The University of Southampton

Category: Rehab and prostheses

The role of AI in the future of prostheses

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With surgeries becoming more accessible and the solution to treating certain diseases that could potentially be fatal, the emergence of prosthetic limbs has definitely been an important medical advancement. One of the earliest prostheses used was a wooden toe discovered on an Egyptian mummy. Throughout the years, implantable prostheses such as hip and knee replacements have helped many patients return to their normal lives. Study of tissues and discovery of stem cells by Drs. James Till & Ernest McCulloch has allowed scientists to generate whole organs and tissues through tissue engineering, allowing them to perfectly match the organs to the patients, thereby reducing the risk of any complications.

Photo of the first prosthetic used to replace a toe on an Egyptian mummy, over 3000 years ago.

The problem with prostheses

However, despite this, implantable prostheses have their disadvantages. For example, they have a very little active role since they mainly act as a form of structural support. Certain actions such as moving individual fingers in a hand replacement are proven to be difficult since this relies on the work of muscles. Artificial joints are often made out of synthetic materials and these get rejected by the body, causing further illnesses. Moreover, they have a relatively short lifespan of around 5 years, meaning they will need to be constantly replaced: this could cause financial problems for some families. Recently, a new process called Targeted Muscle Reinnovation has been brought up which allows scientists to connect individual nerves to the remaining muscles, and therefore make it easier to perform complicated movements. However, the process of creating and testing this is manually tiring for the user.

So how has Artificial Intelligence helped us?

In 2017, a group of researchers created a computer-controlled prosthetic arm that could perform elaborate movements and carry out complex activities. The process doesn’t require the user’s efforts, thereby making it easier for them. Previously used prosthetics were controlled through EMG sensors placed on the skin. This new method makes it easier for testing out the models. Furthermore, these AI-controlled prostheses respond to nerve signaling patterns, allowing them to produce multiple movements simultaneously. A new technique has also evolved called regenerative peripheral nerve interface (RPNI) relies on wrapping a small piece of muscle around an amputated nerve to produce signals which can then be amplified.

Video showing how the AI-powered prosthetic arm works

AI is slowly being used to introduce intelligence to these artificial prostheses and this will hopefully make them more accessible to people in the future. All current models are just prototypes and are yet to be made available for use.

For more information, check out these links:

This scientific article was written by Marijan Hassan on 23/01/2023

  1. https://www.wevolver.com/article/how-ai-is-helping-power-next-generation-prosthetic-limbs

The article was written on 1/09/2020 by the medical futurist

2. https://medicalfuturist.com/the-future-of-prosthetics-depends-on-a-i/

Should ICD’s be classed as Prosthesis or Orthosis?

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A few weeks ago we had a lecture and a workshop all about prosthesis. Before the lecture I thought it would mostly be about prosthetic limbs and joint replacements. I didn’t consider the wide variety of things that could be considered prosthesis and I also didn’t think about orthosis.

I was particularly interested when he mentioned there is some debate as to whether pacemakers should be classed as prostheses or orthoses.

An X-ray image of my brother’s torso with his ICD fitted. This image was from a year after its implantation when he fell out of a tree and snapped the wire!

This in particular interested me as my brother has a heart condition called Long QT syndrome where, as you may guess, he has a prolonged QT interval of his heartbeat. Due to this, when he was a child, he collapsed three times and each of these times, his heart stopped. Therefore, at the age of ten, he had an Implantable Cardioverter Defibrillator (ICD) implanted subcutaneously.

A few fun facts about ICDs and people who have them:

Every 8-10 years he has to have it replaced as the battery wears out, and he gets an updated model – like a phone upgrade!

Also – magnets interfere with its function; therefore, he is unable to go through metal detectors at the airport, and when we hug him, we can’t have our phones in our hands!

Now back to the debate:

The definition of a prosthesis is an artificial device that replaces a missing or impaired body part. This can be internally e.g. a hip replacement, or externally e.g. a prosthetic leg.

An orthosis is defined as a device used to modify the structural and functional characteristic of the neuromuscular and skeletal systems through systems such as immobilisation or support. Orthoses are also usually external e.g. a foot orthotic corrects flat feet and other foot injuries.

An example of an ICD. Medtronic is the brand of ICD my brother has.

Next, what is the difference between a pacemaker and an ICD?

ICDs are similar to pacemakers. According to the NHS website, pacemakers send electrical impulses to your heart to keep it beating regularly and not too slowly. However, ICDs monitor the heart and send a larger electrical shock to the heart to restart it when it stops or to make the heart rate stop beating abnormally or dangerously.

So where does it fit in the prosthesis vs orthosis debate?

Tested against the definition of a prosthesis:

ICDs do not replace a missing body part, but it does replace the impaired function of the sinoatrial node, the body’s natural pacemaker.

And against the definition of an orthosis:

First of all, it is internal not external which is already rare for an orthosis. It doesn’t modify the structure of the heart, but it does modify the function in the event of abnormally high heart rate or when the heart stops.

The heart is not part of the skeletal system, but is it part of the neuromuscular system? The neuromuscular system is defined as the system affecting nerves and muscles. The heart is a muscle and also has electrical activity, so yes, it is.

The debate comes about because it does not fit either definition perfectly, I don’t think there is necessarily an answer. However, in my opinion it fits the description of being an orthosis more than it fits the description of being a prosthesis. Therefore, I would class ICDs as internal orthoses.

This is a video from the British Heart Foundation talking about ICDs