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Increasing Prosthetic Comfort through Sensor Technology

A special issue of Sensors (ISSN 1424-8220). This special issue belongs to the section "Biomedical Sensors".

Deadline for manuscript submissions: closed (16 April 2021) | Viewed by 16237

Special Issue Editors


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Guest Editor
Department of Machine Design, School of Industrial Engineering and Management, KTH Royal Institute of Technology, 10044 Stockholm, Sweden
Interests: system safety; system/software engineering; empirical software engineering; engineering education
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Guest Editor
KTH Royal Institute of Technology, Stockholm, Sweden

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Guest Editor
Electronics RISE IVF AB Argongatan 30, SE-431 53 Mölndal, Sweden
Department of Machine Design, KTH Royal Institute of Technology, SE 100 44 Stockholm, Sweden
Interests: systems theory; architecture design; ontological engineering; domain-specific language; logic programming; anomaly detection; safety engineering
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Limb amputations cause serious physical disabilities that compromise the quality of life of many people around the globe. The World Health Organization estimates that there are ~40 million amputees in the world. This number is expected to increase, due to an aging population and a corresponding higher incidence of diabetes and vascular diseases.

Limb prostheses offer a solution to reduce the negative impact of such disabilities, attempting to restore a normal functionality and amputee autonomy, as much as possible. With an average prosthetic use of 10 hours per day, the comfort from the socket is the most important factor among artificial limb users. However, to achieve functional and comfortable prostheses, great attention must be given to the socket design. A suitable socket must ensure efficient fitting, appropriate load transmission, stability, and control. It often constitutes a key factor for the success or failure of the prosthesis itself.

At present, despite some important recent advances in prosthetics, 35.3% amputees still reject their prostheses or show a rather low satisfaction level due to comfort issues. This is mainly due to socket-related issues, such as poor comfort, reduced biomechanical functionality, and hampered control. In addition, skin lesions occur in the 63%–82% of lower limb amputees, thus causing a prosthesis abandon rate that is around 25%–57%. Thus, there is a continuing healthcare need for an improved prosthetic socket provision technique. The problems related to socket design are a result of current techniques requiring a skilled prosthetist to determine, e.g., the load-bearing capability of the stump using a “touch and feel” technique without quantitative calculations.

However, recent advances in sensor technology are promising to quickly change the practice of prosthetists in this field by providing quantitative, real-time data for the analysis of socket comfort and functionality. As a first step, prosthetists will benefit from real-time 3D pressure maps when fitting patients with new sockets. Combined with advances in Internet-of-Things technology, a natural extension of this support is the online analysis of comfort, notifying prosthetists and patients of the need to replace a socket. In combination with new advanced 3D-printed materials, whose shape can be controlled after printing, modifications to sockets could even happen without the patient having to visit a health care facility.

This Special Issue invites papers pertaining to state-of-the-art sensor technology and theory, which promises to be of use in the MedTec field of prosthetics, including but not limited to:

  • Innovative sensor systems capable of providing a 3D pressure map in real-time for better prosthetic fit;
  • Techniques for low power processing and weight decrease of multiple sensor arrays;
  • Sensor design and packaging to robustly and reliably handle sensors in environments that can experience high temperature, moisture levels and repetitive pressure patterns, while requiring high immunity to EMI;
  • Biomechanical analytics models which match sensor input to the interaction of residual tissue and sockets;
  • Artificial intelligence algorithms to identify patterns in sensor input indicating patient discomfort in regard to prosthetics use.

Dr. Fredrik Asplund
Dr. Matthias Becker
Dr. Klas Brinkfeldt
Prof. De-Jiu Chen
Guest Editors

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Keywords

  • physical sensors
  • smart/intelligent sensors
  • sensor devices
  • Internet of Things
  • human–computer interaction
  • advanced materials for sensing

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Published Papers (3 papers)

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Research

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20 pages, 14045 KiB  
Article
Development of Prototype Low-Cost QTSS™ Wearable Flexible More Enviro-Friendly Pressure, Shear, and Friction Sensors for Dynamic Prosthetic Fit Monitoring
by Valter Dejke, Mattias P. Eng, Klas Brinkfeldt, Josephine Charnley, David Lussey and Chris Lussey
Sensors 2021, 21(11), 3764; https://doi.org/10.3390/s21113764 - 28 May 2021
Cited by 12 | Viewed by 4240
Abstract
There is a current healthcare need for improved prosthetic socket fit provision for the masses using low-cost and simple to manufacture sensors that can measure pressure, shear, and friction. There is also a need to address society’s increasing concerns regarding the environmental impact [...] Read more.
There is a current healthcare need for improved prosthetic socket fit provision for the masses using low-cost and simple to manufacture sensors that can measure pressure, shear, and friction. There is also a need to address society’s increasing concerns regarding the environmental impact of electronics and IoT devices. Prototype thin, low-cost, and low-weight pressure, shear, and loss of friction sensors have been developed and assembled for trans-femoral amputees. These flexible and conformable sensors are simple to manufacture and utilize more enviro-friendly novel magnetite-based QTSS™ (Quantum Technology Supersensor™) quantum materials. They have undergone some initial tests on flat and curved surfaces in a pilot amputee trial, which are presented in this paper. These initial findings indicate that the prototype pressure sensor strip is capable of measuring pressure both on flat and curved socket surfaces in a pilot amputee trial. They have also demonstrated that the prototype shear sensor can indicate increasing shear forces, the resultant direction of the shear forces, and loss of friction/slippage events. Further testing, amputee trials, and ongoing optimization is continuing as part of the SocketSense project to assist prosthetic comfort and fit. Full article
(This article belongs to the Special Issue Increasing Prosthetic Comfort through Sensor Technology)
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18 pages, 13471 KiB  
Article
A Sensor-Based Decision Support System for Transfemoral Socket Rectification
by Michalis Karamousadakis, Antonis Porichis, Suranjan Ottikkutti, DeJiu Chen and Panagiotis Vartholomeos
Sensors 2021, 21(11), 3743; https://doi.org/10.3390/s21113743 - 28 May 2021
Cited by 10 | Viewed by 4306
Abstract
A decision support system (DSS) was developed that outputs suggestions for socket-rectification actions to the prosthetist, aiming at improving the fitness of transfemoral prosthetic socket design and reducing the time needed for the final socket design. For this purpose, the DSS employs a [...] Read more.
A decision support system (DSS) was developed that outputs suggestions for socket-rectification actions to the prosthetist, aiming at improving the fitness of transfemoral prosthetic socket design and reducing the time needed for the final socket design. For this purpose, the DSS employs a fuzzy-logic inference engine (IE) which combines a set of rectification rules with pressure measurements generated by sensors embedded in the socket, for deciding the rectification actions. The latter is then processed by an algorithm that receives, manipulates and modifies a 3D digital socket model as a triangle mesh formatted inside an STL file. The DSS results were validated and tested in an FEA simulation environment, by simulating and comparing the donning process among a good-fitting socket, a loose socket (poor-fit) and several rectified sockets produced by the proposed DSS. The simulation results indicate that volume reduction improves the pressure distribution over the stump. However, as the intensity of socket rectification increases, i.e., as volume reduction increases, high pressures appear in other parts of the socket which generate discomfort. Therefore, a trade-off is required between the amount of rectification and the balance of the pressure distributions experienced at the stump. Full article
(This article belongs to the Special Issue Increasing Prosthetic Comfort through Sensor Technology)
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Review

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21 pages, 460 KiB  
Review
A Scoping Review of Pressure Measurements in Prosthetic Sockets of Transfemoral Amputees during Ambulation: Key Considerations for Sensor Design
by Siu-Teing Ko, Fredrik Asplund and Begum Zeybek
Sensors 2021, 21(15), 5016; https://doi.org/10.3390/s21155016 - 23 Jul 2021
Cited by 10 | Viewed by 5529
Abstract
Sensor systems to measure pressure at the stump–socket interface of transfemoral amputees are receiving increasing attention as they allow monitoring to evaluate patient comfort and socket fit. However, transfemoral amputees have many unique characteristics, and it is unclear whether existing research on sensor [...] Read more.
Sensor systems to measure pressure at the stump–socket interface of transfemoral amputees are receiving increasing attention as they allow monitoring to evaluate patient comfort and socket fit. However, transfemoral amputees have many unique characteristics, and it is unclear whether existing research on sensor systems take these sufficiently into account or if it is conducted in ways likely to lead to substantial breakthroughs. This investigation addresses these concerns through a scoping review to profile research regarding sensors in transfemoral sockets with the aim of advancing and improving prosthetic socket design, comfort and fit for transfemoral amputees. Publications found from searching four scientific databases were screened, and 17 papers were found relating to the aim of this review. After quality assessment, 12 articles were finally selected for analysis. Three main contributions are provided: a de facto methodology for experimental studies on the implications of intra-socket pressure sensor use for transfemoral amputees; the suggestion that associated sensor design breakthroughs would be more likely if pressure sensors were developed in close combination with other types of sensors and in closer cooperation with those in possession of an in-depth domain knowledge in prosthetics; and that this research would be facilitated by increased interdisciplinary cooperation and open research data generation. Full article
(This article belongs to the Special Issue Increasing Prosthetic Comfort through Sensor Technology)
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