possibilities, new solutions and new opportunities in the development of O&P products and services. In fact a breakthrough research has been done whereby the prosthetic socket that was made out of natural resources known as kenaf is displayed here.

ORTHOTICS AND PROSTHETICS TODAY It is a pleasure for me to be here this morning and have the opportunity of sharing with you some views regarding the current status of the orthotics and prosthetics. For your kind information there are too few service providers to provide adequate service to the ever- increasing handicapped population. This results all too frequently in undue delay in fitting patients with artificial limbs or orthotic devices. It also tends to lower the quality of appliances provided, in that the demands of time alter the care and skill of fabrication. I think that there will be little disagreement that more manpower is needed in the field. The following possible solutions to this problem exist. Thus, an intensive and organized effort to attract intelligent young men into the profession is needed. This should be an all-out effort conducted as a function of our national organization and extending into all areas of the country. Young generation at every university or college in the nation should be made aware of the fascinating potentials which exist in this profession, being as it is, a common merging ground for the sciences of medicine and engineering.

Thanking the iCOP 2019 PARTICIPANTS & COMMITTEE I would like to take this opportunity to express my heartfelt thanks to all the participants, keynote speakers and exhibitors for your very active participation and support. Besides that, I sincerely appreciate iCOP2019 committee members especially from KDU (Dr Praveena, Dr Tan Sin Jin, Dr Cheng Xiau San, Ts Nagentrau, Mr Kenneth, Mr Dzulhelmy) for their dedication and commitment towards the success of the 1st International Conference on Orthotics and Prosthetics (iCOP 19). Your work is truly commendable. I sincerely hope that you will enjoy the 1st International Conference on Orthotics and Prosthetics (iCOP 19) through the scientific exchanges you engage in.

With best wishes for a successful Conference, Assoc. Prof. Ir. Ts. Dr. Mohamed Thariq bin Haji Hameed Sultan Chairman International Conference on Orthotics and Prosthetics (iCOP 19)

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 2

Committees

Chairman Assoc. Prof. Ir. Ts. Dr. Mohamed Thariq bin Haji Hameed Sultan, UPM Co-Chair Dr. Sivajothi Paramasivam, UOW Malaysia KDU Co-Chair Dr. Nooranida binti Arifin, UM Secretary Dr. Praveena Nair Sivasankaran, UOW Malaysia KDU Treasurer Dr. Kenneth Fung Hon Ngen, UOW Malaysia KDU Head of Publication Dr. Mohammad Jawaid, UPM Head of Sponsorship Ts. Nagentrau Muniandy, UOW Malaysia KDU Head of Promotion Dr. Alireza Zourmand, UOW Malaysia KDU Head of Multimedia Mohamad Dzulhelmy bin Amari, UOW Malaysia KDU Head of Logistics Dr. Cheng Xiau San, UOW Malaysia KDU Head of Technical Dr. Tan Sin Jin, UOW Malaysia KDU Program

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 3

Information The 1st International Conference on Orthotics and Prosthetics 2019 (iCOP2019) warmly welcomes academics, industry leaders and students to a 2 day conference focusing on new advancements in the field of limb prosthetics, robotics and related disciplines. With the theme, "Empowering Disability through Technology", iCOP2019 seeks to gather key stakeholders in the field and promote knowledge sharing and collaboration.

Conference Venue Auditorium, Level 3A, UOW Malaysia KDU

Speakers Presentation Venue Auditorium, Level 3A, UOW Malaysia KDU Discovery Circle 1, Level 2, UOW Malaysia KDU Discovery Circle 2, Level 2, UOW Malaysia KDU

Conference Identification Tag All participants will be issued with conference identification tag upon registration. All participants are expected to wear the tag at all times.

Refreshment and Lunch Refreshment and lunch will be served outside Auditorium.

Muslim Prayer Room/Surau The prayer rooms are located at Ground Floor.

Certificate for Oral Presenters Oral presenters will receive a certificate of presentation from the session chair after their presentations or at the end of the session.

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 4

Conference Programme

End

Break

Lunch

Agenda

BioAapps

Registration Registration

MOU signing MOU

Photo session Photo

(iCOP2019)

Invited speaker 2 speaker Invited

Invited speaker 1 speaker Invited

Keynote speech 2 speech Keynote

Keynote speech 1 speech Keynote

Welcome remarks Welcome

(Ms.Asliza Ahmad)

Developing and Testing an Interface Pressure Pressure Interface an Testing and Developing

Seating Foot Press Gymnasium Supporting for Press Supporting Gymnasium Foot Seating

(Prof Gursel Alici, UOW) Alici, Gursel (Prof

Development Of OrthoticsDevelopment Customised Insole

A Comparative Analysis between Conventional Conventional between Analysis A Comparative

Opening ceremony by Minister Minister by ceremony Opening

Wednesday, 20 Novermber Wednesday, 2019

Modern Trends in Robotic Surgery Robotic in Trends Modern

ISPO’s Vision,ISPO’s Status Mission Current and

(Dr. Nooranida & Prof Kazuhiro Sakai, ISPO) Sakai, Kazuhiro Prof & Nooranida (Dr.

Dr. Alpha Agape Gopalai, Monash University Monash Gopalai, Agape Alpha Dr.

Technology: Analysis OfAnalysis Materials ABS TPU And Technology:

using Pressure Distribution and Additive Manufacturing Manufacturing Distribution Additive Pressure and using

4) 20191114:

Control Control System Socket Prosthetic 3Din Transtibial Printed

3) 20191103:

Orthosis

Manufacturing and Additive Manufacturing of Ankle-Foot of Ankle-Foot Manufacturing Additive and Manufacturing

2) 20191105:

and Rapid Drop Analysis Rapid and

Rehabilitation People: Improvement of time, Comfortability Improvement of time, People: Rehabilitation

1) 20191112:

Session chair: Dr. Natiara, UiTM Natiara, Dr. chair: Session

Venue: Discovery Circle 2, Level 2 2, Level Circle Discovery Venue:

Oral presentations Oral

(Assistant Professor Dr. Mohamed Khan Afthab Ahamed Khan, UCSI) Khan, Ahamed Afthab Khan Mohamed Dr. (AssistantProfessor

1st International Conference on Orthotics and Prosthetics and Orthotics on Conference International 1st

Wearable Technology: Assisting Rehabilitation, Improving Quality ofLife Quality Improving Assisting Rehabilitation, Technology: Wearable

(Assoc. Prof. Ir. Ts. Dr. Mohamed Thariq bin Haji Hameed Sultan, Chairman) Sultan, Hameed Haji bin Thariq Ts. Ir. Mohamed Dr. (Assoc.Prof.

(YBM. Tengku Zulpuri Shah bin Raja Puji, Deputy Minister of Water, Land and Natural Resources) Natural and Land Water, of Minister Deputy Puji, Raja bin Shah Zulpuri Tengku (YBM.

Contact Pressure in The Chêneau Brace in Patients with Double-Curve Adolescent Idiopathic Scoliosis Idiopathic Adolescent Double-Curve with Patients in Brace Chêneau Pressure The in Contact

Soft Robotics for Prosthetic Devices; Can Soft Robotics Bring Prosthetic Devices One-step Closer to Their Natural Counterparts? Natural Their Closer to Devices One-step Prosthetic Bring SoftRobotics Can Devices; for Prosthetic SoftRobotics

Review of Actuators in Foot/Ankle Rehabilitation Rehabilitation Review of Actuators Foot/Ankle in

Variable Stiffness toInterface Variable Shape and

The Influence of Manganese Oxide on the on Oxide of Manganese Influence The

Fabrication of Stewart by Fabrication Actuated Platform

Therapy

4) 20191102:

Improve Improve Comfort Orthosesin Prostheses and

3) 20191109:

Densification and Mechanical Properties of 3Y-TZP Properties ceramic Mechanical and Densification

2) 20191106:

Pneumatic Artificial Muscle for Foot/Ankle Rehabilitation for Muscle Foot/Ankle Artificial Pneumatic

1) 20191101:

Ahamed Khan, UCSI Khan, Ahamed

Session chair: Assistant Professor Dr. Mohamed Khan Afthab Afthab Khan Mohamed Dr. Assistant Professor chair: Session

Venue: Auditorium, Level 3A Level Auditorium, Venue:

Oral presentations Oral

Time

4.45pm

3.454.45 pm- pm

3.153.45 pm- pm

2.45 3.15 pm- pm

2.152.45 pm- pm

1.30 2.15 pm- pm

12.30 1.30 pm- pm

12.0012.30am - pm

11.1512.00am - pm

11.0011.15am - am

9.3011.00am - am 9.009.30 am - am

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 5

Surface Electromyography Signal SurfaceElectromyography

Artificial Heart Valves: A Review Review ArtificialA Valves: Heart

EEG-based Brain Wave Controlled Controlled Wave Brain EEG-based

on the Materials and ProcessesInvolved Materials and the on

3) 20191116:3)

forControl Artificial Hand

2) 20191116: 2)

Intelligent Prosthetic Arm Prosthetic Intelligent

1) 20191115:1)

Session chair: Ms. Farah Syazwani, UPM Syazwani, Ms. Farah chair: Session

Venue: Discovery Circle 1, Level 2 1, Level Circle Discovery Venue:

Oral presentations Oral

End

Break

Socso

Break

Lunch

(Ossur)

Agenda

Flash talk Flash

Keynote 4 Keynote

Keynote 3 Keynote

Registration Registration

Closing remarks Closing

Invited speaker 4 speaker Invited

Invited speaker 3 speaker Invited

(Mr. Kenneth Tan) Kenneth (Mr.

The Influence of the Transtibial Prosthetic Prosthetic Transtibial ofthe Influence The

Foot Lax: A Web-based Tool for Self- Tool Web-based A Lax: Foot

(Endolite & Mr. Gary) Mr. & (Endolite

(Sponsor & Exhibitors) & (Sponsor

Development of Counter Balance Arm Sling Balance ofCounter Development

Dr. Chan Bee Ting, UCSI Ting, Bee Chan Dr.

(Dr. Chan Chow Khuen, UM) Khuen, Chow Chan (Dr.

Conference Certificates Giving Certificates Conference

Thursday, 21 November Thursday, 2019

Biomechanics in a Diseased Heart Diseased a in Biomechanics

(Mr. Chong Wei Tatt & Mr. Khairul) Mr. & Tatt Wei Chong (Mr.

Sharing Session from Prosthetic Users Prosthetic from Session Sharing

(Assoc. Prof. Ir. Dr. Irraivan Elamvazuthi, UTP) Elamvazuthi, Irraivan Dr. Ir. (Assoc.Prof.

Length on Gait Pattern and Walking Stability Walking and Pattern Gait on Length

3) 20191108:3)

Rehabilitation People Rehabilitation

CBAS Assistive CBAS for Device Hemiparesis Post-Stroke

2) 20191113:2)

management ofBunions management

1) 20191111:1)

Session chair: Dr. Chan Chow Khuen, UM Khuen, Chow Chan Dr. chair: Session

Venue: Discovery Circle 2, Level 2 2, Level Circle Discovery Venue:

Oral presentations Oral

Perspectives on Emerging Innovative Rehabilitation Technologies Rehabilitation Innovative Emerging on Perspectives

(Assoc. Prof. Ir. Ts. Dr. Mohamed Thariq bin Haji Hameed Sultan, Chairman) Sultan, Hameed Haji bin Thariq Ts. Ir. Mohamed Dr. (Assoc.Prof.

(Dr. Saari Mohamed Yatim, Head of Rehabilitation Department at Hospital Serdang) Hospital at Department Rehabilitation of Yatim,Head Mohamed Saari (Dr.

Computational Biomechanics and Musculoskeletal Modeling in Quantifying Human Movements due to Different Factors Different Factors to due Movements Human Quantifying in Modeling Musculoskeletal and Biomechanics Computational

A New Personalised Liner with Embedded Embedded with Liner Personalised New A

The Effects of Prosthetic Knee Joints in Joints Knee Effectsof Prosthetic The

Modified Adjustable Ankle Foot Orthosis Foot Ankle ModifiedAdjustable

(YBhg. Prof. Dato' Dr. Muhammad Fauzi Mohd Zain, Director, Institutions of Higher Education Research Excellence Division (BKPI), Department of Higher Education, MoE) Education, Higher of (BKPI), Department Division Excellence Research Education Higher of Institutions Zain,Director, Mohd MuhammadDato'Dr.Fauzi (YBhg.Prof.

TransfemoralAmputees

Walking and Dual-task Activity Performance in Performance Activity Dual-task and Walking

3) 20191104:3)

Amputees

Temperature and HumiditySensors Limb for and Lower Temperature

2) 20191110: 2)

Flexion Contracture In Spastic Hemiplegic CerebralPalsy Hemiplegic Spastic In Contracture Flexion

Following Botulinum Toxin A Injection To Reduce Plantar- Reduce To Injection A Toxin Botulinum Following

1) 20191107:1)

Session chair: Dr. Ting Chen Hunt, UTAR Hunt, Chen Ting Dr. chair: Session

Venue: Auditorium, Level 3A Level Auditorium, Venue:

Oral presentations Oral

Time

5.15pm

5.005.15 pm- pm

4.305.00 pm- pm

3.454.30 pm- pm

3.153.45 pm- pm

3.003.15 pm- pm

2.453.00 pm- pm

2.152.45 pm- pm

1.302.15 pm- pm

12.30 1.30 pm- pm

12.0012.30 pm- pm

11.0012.00am - am

10.3011.00am - am

10.1510.30am - am 9.3010.15am - am 9.009.30am - am

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 6

Keynote Speakers

Prof. Gursel Alici

School of Mechanical, Materials, Mechatronic and Biomedical Engineering Applied Mechatronics and Biomedical Engineering Research (AMBER) Group ARC Center of Excellence for Electromaterials Science (ACES) University of Wollongong, 2522 NSW, Australia

Prof. Gursel Alici received his BSc degree in Mechanical Engineering from Middle East Technical University, Turkey, in 1988, and Ph.D. degree in Robotics from the Department of Engineering Science, Oxford University, Oxford, U.K., in 1994. He is currently a Senior Professor at the University of Wollongong, Wollongong, Australia, where he is the Head of the School of Mechanical, Materials. Mechatronic and Biomedical Engineering since 2011. His research interests are soft robotics, system dynamics and control, robotic drug delivery systems, novel actuation concepts for biomechatronic applications, robotic mechanisms and manipulation systems, soft and smart actuators and sensors, prosthetic devices, and medical robotics. He has generated more than 350-refereed publications and delivered numerous invited seminars and keynote talks on his areas of research.

Prof. Gursel Alici was a Technical Editor of the IEEE/ASME Transactions on Mechatronics during 2008–2012. He is a Technical Editor of the IEEE Access, the first IEEE open access journal with interdisciplinary scope. He has served on the international program committees of numerous IEEE/ASME International Conferences on Robotics and Mechatronics. He was the General Chair of the 2013 IEEE/ASME International Conference on Advanced Intelligent Mechatronics held in Wollongong, Australia. He is the leader of Soft Robotics for Prosthetic Devices theme of the ARC Center of Excellence for Electromaterials Science. He received the Outstanding Contributions to Teaching and Learning Award in 2010, the Vice-Chancellor’s Interdisciplinary Research Excellence Award in 2013, and Vice-Chancellor’s Award for Research Supervision in 2018 from the University of Wollongong. He has held a visiting professorship position at Swiss Federal Institute of Technology, Lausanne (EPFL) (2007, 2010), City University of Hong Kong (2014), University of Science and Technology of China (USTC) (2015), and University of British Columbia, Canada (2019).

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 7

Soft robotics for prosthetic devices; can soft robotics bring prosthetic devices one- step closer to their natural counterparts?

Although there is no universally agreed definition for robotics, we define robotics as the science and engineering of reprogrammable, multi-functional, multi-purpose and versatile systems and devices intelligently linking sensing to action in order to undertake a diverse range of tasks. This definition can be extended to soft robotics as the science and engineering of the robots primarily made of soft materials, components and monolithic active structures such that these soft robots can safely interact with and adapt to their environment better than the robots made of hard components. Soft robotics offers unprecedented solutions for applications involving safe interaction with humans and objects, and manipulating and grasping fragile objects, crops and similar agricultural products. Further, the progress in soft robotics will have a significant impact especially on medical applications such as wearable robots, prosthetic devices, assistive devices, and rehabilitation devices. Soft materials with programmable mechanical, electrical and rheological properties, and conformable to additive manufacturing based on 3D printing are essential to make soft robots. We should also re-visit current robotics concepts to establish new design/manufacturing/modelling/control principles for soft robotic systems.

In this talk, we aim to update on where we are in soft robotics to build prosthetic hands with features that will bring them one-step closer to their natural counterparts. The history of prosthetic hands dates back to 202 BC. Since then, significant efforts have been dedicated to the development of prosthetic hands. The primary features of a prosthetic hand should be to receive and identify its user’s intention noninvasively, and equally importantly send sensory feedback about its “state” to its user noninvasively in order to help “restore normality” for its user. The communication between a prosthetic device and its user (i.e., human-machine interface) has been a challenging research problem. We will also present the progress we have made in the research theme of soft robotics for prosthetic devices and the establishment of a fully 3D printed transradial prosthetic hand at our research center, ACES, at University of Wollongong.

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 8

Prof. Kazuhiro Sakai ISPO Executive Board Member Prosthetics and Orthotics Director University of Human Arts and Sciences, Japan

Prof. Kazuhiro Sakai is a Professor in the Department of Rehabilitation, University of Human Arts and Sciences, Japan. He has been involved in the Prosthetics and Orthotics industry and academia since 1987 and has more than 30 years of experience in both Japan and Thailand. Professor Sakai currently serves as an Executive Board Member of the International Society for Prosthetics and Orthotics and Vice President of the Japanese Society for Prosthetics and Orthotics.

ISPO’s Vision, Mission and Current Status

The International Society for Prosthetics and Orthotics (ISPO) was founded as a non- governmental organisation (NGO) in 1970, in Copenhagen, Denmark. For almost 50 years, ISPO has provided an effective platform for the exchange and communication on all aspects of the science and practice associated with the provision of prosthetic and orthotic care, rehabilitation engineering and related areas. ISPO’s mission is to improve the quality of life for persons who may benefit from the rehabilitation practice of prosthetic, orthotic, mobility and assistive technology by:

 Promoting multidisciplinary practice  Facilitating professional education to provide quality care  Promoting research and evidence-based practice  Facilitating innovative and appropriate technology development  Fostering international collaboration and consensus  Facilitating knowledge exchange

ISPO is also a global organization which has 74 member societies (2019), over 3,100 members, represented in 101 countries.

In my Keynote, I would like to share with audience on ISPO’s vision and mission as well as ongoing activities.

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 9

Dr. Saari Mohamad Yatim Head of Rehabilitation Department Hospital Serdang, Malaysia

Dr. Saari Mohamad Yatim is a Consultant Rehabilitation Physician and Head of Rehabilitation Department at Hospital Serdang. He also serves as the Selangor State Advisor of Rehabilitation Medicine Services and as Deputy National Head Advisor of Rehabilitation Medicine Services, Ministry of Health Malaysia. Dr Saari’s area of expertise are in Cardiopulmonary Rehabilitation and Amputee Rehabilitation. He also sits as an Executive Board Member of the Asia-Oceanian Society of Physical & Rehabilitation Medicine.

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 10

Assoc. Prof. Ir. Dr. Irraivan Elamvazuthi Dept of Electrical & Electronic Engineering Universiti Teknologi PETRONAS, Malaysia

Assoc. Prof. Ir. Dr. Irraivan Elamvazuthi obtained his PhD from the Department of Automatic Control & Systems Engineering, University of Sheffield, UK in 2002. Currently, he is an Associate Professor at the Department of Electrical and Electronic Engineering, Universiti Teknologi PETRONAS (UTP). Before joining UTP, he has worked at University Kuala Lumpur, Standards and Industrial Research Institute of Malaysia (SIRIM) and UMW Industrial Pzower. His research interests include Control & Systems Engineering with focus on Robotics, Bio-Medical, Energy and Optimization. He is a member of IEEE, IEEE Robotics & Automation Society (RAS) and IEEE Control Systems Society. He is currently the chair of IEEE Robotics & Automation Society, Malaysia Chapter.

Perspectives on Emerging Innovative Rehabilitation Technologies

Stroke is the primary cause of disability in many countries. The goal of rehabilitation is to assist stroke patients to achieve and to maintain quality of life. In this regard, the development of exoskeletons has ushered new era aimed at optimizing restoration of quality of life to those who are physically debilitated. In this talk, perspectives on emerging innovative rehabilitation technologies would be presented. The benefits of these technologies on the patients and caregivers would be elucidated.

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 11

Invited Speakers

Ms. Noor Asliza Ahmad BioApps Sdn Bhd University Of Malaya Medical Centre Kuala Lumpur, Malaysia

Contact Pressure in The Chêneau Brace in Patients with Double-Curve Adolescent Idiopathic Scoliosis

The Chêneau brace has proven its effectiveness in treating the Adolescent Idiopathic Scoliosis (AIS) patient. However, no studies reported on the analysis of contact pressure in double curve AIS patients. In this study, we evaluated the contact pressure of the Chêneau brace action in double curve AIS patient treatment. A total of 72 (60 girls and 12 boys) patients aged 10 years and above recruited in the study. The F-socket transducers (9811E) were used to evaluate the pressure on the right thoracic and left thoracolumbar curves between normal and maximum strap tension and variation of these contact pressure with other tasks. Each patient was asked to do nine different tasks corresponding to daily activities and the contact pressures for each activity were recorded for both normal and maximum tension. The resultant Mean Peak Pressure (MPP) in double curve AIS was higher for right thoracic curve than left thoracolumbar curve in all tasks. The pressure significantly increased at the task of maximal inspiration (p < 0.0001) for both types of curves for normal and maximum tension. The degrees of correction for the thoracic and thoracolumbar curves were 23.2% and 34.5% respectively, after 6 months of brace use (23 h per day). Hence, we could not find any substantial correlation between MPP in standing position and degree of scoliosis correction for two curves having r = 0.158, p = 0.356 and r = -0.024, p = 889 values.

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 12

Assistant Professor Dr. Mohamed Khan Afthab Ahamed Khan Faculty of Engineering, Technology & Built Environment UCSI University Kuala Lumpur, Malaysia

Modern Trends in Robotic Surgery

Over two decades Robotic surgery has been around, and has been a revolutionary step in improving not only in health care medical technology but also in surgical procedures. The application of robotics in medical health care procedures and other surgical applications has become common place in the past decade. Robotic surgery now days are widely accepted across the globe, the drive to provide simpler, more efficient and economical equipment is driving researchers to reach new heights. Robotic surgery has been successfully implemented in several hospitals around the globe and has received worldwide acceptance. Medical Robotics not only enhances non-invasive or minimally invasive surgical procedures it eliminates or decreases technical difficulties faced by clinicians and also offers less pain and discomfort for patients. The most important fact is it lower surgical and hospitalization costs. The focus of this talk is to provide a review of the latest robotic surgical technology and the new challenge for surgeons and engineer, classify and compare the surgical robotic systems and discuss their future directions.

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 13

Dr. Chan Chow Khuen Department of Biomedical Engineering Faculty of Engineering University Malaya, Malaysia

Computational Biomechanics and Musculoskeletal Modeling in Quantifying Human Movements due to Different Factors

Speed and depth are essential in assessing health deterioration. Nevertheless, characterizations of these conditions are often inconsistent due to different methodologies. Speed-related gait assessments particularly are often experimented on the treadmill instead of over-ground, which is incomparable. Moreover, the effects of advancing age in mobility have not been fully understood. This study, therefore, focuses on the speed and depth effects in overground forward (FW) and backward (BW) walking, and squatting among the young and elderly individuals. Altering speeds necessitate varying efforts from the hip and ankle during FW and BW, and hip and knee during squatting. Faster speed adapts more slow-twitching fibers, and vice versa. Speed increment elevates the muscle force, which is affected by muscle velocity. Deeper squat enhances slow-twitching fiber adaptation. This study serves as the benchmark measurements for pathological and abnormality gait assessment and comparison.

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 14

Dr. Alpha Agape Gopalai Mechatronics Engineering School of Engineering Monash University, Malaysia

Wearable Technology: Assisting Rehabilitation, Improving Quality of Life

We are no stranger to wearable technology, from the simple heart rate sensor or sleep quality monitors to highly advanced smart watches. No matter how dependent our lives have become on these tech, they were still concepts and prototypes in laboratories 10 years ago. These developments are all a result of advancements made in the field of measurements, processing and storage which has made wearable tech an alluring field to study. Measuring has never been so small that it could be worn comfortably on the body and around the clock, providing opportunities for medical breakthroughs. We're moving closer to making reliable healthcare products that are useful, desirable and practical for people.

As global mortality rate decreases, we see increasing stress being applied on the healthcare and social well-being ecosystems. It is a common problem globally that there isn’t enough support staff to meet the demands in these systems. It is with this in mind that we at the Human Motion and Rehabilitation Lab, Monash University believe that wearable devices will play a pivotal role in elevating stresses in these ecosystems. We present, three stages of wearables and their potential in the many different aspects of life typically: (1) Rehabilitation, (2) Physio-therapy, and (3) Periodical Monitoring.

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 15

Dr. Chan Bee Ting Faculty of Engineering, Technology & Built Environment UCSI University Kuala Lumpur, Malaysia

Biomechanics in a Diseased Heart

Cardiovascular heart disease recorded the highest mortality worldwide. Among patients who have undergone lower extremity amputation as a result of peripheral artery disease, the prevalence of concomitant cardiovascular heart disease was reported to be as high as 75 percent. Early detection of cardiovascular heart disease improves the treatment strategy and increases patients’ survival. Intracardiac blood flow dynamics has an incremental value in the evaluation of heart disease at an early stage because it changes accordingly in response to structural changes of the heart. Based on medical flow images and 3D simulation model, the heart flow pattern in fifty heart disease patients were investigated. Our study shows the abnormal blood flow pattern and vortex kinetic energy could potentially indicate heart dysfunction. In the model analysis, the strong blood flow acceleration, heart wall dyssynchrony, and vortex-wall interaction are the predominant factors leading to excessive flow energy dissipation in heart. Maladaptive intracardiac blood flow dynamics and excessive flow energetics are the compensatory mechanisms to preserve heart function at the early stage of heart disease.

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 16

Abstracts

20191101

Fabrication of Stewart Platform Actuated by Pneumatic Artificial Muscle for Foot/Ankle Rehabilitation

S.Krishnan1, Naga Privieen1, Raj kumar2, AMA Rani3, Mohamed Thariq bin Hameed Sultan4 and Girma T. Chala5

1Manipal International University, Nilai, Malaysia 2Universiti Tunku Abdul Rahman (UTAR), Bandar Sungai Long, Kajang, Malaysia 3Universiti Teknologi PETRONAS (UTP), Tronoh, Malaysia 4Universiti Putra Malaysia, Malaysia 5International College of Engineering and Management, Muscat, Oman

Corresponding email: [email protected]

Foot/Ankle injuries are amongst the most common injuries of the lower limb and almost 25,000 people experience ankle injuries each day due to vigorous activities. Traditionally, ankle injuries are rehabilitated via physiotherapy using simple equipment like elastic bands and rollers, requiring intensive efforts of therapists and patients. Currently, Stewart platform rehabilitation devices are actuated by various methods including double acting pneumatic cylinder, hydraulic, electric motor and shape memory alloy. The limitation of using these actuation methods is that it provides lower range of motions and requires higher maintenances. The objective of this study is to fabricate Stewart platform using Pneumatic Artificial Muscle to analyze the range of motion of the Foot/Ankle, and to make comparative study between the experiment and theoretical data. The diameters of PAM used were 8 mm, 10 mm and 12 mm. It was observed that stewart platform actuated by PAM of diameter of 12 mm produced maximum platform angle of 31.73°, whereas PAM with the diameter of 10 mm and 8 mm produced maximum platform angle of 28.62° and 25.31°, respectively. Experimental and theoretical results also revealed performance improvement of the current prototype as opposed to pervious study.

Keywords: Pneumatic Artificial Muscle, Stewart platform, Range of motion (ROM)

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 17

20191106

The Influence of Manganese Oxide on the Densification and Mechanical Properties of 3Y-TZP ceramic

M. L. Ting1, K. L. Chin1, H. K. Jun1, C. K. Ng2, S. Ramesh3, W. D. Teng3 and C. H. Ting1*

1 Department of Mechanical and Materials & Manufacturing Engineering, Universiti Tunku Abdul Rahman, Jalan Sungai Long, Bandar Sungai Long, Cheras, Kajang 43000, Malaysia 2 Tunku Abdul Rahman University College, Jalan Genting Kelang, Setapak, Kuala Lumpur 53300, Malaysia 3 Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia 4 Ceramics Technology Group, SIRIM Berhad, Shah Alam 40911, Malaysia

Corresponding email: [email protected]

With outstanding integration of mechanical performances and biocompatibility, 3mol% of yttria stabilised tetragonal zirconia polycrystals (3Y-TZP) ceramics is extensively fabricated as biomedical implants, especially for orthopaedic prostheses, such as femoral heads for total hip replacement. The characterisation of 3Y-TZP ceramics with excellent wear resistance, strength and fracture resistance are owing to the transformation toughening mechanism of tetragonal grains. Generally, elevated firing temperature (> 1500 oC) was required to produce 3Y-TZP bodies with promising densification through conventional sintering (CS). Consequently, grain coarsening is incurred and resulted in impairment of mechanical properties. The main weakness of 3Y-TZP ceramics is the spontaneous tetragonal to monoclinic phase transformation under humid environment, which is known as low-temperature degradation (LTD). Recently, the beneficial effect of Manganese (IV) oxide (MnO2) on 3Y-TZP sintered bodies have brought considerable attention to current researchers. MnO2, as a transitional metal oxide, that possesses lower melting point (535 oC) is effective in grain boundaries modification, which will improve the densification mechanical performances and LTD resistance of sintered 3Y-TZP ceramics at lower sintering temperatures. In present work, pure and MnO2 (0.3 wt% & 0.5 wt%) doped 3Y-TZP green bodies were prepared and subjected to CS at temperature ranges between 1200 oC – 1500 oC for an hour of dwelling time. Bulk density measurement and mechanical tests of sintered samples were conducted accordingly. It is worth to reveal that the sintered MnO2 doped 3Y-TZPs could attain > 96 % of relative densities, > 200 GPa of elastic modulus (E) and > 13 GPa of Vicker’s hardness (Hv) at firing temperature of 1250 oC which was 100 oC lower than that of sintered pure 3Y-TZP ceramics. Besides, the fracture toughness (KIc) of fired 3Y-TZP samples fell within the acceptable range of 5 MPa.m1/2 – 7 MPa.m1/2 and was unaltered by various sintering temperatures and addition of MnO2.

Keywords: 3Y-TZP, Sintering, Mechanical Properties

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 18

20191109

Variable Stiffness and Shape Interface to Improve Comfort in Orthoses and Prostheses

Linda Paternò1, Michele Ibrahimi1, Leonardo Ricotti1, Emanuele Gruppioni2 and Arianna Menciassi1

1The BioRobotics Institute, Scuola Superiore Sant’Anna, Pontedera (PI), Italy 2INAIL Centro Protesi, Budrio (BO), Italy

Corresponding email: [email protected]

Limb orthoses and prostheses usually require high tissues compression to guarantee a good fitting. However, it can lead to several dermatological problems, which are the major reported complaints by patients. This work proposes a wearable band able to change its shape and stiffness when a subject switches from a standing to a sitting position. The band is made of two variable stiffness layer jamming chambers and an interposed pneumatic chamber which actuates the device shape change. The layer jamming chambers consist of a sealed flexible bag containing sandpaper layers. In their resting state, they are highly compliant. When vacuum is applied inside, the stiffness of the chambers significantly increases. The proposed band can be wrapped around the limb. Then, the outer layer jamming chamber is stiffened and the pneumatic chamber inflated pushing the inner layer jamming chamber against the limb. Subsequently, the inner layer jamming chamber is stiffened and the outer one softened. The interposed pneumatic chamber is deflated and, consequently, the outer layer jamming chamber adapts to the inner shape. Human tests have been carried out to verify interfacial pressure changes. When the subject was standing, the band was activated. This caused a pressure increment at the interface allowing a fitting improvement. When the subject sat, the device was deactivated causing a pressure relief. The proposed variable stiffness/shape band is able to improve comfort in wearable devices by allowing pressure relief on tissues in static tasks. This may prevent skin problems due to high pressures on tissues for long periods.

Keywords: variable stiffness, variable shape, layer jamming, pneumatic actuators, wearable devices, soft robotics

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 19

20191102

A review of Actuators in Foot/Ankle Rehabilitation Therapy

Krishnan Subramaniam1, Naga Privieen1, Vishalini Sri2, Ritesh R. Bhat3, AMA Rani4, Mohamed Thariq Hammed Sultan5 and Girma T. Chala6

1Manipal International University, Nilai, Malaysia 2SMK Buntong, Perak, Malaysia 3Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India 4Universiti Teknologi PETRONAS (UTP), Tronoh, Malaysia 5Universiti Putra Malaysia (UPM), Malaysia 6International College of Engineering and Management (ICEM), Muscat, Oman

Corresponding email: [email protected]

Ankle injury is one of the physical injuries that commonly occur during physical related activities, especially in sports. Currently, there are established treatments for ankle rehabilitation at the hospital. This treatment involves range of motion exercises and endurance exercises. However, current treatment requires patients to visit to hospital frequently which is very repetitive in nature. Ankle rehabilitation robots are developed to enhance ankle strength, flexibility and proprioception after injury and promote motor learning and ankle plasticity in patients with drop foot. This article reviews the types of actuators used in ankle rehabilitation and discusses the evolution of industrial robotics towards rehabilitation.

Keywords: Pneumatics Artificial Muscle, Shape Memory Alloy (SMA), Servo Motor, Range of Motion

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 20

20191112

Seating Foot Press Gymnasium Supporting for Rehabilitation People: Analysis Improvement of time, Comfortability and Rapid Drop

Ruzy Haryati Hambali1, 2, Seri Rahayu Kamat1, Muhammad Fikri Zainuddin1, 5, Muhamad Ammar Farhan Maula Mohd Azam1, Suriati Akmal1, 3 Zainizam Rasid4 and Hafifi Hisham4

1 Centre of Smart System and Innovative Design, Faculty of Manufacturing Engineering, Universiti Teknikal Malaysia Melaka, Hang Tuah Jaya, 76100 Durian Tunggal, Melaka, Malaysia 2 Lancaster Product Development Unit, Department of Engineering, Lancaster University, Lancaster, UK 3 Center for Advanced Computing Technology, Institut Pengurusan Teknologi dan Keusahawanan, Universiti Teknikal Malaysia Melaka, Hang Tuah Jaya, 76100 Durian Tunggal, Melaka, Malaysia 4 Pusat Rehabilitasi PERKESO, Melaka, Malaysia 5 Composite Technology Research Malaysia, 75350 Melaka, Malaysia

Corresponding email: [email protected]

Pressure foot press is an equipment used for weight training exercises at the gymnasium. The equipment can be used to evaluate users’ overall lower body strength. It is utilised for rehabilitation and exercises for the rehabilitation candidate (RC). However, repeated activities and the disabilities experienced by the RC cause muscle fatigue associated to tiredness and pain. It may also inflict severe injuries include the hyperextension of knee, as well leads to rapid drop after repetitive movement. Therefore, this project aims to fabricate an Achilles sole as a supporting assistive device to support the RC’s legs. The device was fabricated to enhance the functionality of the foot press equipment and increase the comfortability and independency of the RC. It was also developed to increase the safety of RC and avoid any unexpected injuries while using the equipment. The product was validated using the rapid drop analysis, physical analysis, and comfortability voice of customer (VOC). The results show that the product is able to support their legs from any rapid drop during exercises, increase the exercise time, and reduce pain and injuries experienced by the RC.

Keywords: Assistive device technology, Physical rehabilitation, Additive manufacturing technology, Knee injuries, Quality of life.

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 21

20191105

A Comparative Analysis between Conventional Manufacturing and Additive Manufacturing of Ankle-Foot Orthosis

F.S. Shahar1, M. T. H .Sultan1,2,3, A.U. M Shah1,2 and S.N. A. Safri2

1Department of Aerospace Engineering, Faculty of Engineering, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia 2Laboratory of Biocomposite Technology, Institute of Tropical Forestry and Forest Products (INTROP), Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia 3Aerospace Malaysia Innovation Centre (944751-A), Prime Minister’s Department, MIGHT Partnership Hub, Jalan Impact, 63000 Cyberjaya, Selangor Darul Ehsan, Malaysia

Corresponding email: [email protected]

3D printing has been attracting attention in the recent years due to its versatility in design optimisation and a decrease in labour and production cost. 3D printing has been implemented in many major sectors such as automotive, aerospace, and healthcare. One of the most recent research which involves this technology is in the prosthetics and orthotics field. The aim of this paper is to review recent researches on Ankle-Foot Orthosis (AFO) which uses 3D printing in its manufacturing and fabrication phase. This paper discusses on the current 3D printing technologies used for AFO, comparison between Conventional Manufacturing (CM) of AFO and Additive Manufacturing (AM) of AFO, as well as the mechanical properties of AFO prototypes build from 3D printing. The results obtained from this review paper is that most current research uses Fused Deposition Modelling (FDM) or Selective Laser Sintering (SLS) for AFO manufacturing, and the materials used are mostly thermoplastics such as Nylon and Polyamide (PA). The results also shown that the tensile strength and Young’s Modulus of a 3D printed AFO could reach as high as 43 MPa and 3.9 GPa respectively. It can be concluded that 3D printing provides wider opportunities in the development of AFO due to its versatility in optimizing complex geometries, time and weight savings, as well as its cost effectiveness.

Keywords: 3D Printing; Additive Manufacturing; Ankle-Foot Orthosis, Fused Deposition Modeling; Selective Laser Sintering

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 22

20191103

An Interface Pressure Control System for 3D Printed Below Knee Prosthetic Socket: APreliminary Assessment during Static Loading

Murad Abdullah Subih1, Nooranida Arifin1,2 and Ebrahim Al-Fakih3

1Department of Biomedical Engineering, University of Malaya – Malaysia 2Center of Applied Biomechanics, Faculty of Engineering, University Malaya 3Dept. of Biomedical Engineering, College of Engineering Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia

Corresponding email: [email protected]

The perfect selection of prosthetic suspension system and the excellent fitting of the residual limb inside the prosthetic socket have a positive impact of amputee's activities. The residual limb should be in fully contact inside the prosthetic socket to guarantee proper pressure distribution. The continuous change of the residual limb size leads to poor attachment of the residual limb in the prosthetic socket and causes high pressure interface and skin wound. Thus, the aim of this study is to control the pressure interface in the transtibial prosthetic socket through developing an air pneumatic suspension system. Electronic system was designed to control the desire pressure inside 3D printed transtibial socket. The electronic system was attached into the pylon of the prosthetic device in a small box to minimize weight and improve the cosmesis of the prosthesis. 3D printed socket was built with tiny air bladders which were embedded in the liner. The inflation and deflation of the air bladders inside the 3D printed socket can be controlled using the pre-programmed keypad. The pressure distribution in 3D printed socket was evaluated using F- socket transducers through gait simulation machine. Gait simulation machine was used to apply a weight on the prosthetic device. Pressures reduction inside the 3D printed socket were recorded at all sides (ranging from 2 to 45 kPa), especially in the medial (45 kPa) and posterior (12 kPa) sides of the stump. The highest reduction in pressure of 45 kPa was recorded in the medial side during the inflation of the medial air bladder. The final product of this project will eliminate the use of expensive silicone liners, relieve the peak pressures on the amputee's residual limb bony areas, and lastly manage the inner size of the socket in order to accommodate the continuous changes of the residual limb, especially for diabetic amputees.

Keywords: pressure interface; electronic system; 3D printed socket; prosthetic socket; air bladders.

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 23

20191114

Development of Customised Orthotics Insole using Pressure Distribution and Additive Manufacturing Technology: Analysis of ABS And TPU Materials

Ruzy Haryati Hambali1, 2, Siti Khadijah Khalil1, Seri Rahayu Kamat1, Supapan Chaiprapat5, Suriati Akmal1, 3 and Hafifi Hisham4

1 Centre of Smart System and Innovative Design, Faculty of Manufacturing Engineering, Universiti Teknikal Malaysia Melaka, Hang Tuah Jaya, 76100 Durian Tunggal, Melaka, Malaysia 2 Lancaster Product Development Unit, Department of Engineering, Lancaster University, Lancaster, UK 3 Center for Advanced Computing Technology, Institut Pengurusan Teknologi dan Keusahawanan, Universiti Teknikal Malaysia Melaka, Hang Tuah Jaya, 76100 Durian Tunggal, Melaka, Malaysia 4 Pusat Rehabilitasi PERKESO, Melaka, Malaysia 5 Department of Industrial Engineering, Prince of Songkla University, Hat-Yai, Songkhla 90112, Thailand.

Corresponding email: [email protected]

Insole discovered made from variety of materials, although many modern shoes have actually soles made from natural rubber, polyvinyl chloride (PVC) or polyurethane substances. The function of shoe insole was to provide cushioning which to decrease the impact forces acting on the body during standing and other activities. Nowadays, working in prolonged standing among industrial workers has been shown to be associated with different potentially serious health outcomes, namely lower back pain, leg pain, fatigue, discomfort and other health issues. Customisation or personalisation of insole offers a solution that will provide a perfect fit and comfort to the shoes wearer based on ergonomic considerations. It works in a way that it alters the pressure away from painful areas by increasing the surface area that supports the weight of the body and evenly distribute it to the whole plantar area. Survey was conducted among workers at a manufacturing industry company to study on the level of pain experienced by them together with their foot anthropometry. Then, the foot pressure of each of the workers were collected by using pressure measurement device (F-scan). Combination of these data were used to design the customised insole that is fit for the worker. The personalized insoles were fabricated by Additive Manufacturing (AM) technology using acrylonitrile butadiene styrene (ABS) and thermoplastic polyurethane (TPU) and obtained the difference of these two materials. Next, all insoles were validated by using the F-scan pressure distribution sensor to ensure on their effectiveness in reducing pressure on the foot and muscle activity hence improving the comfort of the shoe wearer.

Keywords: Customised insole, Customised orthotics, Additive manufacturing technology, ABS, TPU, Pressure distribution.

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 24

20191107

Modified Adjustable Ankle Foot Orthosis Following Toxin A Injection To Reduce Plantar-Flexion Contracture In Spastic Hemiplegic Cerebral Palsy

Chan SC¹, Ahmad Fauzi¹ A Choong YH¹ and NM Hashim²

¹Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia ²Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Teknologi MARA, 57000, Selangor, Malaysia

Corresponding email: [email protected]

The purpose of this article is to describe spasticity management in a child with cerebral palsy (CP) and the option of adjustable solid Ankle Foot Orthosis (AFO) following Botulinum toxin A (BoNT-A) injection to improve the outcome as an alternative to serial casting to provide low load prolonged stretch effect. A 13 year old girl with left spastic hemiplegic CP under Rehabilitation Medicine clinic follow up complained of worsening of equinus gait with varus deformity and pain during walking. Complete clinical examination was carried out. Patient had BoNT-A injection for her left gastrocnemius and soleus followed by serial casting with the aim to improve gait and pain management. Serial casting was poorly tolerated after the first cycle; henceforth an option of adjustable solid AFO was discussed. Patient prescribed with adjustable solid AFO after discussion with a certified orthotist and prothetist (CPO) and parents. The patient's dorsiflexion passive range of motion increased from −25 degrees to -15 degrees after 2 months of usage at night with gradual adjustment. The application of an adjustable ankle- foot orthosis following BoNT-A injection may reduce plantar flexion contractures in cerebral palsy patients. Thus this may be an option for patients whom are unable to tolerate serial casting post BoNT-A injection.

Keywords: equinovarus foot, cerebral palsy, adjustable, ankle foot orthosis

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 25

20191104

The Effects of Prosthetic Knee Joints in Walking and Dual-task Activity Performance in Transfemoral Amputees

Nur Amira Adlan, Nooranida Arifin, Noor Azuan Abu Osman

Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Jalan Universiti, 50603 Kuala Lumpur, Malaysia

Corresponding email: [email protected]

Transfemoral amputees face mobility challenges as they permanently lose some parts of the musculoskeletal system. The concentration on walking can be interrupted as they also need to give attention to cognitive resources. A prosthetic component such as knee joint could affect the achievement of successful ambulation among transfemoral amputees. Numerous studies have been done to investigate the performance of transfemoral amputees based on gait analysis and dual-task activities. However, there is no comprehensive studies have evaluated the effects of prosthetic knee joints during normal walking and dual-task activities in terms of kinetic and kinematic parameters. Dual-task gait analysis is important in order to assess and treat individuals with lower extremity amputation to gain their ability to walk in the long term. It is one of the biomechanical assessment which helps to identify movement-related problems regarding balance and stability among patients with lower extremity amputation. Thus, this systematic review focuses on the current findings on the biomechanical assessment of prosthetic knee joints and dual-task activities between lower limb amputees or healthy controls. Transfemoral amputees have greater instability and low performance during gait assessment compared to healthy controls and transtibial amputees. They walked slower and have greater asymmetry during walking. Among transfemoral amputees, participants with active microcontroller mechanism required less work and cognitive attention than participants with a passive knee joint mechanism. The higher k-level function indicates the greater achievement in performing gait assessment. Further evaluation is needed as dual-task gait assessment can help to improve gait rehabilitation among transfemoral amputees.

Keywords: transfemoral, gait analysis, walking, dual-task, kinetics, and kinemat

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 26

20191110

A New Personalised Liner with Embedded Temperature and Humidity Sensors for Lower Limb Amputees

Paternò, L.1, Dhokia, V.2 and Seminati, E.3

1The BioRobotics Institute, Scuola Superiore Sant’Anna, PISA, IT 2Department of Mechanical Engineering, University of Bath, BATH, UK 3Department for Health, University of Bath, BATH, UK

Corresponding email: [email protected]

More than 53% of prosthetic users report discomforts due to excessive heat or sweating. Monitoring the thermal environment within prosthetic sockets has been notoriously complex because of the lack of appropriate measurement systems. The aim of this study was to design a personalised liner with embedded temperature and humidity sensors. The Hygrochron iButtons (Type: DS1923-F5#) are small and wireless devices, able to measure temperature and relative humidity changes, without being invasive for patients. These sensors were selected to be incorporated in a personalised ad-hoc liner at the skin interface. The liner was designed starting from the scan of the patient’s residual limb to allow a perfect fitting. Then, it was manufactured by the Bath cryogenic CNC machining facility. One unilateral trans-tibial amputee was recruited to participate in a review board-approved study to analyse the thermal environment within the socket during rest and exercise activities. The results of the experimental tests showed that approximately 15-minutes after donning the prosthesis, the skin temperature reached a constant trend. In general, physical activity rapidly increased the temperature while cessation of activity caused a moderate decrease. On the contrary, the relative humidity was always characterised by an increasing trend. To identify suitable technological solutions for sockets and liners, the main factors acting at the skin-prosthesis interface have to be quantified. This work described the design of a new personalised liner with embedded temperature and humidity sensors. This allowed for the characterization of the thermal environment within the socket during human tests.

Keywords: Cryogenic CNC Machining, Humidity, Prosthetic Liner, Prosthetic Socket, Temperature, Trans-tibial Amputation

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 27

20191111

Foot Lax: A Web-based Tool for Self-management of Bunions

Law Foong Li1, Khaw Chi Hun1, Julian Lee Eng Kim1 and Zarinah Mohd Kasirun2

1Department of Computing, School of Computing and Creative Media UOW Malaysia KDU University College 40150 Glenmarie Shah Alam, Malaysia

2Department of Software Engineering, Faculty of Computer Science and Information Technology University of Malaya 50603 Kuala Lumpur, Malaysia

Corresponding email: [email protected]

Hallux valgus also known as bunions is commonly seen in adolescents and adults particularly in women. The cause of bunions is not completely known; they may be an inherited abnormality, or they may be caused by many years of wearing ill-fitting footwear. It is generally accepted that tight-fitting shoes can worsen bunions over time. The average person who develop bunions will tend to prefer over-the-counter (OTC) device such as bunion splint to relieve the pain caused by the deformity. However does the bunion splint device really work? There is no scientific evidence suggesting that the bunion splint is successful in correcting or improving bunions with merely just personal accounts of users posting daily videos wearing the device and still needing surgery to correct the deformity. Hence, this study aims to assist patients to delay bunions progression with a low maintenance and non-surgical option via a web-based self- management bunions treatment application called Foot-Lax, and ultimately it allows the patients to continue a normal, active life. To date there are no applications on any platforms; hence a web-based is developed to support this need. It can later be improvised on to other platforms. Foot-Lax helps patients consistently to manage bunions recovery progress at their fingertips. The availability of Foot-Lax allows patients to accomplish the day-to-day treatment tasks with confidence by reviewing the recovery progression summary which may eventually prevent bunions from worsening and thus reducing the chances of a surgical procedure.

Keywords: Bunions, non-surgical, web-based, self-management, treatment

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 28

20191113

Development of Counter Balance Arm Sling for Hemiparesis Post-Stroke Rehabilitation People

Ruzy Haryati Hambali1, 2, Nur Nabilah Mohamad Khairon1 Syamimi Shamsuddin1, Winal Zikril Zulkifli1, Suriati Akmal1, 3 Mohd Zoolfaiz Md Salleh4, Muhammad Salihin Md Pauzi4 and Hafifi Hisham4

Corresponding email: [email protected]

Patients of neurological diseases with hemiparesis condition in PERKESO Rehabilitation Centre (PRC) experience problems in lifting their arms due to the degeneration of their muscles. Previous researches stated that patients require an assistive device (AD) as a medical rehabilitation to support the weight of their arm and promote their independency. However, it was reported that the AD has not been provided by the PRC. Moreover, the existing AD in the current market is difficult to own due to the high manufacturing and production costs, limited size and availability, and not user friendly (immobile and non-detachable design). This project aims to develop an AD that supports the upper limb of the neurological patients with hemiparesis. A new counter-balance arm sling (CBAS) with mobile, detachable, economical, and ergonomic design was successfully developed. The product was tested and validated by the therapist and patients. The results show that the product accomplished the purpose of CBAS equipment for the patients as an AD to support their arms for individuals with weakness of one side of the body to carry out therapy exercises and daily activities. This product also has an extra feature as an exercise aid to help the user for upper limb strengthening which will eventually improve their quality of life.

Keywords: Hemiplegia/hemiparesis, Physical rehabilitation, Assistive device technology, Additive manufacturing technology, Counter balance arm sling, Quality of life

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 29

20191108

The Influence of the Transtibial Prosthetic Length on Gait Pattern and Walking Stability

Wang Y.1,2 and Leong, A. K. L.1

1Department of Biomedical Engineering, The Hong Kong Polytechnic University 2Hospital Authority, Hong Kong

Corresponding email: [email protected]

Prosthetic length is an important consideration when fitting a prosthesis. Leg length discrepancy can be related to higher risk of fall, and chronic lower back pain. However, it was reported that most of the prosthetic length is insufficient. Incorrect prosthetic length might be caused by measurement error, misleading subjective feeling or poor socket fit. Despite of the importance of prosthetic length, there is limited information about the immediate effects of leg length difference on the gait pattern and walking stability. The aim of this work is to study the immediate effects of small range of prosthetic length change on gait pattern and walking stability in unilateral transtibial amputees. 5 subjects completed the study. Each subject walk with 5 different length of prosthesis, original length, prosthetic side +/- 3mm, prosthetic side +/- 6mm. Subjects walk in a 10-meter walkway with self-selected speed with marker and trunk accelerometer. The gait pattern will be assessed based on the prosthetic observational gait scale (POGS) in terms of alongside video analysis. Walking stability was measured by the root mean square and range of the acceleration. The change in prosthetic length affected the gait pattern and walking stability of subjects. The walking parameters of different length showed a significant difference (p=0.00). The variability of the acceleration among all trials also showed a significant difference (p=0.03). As a conclusion, the change of prosthetic length have an immediate effects on the unilateral amputees’ gait pattern and walking stability.

Keywords: Amputees, Leg Length Discrepancy, Accelerometer, Prosthetic Observational Gait Scale

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 30

20191115

EEG-based Brain Wave Controlled Intelligent Prosthetic Arm

Lip Z. H. and Zourmand A.

School of Engineering UOW Malaysia KDU University College 40150 Glenmarie Shah Alam, Malaysia

Corresponding email: [email protected]

The amputees nowadays usually wear a prosthetic arm which are not functionable. These prosthetic arms unable to help them to carry out their basic daily work independently. However, the EEG based brain wave controlled intelligent prosthetic arm is able to assist the amputees to carry out basic daily work. By using the EEG brain wave controlled, the amputees can control the movement of the prosthetic arm by visualizing the movement of the arm. Besides the amputees, the patients who are unable to move their body or having neuron problem also can use their thought to control the prosthetic arm. The EEG based brain wave controlled intelligent 3D printed prosthetic arm is designed to use the amputee’s brain wave to control the movement of the prosthetic arm. The amputee needs to be trained in order to control every arm movement correctly. The machine learning technique is used in the MATLAB to classify the brain signal of the arm movement accurately for the user. Every classified arm movement will send a discrete signal to the 3D printed prosthetic arm in order to control the arm. So, the EEG based brain wave controlled intelligent 3D printed prosthetic arm can help the amputees to regain their mobility of their arm and carry out some basic daily work.

Keywords: Electroencephalography (EEG), sensorimotor cortex, mu rhythm, prosthetic arm

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 31

20191116

Surface Electromyography Signal for Artificial Hand Control

Jonathan V. P., Lip Z. H. and Goh T. T

School of Engineering UOW Malaysia KDU University College 40150 Glenmarie Shah Alam, Malaysia

Corresponding email: [email protected]

Prosthetic hands are artificial devices designed for people with upper extremity amputations to provide them some functions of natural hands. An amputee that has lost upper limbs goes through many different consequences not only in the physical aspect but also including socially, economically and psychologically. These consequences can be minimized and the amputee can adapt to a normal life with the help of artificial hands, wrists as well as arms that performs daily tasks including grabbing objects, typing, writing, dressing and many more. In this day and age, there are many different commercial prosthetics devices. The main aim of this project is to develop a system that senses muscle contractions from the skin surface to control the fingers, of a prosthetic hand, to type by pressing the button on the keyboard. Surface Electromyography Signal shall be collected using MyoWare muscle sensor depending on the sensor position attaching at the limb. The signal shall be analyze and used to control the finger to type.

Keywords: Assistive device technology, hemiparesis, medical rehabilitation, quality of life

International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019 Page 32

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International Conference on Orthotics and Prosthetics (iCOP 2019) 20th November 2019 – 21st November 2019

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