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The application of clinical
engineering
Dr Peter Worsley
Dr Alex Dickinson
Rehabilitation International World Congress, Ed...
The Clinical Challenge
• Amputation can results from many causes:
– vascular disease (54%) – including diabetes
and periph...
Evolution of Prosthetics and
Orthotics
3
• Prosthetic and orthotic devices are frequently
used to aid rehabilitation and i...
Fitting Prosthetics and
Orthotics
• The interface between the device
and the individual is critical
• Load bearing surface...
Engineering Solutions:
Residual limb imaging
5
• CAD/CAM technologies are
established in P&O device design
• Metrology-lev...
Benefits of CAD CAM
• Highly accurate
• Cost/material reducing
• Repository of Shape Information
• Biofeedback
• Additive ...
Engineering Solutions:
Intelligent prosthetic
pressure sensors
7
• In recent years shear sensing devices have
been develop...
Amputee application
Conclusions
• Great advances in Prosthetic and Orthotic
device design
• However, the interface between the residual
limb a...
Thank you
Acknowledgements:
M Hulland, J Steer.
Funding provided by the Institute for Life Sciences and the Royal Academy ...
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RIWC_PARA_A169 modern prosthetics – an interdisciplinary approach the application of clinical engineering

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RIWC_PARA_A169 modern prosthetics – an interdisciplinary approach the application of clinical engineering

  1. 1. The application of clinical engineering Dr Peter Worsley Dr Alex Dickinson Rehabilitation International World Congress, Edinburgh, 26th October 2016 Faculty of Health Sciences
  2. 2. The Clinical Challenge • Amputation can results from many causes: – vascular disease (54%) – including diabetes and peripheral arterial disease – Trauma (45%) – Cancer (2%) • As with many healthcare problems, each case is very specific to a given individual • Amputation can also occur at many different body locations 2
  3. 3. Evolution of Prosthetics and Orthotics 3 • Prosthetic and orthotic devices are frequently used to aid rehabilitation and improve quality of life for individuals with amputation. • Clinical engineering advances have resulted in evolution of complex prosthetic and orthotic devices • However these come at a cost • In addition there is a significant proportion of individuals who reject their device – Pain – Poor fit – Limited functional gains
  4. 4. Fitting Prosthetics and Orthotics • The interface between the device and the individual is critical • Load bearing surface between the prosthetic and the residual limb • Residual limbs come in all different shapes and sizes • Fitting a socket is often an iterative process reliant on the skill of the prosthetist • Residual limbs change shape over time 4
  5. 5. Engineering Solutions: Residual limb imaging 5 • CAD/CAM technologies are established in P&O device design • Metrology-level accuracy1 • Cheap alternative systems – What is accuracy and repeatability? – What accuracy is really required? – Do requirements differ with use? 5 1: Dickinson, Steer, Woods and Worsley 2016, J Rehab Res Dev 53(2) 207-218 Sidles et al 1989, JPO WillowWoodco.com
  6. 6. Benefits of CAD CAM • Highly accurate • Cost/material reducing • Repository of Shape Information • Biofeedback • Additive manufacturing 6
  7. 7. Engineering Solutions: Intelligent prosthetic pressure sensors 7 • In recent years shear sensing devices have been developed for related applications • Stump socket interface (Laszczak et al. 2014, 2016) • Automotive industry (Cho et al. 2014) • Sensors now have the ability to measure pressure independently of shear
  8. 8. Amputee application
  9. 9. Conclusions • Great advances in Prosthetic and Orthotic device design • However, the interface between the residual limb and the socket remains challenging • Engineering solutions exist to accurately measure and manufacture sockets • We can also measure the biomechanical conditions at the interface • This could provide an improved way of developing sockets and an early warning system to prevent injury. 9 Technologies are becoming cheaper and may represent opportunities to support efficient limb fitting services in low and middle income countries
  10. 10. Thank you Acknowledgements: M Hulland, J Steer. Funding provided by the Institute for Life Sciences and the Royal Academy Of Engineering

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