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Advancement of Prosthetics

The loss of a limb can have a significant impact on a person's life. We depend on every aspect of our body and any missing part can impede our lives. Limb amputation can happen as a result of trauma or disease. Prosthetics are devices that are designed to replace the missing body part and improve a person's quality of life by restoring normal functions. The quality of prosthetic limbs has improved greatly over the past several years but they remain expensive and treatment is rigorous.


There are many different types of prostheses, with each patient receiving one that specifically fits their needs. When deciding upon prostheses, a person needs to understand their economical capabilities and their functional needs. A passive device is a lightweight prosthetic and is designed to look like the body part it is replacing but has minimum function otherwise.

A passive prosthetic is also static, meaning the device has no movable parts and is useful for bimanual tasks [1]. Having minimal movement, this prosthetic is the cheapest and most affordable option.


Body-powered devices, on the other hand, are operated by a harness or cable and can be compared to a bike break in terms of activation. To operate a body-powered prosthesis, a patient would use other parts of their bodies to manually adjust the device. Being one of the cheaper prosthetic options, there is also a sacrifice for fine motor skills and precision [2].


The last type of prosthetic device is an externally powered device or the myoelectric device. This device is the most practical, however, it is the most expensive and takes a lot of time to get adjusted to. Externally powered prostheses provide movement in the joints without the need for movement from other parts of the body. A sensor in the prosthetic can obtain electrical signals from the muscles and translate those signals into movement, allowing the patient to have a greater resemblance of life before amputation [3].


The materials required for the creation of the prosthetic depends on the type of prosthetic that is being manufactured. The more lightweight a prosthetic, the more convenient it is for the patient. Thus, most prosthetics use plastic, rubber, wood, titanium, or aluminum. It is also important to note that prosthetics are individualized treatments, with each person's amputation varying. To make the prosthetic, there needs to be a measuring of the stump. These measurements need to be accurate so that the prosthetic fits well and is close to resembling the original limb. After obtaining measurements, the mold is made to fit the patient using a thermoplastic sheet. Acting as a simulation, the prosthetic is generated using the help of the mold [4]. Customizing and creating the prosthetic can take anywhere from 3 to 6 weeks, with an additional minimum of 18 weeks for physical therapy [5]. There are currently no standards for prosthetic testing and creation, however, prosthetic companies use their techniques to ensure that patients receive good-quality prosthetics that will last for a minimum of 5 years [4].


Rehabilitation is one of the most difficult parts of the journey of recovering a lost limb. Once the prosthetic is obtained, a patient needs to see a physical therapist for at least 6 months [6]. However, there are many other issues in addition to getting used to having a faux limb. These issues can be pain in the limb, back pain, instability, irritation in the skin, fear, socket discomfort, or generally reduced mobility. Because adjusting to a prosthetic is incredibly difficult and demoralizing, the patient needs to have a strong support system. The recovery time can last much longer than six months and the patient will have a lifelong need for doctor visits [7].


Although prosthetic technology has been rapidly evolving, there is still a long journey for prosthetics to become more affordable and have a larger range of motion. In 2012, Easton LaChapelle met an 8-year-old girl who had a bulky passive prosthetic with incredibly limited mobility. The parents were paying $80,000 for the prosthetic plus additional doctor visits and replacement prosthetics, which cost $160,000 altogether. Amazed at this huge expense for a prosthetic that did not simulate the quality of life as well as an externally powered prosthesis, Easton LaChapelle created a way to 3D print more affordable prosthetics costing between $5,000-$10,000 [8]. Prior to Easton LaChapelle’s innovation, there was not a lot of competition in prosthetic pricing because it was a very limited field. However, with Easton LaChapelle’s 3D printing and increased mass production of higher-quality prosthetics, prosthetics are becoming more readily available and affordable. Lachappelle continues to work on decreasing the cost of the prosthetic while incorporating a greater range of features [9].


Prosthetics still have a long way to go to become more reasonably priced and give patients an easier recovery process. However, with new advancements, greater options, and more information, amputee patients can continue living their everyday life with support from their family and friends.


References

  1. Pickle, N. T., Grabowski, A. M., Jeffers, J. R., & Silverman, A. K. (2017, November The functional roles of muscles, passive prostheses, and powered prostheses during sloped walking in people with a transtibial amputation. Journal of biomechanical engineering. Retrieved October 22, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5676650/

  2. Huinink, L. H. B., Bouwsema, H., Plettenburg, D. H., van der Sluis, C. K., & Bongers, R. M. (2016, October 7). Learning to use a body-powered prosthesis: Changes in functionality and Kinematics. Journal of neuroengineering and rehabilitation. Retrieved October 22, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5054596/

  3. Carey SL, Lura DJ, Highsmith MJ (2015). Differences in myoelectric and body-powered upper-limb prostheses: Systematic Literature Review. Journal of rehabilitation research and development. Retrieved October 22, 2022, from https://pubmed.ncbi.nlm.nih.gov/26230500/

  4. Advameg. (2022). Artificial Limb. How Products Are Made. Retrieved October 22, 2022, from http://www.madehow.com/Volume-1/Artificial-Limb.html

  5. Handspring. (2020, November 16). Prosthetic Arm & Upper Limb Prosthetics. Holistic Care for Patients Needing Upper Limb Prosthetics & Orthoses. Retrieved October 22, 2022, from https://myhandspring.com/

  6. Johns Hopkins Medicine. (2021, August 8). Amputation: Recovery and rehabilitation. Amputation: Recovery and Rehabilitation | Johns Hopkins Medicine. Retrieved October 22, 2022, from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/amputation/amputation-rcovery-and-rehabilitation

  7. Medical Center Orthotics & Prosthetics. (2017, June 20). Prosthetic issues – tips for amputees. MCOP Prosthetics. Retrieved October 22, 2022, from https://mcopro.com/amputee-resources/common-prosthetic-issues/

  8. Elkins, K. (2018, December 5). Meet the 23-year-old inventor Tony Robbins calls 'the next elon musk'. CNBC. Retrieved October 22, 2022, from https://www.cnbc.com/2018/12/05/tony-robbins-23-year-old-easton-lachappelle-is-the-next-elon-musk.html

  9. Unlimited Tomorrow. (2022, July 12). TrueLimb® Prosthetic Arm Manufacturer. Unlimited Tomorrow. Retrieved October 22, 2022, from https://www.unlimitedtomorrow.com/

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