The University of Southampton

Category: Rehab and prostheses

Empowering Lives: How Technology Enhances Prosthetics

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Modern advancements in technology have given humans the capability to utilise the body in ways that were never even considered as being possible 100 years ago. As a Biomedical Electronics Engineer, I’m passionate about the application of myoelectric prosthetics to help people achieve a better quality of life – something made possible through modern engineering marvels.

My passion for this stemmed from a BBC show named “The Big Life Fix”, in particular, an episode about a girl who wanted to become a dancer but was unable to do so due to a partial leg amputation. The engineers on this show designed her a custom prosthetic which allowed her to fulfil her dream – this inspired me and made me want to follow in their footsteps.

News article showing how a bionic arm is aiding with improving the quality of life of amputees https://www.bbc.co.uk/news/technology-68368439

The lecture about biological sensing particularly appealed to me, especially the article written about the “bionic arm powered by AI”. This article demonstrated how a man, born with no lower arms or legs, was shocked at the research and development made by a company in California. This prosthetic combined EMG with machine learning to power a prosthetic arm capable of performing many complex movements, whilst also having haptic feedback which allowed the user to feel when they’re gripping something. The combination of these technologies made me question: What other technologies are used in prosthetics?

What other technological innovations are evident in the prosthetics industry?

Machine learning applied to a prosthetic hand

Further exploration into this showed that many modern prosthetics use machine learning to improve their efficiency. Machine learning is a form of AI which relies on complex algorithms to analyse data and “learn” which data is more favourable, leading to more human-like decisions. Combining this with electromyography (EMG) and electronic systems paves the way for the potential for the creation of life-like artificial limbs.

Whilst 3D printing does not contribute significantly to how a prosthetic is powered, modern advancements in these technologies have allowed for rapid prototyping. The different methodologies, varying from FDM (Fusion Deposition Modelling) to SLA (Stereolithography), alongside material innovations have lead to a conclusion that 3D printing is an entirely suitable manufacturing process for prosthetic production, especially as the lead times can be very short.

Additive manufacturing techniques from https://nwirc.org/debunking-myths-of-3d-printing/

Ethical Issues with Prosthetics

Whilst the idea of prosthetics is generally a positive topic, there are issues regarding their sustainable use. A study by researchers at the University of Bristol suggests that humans could become overdependent on embodied devices which results from the seamless inclusion of machine learning. An argument that they made was that a prosthetic user would be unable to act effectively in an emergency situation due to the slow and sometimes inaccurate feedback of the device.

Another factor to consider is that some prosthetics can be invasive, requiring sub-surface EMG electrodes, with others requiring friction-fit sleeves which, over time, could cause injury to patients adding further financial stress to the healthcare sector.

Assuming that ethical issues are taken into consideration and legislation is followed, prosthetics could become the forefront of future limb rehabilitation.

The combination of these technologies with new innovations and improvements is improving the quality of life of countless individuals, which I find truly inspiring. Technology has improved drastically within the last 100 years, so the true capabilities are really unknown. Potential issues today could be solved in the near future – I find this very exciting, especially with the knowledge that people in the future requiring a prosthetic will have more promise and improved lives.

Waiting for a knee replacement

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Photo of Doctor holding a post-op knee

My dad, along with almost 400,000 others, has been waiting for a knee replacement on the NHS for over a year [1]. This wait has caused numerous complications for him, as originally he was only going to need a partial knee replacement. Now a full knee replacement is required, which will drastically increase recovery time, pain levels, complications and the cost of the procedure on the NHS [2].

Partial knee replacements have been shown to improve quality of life and could of saved almost £2000 on the NHS over my dad’s lifetime if they acted sooner [2]. If we were to go private, a full knee replacement would cost around £14,000 [1]. This amount of money is unfeasible for a lot of UK citizens, especially since the cost-of-living crisis. But for those who cant pay up, they have to suffer with degradation of health and lifestyle.

Image showing partial knee (left) and total knee (right) replacement https://www.drsantoshshetty.com/partial-vs-total-knee-replacement/ (accessed 11/03/2024)

Knee replacement surgery is rapidly developing, but is only accessible to those paying privately. By choosing NHS, you will lose access to using CT Scans to create 3D images of the patients knee, having assisting robotics in surgery and less invasive procedures. All of these have the potential to decrease recovery time and increase surgery success [1]. I believe the NHS should offer a partial payment service for those undergoing knee replacement, as some individuals who cannot afford £14,000 for private may still like to pay extra for more modern materials or procedures in order to increase their quality of life. This offers more balanced healthcare across those with different incomes and allows all individuals to have a say on how they want their body to be treated.

Day-to-day life becomes much more difficult; walking is a challenge, so chores around the house become an impossible task. Some individuals may even need to take time off work or find a new job entirely. Exercising can also become difficult, which may lead to weight gain. However increased weight leads to more pressure on the knee, creating higher levels of pain and will make recovery even harder after surgery.

Knee issues can be incredibly isolating and have a massive impact on mental health. It’s important to note how much waiting lists impact mental health. My dad has stated that the stress and pain that he’s gotten from his knee has worsened his heart condition – yet another issue that has arisen from having to wait. He’s also unable to play with his grandsons, as even getting onto the floor is an impossible task.

Treating patients for knee pain also becomes difficult with long waiting lists. Knee pain is excruciating, but there are no pain killers that are designed to be taken for moderate-severe pain daily for over a year.  This limits any help to only walking stick and physio exercises in the hopes of reducing pain.

Current NICE Guidelines state that adults should be allowed a choice between partial and full if both options are suitable [3]. But with increasing waiting lists, the “choice” is made redundant. With no end in sight, my dad’s knee will continue to degrade, leaving him with increasing pain with each passing day.

Recommended watch – Dame Judi Dench’s story on her total knee replacement

References:

1.           Knee Replacement Surgery in 2023: Should you Stick with the NHS or go Private? 2024  11/03/2024]; Available from: https://www.thebestofhealth.co.uk/health-conditions/consultants-specialists/how-much-does-knee-replacement-surgery-cost-in-the-uk/.

2.           Burn, E., et al., Cost-effectiveness of unicompartmental compared with total knee replacement: a population-based study using data from the National Joint Registry for England and Wales. BMJ Open, 2018. 8(4): p. e020977.

3.           Joint replacement (primary): hip, knee and shoulder. 2022, NICE Quality Standard 206.