ADAM: Anthropomorphic Design for Advanced Manufacture

Lead Research Organisation: University of Nottingham
Department Name: Faculty of Engineering

Abstract

The loss of a limb, either from a congenital defect or surgical amputation, e.g. through accident or disease, has a devastating effect on a person, from both a physical and emotional viewpoint, resulting in a profound lifestyle effect on the individual. In terms of a congenital defect there is the on-going and developing issue of having a significantly different capability than peers, whereas with later life amputees there is the shock of a sudden reduction in physical ability. The mitigation of this problem is to restore as much function as possible and great strides have been made in recent years in utilizing advanced materials and other technologies to develop lower limb prostheses that aid the mobility of amputees. The current landscape of upper limb prosthesis, however, is dominated by designs which are expensive, heavy and uncomfortable with limited functionality leading to poor uptake, with rejections rates up to 45% reported in some literature. Although some highly advanced designs with apparently impressive functionality have been developed in recent years, these still have problems of high weight, poor comfort and poor human-prosthetic interfacing, alongside costs being prohibitive for most individual. Moreover they are uncomfortable and difficult to control, leading to a high rejection rate and preference for simpler, less functional devices with many patients.

Our view is that the emergence of advanced manufacturing and design techniques and increased understanding of man-machine interfaces should be driving a step-change in the effectiveness of upper limb prosthesis but that this is being hindered by the lack of an appropriate design system, with the result that most of the highly advanced designs are actually of little added benefit to the patient. In this proposal we aim to develop an integrated design system in which the needs of the patient, together with constraints, such as the manufacturing technologies available and requirements for device accreditation for healthcare etc., inform the whole design to manufacture process. The core of the proposed design system is a computational platform that interfaces with the various stakeholders, e.g. clinician, designer, manufacturer, controlling data transfer and analysis and applying optimization algorithms to drive the design to an optimal for each individual patient's needs.

Realising an affordable, customised and high performance prosthesis will transform the lives of thousands of people with upper limb absence in the UK and millions on a global scale. With current advances in technology, manufacturing processes, design methods and data-handling techniques it is now possible to envisage a Design System that can integrate stakeholder input throughout the design process, thereby creating the next generation of anthropomorphic prosthetics and physical enhancements.

Planned Impact

The development of a design system for prosthetics and orthotics will benefit the medical device industry through faster, more appropriate and more cost-effective implementation of new technology. An initial system aimed at upper limb prosthesis will be translatable to enable broader impact to other healthcare devices that require integrated design, manufacture and clinical input. Clinical service providers, such as Blatchford, will benefit from the ability to offer improved prosthetics at lower cost. Mark Croysdale, an employee of Blatchford Services, based at the National Orthopeadic Hospital, Stanmore, is a partner on this project to facilitate this impact. With a particular focus in the feasibility study on incorporating advances in Additive Manufacturing (AM) technologies, manufacturers of AM materials and systems will benefit from increased usage of the technology. The EPSRC Centre for Innovative Manufacturing in Additive Manufacturing has a portfolio of current AM industrial partners who will be able to feed directly into this design platform.

End-users will benefit from prosthetic devices with improved functionality and comfort, reducing the current high rejection rates and enabling users to perform tasks currently not possible with existing devices. Both end-users and the National Health Service will benefit from a reduction in the number of visits to clinic to have prosthetics fitted and adjusted and increased patient satisfaction. For patients requiring a series of modified prostheses (growing children for example), this will be of particular importance. The involvement of NHS Nottingham University Hospitals as a project partner and the clinical expertise and network at the University of Strathclyde will ensure clinically relevant impact.

Importantly, the proposed platform will enable advances in technology to be implemented in a safe and efficient way. For example, an increasing number of 3D-printed "Robohands" are being produced by well-intentioned 3D-printing hobbyists for children with amniotic band syndrome; however, many of these devices are being made without the input of medical professionals with no international standards and/or regulatory framework in place. The proposed project will contribute towards building such a framework, aiming to maintain the affordable production of 3d-printed prosthetic devices. Input to this project from the Centre for Healthcare Equipment and Technology Adoption (CHEATA) will facilitate achievement of this goal.
 
Description This grant has helped us to understand the difficulties in coordinating the clinical and engineering aspects of designing and manufacturing effective bespoke prosthetics. In order to improve this we have developed a design framework involving data transfer between all major stakeholders. This is being further developed by two PhD projects that stemmed from the project
Exploitation Route The project provides a framework for clinicians, manufacturers and designers to work more effectively together
Sectors Healthcare,Manufacturing, including Industrial Biotechology

 
Description Cascade Grant
Amount £18,000 (GBP)
Organisation University of Nottingham 
Sector Academic/University
Country United Kingdom
Start 01/2017 
End 01/2020
 
Title Persona database 
Description Personas benchmark database created via simulation of the possible variations within the stereotypes defined (following clinical consultation) 
Type Of Material Data analysis technique 
Provided To Others? No  
Impact Personas benchmark to be available online for further research and testing of prosthetics. 
 
Description Ongoing collaboration with biomechanics lecturer from Universitat Jaume I, Castellon, Spain 
Organisation Jaume I University
Country Spain 
Sector Academic/University 
PI Contribution The main aspects of the collaboration were undertaken at the University of Strathclyde, within the biomechanics labs in the Biomedical Engineering department. Dr. Francisco Javier Andres de la Esperanza visited the University for three months (July-September 2016) where, under the supervision of Dr. Arjan Buis and Mrs Sarah Day, he worked in collaboration with Carlota Cunha Matos to develop novel experimental procedures for the combined assessment of arm and hand function. This required extensive motion capture and data analysis work, as well as optimisation of the experimental procedures for subsequent data collection on recruited volunteers.
Collaborator Contribution Dr. Francisco Javier Andres de la Esperanza and his group at Universitat Jaume I had previously developed a model for kinematic analysis of the hand. As part of this collaboration, that model was adapted and combined with arm models and specific hand function tests, requiring reprogramming of many aspects of the code and subsequent validation of results. This work was started during the lecturer's visit to Strathclyde and has continued after his return to spain. Collaboration is still ongoing with data processing being done partly at Strathclyde and partly at UJI.
Impact The experimental procedures developed during this collaboration and their outcomes in subject testing have been accepted for an oral presentation at the 16th World Congress of the International Society for Prosthetics and Orthotics, which will take place in May 2017. This joint publication is entitled "Investigation Of Wrist And Hand Function For The Improvement Of Upper Limb Prosthetic Device Design" (Cunha-Matos C., Andres F.J., Day S.J., Buis A.). A second congress publication, focusing on aspects of the kinematic model, has been accepted for presentation at the 13th Iberoamerican Conference on Mechanical Engineering. This joint publication is entitled "Evaluation of a Motion Tracking Model of the Upper Limb, Including the Hand" (Andres J., Cunha-Matos C., Jarque-Bou N., Sancho J.L., Buis A., Day, S.). The group of prosthetists and engineering researchers at Strathclyde University has gained important knowledge from Dr. Andres's expertise in the biomechanics of the hand, and Dr. Andres has benefited from the multidisciplinary nature of the group and the clinical expertise of some of its members, as well as from some motion capture and analysis tools he became familiar with at the University of Strathclyde.
Start Year 2016
 
Description Healthcare Technology (Nottingham) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Talk given by Amit N. Pujari on 'Use of AM and 3D printing for upper limb prosthesis' in 'Healthcare Technology - Innovation & Future' series at Nottingham University Hospitals.
Year(s) Of Engagement Activity 2016
 
Description Medilink talk - Additive Manufacturing in Healthcare 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact An overview of the use of additive manufacturing in health care was given highlighting the research at Nottingham University
Year(s) Of Engagement Activity 2016
URL http://www.medilinkem.com/events/events-calendar/2016/11/16/default-calendar/jointsig161116
 
Description Medilink talk - Advancing prosthetics through innovative manufacturing 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Overview of current research efforts from additive manufacturing for advancing prostheses (talk by Dr. A. Panesar)
Year(s) Of Engagement Activity 2016
 
Description Medilink talk - What you should know about prosthetic limbs, but nobody dared to tell you 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Overview of current issues in prosthesis development with a focus on research done at Strathclyde University (talk by Dr. Arjan Buis)
Year(s) Of Engagement Activity 2016
URL http://www.medilinkem.com/events/events-calendar/2016/07/27/default-calendar/3dprintSIG270716
 
Description Oral presentation at the 16th World Congress of the International Society for Prosthetics and Orthotics 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Mrs Sarah Day will present a research paper entitled "Investigation of Wrist and Hand Function for the Improvement of Upper Limb Prosthetic Device Design" (Cunha-Matos C., Andres F.J., Day S.J., Buis A.). There will be opportunity to engage with many colleagues (prosthetists, orthotists, engineers, etc) from institutions across the globe to discuss the applicability of the developed experimental tool for different clinical problems.
Year(s) Of Engagement Activity 2017
URL http://www.ispo2017.org/
 
Description Poster at Centre for Healthcare Technologies symposium, Nottingham 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Discussed routes to realise anthropomorphic design using advanced manufacturing (presented by Dr. A Panesar)
Year(s) Of Engagement Activity 2016
 
Description Presentation of paper at CIBEM 2017 conference in Lisbon 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Paper presentation
Year(s) Of Engagement Activity 2017
URL http://www.cibem13.com/
 
Description Starworks sandpit event for innovations in prosthetics for young people 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact This was a sandpit event for researchers an industry interested in developing innovative upper body prosthetics
Year(s) Of Engagement Activity 2017
URL http://devicesfordignity.org.uk/starworks_cp/