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Low Cost Laser Alignment System: A New Approch: World Journal of Pharmacy and Pharmaceutical Sciences January 2016
Low Cost Laser Alignment System: A New Approch: World Journal of Pharmacy and Pharmaceutical Sciences January 2016
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2 authors, including:
Smita Nayak
Pt. Deendayal Upadhyaya Institute for the Physically Handicapped
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1
MPO, National Institute for the Orthopedically Handicapped.
2
MPO, Workshop Manager, National Institute for the Orthopedically Handicapped.
INTRODUCTION
Alignment of prosthesis is defined as the position of the socket relative to the other prosthetic
components of the limb. During dynamic alignment the prosthetist, using subjective
judgment and feedback from the patient, aims to achieve the most suitable limb geometry for
best function and comfort. Prosthesis acceptability depends on several factors including
cosmesis, mass properties of the prosthesis, comfort, and function. Comfort and function are
directly dependent on the quality of fit of the socket, the quality of suspension, the type of
components used and the relative geometrical position of these components to each other.
The position and orientation of these components, the major elements being the socket,
joint(s), and terminator (e .g. foot), are defined as the alignment of the prosthesis. [1]
Over the years many different mechanical devices to aid in fitting and alignment of lower-
extremity prostheses have been developed to help in the application of one or another
particular set of alignment principles in use by individual titters. Others of these devices are
more general in application and are adaptable for use by any prosthetist regardless of the
particular alignment principles he advocates. In every case, however, an attempt has been
made to improve the fitting and alignment technique by adopting one definite set of
principles and using a mechanical device to aid in the application of those principles. "plumb-
line" method of alignment, a method which, essentially, assumes that the prosthesis carries
weight along a vertical plumb line, the elements of the prosthesis then being arranged using
this line as a reference. Still in general use throughout Europe and the United States, this
system involves the problem of determining the location of the plumb line in the socket so
that it can be extended down to the foot and used as a reference. Holding the plumb line
needs experience and skill. When we place the string of the plumb bob at reference point, the
weight moves freely and it takes time to come in static position.
Precision shifting of component in slight amount of degree or angle is not possible. The
pitting stool, Pivot point balancing device, Vise type fitting stand, Schneider’s alignment
stand, alignment duplication jig are the other common alignment methods used to check the
prosthesis or as a educational aid. The accuracy of these devices is unknown and mostly
followed by the trial and error methods. Although many manufacturers of prosthetic
components give static alignment recommendations from clinical experience using
theoretical alignment reference lines, these general guidelines do not reflect individual
differences. Furthermore, there is a worldwide controversy regarding different alignment
guidelines.[2,3,4] The LASER aligner is used most commonly now a day by various
rehabilitation centers and prosthetic manufactures but it was not readily available due to its
high cost. So this is an attempt to provide a low cost laser alignment device that can be used
by the low economic country.
5.LASERs
6.Battery
7.Switches
8.Connecting wire
9.Charging indicator
10. Angle reading plate (Full circle protractor)
11. charger
1.Tripod Stand
The stand to be fabricated having three adjustable legs or may be one leg having telescopic
movement, so as to obtain height adjustment of the instrument according to the need of
alignment. This stand has a control plate at the top that provide platform to connect the laser
aligner.
Assembling of stand
Cut the upper surface of the “CD Container” and fill it with plaster of Paris, and fix 3rd pipe
of outer diameter 26mm inside it vertically. Connect 2nd pipe with 3rd pipe and 1st pipe with
2nd pipe accordingly. Fix a stand adaptor with the base of LCLA as shown in fig 1and 2.
2. Chassis
A chassis consists of an internal frame that supports a man-made object in its construction
and use. It also allows the lasers in adjustment for fix in preposition.
3. Outer body
outer body is made out of metal sheet of that provide cosmetic look to LCLA and protect
internal parts. Dimension of outer body (60x90x110) mm3.
4. Reflection plates
There are two no. of C shaped reflection plates. The function of it is change the point
projection to line projection of the LASER pointer.
5. LASER pointers
A LASER pointer or LASER pen is a small handheld device with a power source (usually a
battery) and a LASER diode emitting a very narrow coherent low-powered LASER beam of
visible light, intended to be used to highlight something of interest by illuminating it with a
small bright spot of colored light. Power is restricted in most jurisdictions not to exceed
5 mW. There are two no. of LASER present in this aligner. The color of projection of the
LASER may be red and green for identification of vertical and horizontal LASER
Fig 8: switches
8. Connecting wire
Connecting wire for connecting LASER and battery with Switch for individual LASER. The
battery will also connect with a charging port V3.
9. Charging indicator
Just a small circuit having a diode, a LED, and a resistance. It connects with the charging
socket. When charging is on this LED glow and indicates charging of the battery.
11. Charger
a charger for charging battery of 4.5volt output should be used.
Assembling of aligner
Laser pointer was taken and then it opened from its anterior and posterior side & batteries and
front lance was removed. Outer shell of the laser pointer was cut vertically and removed the
laser pointer inside it as shown in fig 13. The push button was removed from it and cut the
spring according to fig 14. Laser wires were solder on its connection according to Fig 15.
The laser was connected with batteries for the checking of function (Fig 16)
Reflection plate was fixed with the Chassis as shown in fig 17. Laser was attached with
the chassis. (Fig 18)
The protector with the body and angle controller with the chassis of adjustable laser was
attached. (Fig 20) Angle controller was rotated and checked for the rotation of adjustable
Laser aligner. (Fig 21).
Switches and charging point were fixed in the respective channels of the body. (Fig 22)
Switches of the laser were tested to check the functionality. Then charger attached with the
charging slot and checked that the indicator was working or not. The leveling tube with its
posterior aspect (user aspect) fixed horizontally. Stand was assembled with the adjustable low
cost aligner. The final device was checked with various clinical trials.
Standardization of aligner: The low cost laser aligner was standardized by following a
plumb line method. A point was marked on the wall by pencil then a plumb line form this
point was drawn. Another point was marked just behind the thread at approximately one
meter of distance from previous point. The plumb line was removed than both points were
checked carefully conforming that these both points were the imaginary vertical line. The
laser was adjusted for coincidence of that line. When both the lasers lines were fixed in
coincidence the aligner was leveled with leveling tube. (The air-bobble should be in center of
tube and static condition) The vertical, horizontal and angular alignment can be possible by
using this low cost alignment device. (Fig 24).
Accuracy of the LCLA checked by following plumb bob method, five vertical lines were
drawn at wall by help of Plumb bob. The aligner was placed in front of wall in suitable
distance. Vertical laser was on and coincide this laser line with first line. The leveling tube
was checked for the bubble was in centre and static or not. This Method repeated for five
times and result was consistence in each trial. Similarly the angulations were checked in each
5 degree interval and the result was found satisfactory.
If any deviation occurs in alignment, it creates discomfort on the stump ultimately patient
discards the prosthesis.
DISCUSSION
Accuracy: The experiment of vertical laser line accuracy parameter, it found that the vertical
laser line matched with the plumb bob traced line. This method repeated five times and the
similar result was found in each time. So this can be predicted that the vertical laser line was
almost accurately vertical. The angular measurement also accurately matched the previously
drawn line by plumb bob. The clinical trial was done in five Trans tibial and three Trans
femoral prosthesis using the low cost laser aligner system and the patients were found
satisfied with this alignment system. The gait was near to normal and they were comfortable
with the prosthesis.
Cost: The cost of this LCLA was found approximately Rs 1800 – Rs 2200 which was very
affordable for the developing countries.
CONCLUSION
The alignment instrument is a prime importance of the fabrication of orthosis and prosthesis.
Conventional instrument of alignment is visual plumb-bob (plummet). Usually in Lower
Limb Prosthesis Plumb-bob is used for weight bearing line. It helps to check the Anterior-
posterior and Medial-lateral static bench alignment but it needs much experience skill to
handle a plumb-bob for alignment and it does not provide an exact angulations relationship
between socket and pylon. To overcome this accuracy and angulations factor the laser beam
Laser Aligner is introduced. These types of aligner provide accuracy in linear as well as
angular relationship between components of prosthesis but not affordable by most of the
P&O workshop of the under developing countries like India due to its high cost. This LCLA
system was an effort to overcome that cost factor and to provide quality of life to the disable
people. Further more studies are required to standardize this instrument universally.
Limitations of LCLA
LASER pointer may dysfunction during use.
No universal shifting method of LASER installed without shifting the instrument
REFERENCES
1. M. S. ZAHEDI, W. D. SPENCE, S. E. SOLOMONIDIS, J . P. PAUL, Alignment of
lower limb prosthesis, Journal of Rehabilitation Research and Development; 1986; 23(2):
2-19.