New developments in prosthetic arm systems

Absence of an upper limb leads to severe impairments in everyday life, which can further influence the social and mental state. For these reasons, early developments in cosmetic and body-driven prostheses date some centuries ago, and they have been evolving ever since. Following the end of the Second World War, rapid developments in technology resulted in powered myoelectric hand prosthetics. In the years to come, these devices were common on the market, though they still suffered high user abandonment rates. The reasons for rejection were trifold - insufficient functionality of the hardware, fragile design, and cumbersome control. In the last decade, both academia and industry have reached major improvements concerning technical features of upper limb prosthetics and methods for their interfacing and control. Advanced robotic hands are offered by several vendors and research groups, with a variety of active and passive wrist options that can be articulated across several degrees of freedom. Nowadays, elbow joint designs include active solutions with different weight and power options. Control features are getting progressively more sophisticated, offering options for multiple sensor integration and multi-joint articulation. Latest developments in socket designs are capable of facilitating implantable and multiple surface electromyography sensors in both traditional and osseointegration-based systems. Novel surgical techniques in combination with modern, sophisticated hardware are enabling restoration of dexterous upper limb functionality. This article is aimed at reviewing the latest state of the upper limb prosthetic market, offering insights on the accompanying technologies and techniques. We also examine the capabilities and features of some of academia’s flagship solutions and methods

How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Recent trends, technical concepts and components of computer-assisted orthopedic surgery systems: A comprehensive review

Computer-assisted orthopedic surgery (CAOS) systems have become one of the most important and challenging types of system in clinical orthopedics, as they enable precise treatment of musculoskeletal diseases, employing modern clinical navigation systems and surgical tools. This paper brings a comprehensive review of recent trends and possibilities of CAOS systems. There are three types of the surgical planning systems, including: systems based on the volumetric images (computer tomography (CT), magnetic resonance imaging (MRI) or ultrasound images), further systems utilize either 2D or 3D fluoroscopic images, and the last one utilizes the kinetic information about the joints and morphological information about the target bones. This complex review is focused on three fundamental aspects of CAOS systems: their essential components, types of CAOS systems, and mechanical tools used in CAOS systems. In this review, we also outline the possibilities for using ultrasound computer-assisted orthopedic surgery (UCAOS) systems as an alternative to conventionally used CAOS systems.Web of Science1923art. no. 519

Analysis of a Lower Limb Prosthesis

The Center for International Rehabilitation (CIR) has programs all over the world to provide people in developing countries with the training and equipment they need to supply prosthetic devices to local landmine victims. CIR has created a monolimb, which is a lower limb prosthesis where the socket and shank are molded from a single piece of thermoplastic material. The monolimb can be fabricated on-site with minimal equipment at a low-cost. The shank portion of the device, which replaces the tibial region of the leg, was investigated through a finite element analysis computer program, COSMOSWorks. The current prosthetic device utilized by CIR uses a hollow, cylindrical shape with a rib on the posterior side as the overall shank design. This study combined varying circular outer diameters and rib lengths to determine which combination of parameters contributed to lower overall von Mises stresses and minimal displacement. Four hollow elliptical cross sectional shapes of different minor and major diameters were also modeled and compared to the results of the circular parameter study. The models were input into COSMOSWorks to perform a static analysis on each of the models and the results were displayed through contour plots. The output for each model was analyzed and compared to determine the maximum stresses and overall stress distributions. The displacement present was examined, paying particular attention to the flexibility across the shank, as the displacement can mimic that of natural ankle movement. The ISO Test Standard 10328, which details the necessary structural testing for lower limb prostheses, was used as the basis for testing. The final results compared the overall stress distributions and displacement of each of the models in COSMOSWorks to determine which shape would best withstand the ISO Test Standard 10328 specified load. The results determined that an increase in diameter and rib length positively influences the von Mises stress results and displacement by decreasing their values throughout the shank

Application of Machine Tools in Orthoses Manufacture

CNC technology is widely used in the manufacture of medical products. An area in which CNC technology has proven to be extremely useful and innovative is Orthotics and Prosthetics (O&P). O&P laboratories are engaged in the manufacture of individual orthoses and prostheses. The usual manual manufacture of such products takes a long time and requires tremendous experience and skill. In this regard, any engineering solution that improves the quality of the production process; reduces production time, production costs, and physical human labor; and at the same time improves the environmental conditions of the production environment will be desirable. Various designs of CNC machine tools for the manufacture of orthoses or molds for their production are in use today. In most cases, customized commercially available numerical control lathes and milling machines are used, as well as industrial robotic arms, but there are also highly specialized designs. For the mentioned purpose, we also encounter the application of additive manufacturing (AM) devices. Due to the fact that issuing of orthoses is often the subject of cost reduction in healthcare systems, the pursuit of production systems that will be cost-effective and functional, easily implemented, and used primarily in small manufacturing practices is imperative

A Brief Review on Metamaterials Applied to the Healthcare Field

Metamaterials refer to any modification of the physical behavior of an existing material through the structured arrangement of repetitive patterns, procedurally generated, which can directly influence its response to deformation, thermal dissipation, and vibrational control. This creates possibilities for solutions that were previously difficult to achieve using conventional materials such as metals, ceramics, polymers, and their composites. The use of this technology has gained momentum with the advent of 3D printing, which has made it possible to apply and create these structures for practical validation. The first structures were modeled at the beginning of the last century, such as the creation of patterns to generate anomalous properties, with diverse applications in fields like optics, thermodynamics, and mechanics, as it allows for material design tailored to specific applications. As a result, applications have expanded to various scales, from millimeter-engineered materials to the nanoscale, drawing the attention of researchers from different fields, including healthcare. This interest stems from the vast array of possibilities and innovations driven by advancements in materials and additive manufacturing, combining these fields to generate increasingly adaptive solutions. In this paper, the concept of metamaterials will be introduced, followed by an exploration of various applications of this technology, including medical equipment, devices, prosthetics, orthotics, and implants, as well as potential future applications of this technology in healthcare

Prosthesis Mapping and Forecasting as a Direction of Innovation in Prosthesis Product Development

The objective of this study is to make a need assessment in the form of identifying trends in the need for prostheses and mapping the priority types of prostheses developed at Dr. R. Soeharso Orthopedic Public Hospital, Surakarta as a reference for innovation in the development of prosthesis products at Dr. R. Soeharso Orthopedic Public Hospital, Surakarta. The method used was descriptive analysis and moving average forecasting of historical data on the use of prostheses. From the results of the descriptive analysis, it was found that the most common types of the prosthesis were under the knee prostheses and the types of prostheses that mostly used imported components were finger prostheses and prostheses that have been developed locally which were lower and upper knee prostheses and also Syme. The results of the prediction of the number of prostheses showed a stable trend and tended to increase slightly with the MAD error rate of 2.375 and MSE of 10.378 and MAPE of 36%. With this accuracy, the results of the forecasting can be used as a reference for the hospital to make supplies of prosthesis components in the next period so that the time for making prostheses can be shortened. Meanwhile, for the development of the direction of innovation, recommendations for the type of prosthesis that is a priority to be developed at Dr. R. Soeharso Orthopedic Public Hospital, Surakarta is an innovation of under-knee and finger prostheses by implementing low-cost product designs

Designing and Modeling a Fail-Safe Mechanism to Be Used in Attachment of a Transcutaneous Femoral Implant to a Prosthetic Device

Amputations are quite common and even modern prosthetic devices are plagued by problems. There are approximately 2 million people living with limb loss in the U.S. and on average 185,000 amputations occur yearly. Common attachment mechanisms for external prosthetic components to a residual limb, that is, sockets, pose numerous challenges. Issues include skin irritation, discomfort, socket fit issues, and immobility. Issues include skin irritation, discomfort, socket fit issues, and immobility. Transcutaneous implants have great potential as a connection method for external prosthetic components to a residual limb but because the implants are typically solid, they correlate to extremely high infection rates at the skin interface. Only one such system is FDA-approved but is inadequate due to its corresponding high infection rates and suboptimal fail-safe mechanism. Highly porous transcutaneous technology potentially offers a solution to this problem via providing a permanent mounting point that bridges the skin and soft tissues while being anchored in the bone. However, a porous metal transcutaneous implant cannot be properly employed until a highly effective safety mechanism is engineered that prevents damage to the residual bone of the user when accidental loads are applied. Existing products on the market lack optimized fail-safe devices. A fail-safe mechanism is essential to release the prosthesis in both falls and more extreme circumstances, such as the device becoming caught, to prevent injury to the prosthetic device and the user’s residual skeleton and surrounding tissues. Hence, the present work, including manual calculations, finite element analysis, and mechanical testing, was undertaken to develop an optimized fail-safe mechanism to be incorporated into a porous metal transcutaneous implant system