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Additional file 1: Figure S1. Electrode screen printing. (a) The screen-printing setup with the screen and template pattern, and red squeegee. (b) The resulting deposition of conductive paste on heat transfer paper. Figure S2. Ivium connection setup for impedance testing. (a) 3-electrode configuration (b) 2-electrode configuration. Figure S3. The agar–electrode impedance. (a) RS structure and (b) RC structure with various conductive coating materials in the frequency range of 1–10000 Hz. The pressure was 20 mmHg (~ 2.66 kPa). Table S1. Summary of current solutions to dry textile electrodes for biopotential monitoring. Table S2. Coating formulations unsuccessfully screen-printed onto dry textile electrodes.

Functional electrical stimulation (FES), through repetitive training (FES-therapy) or continuous assistance (neuro-prosthesis), can restore motor function after paralysis due to spinal cord injury or stroke. With current technology, patients are often incapable of independently applying FES, thereby limiting its use. Novel FES-garments with embedded stimulation electrodes were developed in collaboration with Myant, Canada, to address this problem. The purpose of this study was to collect the views of future end-users to inform the refinement of the device design and to obtain insights on subsequent commercialization of this rehabilitation and assistive technology. A qualitative study was undertaken to determine the needs of potential users (patients and clinicians; n = 19). Participant took part in interviews or focus groups after a presentation of the garments. An inductive content analysis was used to generate the themes from the data and identify data saturation. The identified themes and sub-themes were: (1) User Perspectives: users' characteristics (needs, limitations), expected benefits (beliefs), and anticipated problems (fears); (2) Device Design: technical features, usability, and disadvantages of the garment, cables, stimulator, software, and interface; (3) Acquisition Process: organizational procedures (acquisition and adoption steps); and (4) Business Model: financial and strategic aspects to facilitate commercialization and support users. The insights obtained from end-users and clinicians provide guidelines to optimize the development of novel FES-garments, and strategies for bringing the device to the market. The themes identified can serve to inform other rehabilitation and assistive technology developers with processes and ideas on how to meet these groups’ needs.IMPLICATIONS FOR REHABILITATIONParticipants with neurological paralysis have interest and critical views on new rehabilitation and assistive technology, and the repercussions of using new technologies to address their function, health and wellbeing.The FES-garment design presented appeared acceptable to the end-users, pending resolution of certain shortcomings (wiring, operating duration, robustness, easiness to don and doff).End-users and clinicians had specific views regarding the acquisition process of new technologies (training, customization, and follow-up/support), which are important to take into consideration to ensure broad stakeholders uptake. Participants with neurological paralysis have interest and critical views on new rehabilitation and assistive technology, and the repercussions of using new technologies to address their function, health and wellbeing. The FES-garment design presented appeared acceptable to the end-users, pending resolution of certain shortcomings (wiring, operating duration, robustness, easiness to don and doff). End-users and clinicians had specific views regarding the acquisition process of new technologies (training, customization, and follow-up/support), which are important to take into consideration to ensure broad stakeholders uptake.

Above-knee amputees' rehabilitation aims at providing a comfortable prosthesis to recover autonomy in daily life activities. The aim of our study is to understand the determinants of successful prosthesis fitting, and to provide a new instrumental method to evaluate the quality of the stump-socket interface. A clinical exam and questionnaires were performed in 40 above-knee amputee patients. Gait and posture were assessed in these patients and in 40 matched controls. Pressures at the stump-socket interface were assessed with 14 force sensing resistor sensors, 0.5 mm thick and 25 mm in diameter, placed on the stump. Pressures were analyzed in terms of intensity and with cross-correlation functions. Pressure assessments were repeated in 16 patients to test the reproducibility of the proposed parameters. Pains and skin lesions were more frequent on the bony part of the stump and in thinner patients. Posture and gait were strongly deteriorated in amputees as compared to controls and were negatively correlated to patient's weight but positively correlated to patient's prosthesis experience. However, better prosthesis do not provided better walking capabilities. Most of the proposed pressure parameters were reproducible (50 out of 70). Good prosthesis (providing high satisfaction, few pain and no wound) exhibited higher pressures at mid-height and at the proximal part of the stump, and their pressure patterns covariated strongly (r=0.93-0.99) and were synchronized during gait. Bony parts were less tolerant to pressure. Prosthetic fitting was easier in patients with a big stump because soft tissues distributed the pressures on the stump in a hydrostatic manner. However, these heavier patients had poorer gait capabilities. Thus, a better stump-socket interaction cannot guarantee better walking abilities but only more comfort and less pain and wound during prosthesis use.Pressure measures detected poorly fitted prosthesis. Therefore, it might be interesting to extent the use of pressure measures to clinical practice to improve patient's comfort. However, application of these material and methods in daily practice need additional experiments., La prise en charge des patients amputés fémoraux vise à fournir une prothèse confortable permettant de retrouver une autonomie fonctionnelle. L'objectif de notre travail est de mieux comprendre les déterminants du succès de l'appareillage et de proposer une nouvelle méthode d'évaluation instrumentale de la qualité de l'interface moignon-emboiture. Un examen clinique et des questionnaires ont été réalisés chez 40 patients amputés fémoraux. La posture et la marche ont été mesurées chez ces 40 patients et chez 40 sujets contrôle appariés. Les pressions exercées sur le moignon lors de la marche et des postures debout et assise ont été mesurées avec 14 capteurs piézorésistifs de 0,5 mm d'épaisseur et 25 mm de diamètre placés sur le moignon. Les pressions ont été analysées au regard de leurs intensités et au moyen de fonctions de corrélation croisée. Les mesures de pression ont été répétées chez 16 patients pour étudier la reproductibilité des paramètres proposés. Les douleurs et blessures étaient plus fréquentes sur les zones osseuses et chez les patients plus maigres. La marche et la posture étaient dégradées par rapport aux sujets contrôles, et étaient influencées négativement par le poids des patients et positivement par leur expertise. En revanche, une meilleure emboiture n'apportait pas, en elle-même, une meilleure marche. La majorité des paramètres de pression testés étaient reproductibles (50 sur 70). Les bonnes prothèses (induisant une satisfaction élevée, peu de douleurs et pas de plaie) avaient des pressions plus élevées à mi-hauteur et en racine de cuisse, et des pressions qui covariaient fortement (r=0,93-0,99) et de façon synchronisée lors de la marche sur tout le moignon. Les zones osseuses étaient moins tolérantes aux pressions élevées. L'appareillage était plus aisé chez les patients ayant de gros moignons, car les tissus mous permettaient la répartition des pressions sur un mode hydrostatique. Or, ces patients plus lourds présentaient de moins bonnes capacités locomotrices. Ainsi, une meilleure interaction moignon-emboiture ne peut garantir de meilleures capacités de marche, mais favorise le confort et l'absence de douleur et de plaie dans la prothèse. La mesure des pressions permettait d'identifier les emboitures non-adaptées. Il parait donc intéressant d'étendre son utilisation pour aider les appareilleurs à la conception des emboitures. Cependant, la mise en pratique courante de cette méthodologie nécessite de nouvelles expérimentations.

The aim of this study was to better understand the motor behaviour of hip disarticulated (HD) subjects using a Canadian type prosthesis, and to assess the effects of a new exoprosthetic hip joint system (Hélix3D, Otto Bock®) on balance, gait initiation and gait of HD subjects.; Cette étude vise à mettre en évidence les spécificités posturales et locomotrices des sujets désarticulés de hanche (DH) utilisant une prothèse canadienne, et à évaluer l'effet d'une pièce de hanche récemment développée (Hélix3D, Otto Bock®) sur la posture, l'initiation de la marche et la locomotion de ces sujets DH.