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This series of five papers, three of which are presented here, provides an overview of rehabilitation engineering from the development of a clinic team through to problem-solving techniques. The first paper discusses the development of the biomechanics clinic team, identifies the differences in engineering and medical approaches to patient problems and proposes guidelines for successful teamwork. The second paper demonstrates that the five parameters of motion, force, neural function, shape and tissue quality are basic to information needs for biomechanical problem-solving. The third paper describes a framework for problem-solving that has been successfully employed for both device and process development. The fourth paper delineates the criteria and constraints that determine clinical viability of “products” in rehabilitation engineering and the last paper of the series outlines a very productive dynamic group problem-solving technique. The papers are intended to enhance communications and demonstrate a more disciplined approach to rehabilitation engineering. The remaining two papers will be published in a forthcoming issue of Prosthetics and Orthotics International.

A computer-aided sculpting system for use in prosthetics is described. The prosthetist's sculpting tools now consist of a computer, a graphics terminal, a mouse and an on-screen moveable cursor. Accompanied by the system software, these tools allow systematic modification of a primitive socket using techniques analogous to those used by a prosthetist working with rasps and plaster.

Progress is reported on the development and application of structural matrices in rehabilitation. The development of a stronger and more adjustable matrix than was previously reported is detailed, together with the principles necessary to achieve this. Application of this new matrix to adult seating is described. The emergence of programmable beams and the need for containment matrices are also documented and the advantages of these approaches to a variety of problems in rehabilitation are given.

A method of constructing orthoses and other patient devices using nylon tubing and clip-together standard components is described. This permits the rapid assembly of custom orthoses that can be evaluated before prescription in a clinical setting. These orthoses have been successfully used for the control of thoracic spinal flexion, hip abduction, elbow extension, shoulder abduction, cervical spine stabilization and pressure sore relief. Advantages over existing orthoses include reduced weight, improved comfort and cosmesis, low cost and increased speed of provision. Examples of these orthoses are shown, together with details of their structure, function and clinical results.

A Reference Library of socket shapes for an Above-Knee Computer Aided Socket Design (CASD) System has been created. This library forms part of a more general CASD System (Dean & Saunders, 1985; Novicov & Foort, 1982). It consists of a matrix of reference shapes representing above-knee socket characteristics and is based upon skeletal structure, residuum length and tissue mass. A set of 27 biomechanical reference shapes in the form of male plaster casts were produced by a combination of CNC milling and traditional artisan techniques. Each reference shape was digitized to obtain its cylindrical coordinates. Cross-sectional areas and tissue distributions within each shape and between the shapes were analyzed, modified and then stored numerically within the computer for further implementation of the CASD System for the above-knee amputees. The creation and the analysis of the reference shape data is described.