D-Lab Prosthetics for the Developing World

D-Lab: Prosthetics students test transtibial prosthetic liner in Kenya & Ethiopia

By Katelyn Sweeney MIT '18, Nick Schwartz MIT '18, and Trang Luu MIT '18

 

 

 

This January, in conjunction with the D-Lab: Prosthetics class, Trang Luu, Katelyn Sweeney, and Nick Schwartz traveled to Kenya and Ethiopia to test their transtibial prosthetic liner. The goal of our design is to create a more comfortable interface between the patients and their prostheses, as daily fluid shift in the residual limb can cause discomfort. We ran field trials at the CURE International Hospitals in Kijabe, Kenya and Addis Ababa, Ethiopia. During these trials, the patients were asked to wear the liner with their own prosthesis and rate its comfort measures and aesthetics on a quantified scale.

Making prostheses more comfortable

The results were profound. Many patients tended to not wear their prosthetics in the first place because they were so uncomfortable to walk with, and they opted to use crutches instead. The feedback was very useful and will help us create the next prototype. Overall, there were 14 patients that gave us feedback: seven in Kenya and seven in Ethiopia. Those who were able to use our device in tandem with their current prosthetic were asked to rank its comfort; the others were surveyed on what they would like to see in future iterations. 

The results of our study were greatly beneficial to our research. On a scale from one to four, with four agreeing very strongly, the average patient response to the statement “I can walk more comfortably with the liner” was a three across both locations. One other aspect we took into consideration was aesthetics, so that users would feel comfortable wearing our liner in public. The average patient response to the statement “I want to wear the liner” was a four. Other than the quantitative feedback, we got many suggestions for how to improve our device, and for what each user looks for in an ideal prosthesis.

One of the most special moments for the team happened on our first day of testing in Addis Ababa. A 17 year-old girl named Mariane came all the way from Chichirri, Somalia with a knee disarticulation. With limited availability of inexpensive prostheses in Somalia, she was unable to acquire a prosthetic when she had had her surgery two months prior. With a generous donation of parts from Rogerson Orthotics and Prosthetics in Cambridge, Massachusetts, the team was able to construct one for her from scratch and stand with her as she took her first steps since the surgery. It's a long road ahead, but she made (literal) strides that day and we are so excited to see where she goes from here. 

Lessons in Co-Creation

We all learned the value of co-creation; too often engineers for the developing world will come up with what seems like a brilliant concept on paper but fails in real life because it doesn’t fit into the cultural context of the country. Our team saw success largely due to the fact that we worked alongside the prosthetists in Kenya and Ethiopia to determine what would work and what wouldn’t. We all hope that long-term success will be a result of this cooperation between international healthcare engineers, and all of us hope to go back and continue working on the project.

Exploring Kenya

In addition to working during the weekdays, we were very fortunate to have the opportunity to travel during the weekends. The first weekend in Kenya, we traveled to the Maasai Mara Game Reserve in Kenya. Within the first ten minutes of our game drive we watched a mother cheetah and her two children hunt and eat a gazelle. In an unbelievable stroke of luck, we also saw a pride of three male and three female lions relaxing in the sun. In Ethiopia, we explored various sites in the city such as Mercato, the largest outdoor market in Africa, the National Museum of Ethiopia, home of the oldest human remains (Lucy and Ardie), and visited the hot springs in Sodore.

Thanks and moving forward

We are very thankful to both D-Lab: Prosthetics and Autodesk for their support. Katelyn's trip was made possible by support from a D-Lab Undergraduate Classmen Fieldwork Grant. Without this support we would not have been able to have such a successful trip. 

We have applied to the MIT IDEAS Global Challenge for support and are in the process of scaling our device up to become a viable product for the global healthcare economy. It’s certainly a new challenge for us, but we are looking forward to taking our device to the next level.

D-Lab: Prosthetics for the Developing World – Back for Fall 2015!

A 2014 D-Lab: Prosthetics student testing an aspect of her team’s prototype.

 

Bryan Ranger talking with Fred Ouko, Director of Action Network for the Disabled, in Nairobi, Kenya.

 

Bryan Ranger (l) and David Sengeh (r), two of the co-instructors for D-Lab: Prosthetics Spring 2014.

D-Lab: Prosthetics for the Developing World is back!

In the Spring 2014 term, D-Lab: Prosthetics (EC.722) had projects that ranged from improving prosthetic fit, to a pylon prototype aimed at achieving better shock absorption in lower limb prostheses. One of the projects, which focused on using 2D images to form 3D digital models, even caught the attention of Autodesk! Using Autodesk software, such as 123D Catch and Fusion 360, students demonstrated a simple and low-cost way to create 3D digital models of a limb in computer-aided design software.

Collaborating with Autodesk

Encouraged by the promising results produced by D-Lab: Prosthetics students in the Spring 2014 term, Bryan Ranger and Katerina Mantzavinou, the co-instructors for the fall 2015 course, have been busy working out a collaboration with Autodesk. This relationship will provide further resources and sponsorship for students interested in doing projects related to low-cost prosthetic and orthotic devices as part of the course.

Mentorship from a Kenyan prostheticist

Following the last iteration of this class, two of the spring 2014 course co-instructors, Bryan Ranger and David Sengeh, traveled to Nairobi, Kenya. As part of a MIT Media Lab team, which was responsible for running an innovation workshop at the Nairobi iHub, they worked with Peter Ongubo, a local prosthetist to test ideas related to digital design of prostheses. They specifically discussed aspects of their own research in the Biomechatronics Group, as well as some of the student projects from the previous semester. Not only was the prosthetist excited by the projects, but has also agreed to provide mentorship to student teams this coming semester. His advice will provide much-needed insight into the innovation process in areas of limited resources, and will encourage students in the course to design with the end-user in mind.

Collaboration with Refugee Open Ware

Additionally, the fall 2015 course is collaborating closely with Refugee Open Ware (ROW), an innovation consortium based in Amman, Jordan. ROW's mission is to employ disruptive technology to improve human rights fulfillment for both refugees and host communities in conflict zones. ROW develops open hardware innovation ecosystems (e.g., digital fabrication laboratories and innovation centers) fueled by co-creation between refugees, host communities, and other global resources. Students who enroll in the course this fall will be given challenges that ROW faces in the field so that student projects have the potential to have a direct and meaningful impact. 

Projects with real-world impact

Historically, EC.722 has had a large emphasis on hands-on, yet mostly free-form design. Although the course will not stray far from this approach, this academic term, the curriculum structure has been re-vamped to follow a more deterministic design process. To this end, at the beginning of the term, students will be given specific challenges based on ROW’s defined needs. Mentors from both MIT and the course’s partner organizations will then guide them to delineate appropriate deliverables to build and test before the end of the term. The hope is that this approach will result in student projects that do not just help the course’s partner organizations, but the millions in need of more effective and low-cost rehabilitative equipment in the developing world.

Getting to scale in emerging markets

Furthermore, an exciting addition to the course this fall is an increase in lectures and assignments related to implementation, scale, and leveraging innovation in emerging markets. Gaining an understanding of these concepts, which are not often covered in academic engineering classes, is essential to creating technical solutions that are suitable and sustainable.

Overall, new collaborations with ROW, prosthetists working in the field, and Autodesk have laid the groundwork for course projects that will have real-world impact, and will open the door for students to travel and test their ideas in the field. If you are an undergraduate student that is interested in this type of work, please consider registering!

For questions regarding the course, please contact Bryan Ranger and Katerina Montzavinou, the D-Lab: Prosthetics instructors.

Pediatric Extendable Pylon

150 Projects Tags: 
Status: 
Reviewed
Amputation can happen at any stage in life. However, in places such as India, amputees cannot afford to spend multiple days getting fitted for their limbs, let alone make the trip for multiple return visits. Our goal is to develop an extendable pylon for pediatric prosthesis. The leg must be user-modifiable and user-friendly.
Jaipur

Improved Vacuum Cast System

150 Projects Tags: 
Status: 
Reviewed
This project addresses the need for low cost fitment of prostheses for any type of amputations in resource-constrained settings. The goal is to design a reusable prosthetic mold to be used in the developing world for rapid, low cost fitment of amputees.
New Delhi

Exo-knee Prosthesis

150 Projects Tags: 
Status: 
Reviewed
Transfemoral prosthetic technology is perhaps one of the most researched and well-funded areas in prosthetics. Nonetheless, there is currently no prosthetic knee joint that looks and works like a real leg. Exo-knee is a stance-lock, free swing, exoskeletal, cheap, transfemoral prosthesis that acts like an actual leg.
Jaipur and New Delhi

Lego Leg

150 Projects Tags: 
Status: 
Reviewed
Prosthetic devices in developed countries tend to be expensive due to composite materials and elaborated manufacturing processes. Lego Leg is a prosthetic device that can be assembled out of sheets of composite material and aluminum parts easily manufacturable.
New Delhi
Subscribe to RSS - D-Lab Prosthetics for the Developing World