Data Technologies for Lower Limb Orthosis Design & Assessment

Orthoses are external devices which support, protect or realign musculoskeletal structures to treat injuries, disease or deformity. Cerebral palsy is one of the most prevalent conditions affecting children with 1.5-4 cases per 1000 children (2); worldwide, another common cause of muscle weakness is poliomyelitis, and post-polio syndrome, with an estimation of 12-20 million people worldwide still suffering from the after-effects of the disease(3). In 2015, the NHS estimated that for every £1 spent improving their orthotics services, £4 could be saved in other areas: in-patient stays, surgeries, and further consultations required for example(4). However, non-compliance can be a major problem among lower limb orthosis users, and so ensuring that orthoses satisfactorily address the users' needs is key.

This project takes a biomechanical engineering approach to address the challenges leading to non-compliance of orthoses, including discomfort and pain, and high temperature and humidity due to non-breathable materials. The project is using a novel combination of methodologies including numerical modelling (creating first-of-kind Multiphysics Finite Element Analysis models of the foot-orthosis construct, combining structural and thermal effects) and clinical data collection (tissue injury biomarkers, pressure and microclimate measures), and aiming to combine them to answer research questions around:
- Can we understand which orthosis-skin interface materials present higher and lower risks to skin health?
- Can we understand the mechanisms for skin and deep tissue injury in orthosis use? And
- Can we understand particular biomechanical risk factors in orthosis users, including anatomy (i.e. bone shapes and plantar tissue thickness) and pathology (i.e. bone misalignments, lesions)?