The presentation "Extremely low-cost lower limb prostheses" focuses on innovative solutions to address the global need for affordable prosthetic devices, especially in low- and middle-income countries. It highlights the intersection of biomedical robotics with prosthetic design, underscoring the need for cost-effective technologies that can improve the quality of life for amputees. The document analyzes the problem from a statistical perspective, reviewing literature to understand the extent of the issue, and proposes several solutions. It discusses the significance of low-cost prostheses, detailing methods like 3D printing, use of recycled materials, simplified designs, and mass production techniques to reduce costs. The presentation also examines the average annual incomes of populations in Sierra Leone, Bangladesh, and India to contextualize the affordability of prosthetics. The work showcases various research papers, each presenting a unique approach to designing low-cost prosthetic limbs, from fully mechanical designs to advanced 3D printed, multi-axis feet. It touches upon the pros and cons of these designs, considering factors like manufacturing costs, weight, load capacity, and the need for expert personnel. The insights provided aim to contribute to the development of prosthetic limbs that are accessible to all, especially focusing on the challenges faced by individuals in regions with limited resources.

1. Extremely low-cost lower
limb prostheses
G12
 Mohammad Sabouri
 Arghavan Dalvand
 Peyman Peyvandi Pour
 Behnam Jabbari kalkhoran
Biomedical Robotics 2023
University of Genova

2. CONTENT
S
2
B I O M E D I C A L R O B O T I C S
1. Introduction
2. Problem Analyze
3. Statistical Review
4. Paper Analyze
5. Conclusion

3. 3
What Is The Lower Limb Prostheses ?
• Lower limb prostheses are medical devices designed to replace, fully or
partially, the function and form of missing legs or feet.
• They help individuals who have lost limbs to regain mobility and perform daily
activities more independently.
B I O M E D I C A L R O B O T I C S
Injury:
Trauma
Disease:
Infection
s or
Cancer
Congenit
al
Condition
s Complicati
ons that
arise in
blood
vessels
Introduction

4. 4
Lower Limb Prostheses Problem
World Health Organization (WHO)
https://www.sralab.org/research/labs/bionic-medicine/news/facts-about-limb-
loss#:~:text=Worldwide%2C%20access%20to%20prosthetic%20care,poorer%20clinical%20coverage%20of%20patients
B I O M E D I C A L R O B O T I C S
Introduction

5. 8 / 0 5 / 2 0 X X C O N F E R E N C E P R E S E N T A T I O N
Why low-cost prostheses?
5

6. 6
Lower Limb Prostheses Problem
The International Society for Prosthetics and Orthotics (ISPO) and the World Health
Organization (WHO) estimate that 0.5% of the population are in countries with low or
middle income that require prostheses or orthotics.
But they can not use the prostheses or orthotics
B I O M E D I C A L R O B O T I C S
Estimating the population
of low-income countries
Population in need of
prosthesis
Introduction

7. 7
Introduction
Lack
Why they can not use the prostheses or orthotics
Low or middle
income countries
(Poor countries )
B I O M E D I C A L R O B O T I C S
High

8. 8
Why low-cost prostheses? B I O M E D I C A L R O B O T I C S
Patients may need physical and occupational therapy to learn how to do daily tasks at
home or work:
• Physical therapy usually costs between $50 and $350 per session.
• Occupational therapy can range from $50 to $400 per session.
Cost of prostheses
Introduction

9. 9
Why low-cost prostheses?
Example: Sierra
Leone
$15
B I O M E D I C A L R O B O T I C S
Year Sierra Leone (USD) Bangladesh (USD) India (USD)
2020 550 1700 2100
2021 560 1750 2200
2022 570 1800 2300
Average annual income In the 3 low-income countries
Importance of low-cost prostheses
Introduction

10. 10
solutions • 3D Printing Technology
• Recycled Materials
• Simplified Prosthetic Designs
• Open-Source Designs
• Hybrid Manufacturing Methods
• Mass Production Techniques
• Full mechanical prostheses
B I O M E D I C A L R O B O T I C S
Importance of low-cost prostheses

11. B I O M E D I C A L R O B O T I C S
11
BANGLADESH
SIERRA LEONE
(AFRICA)
INDIA
All these countries are low-income
countries

12. 12
solutions
B I O M E D I C A L R O B O T I C S
Paper 1: A cost-effective prosthetic leg: Design and
development.
(Full Mechanical Idea)
Paper 2: Pioneering low-cost 3D-printed transtibial
prosthetics to serve a rural population in Sierra Leone - an
observational cohort study.
(3D Printing Idea - Socket)
Paper 3: Design and Evaluation of a High-Performance,
Low-Cost Prosthetic Foot for Developing Countries.
(LLTE Design - Foot)
Paper 4: Design Of 3d Printed Low Cost Multi Axis
Prosthetic Foot.
(3D Printing Idea - Foot)
BANGLADES
H
SIERRA
LEONE
(AFRICA)
INDIA

13. 13
Key Point Problem:
 Low Income
 Dependence on imports and limited availability
B I O M E D I C A L R O B O T I C S
1. Fully mechanical Design
• Use simple mechanical components
• Remove all electrical components
2. Local Materials
3. Affordable Materials in this Area
BANGLADES
H
Solution:
A cost-effective prosthetic leg: Design and development
Paper1

14. 14
B I O M E D I C A L R O B O T I C S
A cost-effective prosthetic leg: Design and development
Advanced
prosthetic leg
Simple
prosthetic leg
Simplify
For decrease
the cost
Knee
Paper1
Simplify

15. 15
B I O M E D I C A L R O B O T I C S
Socket Shank Feet
Knee
Joint
Paper1
A cost-effective prosthetic leg: Design and development
Final Product
Results

16. 16
Pros
B I O M E D I C A L R O B O T I C S
• High load-carrying capacity (up to 100 kg)
• Light Weight : 2.6Kg (Normal leg 6-8 kg)
• Overall cost: $227(more than 10 times cheaper)
• Lack of Beauty
• The knee joint is completely mechanical and has a pin.(Setup
by hand)
• Lack of energy storage and return (ESAR) features
Knee
Joint
Paper1
A cost-effective prosthetic leg: Design and development
Cons

17. 17
B I O M E D I C A L R O B O T I C S
Pioneering low-cost 3D-printed transtibial prosthetics to serve a rural
population in Sierra Leone - an observational cohort study
SIERRA LEONE
(AFRICA)
Paper2 Key Point Problem:
1. Low Income (Average 490 USD)
2. Quality Assurance socket (Plaster is not good
material)
3. Usually, Socket made by hand
4. Aesthetics Problem
5. Lack of Experts (The socket shape is highly
dependent on the experience and skills of the
prosthetics)
 Experience
 skills
Socket
The socket is an important part of the prosthesis that is
connected to the body.

18. 18
B I O M E D I C A L R O B O T I C S
Pioneering low-cost 3D-printed transtibial prosthetics to serve a rural
population in Sierra Leone - an observational cohort study
Paper2 Solution:
3D Scan of stump
Using CAD-CAM techniques
Low-cost 3D-printed
3D Scan CAD-CAM 3D Print

19. 19
B I O M E D I C A L R O B O T I C S
Pioneering low-cost 3D-printed transtibial prosthetics to serve a rural
population in Sierra Leone - an observational cohort study
Paper2
Prosthesis with aesthetic
coverage.
Prosthesis with 3D printed
socket.
Results

20. 20
B I O M E D I C A L R O B O T I C S
Pioneering low-cost 3D-printed transtibial prosthetics to serve a rural
population in Sierra Leone - an observational cohort study
Paper2
Pros
• Increased rate of successful prosthetic fitting
• Aesthetics – Epoxy color (Brown- skin tone) - UV
resistant color pigment
• High load-carrying capacity : 6700N
• Light Weight : 352 grams (* Just Socket)
• Short-time Manufacture (17.2 hours- 4 mm wall
thickness )
• Overall cost: 87 USD

21. 21
B I O M E D I C A L R O B O T I C S
Pioneering low-cost 3D-printed transtibial prosthetics to serve a rural
population in Sierra Leone - an observational cohort study
Paper2
Cons
• 87 USD - (in this study asked participants pay 15 USD but they couldn't pay it)
• Importing issue (some parts need to be imported )
• Physiotherapy Inaccessibility
• Equipment: Cost of providing computer, 3D scanner and 3Dprinter( Around
11.500 USD)
Importing cost
Equipment

22. 22
B I O M E D I C A L R O B O T I C S
INDIA
Paper3
Design and Evaluation of a High-Performance, Low-Cost Prosthetic
Foot for Developing Countries
Key Points:
In low-income countries
 Durability challenges
 Cosmetic considerations
 Users in India often do not wear closed toe shoes  dust and dirt
 challenging conditions
 employment opportunities
 social integration
 There is a kind of prosthesis called Jaipur which is
accepted by Indians
 Cost effective
 Durable
 Cosmetic shell
 Available Material
 Lack of (ESAR) features

23. 23
B I O M E D I C A L R O B O T I C S
Paper3
Design and Evaluation of a High-Performance, Low-Cost Prosthetic
Foot for Developing Countries
solution:
 Optimize Jaipur for cosmetic shell
 Design lower leg trajectory error (LLTE)
The LLTE design
framework
Productions Tests

24. 24
B I O M E D I C A L R O B O T I C S
Paper3
Design and Evaluation of a High-Performance, Low-Cost Prosthetic
Foot for Developing Countries
Results:
Final product for test

25. 25
B I O M E D I C A L R O B O T I C S
Paper3
Design and Evaluation of a High-Performance, Low-Cost Prosthetic
Foot for Developing Countries
Pros:
 Cosmetic shell
 Durable
 Low-Cost (Affordable Materials)
 Water Resistant
 Abrasion Resistant
 Light weight
 High Load carrying Capacity (ISO10328 - scaled to the
average weight of an Indian male)
 LLTE feature

26. 26
B I O M E D I C A L R O B O T I C S
Paper3
Design and Evaluation of a High-Performance, Low-Cost Prosthetic
Foot for Developing Countries
Cons:
 Plastic Deformation During tests
 Water Resistant but not waterproof
 insufficient different with Jaipur
 Major faults in human test

27. 27
B I O M E D I C A L R O B O T I C S
Paper4
DESIGN OF 3D PRINTED LOW COST MULTI AXIS PROSTHETIC
FOOT
Key Problem:
 Foot Motion study
 Mathematical Analysis of gait
 Material Selection for low-cost design
 Fused Deposition Modeling (FDM)
Solution:
 Study different materials suitable for 3D printing,
including ABS, PLA, and TPU and finally they chose
PLA
 Integration of kinetic and kinematic data.
 The FDM with layer-by-layer printing of the material,
creating a raft for support, and subsequent removal of
supports after printing completion.
 Considering assessing factors such as stress
distribution, load-bearing capacity, and the degree of
freedom.

28. 28
B I O M E D I C A L R O B O T I C S
Paper4
DESIGN OF 3D PRINTED LOW COST MULTI AXIS PROSTHETIC
FOOT
Pros:
 Lower-manufacturing cost
 Lower-manufacturing time ( 20 Hours)
 Using environmentally friendly resources (PLA)
 Customizable and Patient-Specific Design
Cons:
 Chosen Material is not always locally affordable
 Cost of Complexity of 3D printing process
 Lack of expert Personnel

29. 29
B I O M E D I C A L R O B O T I C S
Conclusion
COST
method Time Material Equipment
PAPER 1 Full Mechanical - 227 $ -
PAPER 2 3D printing (Socket) 17 Hours 87 $ 11500 $
PAPER 3 LLTE Design (Feet)
PAPER 4 3D Printing-MULTI
AXIS (Feet)
20 Hours High High(5k $ to
10k $)

30. 30
B I O M E D I C A L R O B O T I C S
Conclusion
Features
method Weight Max
Load
Expert
Personnel
Performance
PAPER 1 Full Mechanical 2.5 Kg 100 Kg * Average
PAPER 2 3D printing (Socket) 352 G 6700 N *** Hight
PAPER 3 LLTE Design (Feet) Low - *** Low
PAPER 4 3D Printing-MULTI
AXIS (Feet)
Low - ** Above
Average

31. Thanks for Your Attention
8 / 0 5 / 2 0 X X
31
biomedical robotics
B I O M E D I C A L R O B O T I C S