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The University of Southampton
Institute for Life SciencesLife Technologies

Prosthetics & Orthotics

A prosthesis is a device that replaces a body part, which may have been lost through trauma or disease, or be missing due to congenital conditions. For example, an artificial arm or leg is intended to provide the normal function of the missing limb. An orthotic device is used to support, protect or realign a part of the body in response to injury or health condition. No matter how advanced the prosthetic or orthotic device, a comfortable interface with the human is one crucial element of achieving a successful outcome.

Accessing prosthetic limbs in some countries remains a challenge. Picture: Dr Alex Dickinson

Our interdisciplinary research teams, which span areas such as engineering, health sciences, physiotherapy and computer sciences, are working together to develop enhanced measurement techniques that complement the prosthetics design and fitting processes. We focus on the personalised, user-specific ‘socket’ which is used to attach a limb made of otherwise standard prosthetics components.

Current socket fabrication processes, often employing plaster casting, mean people with amputation can require many fittings and adjustments. This can be uncomfortable and time consuming and can lead to people not using their prostheses. Additionally, once a prosthesis is fitted, the mould that was used to create the socket is often destroyed, along with any record of its design. This makes it difficult to produce a matching replacement socket and makes it difficult to analyse the design and use it to inform future practice.

From sensors and 3D scanners to computer modelling and gait analysis, our research is finding new ways of improving the fitting process as well as improving the design and clinical assessment tools used to produce more comfortable, better performing replacement limbs for people with amputations.

We work with clinicians to better understand the challenges they face at the point of care, and with the users themselves, to allow a sustainable implementation of technology.

Related Staff Member

Related Staff Member

Key words

Bioengineering, Fit, Interdisciplinary, Limb, Orthotics, Physiotherapy, Prosthetics,  P&O, Research, Socket

Please see a selection of postgraduate courses related to this subject area below. 

For the full range of undergraduate and postgraduate courses at the University of Southampton, please visit our courses webpages https://www.southampton.ac.uk/courses.page

MSc Biomedical Engineering

This masters course will equip you with the specialist knowledge, expertise and skills to integrate biology and medicine with engineering to solve problems related to living systems.

MSc Health Sciences

Our Masters in Health Sciences - Amputation & Prosthetic Rehabilitation is a flexible programme of higher level study that is suitable for both clinicians and non-clinicians.

MSc Health Psychology

Explore how psychological knowledge can improve wellbeing and manage chronic disorders with our MSc in Health Psychology.

Image credit:  Josh Steer
Image credit: Josh Steer

Improving the next generation of prosthetic limbs

Collaborating with health scientists and clinicians, a team of mechanical engineers in the Bioengineering Science Research Group is developing prosthesis design and clinical assessment tools to help produce more comfortable, better performing replacement limbs.

Around 5000 people enter prosthetic rehabilitation services every year in the UK, after major lower limb amputations.  Despite the development of advanced prosthetic limb technologies, the level of mobility achievable is strongly dependent on successful rehabilitation after surgery, and on optimal fitting of a prosthetic limb. Producing a comfortable and functional socket fit is a challenge; the residual limb’s size fluctuates over the course of each day due to changes in temperature, activity and hydration, and longer term due to deterioration of the reconstructed soft tissues. If the socket fit is not perfect, pressure and shear stress in the soft tissues can cause discomfort or even deep tissue injury, reducing mobility or compromising recovery.

Supported by the Royal Academy of Engineering, EPSRC, EU and the Institute for Life Sciences, we are creating accurate computer models of the interaction between the residual limb and the prosthetic socket in lower limb amputees, based on state-of-the-art imaging and gait analysis techniques. This allows the prediction of how the residual tissues deform and respond to the loads generated in activities of daily living. These models incorporate the daily size variations and long-term adaptation of the residual limb and the considerable influence of variability between patients.

To interpret these models, we are also collecting a first-of-kind suite of biomechanical and physiological measurements of the influence of loading upon the skin and muscle tissues in the residual limb, in an attempt to understand safe loading thresholds. This may also expedite rehabilitation with a prosthesis, by understanding how the tissues can be encouraged to adapt to their new loadbearing role, much like forming a callus on the fingers when learning a musical instrument or a new sport.

These tools will enable healthcare providers to increase the time prosthetic limbs last between adjustments or replacements, and ultimately improve the quality of life of people who use prosthetic lower limbs.

ContactsDr Alex Dickinson plus PhD students Joshua Steer, Jennifer Bramley, Florence Mbithi, Emily Kelly and Emanuele Zappia, and co-supervisors  Dr Peter Worsley, Prof Dan Bader, Prof Martin Browne , Dr Adam Sobey, Prof Cathy Bowen

Rio Woolf and Prof. Liudi Jiang
Rio Woolf and Prof. Liudi Jiang

Fitting prosthetics to a growing child

We are developing a smart socket system that will identify the right time for a child’s prosthetic to be replaced.

The high growth rate of children means that children who have lower limb loss need prosthetics that match their growth rate.  This could mean that a new socket is needed regularly.  Once a prosthetic socket is fitted to a child, it can become too small quite quickly, and if left unaddressed could lead to discomfort and even skeletal development problems.

Supported by StarWorks Proof of Concept Funding, our researchers are developing a novel Socket Interface Monitoring System (SIMS) for children with lower limb absence, which will use a system of sensors in the socket and a smartphone App to help identify the appropriate time for socket adjustments.  With SIMS, the aim is to help ensure children always have good fitting and comfortable prosthesis so that they can participate fully in daily activities and most importantly have fun!

ContactProf Liudi Jiang , Dr Jinghua Tang
 

Widening Access to Prosthetics and Orthotics in Cambodia

About 100 million people worldwide need prosthetics or orthotic devices but an estimated 80 to 90 per cent of those do not have access to such services because of a shortage of personnel, service units and health rehabilitation infrastructures.

The higher incidence of traumatic amputations in lower and middle income countries, caused by accidents, conflict and landmines, means people who need prosthetics or orthotics are typically younger with more physically active years ahead of them compared to users in more economically developed countries, for whom most prosthetics technology has been developed.

Supported by the EPSRC and NIHR under the Global Challenges Research Fund, our researchers from health sciences, medicine, engineering and computer sciences are conducting two studies in Cambodia, southeast Asia, which aim to develop digital tools to improve access to prosthetic and orthotic services, train clinicians and ensure funding is spent more efficiently.

Without reliable measurements, we cannot improve P&O services. We are creating digital measurement tools to assess a user’s residual limb anatomy, biomechanics of gait, typical daily prosthetic limb use, and health status to assess the quality of prosthetics.  To implement these measurements, we are developing a portable digital data collection system, which will enable travelling prosthetists and community workers to access digital casenotes for their patients, so they are able to visit provincial areas to provide evidence-based treatment for those in remote communities who cannot afford to travel.

Excitingly prosthetists, physiotherapists, community workers and patients themselves are involved in directing the technical aspects of the project to ensure it is appropriate for the culture in which it will be implemented.

Contacts: Dr Alex Dickinson, Dr Maggie Donovan-HallDr Cheryl MetcalfDr Peter Worsley , Dr Gary Wills

Collaborator weblinks: http://edgeclinical.com/

https://www.exceed-worldwide.org/

https://www.blupoint.org/ 

http://cspo.org.kh/ (Cambodian School of Prosthetics & Orthotics)

University of Salford Health Sciences:  https://www.salford.ac.uk/research/health-sciences/research-groups/human-movement-technologies 

Image credit: Dr Alex Dickinson
NIHR and EPSRC funded Global Challenge Research Project carried out in Cambodia
Image credit: Dr Alex Dickinson
Accessing prosthetic limbs in some countries remains a challenge
Image credit: Dr Alex Dickinson
Accessing prosthetic limbs in some countries remains a challenge
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