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| © Otto Bock HealthCare
Modern Lower Extrimity Prostetics
Janne Isokangas, CPO, Otto Bock Scandinavia Ab
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| © Otto Bock HealthCare
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| © Otto Bock HealthCare
1919 Otto Bock
Almost one hundred years ago the company was founded
by its namesake, Otto Bock, who started to produce
prostheses and orthopaedic aids for wounded soldiers from
World War I. The company is still family-owned and today
managed by his grandson, Professor Hans Georg Näder.
With over 6 000 employees located in 49 markets
worldwide and an annual turnover of 870 million EUR,
Ottobock is a leading company in the orthopaedic industry.
The global headquarters is today located in Duderstadt,
Germany.
4/28/2016
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| © Otto Bock HealthCare
MedicalCare
Wheelchairs & Seating aids
Orthotics
Prosthetics
Ottobock Scandinavia Group What we provide
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| © Otto Bock HealthCare
Quality for life
4/28/2016
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| © Otto Bock HealthCare 4/28/2016
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| © Otto Bock HealthCare
MOBIS® The Ottobock Mobility System
Technical Solutions
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| © Otto Bock HealthCare
MOBIS®
The choice of the correct prosthesis components by the prosthetist is a
decisive factor for a successful fitting.
MOBIS is a further development of the Ottobock classification system
introduced in 1994.
It focuses on the person and his/her need for a better Quality of life.
With the help of the MOBIS symbol, the prosthetist can immediately
regognise the mobility grade and patient weight for which functional
components such as prosthetic feet, knee joints and hip joints are
recommended.
4/28/2016
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| © Otto Bock HealthCare
MOBIS®
4/28/2016
MOBIS is based on 4 mobility grades
MOBIS defines 4 weight classes
MOBIS is easy to apply
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| © Otto Bock HealthCare
The Ottobock Mobility System: Mobility Grades and Therapy Goals
MOBIS 1
Indoor walker
• Therapy goal:
Restoring the ability to stand and to walk indoors to a limited degree.
MOBIS 2
Restricted outdoor walker
• Therapy goal:
Restoring the patient's ability to stand and walk
both indoors and outdoors.
4/28/2016
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| © Otto Bock HealthCare
The Ottobock Mobility System: Mobility Grades and Therapy Goals
MOBIS 3
Unrestricted outdoor walker
• Therapy goal:
Restoring the patient's ability to stand and to walk
indoors and outdoors with only mild restrictions.
MOBIS 4
Unrestricted outdoor walker with especially high
requirements
• Therapy goal:
Restoring the ability to stand, walk and move about both
indoors and outdoors without any limitations. 4/28/2016
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| © Otto Bock HealthCare
MOBIS® defines 4 weight classes:
< 75 kg
<100 kg
<125 kg
>150 kg
4/28/2016
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| © Otto Bock HealthCare
MOBIS®– Modular components
4/28/2016
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| © Otto Bock HealthCare
Knee Joints and MOBIS
4/28/2016
Security
Functionality
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| © Otto Bock HealthCare
Feet and MOBIS
4/28/2016
Functionality
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| © Otto Bock HealthCare
Modern Technology
Microprosessor-controlled knee joints
C-Leg 4
Genium
Genium X3
Kenevo
Myoelectric upper limb prosthesis technology
Michelangelo, Myo Bock System
Microprocessor-controlled ankel
Triton Smart Ankle
Meridium
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| © Otto Bock HealthCare
C-Leg 4 / 3C98-3 Microprosessor-controlled knee joint
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| © Otto Bock HealthCare
Introduction
Technology
4/28/2016
Inertial Motion Unit (acceleration
sensors and gyroscope)
Charging plug
Servo electronics
Battery
Hydraulics
Electronics
Bluetooth
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| © Otto Bock HealthCare
Introduction
Technology – New control concept for C-Leg 4
4/28/2016
Detected parameters (sampling rate: 100 Hz)
• Knee angle
+ angular velocities
• Knee extension moment
• Inertial Motion Unit (IMU)
Linear accelerations
+ velocities & distances
Orientation of shank in space
+ angular velocities
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| © Otto Bock HealthCare
Introduction
Functional sequence of prosthetic control
4/28/2016
Knee angle
Knee moment
Linear accelerations
Shank inclination
Angular velocities
Servo motor
Flexion valve
Servo motor
Extension valve
Input signals Processor
C-Leg 4 Output signals
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| © Otto Bock HealthCare
Introduction
Characteristics – Improved swing phase behavior
4/28/2016
The swing phase control regulates
the maximum flexion even at different
speeds with a very high accuracy!
• Adaptive swing phase flexion control
Very good support for slow and fast
walking speeds
Adapts flexion resistances to different
walking speeds
Adapts to changed parameters (e.g.
shoe weight)
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| © Otto Bock HealthCare
Introduction
Characteristics – Improved swing phase behavior
4/28/2016
• Real-time swing phase extension control
Adapts extension resistances to
different situations and walking speeds
Adjustable basic resistance for swing
extension during level walking
Minimal resistance when walking stairs
and ramps (reliable foot positioning)
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| © Otto Bock HealthCare
Introduction
Characteristics – Broader range of ADL’s
4/28/2016
• Intuitive Stance Function If the joint is at rest in a
flexed position, it is
instantaneously locked
E.g. useful for standing
on ramps
Locked
joint in
flexion
Flexion
possible
→ no
stable
standing
Stance Function
activated
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| © Otto Bock HealthCare
Introduction
4/28/2016
• Sitting Function (low flexion and
extension resistance)
• Weatherproof (IP67)
• 2 additional MyModes for specific
activities
Characteristics – Broader range of ADL’s
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| © Otto Bock HealthCare
Introduction
Characteristics – Easier use for patient and CPO
4/28/2016
• Ottobock Cockpit app or optional remote
control
Switch modes
Limited changes to adjustments
Battery level indicator
Status indicator
User friendly dialog texts for service and error
messages
• New posterior position for charging receptacle
Additionally protected by a cover
• Adjustable signals (+ louder beeper)
Cockpit
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| © Otto Bock HealthCare
Introduction
Characteristics – Improved outcomes for patient and CPO
4/28/2016
• Safety
Safe backwards walking
Enhanced stumble recovery
Easier stance release → small steps, sand… (real
time control)
Adjustable safety mode
Exit strategy
• Additional improvements compared to old C-Leg
Higher extension resistances possible for a more
convenient stance extension movement (no
hydraulic shortcut)
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| © Otto Bock HealthCare
Introduction
Characteristics – Broader group of patients
4/28/2016
• MOBIS 2 – 4
• Patients with hip disarticulation or
hemipelvectomy have to be fitted with the
7E7, 7E9 or 7E10 hip joint
• Maximum knee angle: 130°
• Up to 136 kg (300 pounds) of body weight
• Minimal installation height = 307 mm (using
LoRider foot)
Shorter users possible
More functional feet possible
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| © Otto Bock HealthCare
Components and Materials
Data Safety Sheets
Component Testing
5.000.000 steps = 3 years (avarage user) REACH ?
Registration, Evaluation, Authorisation and Restriction of Chemicals 2007 ->
CE Marking
Materials
Cytotoxicity Testing (ISO 10993-5)
Irritation- and sensitization testing (ISO 10993-10)
4/28/2016
Documentation
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| © Otto Bock HealthCare
Future ?
4/28/2016
Osseointegration
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| © Otto Bock HealthCare
Future ?
4/28/2016
(TMR) targeted muscle reinnervation
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| © Otto Bock HealthCare
• Official partner to Paralympics since 25 years
• Partner to the International Paralympic Committee since 2005
• Official supplier of technical services for prosthetics, orthotics and wheelchairs for Paralympics Rio 2016
• During London 2012 2080 repairs were made by 78 technicians (ca 10 680 h work)
• We had 13,7 tons of workshop equipment on set and over 15 000 spare parts
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| © Otto Bock HealthCare
Quality for life
4/28/2016