Human-centered Electric Prosthetic (HELP) Hand

Through a partnership with Indian non-profit Bhagwan Mahaveer Viklang Sahayata Samiti, we designed a functional, robust, and and low cost electrically powered prosthetic hand that communicates with unilateral, transradial, urban Indian amputees through a biointerface. The device uses compliant tendon actuation, a small linear servo, and a wearable garment outfitted with flex sensors to produce a device that, once placed inside a prosthetic glove, is anthropomorphic in both look and feel. The prosthesis was developed such that future groups can design for manufacturing and distribution in India

Study of Transtibial Prosthesis at ALC, Chennai, with Special Reference to Modular Prosthesis

INTRODUCTION: WHO estimates that there are 800 million persons with disability in the world and 100 million of them are in India alone. National sample survey organization (The Survey in the 58th Round) in 2002 has shown that 1.85 crore disabled person i.e. 1.8% of the total estimated population present in our country. Of them, 10.66 million (58% of all the disabled) are having Locomotor Disability. There are 8.3 lakh (78/1000 disabled) are with limb loss (NSSO, 2002). Amongst them, most are Transtibial amputee and they need a prosthetic device of appropriate design and at a reasonable cost to perform as effective as the lost limb. Whether as a result of trauma or disease, amputation has always been a part of human experience. There has always been the desire to replace the lost part for functional, cosmetic reasons or for a combination of both. In our national policy and as a result of implementation of Persons with Disability Act’95, an all round effort in this regard was made. Now there is an increased demand for prosthetic fitment services and efforts are made by our government to fit artificial limb by camp approach in order to cover a majority of the amputees. AIM OF THE STUDY: This study was conducted at The Artificial Limb Fitting Center of the Government Institute of Rehabilitation Medicine, Chennai. The Aim of the study was to analyse the two commonly used prosthesis namely the Laminated Exoskeletal Transtibial Prosthesis and the Modular Transtibial Prosthesis in terms of cost, efficacy, utility and also to identify the demographics profile in the study group. SUBJECTS AND METHODS: Thirty unilateral Transtibial amputees of which fifteen using Laminated B.K. Prosthesis with SACH foot and fifteen using Modular B.K Prosthesis with SACH foot for more than 6 months attending ALC, Chennai were selected for the study. The study was conducted between Jan 2011 to May 2011. The patients were explained about the study. A case history format, questionnaires as per published PEQ (Prosthesis evaluation questionnaires) and consent form was filled for each of the selected cases. All the subjects had a general health check up and counseling. INCUSION CRITERIA: 1. Unilateral Below Knee Amputees, 2. Age between 10- 65 years, 3. Amputee using Laminated or Modular Transtibial Prosthesis for more than 6 months, 4. Willingness to cooperate in the study, 5. No residual limb swelling or wound. EXCLUSION CRITERIA: 1. Amputees with other associated limb loss, 2. Amputees with the problems in the sound leg such as fracture and deformities, 3. Amputees without prosthesis, 4. Unmotivated persons. SUMMARY: The study was conducted on 30 unilateral below knee amputees at ALC, Chennai, to compare the cost, efficacy and utility of Transtibial prosthesis. To summarise 1. 63.3% of amputee belongs to age group of 16 -45 years 2. Majority of amputees were males 76.67% were males. 3. 40% of the patients were Daily Laborers 4. Train and Road Traffic Accident were the commonest cause of amputation 70%. 5. The average stump length percentage was 43.31 %. The mean stump length was 20.07 cm. 6. Laminated Prosthesis was costlier than Modular Prosthesis 7. Laminated Prosthesis was cosmetically unacceptable in 40% & Modular in 20% of patients 8. Threshold in doorway was the commonest (70%) Architectural Barrier. 9. Heaviness of Prosthesis was complained by 33% of patients with Laminated Prosthesis and 20 % Patients using Modular Prosthesis. 10. There was no statistical significant findings in terms of ease of performing daily activities such as Sitting, Walking, Toileting, Dressing, Cycling, House Hold, Field Work Place and Recreational Activities. CONCLUSION: This study was aimed to find out the cost, efficacy and utility of the two types of Transtibial Prosthesis i.e. Modular Transtibial Prosthesis and Laminated Transtibial. Prosthesis (Conventional) with SACH foot. It was found that Modular Prosthesis was superior in terms of low cost, high cosmesis and more comfort with a comparable efficacy and utility as compared to the Laminated Prosthesis. In smaller institutions where there is limited financial and manpower availability relative to the patient load Modular Prosthesis is definitely going to be a better choice for Transtibial Amputees. The lesser cost of fabrication of modular prosthesis is an added advantage. Disadvantages of fabricating modular prosthesis are it requires expertise and prefabricated Modular kits must be available. This would mean that it requires a well equipped institutional set up such as ALC, Chennai with adequately trained Prosthetist and facilities for gait analysis and training. The combination of skills, concepts, and techniques of the amputation surgeon, prosthetist, and has enabled amputees to successfully compete in sports and other recreational activities because of their prostheses, rather than inspite of them. Hence due consideration has to be given while designing lower limb prosthesis and it should to cater to the amputee’s need. So as Meanly S. has stated in 1995 the major objective of Prosthetics the world over is to restore the amputee as functional a capacity as possible in his cultural environmental , at the same time achieving a good cosmetic result. Therefore we conclude from the study that comparing Modular Transtibial Prosthesis with conventional laminated Transtibial prosthesis, modular prosthesis is by far superior in terms of technology, cost effectiveness, comfort and cosmesis

Teleoperator system man-machine interface requirements for satellite retrieval and satellite servicing. Volume 2: Design criteria

For abstract, see

Measuring the functional and clinical effectiveness of a passive dynamic ankle foot orthosis when used to rehabilitate complex limb salvage post lower limb blast trauma

Summary: Studies suggest passive dynamic ankle foot orthoses (PD AFO) are effective at improving gait and patient reported outcomes measures (PROM) in personnel who have undergone limb salvage due to blast trauma. Studies using PD AFOs have included able bodied and personnel with variable clinical presentations. This study examines if PD AFO use improves gait and PROMs in personnel injured by the same blast mechanism with similar unilateral deck slap blast injuries. Introduction: Rehabilitation outcomes following limb salvage are reported as substandard, with personnel frequently demonstrating poor functional and psychosocial outcomes. There has been a call for advancements in orthotics to support limb salvage patients eager to preserve their lower limb, yet function at high levels of mobility. PD AFOs are used to improve clinical outcomes. Studies have shown that when combined with exercise rehabilitation PD AFOs can decrease biomechanical pain, improve physical activity and enable return to work in high functioning adults. Method: The study consisted of 12 individuals who had sustained “deck slap” injuries caused by high energy blast trauma. Kinematic, kinetic and temporal spatial parameters were measured walking with and without their PD AFO at a self-selected speed. Participants completed the Lower Extremity Functional Scale (LEFS) and the Foot and Ankle Outcome Score (FAOS) pre and post PD AFO provision. The mean and standard deviation was calculated for each test measure and statistical analysis was conducted using R version 3.5.3. Results: Use of a PD AFO significantly improved each participant’s mean PROM score and user’s propulsive capability. Participant’s gait profile score (GPS) also improved when using the PD AFO. Conclusion: This study suggests that unilateral PD AFO use can improve gait parameters and PROMs in injured personnel who have sustained unilateral blast trauma

The Effects of Insoles on Biomechanics of Standing Balance and Walking of Trans-Femoral Amputees

As the world’s population ages, it is expected that the number of people having experienced amputations will grow, alongside comorbidities. Lifestyle adaptations associated with lower limb amputation are likely to occur and, with this, there is likely an impact on mobility and balance. This research has initially investigated, via a comprehensive survey, the impact of lower limb amputation and prosthetic use on the lives of amputees with a focus on their balance and mobility during daily activities. The survey consisted of parts of the Prosthesis Evaluation Questionnaire (PEQ), the Activities-Specific Balance Confidence (ABC) Scale, and the Oswestry Disability Index (ODI). The results of the survey (155 participants in all levels of lower limb amputation) showed that the majority of LLAs suffered from stump and intact-side pain, frequent falling, LBP with impact on their functionality, and a lower level of balance confidence. A considerable proportion of respondents were at risk of falling and needed intervention to improve their balance. According to the mentioned problems which LLAs deal with on a daily basis and the effectiveness of insoles use on similar balance problems and lower limb pains among non-amputees, it was supposed the insoles used on the intact side of LLAs would improve their situation. Therefore, biomechanical research was conducted to examine the effect of insoles use on perturbed standing balance and self-selected speed walking of TF amputees (11 participants) and a group of non-amputees (14 participants). Data was collected via 3D motion analysis systems, including high-speed cameras and force platforms. The function level of amputee participants was evaluated according to spatio-temporal variables of their walking and their responses to the ABC scale and PEQ-Mobility parts of the survey. Lower self-selected speed and asymmetrical walking compared to non-amputees indicated that amputee participants had lower levels of function. Results of the ABC scale questionnaire showed that most of them had moderate functional level (three amputees with good and one with a low level of functionality). These results corresponded with their PEQ-M scores. The kinematic and kinetic results of walking showed asymmetrical performance of amputees’ limbs with a prominent role of the intact limb. However, the relationship between the centre of mass (COM) and centre of pressure (COP) with lateral borders of BOS as the balance did not exhibit any difference between amputees and non-amputees, which shows proper balance maintenance of amputees during walking. For studying the biomechanics of standing balance, a perturbation was applied by a front/back-pulling load (2.5% of body weight) to the waist of each participant which, upon release, respectively induced backwards and forward falling. The observed changes in COP, COM, ground reaction forces and joint moments during standing and in response to the perturbation indicated that the intact limb of TF amputees had the main role in their balance, which resulted in an asymmetrical posture. Both groups used ankle movements to maintain balance in reaction to the perturbation. Insoles use was associated with changes in a very limited number of biomechanical variables for non-amputees and in none of the amputees’ biomechanical variables. But, the quantitative evaluation of insoles showed most participants were satisfied with insoles and felt more comfortable in their daily activity during their use. The results of this research (including both survey and biomechanical studies) affirm the necessity of providing more support (in the form of medical and musculoskeletal rehabilitation interventions) for LLAs to address the current issues, particularly with balance and their function in daily activities. The use of insoles in the initial phase of gait training after the first prosthesis fit might be beneficial for LLAs