Medicine researchers are part of University team to win £900k for artificial limbs project

Two Medicine researchers are part of University of Southampton team that has won more than £900,000 in funding for a project to improve access to artificial limbs in lower and middle income countries (LMICs).

The ambitious three-year project will see two studies carried out in Cambodia, in southeast Asia, with the aim of developing digital tools to improve access to prosthetic and orthotic (P&O) services, train clinicians and ensure funding is spent more efficiently.

About 100 million people worldwide need prosthetics (artificial limbs) or orthotic devices (braces and splints), but an estimated 80 to 90 per cent of those do not have access to P&O services because of a shortage of personnel, service units and health rehabilitation infrastructures. 

The higher incidence of traumatic amputations in LMICs (caused by accidents, conflict and landmines) means people with P&O needs are typically younger, with more physically active years ahead of them, than users in more economically developed countries, for whom most prosthetics technology has been developed.

The project is one of 15 to receive a total of £16m in funding from the Engineering and Physical Sciences Research Council (EPSRC) and the National Institute for Health Research (NIHR) through the Global Challenges Research Fund (GCRF), a £1.5 billion government fund to support cutting-edge technology that addresses challenges faced by LMICs.

Mechanical engineer Dr Alex Dickinson, from Engineering and the Environment, will be leading the project in partnership with colleagues Dr Maggie Donovan-Hall, Dr Cheryl Metcalf and Dr Peter Worsley, from Health Sciences. They are being mentored by Professor Richard Oreffo and Professor James Batchelor, from Medicine; and Dr Gary Wills, from Electronics and Computer Science.

Alex said: “I’m delighted that we have won this vital backing. In LMICs there are still many more patients than the existing number of clinicians can possibly cope with, and there is an ever-growing population of people with P&O requirements.

“In south-east Asian LMICs, it is estimated that three times the current number of clinicians is required to cater for the amputee population.”

Richard said: “This ground breaking EPSRC project to develop tools to improve prosthetics and orthotics service access and to train clinicians and scientists in Cambodia offers a significant hope to the many affected from landmine trauma in Cambodia.  I am delighted to be involved with Alex‘s team of expert clinicians, academics and policy makers in Cambodia to drive this project forward to transform lives.”

James added: “This team brings together engineering and medicine and integrates skills and approaches that will make an enormous difference to patients in Cambodia.  The Clinical Informatics unit will add insight and support through clinical data capture to blend with the computational modelling and technology hardware, in another exemplar of a cross-faculty team at the University working together to solve clinical problems.”

The project is a result of the Institute for Life Sciences’ FortisNet initiative, which brings together experts from different disciplines across the University.

Alex and his colleagues have spent three years building the project and the partnerships which will help it to deliver real-world impact. They have recruited a world-leading team of clinicians, academics, industry experts and policy-makers who will conduct two data-technology research studies with the aim of developing innovative tools to enhance P&O data. They will investigate:

• Digital measurement tools to assess a user’s residual limb anatomy, biomechanics of gait, typical daily prosthetic limb use, and health status;
• The architecture for a portable digital patient case note system: a robust and secure IT network for travelling prosthetists  to visit provincial areas to provide evidence-based treatment for those in remote communities who cannot afford to travel.

Key to the project is a user-led research model, where the prosthetists, physiotherapists, community workers and patients themselves are involved in directing the technical work.

Alex said: “These technologies have the potential to transform the quality of life of prosthetic limb users worldwide, and are needed today. A more portable P&O service would enable people to access provision, fitting, adjustment and repair of their prosthetics with reduced time off work – essential where an agricultural worker spends their day’s earnings on the same day’s food.

“Prosthetists would access and update case notes for their patients, provide a repository for clinician training and enable users to access information regarding their progress and report problems to obtain critical treatment.”

“A great strength to this project is a set of internationally-leading partners. The collaboration will include researchers at the University of Salford, the Cambodian School of Prosthetics and Orthotics, Exceed Worldwide, National Institute of Social Affairs, Cambodia, the Exceed Research Network, and BluPoint, a University of Southampton digital spin-out company. BluPoint technology will also enable the researchers to disseminate educational material and help people manage their conditions.

EPSRC Chief Executive Professor Philip Nelson commented: “Responding to healthcare challenges in low and middle income countries can require the development of innovative new approaches; key factors include affordability, portability and the requirement for point-of-care operation in often remote locations.

“The projects announced today ensure that these necessities are incorporated into healthcare solutions that have the potential to transform many lives.”