Introductory Chapter: Toward Near-Natural Assistive Devices (original) (raw)

Advances in Prosthetics and Rehabilitation of Individuals with Limb Loss

Physical Medicine and Rehabilitation Clinics of North America, 2019

INTRODUCTION Approximately 1.6 million people in the United States are currently living with limb loss, a population projected to more than double by 2050. 1 Amputation results in a wide range of functional limitations; advances in surgical, rehabilitative, and prosthetic care are aimed at optimizing functional quality of life for the spectrum of individuals with limb loss.

The current state of bionic limbs from the surgeon’s viewpoint

EFORT Open Reviews, 2020

Amputations have a devastating impact on patients’ health with consequent psychological distress, economic loss, difficult reintegration into society, and often low embodiment of standard prosthetic replacement. The main characteristic of bionic limbs is that they establish an interface between the biological residuum and an electronic device, providing not only motor control of prosthesis but also sensitive feedback. Bionic limbs can be classified into three main groups, according to the type of the tissue interfaced: nerve-transferred muscle interfacing (targeted muscular reinnervation), direct muscle interfacing and direct nerve interfacing. Targeted muscular reinnervation (TMR) involves the transfer of the remaining nerves of the amputated stump to the available muscles. With direct muscle interfacing, direct intramuscular implants record muscular contractions which are then wirelessly captured through a coil integrated in the socket to actuate prosthesis movement. The third gro...

Advancements, Trends and Future Prospects of Lower Limb Prosthesis

IEEE Access

Amputees with lower limb loss need special care during daily life activities to make the movement natural as before amputation. No such work exists covering the main aspects from causes of amputation to the psycho-social impact of the amputees after using the prosthetic device. This review presents for lower limb prosthesis; the study of lower limb amputation, design & development, control strategies & machine learning algorithms, the psycho-social impact of prosthetic users, and design trends in patents. Research articles, review papers, magazines, letters, study reports, surveys, and patents, etc. have been used as sources for this review. Traumatic injuries and different diseases have been found as common causes of amputation. Design & development section illustrates design mechanisms, the categories of passive, active, & semi-active prostheses, an overview of a subset of commercially available prosthetic devices, and 3D printing of the accessories. The control section provides information about control techniques, sensors used, machine learning algorithms, and their key outcomes. Quality of life, phantom limb pain, and psycho-social impact of prosthetic users have been summarized for different countries that are believed to attract the interest of the readers. We have also developed an open-source database ''FAKH-50'' for patents to emphasize the design trends and advancements in lower limb prostheses from 1970 to 2020. Overall trend analysis determined is in the descending order as the knee (48%) > ankle (28%) > foot (22%) > hip (2%) patents in the current version of our database. The forthcoming section highlights the challenges and prospects of the domain. A mutual observation demands the design of a bio-compatible, lightweight, and economic prosthesis to track the normal human gait by eliminating phantom limb pain. This will empower the amputees to live a quality life in society. This work may be beneficial for researchers, technicians, clinicians, and amputees. INDEX TERMS Causes of amputation, lower limb amputation, lower limb prosthesis, design mechanisms, semi-active prosthesis, human gait cycle.

Toward higher-performance bionic limbs for wider clinical use

Nature Biomedical Engineering, 2021

Most prosthetic limbs can autonomously move with dexterity, yet they are not perceived by the user as belonging to their own body. Robotic limbs can convey information about the environment with higher precision than biological limbs, but their actual performance is substantially limited by current technologies for the interfacing of the robotic devices with the body and for transferring motor and sensory information bidirectionally between the prosthesis and the user. In this Perspective, we argue that direct skeletal attachment of bionic devices via osseointegration, the amplification of neural signals by targeted muscle innervation, improved prosthesis control via implanted muscle sensors and advanced algorithms, and the provision of sensory feedback by means of electrodes implanted in peripheral nerves, should all be leveraged toward the creation of a new generation of highperformance bionic limbs. These five technologies have been clinically tested in humans, and alongside mechanical redesigns and adequate rehabilitation training should facilitate the wider clinical use of bionic limbs. Prosthetics aim to substitute the loss of an extremity via technological means. Missing a limb leads to significant impairments in the capacity to move and to interact with the environment. This deficiency is associated with the actual functional loss of a body part and with the loss of sensation, and it can also

Effect of Biomaterial Prosthetics on the Rehabilitation of Lower Limb Amputees

BJSTR, 2017

The prosthetics is done in order to help the persons with various degrees of amputation to regain their normal functioning. The prosthetics used for rehabilitation (regaining of body functionality) should be comfortable for the patient and should be durable. After lower limb prosthesis, the most important goal in the rehabilitation process of the amputee is the regaining of walking. The walking ability is very essential for proper functioning. There are two different types of foot available that are used based on function. These are the dynamic and non dynamic response foot (e.g. solid ankle cushion heel). The non dynamic foot is basic for appearance and the functions such as standing and walking, while the dynamic can be used for more intense activities like running. Current prosthetic foot designs do not exactly match the characteristics of normal human foot. Human foot is a multi-functional device that performs various activities, but the functions of prosthetic feet are limited to only few. A person’s prosthesis should be designed and assembled according to the patient’s appearance and functional needs. Over the years there have been significant advancements in prosthetics. New plastics and other materials, such as carbon fiber, have made artificial limbs stronger and lighter, reducing the amount of extra energy necessary to operate the limb. This is very important for trans-femoral amputees. Additional materials have made artificial limbs to look much like real limbs, which is important to trans-radial and trans-humeral amputees because they are more likely to have the artificial limb exposed. The foot provides shock absorption and stability during stance by providing contact to the ground. Additionally it influences the gait biomechanics by its shape and stiffness. The basis of this project is to provide standing and walking functions as well as to make the appearance attractive.

Prosthetic and Orthotic Devices

Assistive Technologies

Prostheses and orthoses are devices intended to improve motor function in amputated patients or patients with different kinds of motor disorders, respectively. Thanks to a multidisciplinary approach that has evolved along the years, prosthetics and orthotics are really two disciplines in which biomechanical and clinical aspects are integrated and take advantage of new materials and technologies. Artificial limb components, limb supporting braces, and many other devices are already available, and can provide effective solutions for locomotion, upper limb function, and posture. Within a clinical/theoretical framework, this chapter addresses the main principles of application and the technical issues related to the use of prostheses and orthoses. These include among others, problems of manufacturing, adaptation to the patient, functional assessment, and the role of advanced technologies. The aforementioned concepts are all to be considered if the objective is to obtain good functional ...