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Table 5 Studies on DTI in transtibial prosthetic users using FE analysis

From: Exploring the role of transtibial prosthetic use in deep tissue injury development: a scoping review

Author and yearType of studyMethodologyInput dataAssumptionsOutcome measures
Portnoy et al. 2008 [34]Experimental study (aetiological)- 3D FEa model
- Donning and static load bearing of one TTAb
- Analysis of internal loading state
- Interface pressure
(pressure sensor)
- Tissue morphology and vertical displacement (MRIc)
- Shear modulus, friction between skin and socket (literature)
- Muscle: isotropic, homogenous, viscoelastic
- Skin: isotropic, homogeneous, hyperelastic
- No differentiation btw. Muscle and fat
- No friction between soft tissue layers
- SEDd, principal compressive and tensile stress and strain, max. Shear stress and strain, von Mises stress
Portnoy et al. 2009 [30]Experimental study (aetiological)- 3D FE model [34]
- Static load bearing of five TTAs
- Analysis of internal loading state and interpatient variability
- Evaluation of DTI risk
- See Portnoy et al. 2008- Soft tissue: isotropic, homogeneous, hyperelastic
- Differentiation btw. Muscle and fat
- Addition of 2 mm skin layer
- No friction between soft tissue layers
- Volume of muscle skin with compressive, tensile, shear strains above threshold value [43]
Portnoy et al. 2011 [33]Experimental Study (aetiological)- 3D FE model [34]
- Sitting with 30° and 90° knee flexion in one TTA
- Assessment of internal loading state and estimation of damage area over time
- See Portnoy et al. 2008- Soft tissue: isotropic, homogeneous, hyperelastic
- Differentiation btw. Muscle and fat tissue
- Addition of 1 mm skin layer
- No friction between soft tissue layers
- Principal tensile and compressive stress, max. Shear stress, von Mises stress
- Time-dependent volume of damaged muscle [43]
- Rate of damage progression [44]
Portnoy et al. 2009 [36]In silico study (risk factors)- 3D FE model [34] of one TTA
- Changes in morphological and mechanical parameters
- See Portnoy et al. 2008- See Portnoy et al. 2009 [30]- SED, principal compressive and tensile stress and strain, max. Shear stress and strain, von Mises stress,
- Volumes of areas with concentrated elevated stress
Lenz 2017 [38]In silico study
(PhD thesis, risk factors)
- Analysis of internal loading state with simplified cuboid FE model
- Simulation of different liners and socks
- Differentiation between slip and no-slip condition
- Liner displacement and mechanical properties (motion capturing)
- Normal and shear interface forces (two-axis load cell)
- Shear modulus, friction between skin and liner, soft tissue and liner thickness (literature)
- Muscle: isotropic, homogeneous, hyperelastic
- Differentiation btw muscle, skin, gel liner
- No friction between soft tissue layers
- Friction between skin and gel liner (slip vs. no-slip)
- Principal compressive stress, max. Shear stress, von Mises stress
Portnoy et al. 2007 [29]Experimental Study (clinical)- 2D FE model for real time stress analysis
- Application on 5 TTAa s during treadmill walking
- Interface pressure (pressure sensor)
- Elastic modulus (Indentation test)
- Tissue morphology
- (X-Ray)
- Soft tissue: isotropic, homogenous, linear elastic
- No differentiation btw. Muscle, fat, and skin
- Principal compressive stress and strain, shear stress, von Mises stress
  1. a Finite Element; b Transtibial amputee; c Magnetic Resonance Imaging; d Strain Energy Density