Much of the research in upper limb prosthetics focuses on complex and expensive systems, the use of which requires access to various auxiliary services (e.g. reliable charging points, fitting and repair centres). Globally, the majority of people with upper limb absence live in settings where they cannot afford to pay for expensive devices and travel to specialist centres for fitting and repair. The result is that many people simply do not have access to prosthetics, and the consequences of living without a suitable prosthetic device can be severe. Indeed, our early work, presented at the World Health Organisation, found that many people with upper limb absence in Uganda survive without suitable upper limb prosthetics, and the devices which are prescribed are poorly maintained. Supply chains are ineffective, leading to unnecessary delay and cost. To address these issues, we are leading a programme of work to develop new, purely mechanical prostheses that are lower cost, easier to manufacture and maintain, and begin to tackle the systemic under-supply problem. We have shown the fundamental limitations of current body-powered (harness driven) upper limb prostheses [1], which led to our focus on devices which can be used without harnessing. We are designing a new open-frame adjustable socket, which should be easier to manufacture and maintain locally [2] and better suited to hot climates. We are also using digital tools to capture both use/non-use [3] and the real world experiences of users. The team includes PhD students in both the UK and Uganda, developing future research leaders in this area. As an example, Kenneth Rubango’s PhD is focusing on supply chain innovation in prosthetics, and he has already introduced a new approach into Uganda. The work is also supported by undergraduate placements and internships.
Team: Prof Laurence Kenney, Prof David Howard, Prof Louise Ackers, Dr John Head, Dr Alix Chadwell, Mick Prince, plus collaborators at University of Jordan, Makerere University (Uganda), UCL, University of Southampton and Portsmouth University.