Autonomous sensor system for the quantification of relative residual bone movement monitoring within lower limb prosthetic sockets

Title; Autonomous sensor system for the quantification of relative residual bone movement monitoring within lower limb prosthetic sockets.
Aims
The PhD scholarship that builds upon existing academic and clinical expertise in soft tissue mechanics, lower limb prosthetic socket design and experimental wearable smart sensor systems, to research, develop and validate an appropriate wearable mobile sensor system capable of in-situ monitoring of small skeletal movement.
This PhD research project has the potential to deliver strategically important research outputs and innovations hence substantially contribute to undergoing work of a multi-disciplinary research teams within CDT and the University of Strathclyde. For example, the Strathclyde research team includes researchers from the department of Biomedical engineering and The Centre for Intelligent Dynamic Communications (CIDCOM) which is part of the EEE department. The proposed PhD project will benefit from consortium expertize targeting development and deployment of smart sensors technologies linked to mobile communication platforms being jointly developed between Biomedical engineering (assistive device expertise and clinical aspects) and CIDCOM (sensors, AI, and communication platform). Worth mentioning is the fact that number of research outputs are on their commercialisation pathway.
The proposed PhD research is timely and well aligned within the CDT goals as well as with the rehabilitation engineering theme in the Health Research strategy at Strathclyde focused to reduce the impact of disability in life. Research also corresponds well with the strategic sensor network activities supported by Strathclyde and Scotland and with the Strathclyde Technology Innovation Centre health technologies theme promoting earlier and accurate treatment with prevention of injury.
Workplan
The research will be multi-disciplinary and equally supported by Biomedical engineering and EEE at Strathclyde and other respected CDT partners. It will be jointly led by Dr Arjan Buis and Professor Ivan Glesk both being first supervisors. A prospective industrial supervisor will be assigned the role of External supervisor whose expertise will enable to access the appropriate groups of prosthetic specialists and patients. Finally, this approach will provide an opportunity to demonstrate project outcomes and platform capabilities to external parties including HMO and private sectors.
Explore and investigate the technologies capable measuring skeletal movement relative to a lower limb prosthetic socket with the required accuracy, including MRI, ultrasound and optical tomography methods.
Develop a specification matrix for ranking and appropriateness of the various technologies investigated.
Design and validate at least two measurement systems derived from previous objectives.
Integrate the designs with the medical communication platform which is being developed in parallel to this project.
After ethical consent has been granted, clinically test and evaluate the developed system.
Outcomes
Real time quantification of residual bone movement within prosthetic sockets informing prosthetic socket design.

The CDT students will help create solutions for amputees and people with debilitating conditions such as stroke and diabetes, reducing mortality and enabling them to live more satisfying, productive and fulfilling lives. These solutions, co-created with industry and people living with disabilities, will have direct economic and societal benefits. The principal beneficiaries are industry, P&O service delivery, people who need P&O devices, and society in general.
Industry
The novel methods, devices and processes co-created with users and industry will have a direct economic value to our industry partners (by the creation of IP, new products, and improved industry and academic links). Our CDT graduates will be the natural potential employees of our industry partners and for companies in the wider healthcare technology sector. This will help address the identified critical skills need and shortage leading to improvement in the UK's competitiveness in this rapidly developing and growing global market. The CDT outcomes will help UK businesses spread risk (because new developments are well founded) and more confidently enter new markets with highly skilled employees (CDT graduates).

P&O service delivery
Doctoral engineering graduates with clinical knowledge are needed to improve the deployment of advanced technologies in practice. Our main UK industry partner, Blatchford, stated: "As technology develops it will become easier for the end-user (the patient), but the providers (the clinicians) are going to need to have a higher level of engineering training, ideally to PhD level". The British Association of Prosthetists and Orthotists estimates that no more than ten practising P&O clinicians have a PhD in the UK. Long-term P&O clinical academic leadership will be substantially improved by the CDT supporting a select number of clinically qualified P&O professionals to gain doctorates.

Users
The innovation of devices, use of device and patient monitoring, and innovation approaches in LMIC should not only lead to improved care but also lower healthcare costs. Diabetes UK estimates that the total healthcare expenditure related to foot ulceration and amputation in diabetes was £1billion (2014-15), with 2/3 of this related to foot ulceration. Small innovations could lead to large cost savings if targeted at the right aspects of care (e.g. earlier adoption, and reducing device abandonment).
An ability to work is fundamental to a person's place in society and their sense of purpose and has a significant societal impact in all territories. This is perhaps greatest in LMIC where attitudes towards disability may still be maturing, and appropriate social care infrastructure is not always in place. In these cases, an ability to work is essential for survival.
Improved design approaches will impact on all users regardless of context, since the device solutions will better match local and individual user needs. Addressing issues related to prosthetic/orthotic device abandonment (e.g. cosmesis) and improved adherence should also lead to greater social participation. Improved device solutions will shift focus from what users "cannot do" to what they now "can do", and help progress attitudes towards acceptance of disability.
Societal
The majority of the global P&O users are of working age, and a key economic impact will be keeping users in work. The average age at amputation due to diabetes is just 52 in the USA but much younger in countries with less well-developed health care and trauma services (e.g. 38 in Iran). Diabetes UK reports that 35-50% of people are of working age at diagnosis and that there are around 70,000 foot ulcers in the UK, precursors to amputation. There is a similar concern for stroke survivors around a quarter of whom are of working age and are 2-3 times more likely to be out of work after eight years.