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Military-funded prosthetic technologies benefit more than ...

May. 06, 2024
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Military-Funded Prosthetic Technologies Impact Civilian Lives

In 1905, an Ohio farmer survived a calamitous railroad accident that claimed both of his legs. Two years later, he established the Ohio Willow Wood company, initially using local timber to handcraft prosthetic limbs. The company not only persevered through the Great Depression and a devastating fire but continues to thrive today in rural Ohio. A little-known trivia about the company during World War II is its temporary shift to manufacturing parts for PT boats and B-17 bombers.

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Today, it's fascinating—albeit ironic—that a company specializing in prosthetics once built parts for war machinery, the very source of increased demand for prosthetic limbs. The unfortunate reality of war has driven researchers to innovate tirelessly to aid service members and veterans who lose limbs.

Soldiers aren’t alone in facing limb loss from IEDs; older veterans also lose limbs due to diabetes and vascular disease. Mobility, crucial to long-term health, heavily relies on prosthetic limbs.

This brings the U.S. Department of Veterans Affairs into the spotlight as a critical contributor to prosthetics development and technological advancements. Innovations designed for service members and veterans extend their benefits far beyond, aiding almost two million Americans—including children, elderly individuals, and young adults dealing with amputations—in enhancing their mobility.

Investment in Innovation

As a biomedical engineer devoted to prosthetics, I've reviewed numerous grant proposals seeking VA funding for prosthetic limb research. Over the years, the federal government has played an indispensable role in pushing prosthetic technology forward. Before the 1980s, prosthetic feet were functional for standing and walking but fell short during more strenuous activities. Veterans Administration Rehabilitation Research and Development funds paved the way for the Seattle Foot. This breakthrough, along with its carbon-fiber counterparts, set the stage for the "blade"-style prostheses now popular in the Paralympics.

Government spending related to defense continues to be a catalyst for prosthetic innovation. The Defense Advanced Research Projects Agency (DARPA) has particularly garnered attention, notably with its “Luke Arm,” named after a well-known fictional character, Luke Skywalker. Headlines echoing from the realm of Star Wars, such as "DARPA Helps Paralyzed Man Feel Again Using a Brain-Controlled Robotic Arm," captivate public imagination.

For prosthetics researchers, traditional funding sources like the National Institutes of Health and the National Science Foundation have become increasingly competitive. As a result, many have directed their focus towards soldiers and veterans. Between 2014 and 2015, the Congressionally Directed Medical Research Program supported 18 Orthotics and Prosthetics Outcomes proposals, although it declined 98 other submissions.

Bridging Technology and Human Anatomy

The ultimate goal is to transition from prosthetics as mere tools to prosthetics as integrated extensions of the human body. While creating prosthetic devices that seamlessly mimic human anatomy is a tall order, significant strides are being made. For example, targeted muscle reinnervation allows nerves to communicate commands like "close hand" to muscles connected to electrodes, which subsequently relay the signals to motorized prostheses. Although these technologies are not yet ready for everyday use, they mark critical progress.

A notable project funded by the Congressionally Directed Medical Research Program at the Rehabilitation Institute of Chicago and Vanderbilt University features motorized, active joints in lower-limb prostheses. Neuroengineering specialist Levi Hargrove leads efforts in enhancing motor control by interpreting muscle signals, thereby enabling smoother transitions between activities such as walking and stair climbing.

Such advancements undoubtedly benefit a far broader audience than just military personnel. My own work, focusing on children with limb loss, has spawned everyday applications of these innovations. At Georgia State University’s Center for Pediatric Locomotion Sciences, we are researching pediatric prosthetic feet, utilizing components that trace back to the VA-funded Seattle Foot. Additionally, at the Shepherd Center, robotic exoskeletons assist paralyzed individuals in moving and remapping neural pathways, an initiative linked to VA prosthetic research.

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While these civilian applications may not receive the same attention as inventions like the Jeep or GPS, their long-term benefits for individuals of all ages are profound and life-changing.

The Rise of Digital Manufacturing in Prosthetics

Revolutionizing Prosthetic Limb Production

Creating a prosthetic limb often involves a painstaking process of casting the patient’s anatomy to build a mold by hand using composite resin, followed by the placement of fixtures and padding. This method requires multiple patient visits and consumes significant time.

Manufacturers face the challenge of producing well-fitting prosthetics, which is both costly and labor-intensive due to the need for customization. With dwindling funding and a demand for more complex products, healthcare providers must seek more efficient production methods.

Digital manufacturing offers a solution by reducing process steps and bridging the gap between patient and product. Starting with a scan that captures measurements and required features, clinicians and technicians can create precise digital models ready for manufacturing. Techniques like CNC machining and 3D printing streamline production, offering high precision or complex geometries, respectively.

The benefits to patients include faster production and a better custom fit, while healthcare providers save time and costs. Digital methods also allow health professionals to focus more on fitting and optimizing the device with the patient.

Accelerating Prosthetic Development

Digital manufacturing is transforming not just production but also the development phase of prosthetics. A primary concern for manufacturers is the time it takes to bring new products to market. By leveraging digital technologies, prosthetics can be designed, manufactured, and adapted swiftly, reducing time and cost.

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