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Research

A 'step change' in prosthetics

Improving access to prosthetic limbs in Cambodia

Published: 15 January 2019

Around 100 million people worldwide need a prosthetic limb to replace an amputated arm or leg, or an orthotic device to support a damaged limb. Yet it’s estimated around 80 per cent of these people don’t have access to these services – and this is a particular issue for low- and middle-income countries.

Southampton researchers are working with clinicians, academics and policymakers in Cambodia to develop digital tools to improve access to prosthetic and orthotic services. The team will also be training clinicians in the use of these digital tools, and undertaking their own research. These results should ensure that funding allocated for prosthetic services is spent more efficiently.

Dr Alex Dickinson, Lecturer in Engineering and Physical Sciences, is leading a multidisciplinary team of engineers and health scientists from Southampton to assess how useful a range of digital technologies could be to prosthetic limb provision in Cambodia.

The legacy of landmines in Cambodia and, more recently, road traffic accidents because of limited infrastructure in booming cities, means there is an urgent need for improved provision for prosthetics and orthotics,” explains Alex. “This is coupled with an increasing incidence of diabetes and vascular disease, both of which are leading causes of amputations.

Dr Alex Dickinson - Lecturer in Engineering and Physical Sciences
Child in village
Assistive devices need to be durable for rural life - Exceed Worldwide

Highly skilled process

Creating a prosthetic limb is a highly skilled process that takes many years to master, and in many countries the supply of qualified prosthetists isn’t keeping pace with the growing numbers of people who need their services.

To address this issue, the team is working alongside prosthetists in Cambodia to investigate whether portable 3D surface scanners and computational shape analysis techniques could help them share good practice, measure a person’s adaptation to their prosthetic device and enable more people to access them.

“Prosthetists like our expert partners at Exceed Worldwide and the Cambodian School of Prosthetics and Orthotics are highly trained, and their practice is based on huge experience; their expertise certainly can’t be replaced by a computer. However, these technologies could help them interpret what they have done before, learn faster and engage with their clients. This could help speed up provision of prosthetics and orthotics to people who really need it,” Alex explains. In collaboration with the University of Salford, the project will also conduct physical activity measurement research, to assess how people use their prosthetics in community settings.

Health psychologist Dr Maggie Donovan-Hall is providing a key element in the team’s approach; she is working closely with the groups of people in Cambodia that use prosthetics, to create technologies that meet their technical, social and cultural needs. To achieve this, Maggie and social affairs researchers in the Cambodian team are carrying out preliminary focus groups with prosthetic service users to ensure the technology will be of benefit to them.

In collaboration with University of Southampton digital spin-out company, BluPoint Ltd, the team is developing a secure method of collecting the scan and activity data in the community, and disseminating information. They will also trial the use of digital versions of clients’ case notes to enable prosthetists to provide treatment to people in remote communities who can’t afford to travel to a clinic, removing the risk that paper-based notes could get lost or damaged in transit.

These portable technologies have the potential to transform the quality of life for people with disabilities by improving access to prosthetics and orthotics services for people in remote locations.

Dr Alex Dickinson - Lecturer in Engineering and Physical Sciences
Child with ankle braces
Orthoses like these ankle braces are often provided for children

Transforming quality of life

“My hope is that they will give people better and faster access to a more personalised prosthetic and orthotic service, and devices that are better suited to their everyday lives. Portable scanners and digital case notes could have the added benefit of patients requiring less time off work for appointments because clinicians are more able to travel to remote locations to visit them in their homes,” says Alex.

The project is a result of the Institute for Life Sciences' FortisNet initiative, which brings together experts from different disciplines across the University, and is funded by the Engineering and Physical Sciences Research Council’s (EPSRC) Global Challenges Research Fund.

Project partners include the University of Salford’s School of Health Sciences, the Cambodian School of Prosthetics and Orthotics, Exceed Worldwide, the Exceed Research Network, and BluPoint Ltd, which will also enable the researchers to disseminate educational material and help people manage their conditions.

More information

Key researchers

Dr Alex Dickinson
Dr Maggie Donovan-Hall
Dr Cheryl Metcalf
Dr Peter Worsley
Dr Gary Wills
Professor James Batchelor
Professor Richard Oreffo

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