Innovations in Prosthetic Athletic Limbs - Research Paper Example

Innovations in Prosthetic Athletic Limbs: (Running blade, MotoKnee - by Biodapt) with more information about affiliation, research grants, conflict of interest and how to contact Innovations in Prosthetic Athletic Limbs: (Running blade, MotoKnee - by Biodapt) In medicine, “prosthesis is an artificial extension that replaces a missing body part, which may be lost through trauma” (Prosthetic, 2013) diseases or congenital conditions. A person with limb amputated experiences a staggered emotional and financial lifestyle changes. This type of prosthetic amputee rehabilitation is co-ordinated by an interdisciplinary team of health care professionals including physiatrists and prosthetists. Limb prosthesis includes both upper and lower extremity. Upper extremity prosthesis is used at varying levels of amputation: shoulder disarticulation, trans-humeral prosthesis, elbow disarticulation, trans-radial prosthesis, wrist disarticulation, full hand, partial hand, finger, partial finger and lower extremity prosthesis provides replacement at varying levels of amputation including “hip disarticulation, trans-femoral prosthesis, knee disarticulation, transtibial prosthesis, foot, partial foot and toe” (Orthotics & Prosthetics, 2014). Upper limb amputations are of less common but were it is found to affect all ages. People with upper limb mutations have better choices rather than lower limbed ones. “Throughout the world, the major objective of prosthetics is to restore the functional capacity as well as the best cosmetic result afforded to, held by a limb deficient person” (Strait, 2006). The most common causes of amputations are vascular diseases, nuclear devices (Berry, 2001), “industrial or environmental accidents, terrorist attacks and the lack of basic public health which often leads to diabetes, gangrene and infections” (Strait, 2006). Vascular diseases were common in United States while in “worn-torn” countries of the world such as Combodia, Iran and Afganisthan, 80-85% of amputees are land mine survivors, which have produced 300,000 amputees worldwide. The history of prosthetics and amputation surgery was paralleled by the development of medical science, culture and civilizations itself. Proper construction and alignment of a prosthetic limb requires a high level of skill with expertise, (2006). Under developed countries aid only very few training programmes for these. According to the World Health Organisation, the supply of technicians has fallen by 40,000, which will take about 50years to train 18000 more skilled professionals (Walsh 2003). Basically a prosthetic limb has “three basic components: the socket, which is the interface between the mechanical support system, the extension (or pylon) which replaces the length of the last limb” and may also in co-operate incorporate a knee/elbow joint if the amputation (Strait, 2006) is above the knee/elbow or the artificial foot/hand. Increasing rate of amputations has led to an ever-growing demand for prosthetic limbs. Several factors account for the prosthetic replacement every year. Multiple replacement limbs and repairs are necessary over a life time but a person’s immediate need for a prosthetic limb is not uniform in all cases. For example, a prosthetic replacement is needed typically every 6-12 months for children and every 3-5 years for adults. Therefore, if a child becomes limb deficient at the age of 10, he will require almost 25 limbs throughout the course of his/her lifetime but an adult requires only 15-20 limbs during his life (Prosthetics Outreach foundation, 2005). In the case of active amputees like athletes there will be a lot of wear and tear of the devices. Also, technology continually improves introducing durable and lighter materials, such as graphite, which promotes the customer amputees to have a better life. These prove that numerous limbs are essential to support the basic needs of amputees. The five factors which are important to prosthetic needs are cost, availability, functionality, durability and cleanliness. The components from industrialised countries do not withstand the challenges that nature presents in rural environments. For example, in a farm based economy or tropical climate, conventional limbs made of resins have only a life span of 18months. Ancient times had “prosthesis as simple crutches or wooden and leather cups” (Strait, 2006). Further his was modified into a type of modified crutch or peg in order to free hands for functioning. Development of an open socket peg leg had cloth rags to soften the distal tibia and fibula and allow a wide range of motion (2006). The prosthesis was very functional and incorporated many basic principles. Prosthetic limbs made of fibre have been found in the “wrappings of Egyptian mummies which were probably the creation of the burial priests rather than a functional device” (2006). International Rehabilitation News, 2000, reported a man in France working in a field with a wooden support under his knee. The development of the scientific approach towards medicine and thereby prosthetic science was brought about by three great Western civilizations such as Egypt, Greece and Rome. Earlier, in the 15th century some of the prosthetic alternatives available were basic peg legs and hand hooks, but there was a heightened use of metal for the fabrication of armour. Some of these were fairly advanced but heavy and cumbersome. The 1600’s developed prosthesis by integrating more intricate internal functions such as springs and gears thereby improving the functions. Towards 1700’s there was a great improvement over prosthetic and surgical principles too. Today modern materials such as plastics, carbon fibre, strong and light weight metals like titanium and aluminium which are water resistant and can withstand harsh environments are commonly used. These materials with advanced designs allow the patient for low energy expenditure. (Strait, 2006). There are four types of artificial limbs as follows: (Upper Limb Amputations, n.d.). 1. Transradial Prosthesis: is an artificial limb that can replace an arm below the elbow. Mainly these are of two types; “cable operated limbs that work by attaching a harness, and cable around the opposite shoulder of the damaged arm” (Prosthetics / Upper Extremity, 2012). One more form of prosthetic available are myoelectric arms which do the sensing with the electrodes as the muscles in the upper arm moves causing an artificial hand to open or close. 2. Transhumeral Prosthesis: helps in replacing an arm missing above the elbow. Trans-humeral and femoral amputees experience similar competes associated with the movement of elbow. 3. Trans-tibial Prosthesis: A BYU organisation in 2009 created a 2-ft prosthetics called Trans-tibial for developing countries. These amputees occur below the knee and extend on the calf to the ground. They regain normal movement by retaining the larger portion on the knee providing an easier movement. It includes three main parts: foot, components and socket. Here the socket holds the residual limb and transfers body weight to the prosthetic thereby providing height and strength. The foot functions to provide cushion comfort and a surface area for walking. (Salmond, 2010). (List of Products, 2012). 4. Trans-femoral Prosthesis: This prosthesis helps to replace a leg missing above the knee. These amputees have less efficiency in regaining the normal movement and, therefore, have to use 80% more energy to walk than a person with two whole legs. Combined technologies with hydraulics, mechanical linkages, carbon fibre and computer processors using improved designs give more control to the users. Some of the prosthetics evaluated in the market are as follows: The peg leg is a simple prosthetic, formed with a wooden base and a plaster socket. A total score of 28 was earned mainly on its cost and availability. The PVC with a wooden foot is a more advanced prosthetic, formed with PVC and a plastic socket, it earned a score of 28 again based on its cost and availability, but gained lower in the categories of functionality, durability and cleanliness. The Jaipur foot designed with rubber, wood and aluminium received a better score of 33 for its functionality, durability and cleanliness rather than the cost and availability. The monolimb and sach foot is a plastic socket attached to a prosthetic foot which had an overall score of 23 for its functionality and aesthetics rather than cost and material (thermoplastics) availability. (Salmond, 2010). Running blades are sport prosthetic legs used by runners and long jumpers designed to transfer the speed and energy created by the athlete on to the track. It has three main parts mainly “a custom-fitted socket and liner which connects the prostheses to the athlete’s body, a knee joint” (Ottobock selects Umeco Prepregs for Running Blades, 2012) and finally a “carbon fibre running blade. Athletes use the front part of the foot (the ball) for running and the carbon fibre blades are to reproduce the function of just the forefoot and have no heel. Spikes attached to the running blades help in gripping the track” (Running Blades Used by Paralympics Athletes, 2012). These types of prostheses are meant for Paralympic athletes who show their speed and strength during their athletic competition. (Butter, 2012). The initial rehabilation, fitting and training process is a critical step towards the patients experiencing maximum benefit from the prosthesis. In developing countries, an overwhelming number of prosthesis are necessary and, therefore, their availability, cost and accessibility are significant for limb deficient persons, who may not be able to succeed or may be accepted by the society. Fundamentally proven prosthetic principles are never outdated but the methods to accomplish them are to be refined. The concepts that were impractical in the past became possible now with the development in materials and technology. The emergence of products ranging from conventional to energy-storing feet helps the amputees lead more normal and productive lives. Technological growth and increasing consumer demands have bolstered the prosthetics market growth. High priced prosthetics compel the consumers for buying low priced products, restricting the market growth. The first few years of 21st century and the last decade of 20th century showed rapid technological advances in lower limb prosthesis. Studies from Europe and the US suggest 70-75% of the overall amputee satisfaction with the prosthesis remained constant. A combination of biomechanics of locomotion combined with clinical experimentation showed a steady evolution in lower limb prosthesis. Advanced design technology using cosmetically acceptable materials enabled amputees to replace older prosthetic devices with newer ones and, therefore, providing greater comfort, protection and patient acceptability. This also helped in making the treatments effective and of shorter duration. Technological advances increased the prevalence and visibility of prosthetic devices in the areas of sports such as skiing, running and tennis. (McGimpsey & Bradford, n.d.). Overall, the number of amputees is accelerating worldwide. Say, for an example, there were 1.5 million amputees in the United States who were customers of limb prosthetic services and products. Later on this increased by 185,000 per year, among them 6000 were upper extremity (arm, finger, hand) amputees. New technologies and innovations created a drastic market demand and has well pressurised this field. Academic funded researches decreased while defence related research has dramatically decreased. Most of the amputees prefer a limb that is life-like and inconspicuous. The present state of this art involves the creation of a carefully sculpted match similar to the opposite limb, with individual colouring and giving a life-like finish which seems to be costly. Despite modern prosthesis, people vary in their ability to adjust the change in body image and lifestyle. Since these prostheses prove successful for long-term, direct attachment of an artificial limb to the skeleton avoid difficulties inherent in creating custom – designed prosthesis sockets. Their fitting comforts depend on volumetric matching to the amputation stamp. Because of the costs involved most of the amputees prefer “semi-custom” external coverings that are mass produced industrially from less expensive materials and providing a generic external appearance. Future development of prosthesis will depend greatly on demand. The devices with low market cost and limited functions will continue to expand in an effort to meet the needs of developing world. At the same time, adaptation of innovative techniques from aerospace and computer industries continue, and are applied on the existing artificial limbs as well as producing limbs closely related to the missing ones. Initially these prostheses were meant only for athletes, but with experience manufacturers discovered simpler ones with moderate cost for less active individuals. References Butter, S. (2012). Running on Blades... The Role of Technology in Paralympics. London Evening Standard. Retrieved May 10, 2014, from http://www.standard.co.uk/olympics/olympic-news/running-on-blades-the-role-of-technology-in-paralympics-8104167.html List of Products. (2012). BMS Medical Supplies. Retrieved May 10, 2014, from http://www.bmsmedicalsupplies.com/products.php McGimpsey, G. & Bradford, T. C. (n.d.). Limb Prosthetics Services and Devices: Critical Unmet Need: Market Analysis. Bioengineering Institute Center for Neuroprosthetics Worcester Polytechnic Institution. Retrieved May 10, 2014, from http://www.nist.gov/tip/wp/pswp/upload/239_limb_prosthetics_services_devices.pdf Orthotics & Prosthetics. (2014). Department of Orthopaedic Surgery. Retrieved May 10, 2014, from http://orthosurg.ucsf.edu/patient-care/divisions/orthotics-and-prosthetics/patient-information/services/prosthetics/#.U23S1FegaXY Ottobock Selects Umeco Prepregs for Running Blades. (2012). Reinforced Plastics.com. Retrieved May 10, 2014, from http://www.reinforcedplastics.com/view/27771/ottobock-selects-umeco-prepregs-for-running-blades/ Prosthetic. (2013). ZME Science. Retrieved May 10, 2014, from http://www.zmescience.com/tag/prosthetic/ Prosthetics / Upper Extremity. (2012). Allied Orthopedics. Retrieved May 10, 2014, from http://alliedorthopedics.com/prosthetic-upper.html Running Blades Used by Paralympics Athletes. (2012). Ottobock. Retrieved May 10, 2014, from http://passion.ottobock.com/fileadmin/_passion/user_upload/technology/Running_blades_used_by_Paralympic_athletes.pdf Salmond, L. H. (2010). Transtibial Prosthetics for Developing Countries: A Comparative Analysis with the 2ft Prosthetic Foot. Brigham Young University, Provo, UT. Retrieved May 10, 2014, from http://www.et.byu.edu/~lsalmond/2ft%20Comparison%20Technical%20Report.pdf Strait, E. (2006). Prosthetics in Developing Countries. Prosthetics Resident. Retrieved May 10, 2014, from http://www.oandp.org/publications/resident/pdf/DevelopingCountries.pdf Upper Limb Amputations. (n.d.). Capital Health. Retrieved May 10, 2014, from http://www.cdha.nshealth.ca/amputee-rehabilitation-musculoskeletal- program/patient-family-information/upper-limb-amputations Read More