Fit-for-purpose, affordable body-powered prostheses

适合用途、价格实惠的身体动力假肢

• 批准号: EP/R013985/1
• 负责人: Laurence Kenney
• 金额: $ 180.01万
• 依托单位: University of Salford
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2018
• 资助国家: 英国
• 起止时间: 2018 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=EP%2FR013985%2F1
• 关键词: Fit; purpose; affordable; body; powered

Upper limb loss can have devastating effects on an individual, particularly if that person is already surviving at a subsistence level. Prostheses can be used to replace the missing limb, offering both cosmetic and functional benefits. In lower and middle income countries (LMICs), conflict and road traffic accidents mean that demand for upper limb prostheses is high, however provision is sparse, and maintenance is a major challenge.Body-powered (BP) prostheses have seen little development since the early 20th century, despite high self-reported rates of rejection. Nevertheless, BP prostheses are well suited for use in LMICs, being potentially simple to manufacture and maintain. If the reasons for rejection (e.g. limited functionality, cost and heat-related discomfort) can be addressed, BP prostheses offer a potentially viable solution. Therefore, this project will bring together an experienced team from across the UK, Uganda and Jordan to create a new BP prosthesis that is optimised for adoption by LMIC prosthetic services and acceptable to LMIC users. This will include establishing methods of fabrication, fitting and evaluation of the prosthesis which are appropriate to LMICs.Our two LMIC partners (Uganda and Jordon) have been selected because of the unique challenges of prosthetic provision in these countries. Uganda is one of the least developed countries in the world, with poorly resourced and fragmented rehabilitation services. Jordan is an upper middle income country, with well-developed clinical training, but facing immense pressures on prosthetic services due, in part, to regional conflicts.To achieve our goals, the following work packages (WPs) are planned:WP1: The requirements of amputees in both Jordan and Uganda will be investigated using focus groups and questionnaires. WP2: We will develop an engineering/human factors specification for a BP prosthesis optimised for LMICs by identifying the key features of the conventional BP prosthesis that determine its functionality and usability. WP3: Informed by WP1 & 2 we will develop a new design, optimised for LMICs. We aim to restore a high level of functionality, in a culturally acceptable manner, and in a way that is well suited to local prescription, manufacture and fitting. To ensure local relevance, we will work closely with our partners in Jordan and Uganda.WP4: In parallel to the work in WP3, we will address more ambitious design challenges, creating and testing a highly novel prototype in the laboratory. This division of the work will allow us to move quickly towards a practical solution for LMICs and to also include more novel but higher risk research. WP5: There is currently no objective data on the extent to which prostheses are worn, how they are used, or the impact on daily life. We will develop a digital tool kit that includes a sensor system to capture both motion of the prosthetic arm and complementary data (for example, prosthetic hand opening/closing and location), and an Android app to provide feedback to designers, clinicians, and users.WP6: To support the long term impact of this project, we will work with our LMIC partners to support improved provision (including local manufacture and better clinical support) and hence enable uptake of the new BP prosthesis.

失去上肢可能会对个人造成毁灭性的影响，特别是如果这个人已经在维持生存的水平上。假肢可以用来替代缺失的肢体，提供美容和功能上的好处。在中低收入国家，冲突和道路交通事故意味着对上肢假体的需求很高，但供应稀少，维护是一个主要挑战。自20世纪初以来，身体动力(BP)假体几乎没有发展，尽管自我报告的排斥率很高。然而，BP假体非常适合用于LMIC，潜在地易于制造和维护。如果排斥反应的原因(例如，功能有限、成本和与热有关的不适)能够得到解决，BP假体就提供了一个潜在的可行解决方案。因此，该项目将汇集来自英国、乌干达和约旦的一支经验丰富的团队，以创造一种新的BP假体，该假体经过优化，适合LMIC假体服务机构采用，并为LMIC用户所接受。这将包括建立适合LMIC的假体制造、装配和评估方法。我们的两个LMIC合作伙伴(乌干达和乔登)之所以被选中，是因为这些国家在假体供应方面面临的独特挑战。乌干达是世界上最不发达的国家之一，康复服务资源匮乏且分散。约旦是一个中上收入国家，拥有完善的临床培训，但由于地区冲突，在假肢服务方面面临着巨大的压力。为了实现我们的目标，计划了以下工作包(WPS)：WP1：将使用焦点小组和问卷调查约旦和乌干达截肢者的需求。WP2：我们将通过确定决定其功能和可用性的传统BP假体的关键特征，为BP假体制定一项针对LMICs进行优化的工程/人为因素规范。WP3：受WP1和2的启发，我们将开发一种新的设计，针对LMIC进行优化。我们的目标是以一种文化上可接受的方式，以一种非常适合当地处方、制造和试穿的方式，恢复高水平的功能。为了确保与当地的相关性，我们将与约旦和乌干达的合作伙伴密切合作。WP4：在WP3工作的同时，我们将应对更雄心勃勃的设计挑战，在实验室创造和测试高度新颖的原型。这项工作的分工将使我们能够迅速为LMIC找到一个实用的解决方案，并包括更新颖但风险更高的研究。WP5：目前还没有关于假体磨损程度、如何使用假体或对日常生活的影响的客观数据。我们将开发一个数字工具包，其中包括一个传感器系统来捕获假肢的运动和补充数据(例如，假手的打开/关闭和位置)，以及一个Android应用程序，为设计师、临床医生和用户提供反馈。WP6：为了支持该项目的长期影响，我们将与LMIC合作伙伴合作，支持改进供应(包括本地制造和更好的临床支持)，从而使新的BP假体能够被采用。

项目成果

Understanding how harnessing affects a user's workspace

了解利用如何影响用户的工作空间

• 发表时间: 2020
• 作者: Chadwell A

Scoping and Exploratory Work to Underpin the Research and Design Parameters to Develop a 'Fit-for-Purpose' Body-Powered Upper Limb Prosthesis

范围界定和探索性工作，以支持研究和设计参数，以开发“适合用途”的身体动力上肢假肢

• 发表时间: 2019
• 作者: Donovan-Hall M

An initial exploration of the impact of Ugandan prosthetic provision and repair services on users

初步探讨乌干达假肢供应和维修服务对用户的影响

• 发表时间: 2019
• 作者: Deere B

Prosthetics and Orthotics facilities in Uganda

乌干达的假肢和矫形设施

• 发表时间: 2019
• 作者: Cockcroft A

Technology to monitor everyday upper-limb prosthesis use - a review

监测日常上肢假肢使用的技术——回顾

• 发表时间: 2020
• 作者: Chadwell A