While upper limb loss/absence is relatively unusual in the UK, in other parts of the world, for example in areas of conflict, and/or where road safety is poor, it is believed to be much more common. The prosthetics available in these regions are often costly and are usually fitted and maintained by a relatively small specialist workforce in hospitals or clinics, places which many find difficult to access. The consequences of living with limb loss but without a suitable prosthetic device can be severe, particularly for people in low resource settings. For example, they may no longer be able to work and certain modes of travel may no longer be possible.
To address these issues, Fit-for-purpose, affordable body-powered prostheses is designing upper limb prostheses that are both low cost and fit for their purpose and circumstance. The project is funded through the Engineering and Physical Sciences Research Council (EPSRC) and National Institute for Health Research (NIHR) Global Challenges Research Fund. The partners are addressing these through a series of activities, described below:
1. Understanding user needs, cultural constraints, and clinical and manufacturing resources. To inform the work in the project, we are undertaking a series of scoping studies and focus group activities in both Jordan and Uganda. The work involves discussions with people with limb absence, clinicians and, manufacturers, including those in the P&O sector and other engineering firms.
2. Developing specifications. Through a number of activities, including analysing the limitations with current body-powered devices we are developing engineering specifications for the new designs. The work focuses not only on the end effector (‘hand’), but also the socket and other components.
3. Design and manufacture of novel designs. Informed by the work described above, the new designs will be developed and tested. The testing will begin in the labs, but field testing in Uganda and Jordan is planned for later in the project.
4. Advanced design features. This work is focusing on possible alternatives to the traditional, Bowden cable, transmission used in most body-powered devices.
5. Digital tools for support and evaluation. We have surprisingly little data on how prostheses are used, or perhaps not used, in the real world. Further, we know from our early results that some people living with limb absence report feelings of isolation. In this work we are investigating how digital tools might be used to address both of these issues.
6. Impact. We aim to have a lasting positive impact in Uganda and Jordan. We are working towards this through a series of activities, including capacity building in both countries and technology transfer issues.