Digital Health & Advances in Prosthetic Therapy: Improving Life for Patients with Amputations
BearingOn.Health Original Contribution
December 2023
by Anne Llewellyn, MS, BHSA, RN, CRRN, CMGT-BC, BCPA, FCM
I’m excited to share some of the innovative changes happening in the area of prosthetics – and many, but not all, are digital technology related. Microprocessors and AI, coupled with new surgical techniques and materials are heralding a new era in prosthetics. And importantly, these innovations are helping people with amputations live a fuller life.
As a catastrophic case manager, I have worked with my patients to obtain the resources needed to replace a limb after a catastrophic injury. The key members of the team were surgeons, nurses, physical and occupational therapists as well as licensed and certified Prosthetist/Orthotist. Licensed and certified Prosthetist/Orthotist, are experts in evaluating the injury, preparing the stump and choosing the right prosthetic for the person.
Matthew Klein is the Area Director, for Florida and the U.S. Virgin Islands for Hanger Clinics. I have collaborated with Matt to support several patients who suffered amputations (both upper and lower extremities). He helped both me and my patients understand the advances taking place that allow people to get back to a quality life doing things they loved.
Here is what Matt Shared:
Over the last decade, there have been revolutionary advances in the following areas that are changing the industry while providing improved systems for the limb difference community. These include:
New innovative composite materials
3D printing technology
Microprocessors
Improved surgical techniques including Targeted Muscle Reinnervation (TMR)
Osseointegration
Matt explained:
Targeted Muscle Reinnervation is a surgical procedure where the severed nerve during an amputation is rerouted to a new set of muscle targets using microsurgical techniques. This procedure was initially intended to assist with reducing pain from neuromas and phantom pain, and has since resulted in a major advancement in upper extremity prosthetics. Through the use of TMR, prosthetic users have increased control over their prosthesis allowing intuitive control over multi-articulating joints. Often, TMR is coupled with a technology called Coapt which assists in restoring natural movements using advanced machine learning algorithms. This allows the prosthetist to make fine adjustments using a Bluetooth controller.
Osseointegration involves the direct integration of a prosthesis to the user’s skeletal anatomy improving linkage to the prosthesis that has the potential to provide a more natural, comfortable and intuitive gait pattern.
Carbon fiber, prepreg laminate composites, 3D printed components have resulted in lighter weight and stronger dynamic prosthesis. Advancements in material science and manufacturing have resulted in new designs and options for partial fingers and hands. Companies like Naked Prosthetics now provide lightweight 3D printed prostheses that restore function for the partial hand and finger patient population where viable options were previously not available.
Advancements in smaller, more durable and less expensive microprocessors have changed the prosthetic landscape. Options include microprocessor hands, elbows, ankles, and knees that provide improved function and safety. In many cases, microprocessor designs use algorithms that assist in reducing the mental effort required to utilize the technology. Users can return their focus to living and not having to be concerned, for example, with their knee buckling and falling. Gyroscopes are often used in combination with microprocessors that incorporate AI type processing that predict movement patterns enhancing function resulting in improved patient outcomes.
According to Matt, innovations in AI controlled prostheses will undoubtedly dominate the future of this industry. Sensory feedback studies whereby users can feel the objects they touch and hold are underway as researchers connect the dots on connecting a prosthesis to the user’s somatosensory system. We have witnessed the progression from body controlled prosthetic designs to muscle control using electrodes interfacing with EMG signals. AI mind-controlled research is underway and is yielding promising outcomes that will revolutionize our industry.
Advances in technology are helping people find life after limb loss. Coupled with proper prosthetic options, new surgical techniques and, of course, training, education and emotional support for amputees AND their family, people return to work, and to the activities they love.