Category: Implants and Prostheses

Categories : Implants and ProsthesesTags :

Prosthetics Technology – Restoring a Life of Mobility, Without Limitations

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A new generation of prosthetic digits is transforming the lives of finger amputees.

Whilst small in size, the role of fingers in our overall body mobility is huge. Our fingers play a critical role in the accomplishment of everyday activities, allowing for tactile sensations and multiple fine movements from the grasping and manipulation of objects through to performing complex tasks.

Unfortunately, a significant number of finger amputations occurs each year. In fact, finger amputations account for well over 90% of all upper limb loss. The impact of this often extends far beyond the immediate area of amputation, having a much greater effect on the individual’s entire mobility.  According to the American Medical Association, losing the index and middle fingers mid-metacarpal creates a 40% impairment of the hand, 36% impairment of the upper extremity and 22% impairment of the whole body. The loss of four fingers is equivalent to a leg amputation or the loss of an eye in total impairment. [1]

The role of prosthetics in assisting these amputees to lead a far more mobile and functional life has come a long way. Traditionally, prosthetic fingers were only cosmetic and not functional. However, innovations in prosthetics technology have revolutionised this, enabling partial hand and/ or finger amputees to not only return to work but, as importantly, to a life without limitations. A recent report by the National Library of Medicine, stated that, “Over the past decade, significant advances have been made in 3D-printed prosthetics owing to their light weight, on-site fabrication, and easy customisation.” [2]

“Technology has struggled to provide relevant and fit-for-purpose solutions, leaving a void in the market,” says Ernst van Dyk (Managing Director, Össur South Africa). Össur, a global provider of non-invasive orthopaedics, recently announced its ownership of Naked Prosthetics – a provider of functional devices for partial hand and finger amputees. Making use of traditional machining, injection moulding and 3D printing, Naked Prosthetics develops and makes customised, robust and functional prostheses.

“We offer a fully customisable prosthetic finger design that allows the amputee full finger functionality,” continues van Dyk. These biomechanical prosthetic fingers are designed to replace partial or total loss of the fingers and functions exactly as a finger would. Further, the prosthetic, a non-motorised device, uses the remainder of an amputee’s finger to power the device.

Using sizing rings and photos specific to each amputee, the devices make use of a very high-end 3D printer to create the simple, elegant and fully functional device. Working with physicians, surgeons and prosthetists, each prosthetic finger is customised to the exact needs of each individual patient. Each affected finger receives a custom design to restore digit length, joint spacing and range of motion, accounting for a user’s unique amputation level and joint capability. Beyond the functional design, each has been tested for structural integrity and fatigue life.

Using mass-customisation and novel design, Naked Prosthetics’ fingers restore natural motion, dexterity and strength and are the result of strong collaboration between experienced engineers from aerospace, robotics, prosthetics and product development together with clinicians and patients. A strong focus on engineering design means that the devices are kinematically and structurally optimised to account for both the capabilities of the patient’s driving joints and the conditions under which the devices are used. Each device is designed with a safety factor above and beyond any forces the user will experience and can be used in virtually any environment.

Operated by the user through intuitive movement and driven by remaining intact joints, these prostheses require little acclimation and restore digit dexterity and hand strength without specialised training. Users report that with time these prostheses feel like a part of their bodies.

“Once a customer is fitted with their prosthetic finger, it is only a matter of weeks or months before they are fully functioning,” continues van Dyk. “Although the finger, or a portion of the finger is gone, the vibration of what is left sends a message to the brain allowing it to re-map and bring back function.” These functional, high-quality finger devices aim to restore the user’s ability to perform daily tasks, support job retention and encourage an active lifestyle.

Products such as these were not possible until only a few years ago. Says van Dyk, “Detailed CAD technology and 3-D printing makes it possible to mass-produce mechanical prostheses. It includes our custom body-driven devices (PIPDriver, MCPDriver, and ThumbDriver) that are designed for the unique shape of each patient’s hand and fingers after their amputation as well as the GripLock Finger (a passive, positionable device for those who suffered complete finger amputations or were born with congenital anomalies).” The GripLock Finger weighs in at an industry best of 25 grams and can hold up to 90 kilograms. These prostheses, made from aluminium, stainless steel, and medical-grade nylon (with a conductive tip that works on smart touch screens), are strong and rugged.

“The prevalence of finger and thumb amputations and the impact of this on the lives of these amputees deserves a high level of care,” says van Dyk. “Whilst development of prostheses has been impeded by technical and anatomical challenges, a new generation of practical, durable and body-driven prosthetic digits can enable care teams to address an unmet need and transform the lives of people who have undergone finger amputation.”

[1] April 2021 O&P Almanac by AOPA – Issuu

[1] Functional improvement by body-powered 3D-printed prosthesis in patients with finger amputation – PMC (nih.gov)

Categories : Implants and ProsthesesTags :

Össur South Africa Extends its Range of Non-invasive Prosthetics with Naked Prosthetics for Finger and Partial-hand Amputations

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Össur South Africa has announced the availability of Naked Prosthetics to the local market. This range of custom-made prostheses, precisely tailored to the user’s amputation and individual hand structure, positively impacts those with finger and partial-hand amputations by providing functional finger prostheses of high quality.

“Partial hand limb loss is the most prevalent of upper limb loss, with over 90% of upper limb amputations involving the fingers. Finger and partial-hand amputations also accounts for a significant number of amputations each year,” says Ernst van Dyk, Managing Director, Össur South Africa.

Whilst more common amongst working age men, finger and partial-hand amputations occurs regardless of gender or age. “The lack of mobility resulting from a finger and partial-hand amputation is not limited to the area of amputation only. Many amputees experience loss of mobility beyond the area of amputation,” stresses van Dyk. No fewer than 5% experience a resultant impairment of the entire body and as many as 75% of heavy manual labourers are unable to return to work.

“With Naked Prosthetics we are dedicated to positively impacting the lives of finger and partial-hand amputees. We aim to provide them with functional, high-quality solutions that seamlessly integrate into their lives and empower them to not only resume employment but, as importantly, to engage in the activities they love, thereby assisting them to live a life without limitations,” says van Dyk.

Naked Prosthetics’ innovative solutions, the result of strong research and development (R&D) efforts and manufacturing capabilities, has been recognised by Business Insider as one of the medical technologies that are changing people’s lives[1]. It currently offers four custom-designed devices that are fabricated to within millimetres of a patient’s unique anatomy to mimic the complex motion of a finger.

  • The PIPDriver is a body-controlled prosthesis designed for a finger amputation or limb difference on the proximal or distal phalanx. Its design is anatomically adapted to the proximal and distal interphalangeal joints for intuitive and natural movements. Benefits include improved functionality for everyday activities. It is easy to clean and care for, easy to put on and take off and has a cage-like structure that protects the residual finger. Its slim and smooth design allows the prosthesis to be worn on two or more adjacent fingers. It also includes a conductive tip option for touchscreen operation.
  • The MCPDriver is a body-driven prosthesis designed for a finger amputation or limb difference on the MCP joint (also known as the knuckle) of the index, middle, ring, and/or the little finger. It restores the original finger length, thereby helping to imitate natural gripping patterns and excels at restoring pinch, key, cylindrical and power grasps as well as grip stability. Its durable stainless-steel linkages and robust components allow the user to return to a highly demanding lifestyle. Benefits include a silicone pad that cushions the backplate for improved comfort, interchangeable silicone adjustment inserts that can be used to vary the volume and adjusting discs to obtain the best possible fit. Its natural abduction and adduction allow for intuitive use. As a result, the acclimatisation time after the initial fitting can be considerably reduced. It also includes the conductive tip option for touchscreen operation.
  • The ThumbDriver is a body-controlled prosthesis designed for an amputation or limb difference on the MCP joint of the thumb. It can restore two and three-point grips, enable secure gripping patterns with medium to large diameters and improve fine motor functions and skills. It features an adjustable preflex option that allows you to adapt the prosthesis according to the requirements of the task at hand. As a result, functional gripping patterns can be more easily attained.
  • The GripLock Finger is a passive and positionable prosthetic finger designed for a finger amputation or limb difference on the MCP joint of the index, middle, ring, and/or little finger. It is intended for use in conjunction with a custom-made socket adapted by a certified prosthetist. You can flex the finger to various degrees with your other hand or on a hard surface. Subsequently, you can release and fully extend the GripLock Finger by pressing the latch (lever arm) on the back or flexing the finger beyond the last locking position. It restores the original length, supports the use of both hands, prevents a misalignment of the metacarpal bone and provides a valuable tool to master everyday activities.  GripLock Fingers can be combined with our MCPDriver, PIPDriver, and/or ThumbDriver.

Says Kai, a trained plant and machine operator who suffered the loss of his forefinger, middle and ring finger after a work-related accident. “Thanks to the precise adaptation to my individual anatomical conditions, the prosthesis is an irreplaceable everyday companion for me. When I come home at night, I take off the prosthesis in seconds – just like you kick off your shoes after a long day at work. I think it’s important to convey to other people in similar situations that a work accident like mine doesn’t have to mean the end of the world. You can come to terms with many situations and end up living a normal life.”

Similarly, Cara (an active member of the Finger and Partial Hand Amputee Peer & Support Group), lost two and a half fingers on her left hand due to an unforeseen accident. Prior to her accident, Cara was an avid yogi and enjoyed practicing inversions (yoga poses where the heart is higher from the ground than the head) and handstands. “I spent a year doing physical therapy to regain strength in my left hand, but I still felt as though I was struggling to hold and grip my mat as I practiced yoga,” she recalls. Every time she tried to balance her weight, she would fall backwards due to the lack of grip and support. Within one week of receiving her Naked Prosthetics PIPDrivers, Cara was able to hold a side plank during yoga. “You may feel hopeless in the moment, but it does get better. And you will be surprised at what you could learn. I am a different person now and I grew from the experience.”

“We are committed to helping digit amputees discover innovative and life-changing solutions. It’s all about function and getting people back to living full lives, without limitations,” continues van Dyk. “We believe our range of technologically advanced and custom-made prostheses helps to achieve exactly this and we are excited to be able to offer it to local amputees.”

To find out more, please visit: https://www.ossur.com/en-za/prosthetics/np-devices

[1] Naked Prosthetics’ Technology Recognized – The O&P EDGE Magazine (opedge.com)

Categories : ENT Implants and ProsthesesTags :

Among Those Eligible, Low Levels of Referrals for Cochlear Implants

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Photo by Brett Sayles

A survey conducted in the UK found that people with severe to profound hearing loss who were eligible for cochlear implants were less likely to be referred if they lived in deprived areas and were male.

The study, published in PLOS Medicine, was carried out to determine the rates at which people in the UK with hearing loss were getting correctly referred for implants under the NHS, and where disparities might exist. Referrals were to be made on the basis of meeting pure tone audiometric threshold criteria.

Of 6171 participants in the survey who underwent the pure tone test and already did not have a cochlear implant, only 38% were informed of their eligibility and a mere 9% were actually referred for assessment.

Participants were less likely to be referred if they lived in more economically deprived areas and also within London, were male or were older. In addition to these factors, living in more remote areas, and being Black or Asian also reduced the likelihood of being informed of eligibility.

Lower odds of referrals in economically deprived areas is in line with data from both public and private healthcare sectors in Australia and the U.S.

The researchers also found that the presence of a “cochlear implant champion” increased the likelihood of discussions around cochlear implants but not referrals. That males were less likely to be referred or informed to were interpreted as stemming from men’s differences in health-seeking behaviour compared to women.

Limitations included the observational nature of the study, reliance on accurate documentation of the referring service, and potential underrepresentation of certain demographic groups.

Categories : Implants and Prostheses NeurologyTags :

New Neural Prosthetic Device Can Help Restore Memory in Humans

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Source: CC0

Scientists have demonstrated the first successful use of a neural prosthetic device to recall specific memories. The findings appear online in Frontiers in Computational Neuroscience.

This groundbreaking research was derived from a 2018 study led by Robert Hampson, PhD, professor of regenerative medicine, translational neuroscience and neurology at Wake Forest University School of Medicine. That study demonstrated the successful implementation of a prosthetic system that uses a person’s own memory patterns to facilitate the brain’s ability to encode and recall memory, improving recall by as much as 37%.

In the previous study, the team’s electronic prosthetic system was based on a multi-input multi-output (MIMO) nonlinear mathematical model, and the researchers influenced the firing patterns of multiple neurons in the hippocampus, a part of the brain involved in making new memories.

In this study, researchers from Wake Forest and University of Southern California (USC) built a new model of processes that assists the hippocampus in helping people remember specific information.

When the brain tries to store or recall information such as, “I turned off the stove” or “Where did I put my car keys?” groups of cells work together in neural ensembles that activate so that the information is stored or recalled.

Using recordings of the activity of these brain cells, the researchers created a memory decoding model (MDM) which let them decode what neural activity is used to store different pieces of specific information.

The neural activity decoded by the MDM was then used to create a pattern, or code, which was used to apply neurostimulation to the hippocampus when the brain was trying to store that information.

“Here, we not only highlight an innovative technique for neurostimulation to enhance memory, but we also demonstrate that stimulating memory isn’t just limited to a general approach but can also be applied to specific information that is critical to a person,” said Brent Roeder, Ph.D., a research fellow in the department of translational neuroscience at Wake Forest University School of Medicine and the study’s corresponding author.

The team enrolled 14 adults with epilepsy who were participating in a diagnostic brain-mapping procedure that used surgically implanted electrodes placed in various parts of the brain to pinpoint the origin of their seizures.

Participants underwent all surgical procedures, post-operative monitoring and neurocognitive testing at one of the three sites participating in this study including Atrium Health Wake Forest Baptist Medical Center, Keck Hospital of USC in Los Angeles and Rancho Los Amigo National Rehabilitation Center in Downey, California.

The team delivered MDM electrical stimulation during visual recognition memory tasks to see if the stimulation could help people remember images better.

They found that when they used this electrical stimulation, there were significant changes in how well people remembered things. In about 22% of cases, there was a noticeable difference in performance.

When they looked specifically at participants with impaired memory function, who were given the stimulation on both sides of their brain, almost 40% of them showed significant changes in memory performance.

“Our goal is to create an intervention that can restore memory function that’s lost because of Alzheimer’s disease, stroke or head injury,” Roeder said.

“We found the most pronounced change occurred in people who had impaired memory.”

Roeder said he hopes the technology can be refined to help people live independently by helping them recall critical information such as whether medication has been taken or whether a door is locked.

“While much more research is needed, we know that MDM-based stimulation has the potential to be used to significantly modify memory,” Roeder said.

Source: Atrium Health Wake Forest Baptist

Categories : Cardiovascular Disease Implants and ProsthesesTags :

A New Pain-free Way to Treat Ventricular Arrhythmia

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A breakthrough study sets the foundation of a ground-breaking treatment regimen for treating ventricular arrhythmia. The study, published in Nature Communications, demonstrates the design and feasibility of a new hydrogel-based pacing modality.

The urgent need for an effective therapeutic regimen for ventricular arrhythmia inspired a team led by Dr. Mehdi Razavi at The Texas Heart Institute (THI), to collaborate The University of Texas at Austin (UT Austin) Cockrell School of Engineering led by Dr. Elizabeth Cosgriff-Hernandez, to co-develop an innovative strategy that addresses the pathophysiology of re-entrant arrhythmia.

Ventricular arrhythmia, which occurs in the lower chambers of the heart or ventricles, is the leading cause of sudden cardiac death in the United States.

When heart rhythm abnormality occurs in a self-sustained manner, it is called re-entrant arrhythmia, which is usually fatal.

“Re-entry occurs mainly from delayed conduction in scarred heart tissues, usually after coronary artery occlusion during a heart attack, which can be corrected by enabling pacing in these regions,” said Dr. Razavi, a practicing cardiologist and cardiac electrophysiologist.

“These hydrogels then can access the scarred tissue, thereby enabling direct pacing of the otherwise inaccessible regions of the heart.”

Given hydrogels’ biostability, biocompatibility, tunable properties, and the ease of incorporating electrical conductivity, the scientists are exploring them as potential electrodes that can be easily delivered inside coronary veins.

A clinical advantage of the unique system is that ischemia can be avoided by delivering the hydrogel using the veins.

The researchers successfully deployed the innovative hydrogel technology through minimally invasive catheter delivery in a pig model.

“The hydrogels have significant conductive properties that enable simultaneous pacing from multiple sites along the length of the hydrogel and create a conduction highway similar to those in Purkinje fibers,” according to Dr. Cosgriff-Hernandez.

Today, arrhythmia is treatable with medicines and procedures that control the irregular rhythms.

The current anti-arrhythmic drugs on the market are not always effective; although the drugs slow the conduction velocity, they facilitate re-entry arrhythmia.

Moreover, these drugs can be toxic and can lead to the destruction of tissues near the diseased regions of the heart.

Even with the widely used interventional ablation therapies, arrhythmia recurs in a significant proportion of patients. None of these procedures address the mechanism of re-entry.

Cardiac defibrillators implanted to compensate for the shortfalls in the current therapy options are painful when delivering electric shocks to restore heart rhythm and can severely deteriorate the patient’s quality of life.

If left untreated, arrhythmia can damage the heart, brain, or other organs, leading to stroke or cardiac arrest, during which the heart suddenly and unexpectedly stops beating.

“When injected into target vessels, the conductive hydrogel conforms to the patient’s vessel morphology. Adding a traditional pacemaker to this gel allows for pacing that resembles the native conduction in the heart — effectively mimicking the native electrical rhythm of the heart — and extinguishes the cause for arrhythmia, providing painless defibrillation,” added Dr. Cosgriff-Hernandez.

The work demonstrates for the first time the ability to confer direct electrical stimulation of the native and scarred mid-myocardium through injectable hydrogel electrodes as a pacing modality.

With minimally invasive catheter delivery and standard pacemaker technologies, this study indicates the feasibility of a novel pacing modality that resembles native conduction, potentially eliminating lethal re-entrant arrhythmia and providing painless defibrillation, which can be successfully adopted in a clinical workflow.

The scientific advance is significant considering pain management is highly relevant to overall wellness for patients with heart, lung, and blood diseases.

Such innovation in painless defibrillation and preventing arrhythmia could revolutionize cardiac rhythm management.

Source: Texas Heart Institute 

Categories : Implants and Prostheses NeurologyTags :

Brain Implants ‘Turn the Lights Back on’ for Cognitive Function after TBI

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Deep brain stimulation illustration. Credit: NIH

Moderate to severe traumatic brain injury carries lasting effects: trouble with focussing, recall and decision-making. Though many recover enough to live independently, their impairments prevent them from returning to school or work and from resuming their social lives. Current treatments offer little improvement, but results of a clinical trial of a new brain stimulation device, published in Nature Medicine, have shown great promise in at least partially restoring cognitive function.

“In general, there’s very little in the way of treatment for these patients,” said Jaimie Henderson, MD, professor of neurosurgery and co-senior author of the study.

But the fact that these patients had emerged from comas and recovered a fair amount of cognitive function suggested that the brain systems that support attention and arousal – the ability to stay awake, pay attention to a conversation, focus on a task – were relatively preserved.

These systems connect the thalamus, a relay station deep inside the brain, to points throughout the cortex, the brain’s outer layer, which control higher cognitive functions.

‘Dimmed lights’

“In these patients, those pathways are largely intact, but everything has been down-regulated,” said Henderson, the John and Jene Blume-Robert and Ruth Halperin Professor. “It’s as if the lights had been dimmed and there just wasn’t enough electricity to turn them back up.”

In particular, an area of the thalamus called the central lateral nucleus functions as a hub that regulates many aspects of consciousness.

“The central lateral nucleus is optimised to drive things broadly, but its vulnerability is that if you have a multifocal injury, it tends to take a greater hit because a hit can come from almost anywhere in the brain,” said Nicholas Schiff, MD, a professor at Weill Cornell Medicine and co-senior author of the study.

The researchers hoped that precise electrical stimulation of the central lateral nucleus and its connections could reactivate these pathways, turning the lights back up.

Precise placement

In the trial, the researchers recruited five participants who had lasting cognitive impairments more than two years after moderate to severe traumatic brain injury. They were aged 22 to 60, with injuries sustained three to 18 years earlier.

The challenge was placing the stimulation device in a small target in the right area, which varied across individuals. Each brain is shaped differently to begin with, and the injuries had led to further modifications.

“That’s why we developed a number of tools to better define what that area was,” Henderson said. The researchers created a virtual model of each brain that allowed them to pinpoint the location and level of stimulation that would activate the central lateral nucleus.

Guided by these models, Henderson surgically implanted the devices in the five participants.

“It’s important to target the area precisely,” he said. “If you’re even a few millimetres off target, you’re outside the effective zone.”

A pioneering moment

After a two-week titration phase to optimise the stimulation, the participants spent 90 days with the device turned on for 12 hours a day.

Their progress was measured by a standard test of mental processing speed, called the trail-making test, which involves drawing lines connecting a jumble of letters and numbers.

“It’s a very sensitive test of exactly the things that we’re looking at: the ability to focus, concentrate and plan, and to do this in a way that is sensitive to time,” Henderson said.

At the end of the 90-day treatment period, the participants had improved their speeds on the test, on average, by 32%, far exceeding the 10% the researchers had aimed for.  

“The only surprising thing is it worked the way we predicted it would, which is not always a given,” Henderson said.

For the participants and their families, the improvements were apparent in their daily lives. They resumed activities that had seemed impossible – reading books, watching TV shows, playing video games or finishing a homework assignment. They felt less fatigued and could get through the day without napping.

The therapy was so effective the researchers had trouble completing the last part of their study. They had planned a blinded withdrawal phase, in which half the participants would be randomly selected to have their devices turned off. Two of the patients declined, unwilling to take that chance. Of the three who participated in the withdrawal phase, one was randomized to have their device turned off. After three weeks without stimulation, that participant performed 34% slower on the trail-making test.

The clinical trial is the first to target this region of the brain in patients with moderate to severe traumatic brain injury, and it offers hope for many who have plateaued in their recovery.

“This is a pioneering moment,” Schiff said. “Our goal now is to try to take the systematic steps to make this a therapy. This is enough of a signal for us to make every effort.”

Source: Stanford Medicine

Categories : Cardiovascular Disease Implants and ProsthesesTags :

No-aspirin Regimen Benefits Heart Failure Patients with LVADs

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Photo by cottonbro studio

A recent clinical trial published in JAMA found that excluding aspirin for advanced heart failure (HF) patients with a ventricular assist device saw a reduction in bleeding events while maintaining their survival rates.

The ARIES-HM3 Randomised Clinical Trial assessed the safety and efficacy of excluding aspirin from the antithrombotic regimen in patients with advanced HF who have undergone implantation of a fully magnetically levitated left ventricular assist device (LVAD).

“We can now safely say that not giving aspirin is not only safe from a thromboembolic risk profile but results in improved adverse event rate by a significant reduction in non-surgical bleeding which is a well-known complication related to LVAD therapy,” said Mirnela Byku, MD, P.D, MBA, co-author of the study and director of the UNC Durable Mechanical Circulatory Device Program at the UNC School of Medicine.

“Improving not only longevity but also reducing morbidity and improving quality of life is a big focus in the field of MCS.”

Until this study, there had been no consensus in the field about use of or dose of aspirin in the LVAD population.

The international clinical trial followed a randomised, double-blind, placebo-controlled design and involved 628 patients across 51 centres in 9 countries.

The patients were divided into two groups: one receiving aspirin (100mg/d) and the other receiving a placebo in addition to vitamin K antagonist (VKA) therapy.

A focus was to determine if the likelihood a patient experiences major nonsurgical haemocompatibility-related adverse events (such as stroke, pump thrombosis, major bleeding, or arterial peripheral thromboembolism) within 12 months differed between the two groups.

The results showed that not giving aspirin to patients with advanced HF, treated with a fully magnetically levitated LVAD who are receiving VKAs, did not make their survival worse. Furthermore, aspirin avoidance was associated with a significant reduction (34%) in major nonsurgical bleeding events.

Source: University of North Carolina Health Care

Categories : Implants and ProsthesesTags :

‘Cyberpunk’ Inspired Finger Prostheses will be Available to All via 3D Printing

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A groundbreaking, easy-to-use 3D printable finger prosthesis created by a recent University of Houston graduate could offer amputees a low-cost solution to restore finger functionality. David Edquilang first designed Lunet, which doesn’t need metal fasteners, adhesives or special tools to assemble, as an undergraduate student at the Gerald D. Hines College of Architecture and Design. While standard prostheses can cost thousands of dollars, Edquilang aims to make his design open access on the internet, instead of selling it.

Edquilang explains: “Lunet began when I decided to design and 3D print prototype finger mechanisms for a prosthetic hand for fun in my free time. 2 weeks and 18 prototypes later, I created a mechanism and finger structure that closely replicated the range of motion of real fingers.”

Edquilang’s mentor at UH was Associate Professor Jeff Feng, co-director of UH’s Industrial Design program. Through a partnership with Harris Health System, Feng learned of a patient who had her fingers amputated due to frostbite. Inspired by working on an upper limb prosthesis Edquilang previously developed with student Niell Gorman, working closely with Professor Feng, Edquilang created prosthetic fingers that returned mobility to the patient, allowing her to pick up objects again.

Edquilang continues: “My professor and I were then referred to a finger amputee who lost 3 of her fingers. I applied the mechanism I created to design a finger prosthesis for her. Nearly 40 design iterations and multiple rounds of patient testing were performed to ultimately create a functional prosthesis that fit her.

His “breakthrough” came from a literal break in his design.

“After we finished working with this amputee patient, I continued to tinker with my finger designs. I intentionally broke one of my finger prototypes to see where its structural weakpoint is. It broke at the distal knuckle. This led to me having a breakthrough in the design. I added a linkage that replaces the previously rigid distal knuckle, and I stumbled upon inventing a novel finger mechanism that was more flexible and nearly unbreakable. I then set on refining the design to be more functional, easily 3D printable, and more visually appealing. Inspiration from cyberpunk art and fighter jets influenced the design. 28 design iterations and a myriad of prototypes later resulted in Lunet.”

“It feels great knowing you have the capability to positively impact people’s lives and give them help they otherwise wouldn’t be able to get,” said Edquilang.

“Not every good idea needs to be turned into a business. Sometimes, the best ideas just need to be put out there ,” said Edquilang, who graduated with a Bachelor of Science in Industrial Design last year. “Medical insurance will often not cover the cost of a finger prosthesis, since it is not considered vital enough compared to an arm or leg. Making Lunet available online for free will allow it to help the greatest number of people.”

Lunet wins awards

The prosthetic design garnered Edquilang a 2023 Red Dot: Luminary award, the highest level of recognition accorded at the Red Dot Award: Design Concept. He and Feng took home the coveted accolade at Red Dot’s ceremony last month in Singapore.

“Good results come from dedication. Extraordinary results come from experimentation. Incredible results come from a combination of both,” he said upon winning the award. He has also received a number of other accolades, including iFDesign, and national runner up for the James Dyson Award.

“David’s recent success in winning the most prestigious design awards across the world is the best manifestation of the unparalleled education and training students experience in our Industrial Design program,” Feng said. “Built upon a belief that every student is a creative individual, the program pedagogy focuses on methods of cultivating innovative minds, which is enforced with rigorous professional training.”

Lunet’s geometry inspired its name

Lunet is made up of two common types of 3D printed plastics: polylactic acid and thermoplastic polyurethane. Each finger is made up of four parts held together by plastic pins. Edquilang describes arcs and circular orbits as the foundation for the motion of the finger mechanism. The geometric basis of the design evoked the idea that the prosthesis orbits around the user’s joints like a moon, or lunet, hence the name.

Another element of Lunet’s uniqueness is that it is nearly impossible to break; other finger prosthetics can be complicated and require many parts.

“The problem with higher mechanical complexity is that these designs are less durable,” Edquilang said. “The more parts you have, the more points of failure. You need to make prosthetic fingers robust and as strong as possible, so it doesn’t break under normal use, yet you want the design to be simple. This was one of the greatest challenges in making Lunet.”

He encourages other design students not to be afraid to experiment and fail because that is often how one can learn to improve the most.

“Where the world has an abundance of problems, designers have an abundance of talent, and we should not be selfish with it,” Edquilang said.

Source: University of Houston

Categories : Implants and Prostheses OphthalmologyTags :

Mapping the ‘Light’ Seen by Closed Eyes could Help Prosthetic Eyes See Better

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Photo by Arteum.ro on Unsplash

Researchers at Monash University have identified a new way of mapping ‘phosphenes’ – the visual perception of the bright flashes we see when no light is entering the eye – to improve the outcome of surgery for patients receiving a cortical visual prosthesis.

Cortical visual prostheses are devices implanted onto the brain with the aim of restoring sight by directly stimulating the area responsible for vision, the visual cortex, bypassing damage to the retina of the eye or the optic nerve. Phosphenes, apparent flashes and patterns of lights, were described by the ancient Greeks and can be elicited by pressure, injury, disease, certain medications or direct electrical stimulation.

A typical prosthesis consists of an array of fine electrodes, each of which is designed to trigger a phosphene. Given the limited number of electrodes, understanding how electrodes can best be placed to generate useful perceived images becomes critical.

Published in the Journal of Neural Engineering, the study presents a more realistic simulation for cortical prosthetic vision.

As part of this researchers from the Department of Electrical and Computer Systems Engineering at Monash University, led by Associate Professor Yan Tat Wong, are honing in on the ideal distribution of phosphenes.

“Phosphenes are likely to be distributed unevenly in an individual’s visual field, and differences in the surface of the brain also affect how surgeons place implants, which together result in a phosphene map unique to each patient,” Associate Professor Wong said.

The study used a retinotopy dataset based on magnetic resonance imaging (MRI) scans, consulting with a neurosurgeon about realistic electrode implantation sites in different individuals, and applying a clustering algorithm to determine the most suitable regions to present stimuli.

Sighted participants recruited for the study were asked to test and verify the phosphene maps based on visual acuity and object recognition.

“We’re proposing a new process that incorporates our simulation paradigm into surgical planning to help optimise the implantation of a cortical prosthesis,” Associate Professor Wong said.

The process would begin with an MRI scan to plot the recipient’s brain surface in the area of the visual cortex. Potential implant locations would then be identified, and the simulation developed in the Monash research would be used to plot phosphene maps.

“We can use the metrics we computed to find practical implant locations that are more likely to give us a usable phosphene map, and we can verify those options through psychophysics tests on sighted participants using a virtual reality headset,” Associate Professor Wong said.

“We believe this is the first approach that realistically simulates the visual experience of cortical prosthetic vision.”

Source: Monash University

Categories : Implants and Prostheses Medical Research & TechnologyTags :

Mastering a Third Robotic Arm is Surprisingly Quick

On By ModernMedia
Interfaces for DoF augmentation (figure by Tobias Pistohl). From Eden at al., Nature Communications. 2022

Busy doctors and nurses may have often found themselves wishing they had an extra arm to help with a patient or help with a difficult suture. Researchers around the world are developing supernumerary robotic arms to help workers achieve certain tasks unaided, or with less strain – but how long would it take to master learning an additional limb? The answer is: not long at all. One hour’s worth of training is enough for people to carry out a task with their ‘third arm’ as effectively as with a partner, according to the results of a new study published in IEEE Open Journal of Engineering in Medicine and Biology.

A new study by researchers at Queen Mary University of London, Imperial College London and The University of Melbourne has found that people can learn to use supernumerary robotic arms as effectively as working with a partner in just one hour of training.

The study investigated the potential of supernumerary robotic arms to help people perform tasks that require more than two hands. The idea of human augmentation with additional artificial limbs has long been a staple of science fiction.

Demonstrating performing a suture with an assistant robotic arm.

“Many tasks in daily life, such as opening a door while carrying a big package, require more than two hands,” said Dr Ekaterina Ivanova, lead author of the study from Queen Mary University of London. “Supernumerary robotic arms have been proposed as a way to allow people to do these tasks more easily, but until now, it was not clear how easy they would be to use.”

The study involved 24 participants who were asked to perform a variety of tasks with a supernumerary robotic arm. The participants were either given one hour of training in how to use the arm, or they were asked to work with a partner.

The results showed that the participants who had received training on the supernumerary arm performed the tasks just as well as the participants who were working with a partner. This suggests that supernumerary robotic arms can be a viable alternative to working with a partner, and that they can be learned to use effectively in a relatively short amount of time.

“Our findings are promising for the development of supernumerary robotic arms,” said Dr Ivanova. “They suggest that these arms could be used to help people with a variety of tasks, such as surgery, industrial work, or rehabilitation.”

Source: Queen Mary University of London