Question: Focus questions How has prosthesis improved over

Question:
“Advancements in biomedical engineering i.e. Prosthesis, have significantly
improved the treatment and well-being of injuries sustained by veterans” to
what extent is this true.

 

Introduction

Loss of limbs is unfortunately a very
real risk for those who choose to defend our country. Since Australia pledged
to assist the US in their war against terrorism in Afghanistan and Iraq, 252
Australian troops have suffered war related injuries, this includes amputation,
fractures, gun wounds, hearing loss lacerations and traumatic brain injury.1 Prosthesis
is becoming more prevalent in society, a study was done by L. E. Pezzin found
that out of 935 surveyed persons, 94.5% used prosthesis extensively (71hr/w)
and out of that 75.7% were satisfied with their prosthesis.2 Biomedical
engineering is a broad term for research or technology that combines
engineering, biology and medicine to problem solve.3 A
more focused study will be on one specific part of biomedical engineering and
that is prosthesis.

 

Above can be seen the
basics of the most common limb prosthetics that are commercially used. However,
biomedical engineer and prosthesis does not stop here, current technology
allows many body parts to be replaced with a mechanical replacement. Things
such as eyes, hands and parts of the male reproductive system.

The aim of this report
is to shed light on the many benefits that come with advancements of biomedical
engineering and the practical application and impact that it has on our
Australian troops fighting for our freedom. This will be done through the use
of both primary sources such as an interview and secondary sources such as
websites and case studies done by others.

Focus questions

How has prosthesis improved over the
last decade?

Prosthesis has come a long
way since the first uses of crude prosthetics made of bronze and iron in around
300 B.C4. Issues
with earlier prosthetics include ill-fitting, irritation towards the remaining
limb , soreness and ineffectiveness. Today we have fully functioning limbs that
give the wearer almost full use of their missing limb. One of the most notable
advances recently is the “Luke arm” that was developed by Dean Kamen5.
The “Luke arm” is a functioning arm that can be used by full arm amputees,
below shoulder amputees and below elbow amputees. Depending on the patient, the
luke arm can be controlled through a variety of input mechanisms, however the
most common is an electromyogram (EMG) sensor. EMG sensors allows the amputee
to use the existing muscles in their arm to control the device.6 If
this option is not viable a simpler input device can be used such as switches
or touch pads. Switches are operated by simply pressing down or toggling,
switches offer more limited control of the device. Switches are often capable
of things such as grabbing onto something or other preprogramed actions. Touch
pads are more versatile than switches and enable proportional control of the
device. This means varying pressures can be applied to the touchpad to adjust
the output signal. This enables more control of the speed or strength of the
action being done by the prosthesis. Both mechanically functioning prosthetics
and the way they are controlled is very recent technology that is still being
developed and tested. The first mind controlled robotic arm that is permanently
attached to the body was made by max Ortiz Catalan and Rickard Branemark who
are from the Chalmers university of technology.7
However, this technology is not yet commercially available unlike the luke arm.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What are the physical effects of
prosthesis?

In 2007-08 nearly
80,000 people had an amputation because of an injury8.
With an increase in road accidents and amputations due to diabetes a larger
portion of the Australian population is being affected by prosthetics. The
physical effects of prosthetics extend way beyond just being able to walk again
but trials are currently being done for people to see again. Bionic eyes are a
new and upcoming technology with trials being done in Australia on 3 people between
2012-2014.9
This technology isn’t perfect and does not restore full vision to the user, but
patients were able to locate items on a table and navigate around objects when
walking. This technology is not available for people because “a functional visual pathway from the retina
to the brain along the optic nerve, as well as some intact retinal cells.”10.
Further to just the physical effects, amputees are also able to work again.
(NEED STATISTIC). In some cases, amputees are able to be mobile even without
the use of prosthetics, but a personalized prosthetic allows easier and more
natural movement. Some of the negative long-term effects include deep tissue
damage in the residual limb, joint problems such as arthritis and in lower limb
amputees back pain. 11

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What are the psychological effects of
prosthesis

With amputation often
comes a host of psychological after effects including things such as
depression, anxiety, loss of self-esteem/self-confidence and fear of rejection12.
The department of Physical Therapy in the university of Jordan Amman did a
study on the prevalence of depression and anxiety in Jordanian patients and
found that anxiety had a 37% prevalence and depression had 20%13.
Prosthesis can help with body image, depression and anxiety.14
One significant variable in the effectiveness of prothesis to improve mental
well-being is the function ability and the aesthetics of the device. If the
patient does not like the aesthetics or if they find the prosthesis difficult to
use, then they are less likely to wear it and benefit from it. Prosthetics
increase mobility of the user and this enables them more opportunities to enter
the workforce. With this comes increased social interaction and increased
mental well-being. Prosthesis often enables user to become more accepting of
their limb loss by giving them partial use of it. However, the success of
prosthesis to assist in mental wellbeing also depends on the personality style
of the patient. More narcissistically qualities tend to react more negatively.15
Unemployment is associated with a more intense feeling of stress and may
increase the chance of phantom limb pain. Also, it has been found that the
earlier that the patient is given access to prosthesis the less anxious, sad and
self-conscious they are.16

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What financial support is offered for
amputees in Australia?

Throughout Australia there are many people
living in poverty. In 2014, the headline poverty rate was 13.3%17.
Losing a limb and having an amputation and buying prosthesis can put massive
stress on families or individuals that live in poverty. Loss of a limb can
potentially make finding employment a challenge, something that prosthesis can
heavily assist. However proper individualized leg prosthesis is not cheap and
can cost upwards of $5,00018.
However, there is a variety of government programs and non-profit organisations
that provide or subsidies equipment for amputees. South Australia has the
Domiciliary equipment service which provides a variety of programs to help
those pay for needed equipment. If the patients injury occurred from serving in
the military then they may be eligible for compensation. However these schemes
often fail veterans. The SA Amputee Limbs Scheme (SAALS) is beginning to deny
customers personalise prosthetics will only supply one general purpose
prosthetics. 19Having
the right prosthetic is vital to the recovery and integrat

1 M Swyrydan,
‘Australian veterans’ health: Afghanistan’, Medical
Association for Prevention of War, Viewed on 27 January 2018, http://www.mapw.org.au/download/australian-veterans-health-afghanistan-mapw-war-and-health-fact-sheet-8

2 L. E. Pezzin PhD T. R. Dillingham MD MS E. J. MacKenzie PhD P. E. MPH P.
Rossbach RN, ‘Use and satisfaction with prosthetic limb devices and related
services, Physcial Medicine and
Rehabilitation, Volume 85, Issue 5, May 2004, Pages 723-729

3 Michigan
Technological University, ‘What is biomedical Engineering, Michigan
Technological University, viewed on 28 January 2018, https://www.mtu.edu/biomedical/department/what-is/

4 K M.
Norton, ‘A Brief History of Prosthetics’, Amputee
Coalition, November/December 2007, viewed on 29 Jan. 18, https://www.amputee-coalition.org/resources/a-brief-history-of-prosthetics/

5 J
Vincent, ‘DARPA-funded prosthetic arm set to go on sale later this year’, The Verge, July 2016, viewed on 29 Jan.
18, https://www.theverge.com/2016/7/11/12147726/prosthetic-luke-arm-commercial-launch-2016

6 S. Sudarsan and
Dr.E. ChandraSekaran, ‘Design and Development of EMG Controlled Prosthetics
Limb’, Procedia Engineering, vol 38, 2012, Pages 3547-3551.

7 Chalmers
University of Technology. “World premiere of muscle and nerve controlled
arm prosthesis.” ScienceDaily. ScienceDaily,
February 2013, viewed on 29 January 2018 www.sciencedaily.com/releases/2013/02/130222075730.htm

8 Australian Bureau
of Statistics, ‘Year Book Australia 2012’, Australian
Bureau of Statistics, 11 November 2015, 29 January 2018, http://www.abs.gov.au/ausstats/[email protected]/Lookup/by%20Subject/1301.0~2012~Main%20Features~Health%20status~229

9 M.
Petoe L. Ayton and M. Shivdasani, ‘Artufucial Vision: What people with bionic
eyes see’, The Conversation, 17
August 2017, Viewed on 29 Jan. 18, http://theconversation.com/artificial-vision-what-people-with-bionic-eyes-see-79758

10 Bionic
Vision Australia, ‘How does it work?’, Bionic
Vision Australia, Viewed on 29 Jan. 18 http://bionicvision.org.au/eye/how_does_it_work

11 N. LaRaia, PT DPT NCS ‘ What are some of the long-term
physical effects of using or not using prosthesis’, Ask the Physical Therapist, Volumes 20, Issue 6, November/December
2010, Pages 1-2

12 S. Morris PhD,
‘The Psychological Aspects of Amputation’, Amputation
Coalition, 18 September 2008, viewed on 29 January 2018 https://www.amputee-coalition.org/resources/the-psychological-aspects/

13 ZM
Hawamdeh, YS Othman AI Ibrahim, ‘Assessment of anxiety and depression after
lower limb amputation in Jordanian patients’, DovePress, Volume 4 Issue 3, June 2008, Pages 627-633

14 S
Sansoni, ‘Psychological distress and well-being in prosthetic users the role of
realism in below-knee prostheses.’ Universidad
de Los Andes 9th International Conference on Design and Emotion 2014: The
Colors of Care. 552-561.

15 American
Academy of Orthopaedic Surgeons, ‘Psychological Adaptation to Amputation
Edition 2’, Atlas of Limb Prosthetics,
J W. Michael, American Academy of Orthopaedic Surgeons, Illinois, 1 August2002,
Chapter 28

16 ‘Psychological
Adaptation to Amputation Edition 2’, Atlas
of Limb Prosthetics

17 Australian
Council of Social Service, ‘Poverty in Australia’, Analysis & Policy Observatory, 2018, Viewed on 29 Jan. 18, http://apo.org.au/node/68362

18 People
Pledge Australia, ‘Prosthetic and Artificial leg prices, a closer view on the
cost for families looking to help a loved one with mobility’, People Pledge Australia Blog,  2017, Viewed on 29 Jan. 18 http://peoplepledge.com.au/blog/prosthetic-and-artificial-leg-prices-a-closer-view-on-the-cost-for-families-looking-to-help-a-loved-one-with-mobility/

19 L
Waldhuter, ‘Amputee requests for prosthetics in South Australia rejected under
scheme’s tighter rules’, ABC News, 30
November 2016, Viewed on 29 Jan. 18. http://www.abc.net.au/news/2016-11-30/rules-tightened-on-amputee-prosthetics-in-sa/8080966

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