Prosthesis

Research

15 pages, 14776 KiB

Open AccessEditor’s ChoiceArticle

Evolving 3D-Printing Strategies for Structural and Cosmetic Components in Upper Limb Prosthesis

by Albert Manero, John Sparkman, Matt Dombrowski, Peter Smith, Pavan Senthil, Spencer Smith, Viviana Rivera and Albert Chi

Prosthesis 2023, 5(1), 167-181; https://doi.org/10.3390/prosthesis5010013 - 3 Feb 2023

Cited by 3 | Viewed by 10742

Abstract

The evolution of prosthetic limbs continues to develop, with novel manufacturing techniques being evaluated, including additive manufacturing. Additive manufacturing (AM), or 3D-printing, holds promise for enabling personalized and tailored medical device options. The requirements for personalized medicine, coupled with the limitations of small-batch [...] Read more.

The evolution of prosthetic limbs continues to develop, with novel manufacturing techniques being evaluated, including additive manufacturing. Additive manufacturing (AM), or 3D-printing, holds promise for enabling personalized and tailored medical device options. The requirements for personalized medicine, coupled with the limitations of small-batch manufacturing, have made the technique viable for exploration. In this manuscript, an approach is presented for incorporating additive manufacturing for prostheses, both as a final part and in applications as an intermediate manufacturing step. As a result, through the use of these methods a multi-gesture capable electromyographic prosthesis was designed and manufactured, currently being evaluated in clinical trials for pediatric patients. This paper explored the results of this unique method of applying additive manufacturing techniques, and assessed how the blend of different manufacturing techniques improved performance and reduced device weight. Creating unique and aesthetic cosmetic coverings for the device was achieved through using additive manufacturing as an intermediate manufacturing component and, then, applying thermoforming. Cosmesis components saw a 33% reduction in weight from this change in manufacturing. The approach is explored to blend multiple manufacturing techniques to create cosmesis components and structural components for the prosthesis. The techniques serve the design intent to reduce reported challenges with upper limb prosthesis devices and to encourage device retention. Recommendations for manufacturing strategies are discussed, including the limitations. Full article

(This article belongs to the Special Issue 3D Printing Strategies for Limb Prostheses)

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18 pages, 1593 KiB

Open AccessFeature PaperArticle

3D Printing in LMICs: Functional Design for Upper Limb Prosthetics in Uganda

by Ali Hussaini, Peter Kyberd, Benedict Mulindwa, Robert Ssekitoleko, William Keeble, Laurence Kenney and David Howard

Prosthesis 2023, 5(1), 130-147; https://doi.org/10.3390/prosthesis5010011 - 1 Feb 2023

Cited by 3 | Viewed by 4123

Abstract

Meeting the needs of persons with upper limb loss in Uganda requires an understanding of the needs and desires of the local population. The limitations of resources and accessibility for the individual gave rise to a focused design methodology for delivering a culturally [...] Read more.

Meeting the needs of persons with upper limb loss in Uganda requires an understanding of the needs and desires of the local population. The limitations of resources and accessibility for the individual gave rise to a focused design methodology for delivering a culturally acceptable solution using 3D Printing technology. A series of co-design activities were held in Uganda and provided direct feedback to drive the design of two prototypes based on acceptable aesthetics and priority Activities of Daily Living. Two terminal device prototypes were 3D printed in the UK. These can be directly attached to a standard proximal socket thread. The passive hand was printed in a flexible filament and the prehensor was printed in a durable impact resistant material. Local researchers in Uganda have similar 3D printers, filaments, and assembly hardware, which allowed for concurrent development and refinement of the prototypes. Local participation provides a rich user feedback environment to understand which elements of prosthetic device design are integral to delivering acceptable prosthetics solutions for fabrication in Uganda. 3D printing can provide a viable route to addressing the needs of the user. The proposed terminal devices are now in the process of being printed locally for field testing. Full article

(This article belongs to the Special Issue 3D Printing Strategies for Limb Prostheses)

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22 pages, 48586 KiB

Open AccessEditor’s ChoiceArticle

3D Printed Energy Return Elements for Upper Limb Sports Prosthetics

by Jung Wook Park, Ben Greenspan, Taylor Tabb, Eric Gallo and Andreea Danielescu

Prosthesis 2023, 5(1), 13-34; https://doi.org/10.3390/prosthesis5010002 - 4 Jan 2023

Cited by 6 | Viewed by 4721

Abstract

Prosthetics are an extension of the human body and must provide functionality similar to that of a non-disabled individual to be effective. Sports prosthetics such as the Flex-Foot Cheetah from Össur have demonstrated the value of creating devices that both provide mechanical support [...] Read more.

Prosthetics are an extension of the human body and must provide functionality similar to that of a non-disabled individual to be effective. Sports prosthetics such as the Flex-Foot Cheetah from Össur have demonstrated the value of creating devices that both provide mechanical support and introduce passive energy return to mimic forces otherwise produced at joints. These energy return mechanisms have not yet been demonstrated for upper limb prosthetics but could improve their effectiveness and provide a greater range of motion and control. Using multi-material 3D printing technology, we extend energy return components to upper limb prosthetics by developing novel force-sensing springs and applying them to a basketball prosthetic. The 3D-printed springs compensate for the forces otherwise generated by wrist and finger flexion while measuring the mechanical deflection. We discuss design guidelines, methods for integrated 3D printed energy return within prosthetics, and broader applications in assistive technologies. Full article

(This article belongs to the Special Issue 3D Printing Strategies for Limb Prostheses)

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20 pages, 4877 KiB

Open AccessArticle

An Instrumented Printed Insert for Continuous Monitoring of Distal Limb Motion in Suction and Elevated Vacuum Sockets

by Kendrick A. Coburn, Nicholas S. DeGrasse, Joseph C. Mertens, Katheryn J. Allyn, Nicholas K. McCarthy, Daniel Ballesteros, Joseph L. Garbini and Joan E. Sanders

Prosthesis 2022, 4(4), 710-729; https://doi.org/10.3390/prosthesis4040056 - 2 Dec 2022

Cited by 2 | Viewed by 2056

Abstract

A suction or elevated vacuum prosthetic socket that loses vacuum pressure may cause excessive limb motion, putting the user at risk of skin irritation, gait instability and injury. The purpose of this research was to develop a method to monitor distal limb motion [...] Read more.

A suction or elevated vacuum prosthetic socket that loses vacuum pressure may cause excessive limb motion, putting the user at risk of skin irritation, gait instability and injury. The purpose of this research was to develop a method to monitor distal limb motion and then test a small group of participants wearing suction sockets to identify variables that strongly influenced motion. A thin plastic insert holding two inductive sensor antennae was designed and printed. Inserts were placed in suction sockets made for four participants who regularly used suction or elevated vacuum suspension. Participants wore a liner with a trace amount of iron powder in the elastomer that served as a distance target for the sensors. In-lab testing demonstrated that the sensed distance increased when participants added socks and decreased when they removed socks, demonstrating proper sensor performance. Results from take-home testing (3–5 days) suggest that research investigation into cyclic limb motion for sock presence v. absence should be pursued, as should the influence of bodily position between bouts of walking. These variables may have an important influence on suspension. Long-term monitoring may provide clinical insight to improve fit and to enhance suction and elevated vacuum technology. Full article

(This article belongs to the Special Issue 3D Printing Strategies for Limb Prostheses)

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15 pages, 6035 KiB

Open AccessEditor’s ChoiceArticle

Conceptualization of an Anthropomorphic Replacement Hand with a Sensory Feedback System

by Lea Allmendinger, Simon Hazubski and Andreas Otte

Prosthesis 2022, 4(4), 695-709; https://doi.org/10.3390/prosthesis4040055 - 30 Nov 2022

Cited by 2 | Viewed by 1996

Abstract

In this paper, a concept for an anthropomorphic replacement hand cast with silicone with an integrated sensory feedback system is presented. In order to construct the personalized replacement hand, a 3D scan of a healthy hand was used to create a 3D-printed mold [...] Read more.

In this paper, a concept for an anthropomorphic replacement hand cast with silicone with an integrated sensory feedback system is presented. In order to construct the personalized replacement hand, a 3D scan of a healthy hand was used to create a 3D-printed mold using computer-aided design (CAD). To allow for movement of the index and middle fingers, a motorized orthosis was used. Information about the applied force for grasping and the degree of flexion of the fingers is registered using two pressure sensors and one bending sensor in each movable finger. To integrate the sensors and additional cavities for increased flexibility, the fingers were cast in three parts, separately from the rest of the hand. A silicone adhesive (Silpuran 4200) was examined to combine the individual parts afterwards. For this, tests with different geometries were carried out. Furthermore, different test series for the secure integration of the sensors were performed, including measurements of the registered information of the sensors. Based on these findings, skin-toned individual fingers and a replacement hand with integrated sensors were created. Using Silpuran 4200, it was possible to integrate the needed cavities and to place the sensors securely into the hand while retaining full flexion using a motorized orthosis. The measurements during different loadings and while grasping various objects proved that it is possible to realize such a sensory feedback system in a replacement hand. As a result, it can be stated that the cost-effective realization of a personalized, anthropomorphic replacement hand with an integrated sensory feedback system is possible using 3D scanning and 3D printing. By integrating smaller sensors, the risk of damaging the sensors through movement could be decreased. Full article

(This article belongs to the Special Issue 3D Printing Strategies for Limb Prostheses)

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11 pages, 15771 KiB

Open AccessArticle

Design Evaluation of FFF-Printed Transtibial Prosthetic Sockets Using Follow-Up and Finite Element Analysis

by Merel van der Stelt, Fianna Stenveld, Thom Bitter, Thomas J. J. Maal and Dennis Janssen

Prosthesis 2022, 4(4), 589-599; https://doi.org/10.3390/prosthesis4040048 - 14 Oct 2022

Cited by 4 | Viewed by 4636

Abstract

Background: Participants in Sierra Leone received a Fused Filament Fabrication (FFF)-printed transtibial prosthetic socket. Follow-up was conducted on this group over a period of 21 months. To investigate the failure of some of the FFF-printed transtibial sockets, further strength investigation is desired. Methods: [...] Read more.

Background: Participants in Sierra Leone received a Fused Filament Fabrication (FFF)-printed transtibial prosthetic socket. Follow-up was conducted on this group over a period of 21 months. To investigate the failure of some of the FFF-printed transtibial sockets, further strength investigation is desired. Methods: A finite element (FE) analysis provided an extensive overview of the strength of the socket. Using follow-up data and FE analyses, weak spots were identified, and the required optimization/reinforcement of the socket wall was determined. Results: Five sockets with a 4 mm wall thickness were tested by five participants. The strength of the 4 mm prosthetic socket seemed to be sufficient for people with limited activity. The 4 mm sockets used by active participants failed at the patella tendon or popliteal area. One socket with a wall thickness of 6 mm was used by an active user and remained intact after one year of use. An FE analysis of the socket showed high stresses in the patella tendon area. An increased wall thickness of 7 mm leads to a decrease of 26% in the stress corresponding to the observed failure in the patella tendon area, compared to the 4 mm socket. Conclusions: Follow-up in combination with an FE analysis can provide insight into the strength of the transtibial socket. In future designs, both the patella tendon and popliteal area will be reinforced by a thickened trim line of 7 mm. A design with a thickened trimline of 7 mm is expected to be sufficiently strong for active users. Another follow-up study will be performed to confirm this. Full article

(This article belongs to the Special Issue 3D Printing Strategies for Limb Prostheses)

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21 pages, 37396 KiB

Open AccessEditor’s ChoiceArticle

Prosthetic Sockets: Tensile Behavior of Vacuum Infiltrated Fused Deposition Modeling Sandwich Structure Composites

by Isaac A. Cabrera, Parker J. Hill, Win-Ying Zhao, Trinity C. Pike, Marc A. Meyers, Ramesh R. Rao and Albert Y. M. Lin

Prosthesis 2022, 4(3), 317-337; https://doi.org/10.3390/prosthesis4030027 - 22 Jun 2022

Cited by 4 | Viewed by 3838

Abstract

The development of novel materials will enable a new generation of prosthetic devices to be built with additive manufacturing (AM). Vacuum infiltrated sandwich structure composites are a promising approach for building prosthetic sockets via AM. In this paper, we test the tensile properties [...] Read more.

The development of novel materials will enable a new generation of prosthetic devices to be built with additive manufacturing (AM). Vacuum infiltrated sandwich structure composites are a promising approach for building prosthetic sockets via AM. In this paper, we test the tensile properties of 18 different composite material configurations using ASTM D638. These composites were manufactured using a custom vacuum infiltration method and had varying filament materials, infiltrated matrix materials, and print directions. Several material-matrix-print composites showed higher ultimate tensile strengths and reduced anisotropy compared to full-infill control samples. However, the mechanical properties of these composites were limited by a large degree of porosity due to the manufacturing method. Still, the results were sufficiently promising to create a proof of concept prosthetic socket via the vacuum infiltration method. Future research should focus on reducing porosity defects and investigating additional material-matrix-print combinations. Full article

(This article belongs to the Special Issue 3D Printing Strategies for Limb Prostheses)

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12 pages, 1314 KiB

Open AccessEditor’s ChoiceArticle

Real-World Testing of the Self Grasping Hand, a Novel Adjustable Passive Prosthesis: A Single Group Pilot Study

by Lisa O’Brien, Elena Montesano, Alix Chadwell, Laurence Kenney and Gerwin Smit

Prosthesis 2022, 4(1), 48-59; https://doi.org/10.3390/prosthesis4010006 - 8 Feb 2022

Cited by 5 | Viewed by 4357

Abstract

(1) Background: This study investigated the feasibility of conducting a two-week “real-world” trial of the Self Grasping Hand (SGH), a novel 3D printed passive adjustable prosthesis for hand absence; (2) Methods: Single-group pilot study of nine adults with trans-radial limb absence; five used [...] Read more.

(1) Background: This study investigated the feasibility of conducting a two-week “real-world” trial of the Self Grasping Hand (SGH), a novel 3D printed passive adjustable prosthesis for hand absence; (2) Methods: Single-group pilot study of nine adults with trans-radial limb absence; five used body-powered split-hooks, and four had passive cosmetic hands as their usual prosthesis. Data from activity monitors were used to measure wear time and bilateral activity. At the end of the two-week trial, function and satisfaction were measured using the Orthotics and Prosthetics Users’ Survey Function Scale (OPUS) and the prosthesis satisfaction sub-scales of the Trinity Amputations and Prosthesis Experience Scale (TAPES). Semi-structured interviews captured consumer feedback and suggestions for improvement; (3) Results: Average SGH wear time over 2 weeks was 17.5 h (10% of total prosthesis wear time) for split-hook users and 83.5 h (63% of total prosthesis wear time) for cosmetic hand users. Mean satisfaction was 5.2/10, and mean function score was 47.9/100; (4) Two-week real-world consumer testing of the SGH is feasible using the methods described. Future SGH designs need to be more robust with easier grasp lock/unlock. Full article

(This article belongs to the Special Issue 3D Printing Strategies for Limb Prostheses)

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