V. The Politics and Public View of Prosthetic Rehabilitation

         There is no real controversy between the use of prosthetics and politics. The only issue that slows down the release of prosthetics is the time it takes for the government to approve the prosthetic to be distributed to the public. However, like all medical treatments that is understandable. You wouldn’t want the FDA to release a medicine that has detrimental side effects. Same goes for prosthetics; an artificial limb may malfunction and do something harmful like uncontrollably increase the grip when holding something delicate such as a baby or the battery may be corrosive and may harm the user. Usually these issues are not a problem for artificial limbs but as stated earlier in this blog prosthetics aren’t only artificial limbs. Most prosthetics that take a long time to be approved by the government usually require very invasive surgery like brain-computer implants or artificial spinal nerve biofilm. 

         Another thing that thwarts the release of a prosthetic to the general public is funding. Funding is highly essential for prosthetics. Usually the development requires a lot of money due to moving parts, development of miniaturized computers, animal experiments, and human prototyping models before the actual human experiments. In the case of an artificial limb, a limb may cost thousands of dollars. The prototype must be developed and fine-tuned before through experimentation before it may be made for human experimentation.

         I couldn’t imagine the public having an issue with the development of prosthetics. I would imagine the only thought that would cross an individual’s mind when seeing a prosthetic is a sense of curiosity of how the disability may have occurred or how cool the prosthetic is. Besides the restoration of function to the prosthetic user I believe patients psychologically feel a sense of relief their disability no longer singles them out from the general public.

IV. Journal Review: Tactile prosthetics in WiseSkin

The journal “Tactile prosthetics in WiseSkin” was published in the Date ’15 Journal of this year. This paper explores the answer to one of artificial limbs’ major issues; the inability to assess pressure exerted by the prosthetic controlled by the user. Prosthetic.

            This issue effects the users ability to grip objects with a prosthetic hand or allow the user to receive incoming information about objects touching the prosthetic.

            This journal works to determine the proper amount of tactile receptors should be placed around a prosthetic and the development of a wireless sensor that operates on low power usage that can be embedded in artificial skin undetected. Sensors developed must be able to send signals to the user through the use of a sensor node that can be invasively implanted into the user’s brain or strap on to the users arm.

            The smart skin or “Wise Skin” is produced in sheets composed of several layers, one layer being full of electrodes and others as protective layers to support the electrode sensors and protect them. The skin is then fitted on a prosthetic hand or leg to give tactile information to the user.

            In addition to tactile sensation the development of an electrode sensor that can detect temperature is currently taking place by the same company. The invention of this technology is restoring all function of a normal limb to the prosthetic user.

http://www.ageekyworld.com/wp-content/uploads/2014/12/skin5.jpg

Farserotu, J., Decotignie, J., Baborowski, J., Volpe, P., Quirós, C., Kopta, V., . . . Antfolk, C. (2015). Tactile Prosthetics in WiseSkin. Date '15, 1(1), 1695-1697. Retrieved from Google Scholar.

III. The New Kid on the Block

Albert Mareno:

An engineer graduate from the University of Central Florida (UCF) has quickly made a name for himself in the prosthetic world. How did he do it? Well Albert Mareno is making children’s dreams come true.

Albert has been 3D printing and assembling mechanical parts to make themed artificial limbs. You may have recently heard of his work in recent news stories focusing on Robert Downy Jr. delivering an Iron Man themed prosthetic hand to a 6 year-old boy named Alex who was born with a malformed hand. Alex was not the only one pleased with his gift but so were his parents. They stated prostheses with the moving capability like the one Albert made usually cost at minimum of $4,000 but the one that Albert 3D prints is valued at $350. At the bottom of this post is a video of the interaction between Robert Downey Jr. and Alex.

http://www.polygon.com/2015/3/12/8200687/iron-man-engineering-prosthetics

The actual themed 3D printed hand begins at the upper forearm and ends with functioning hand. The movements of the fingers are powered by an internal device with electrode pads that are attached to the biceps, triceps, and remains of the flexor and extensor family.

Albert says that he hopes that his team will develop are more functional hand in the future. He says that his first goal is to establish movement at the elbow. Albert says he plans to further reduce the cost of these prosthetics while adding new technology such as sensation technology that is currently being manufactured at a very high price.

Albert is involved in a global citizen science called The Collective Project. This project hopes that participants share ideas of future prostheses designs and ideas how to improve the prosthetic while reducing cost.

Alex is not the only kid that has received one of Albert’s artificial limbs. Kids that have one seem ecstatic about a better prosthetic and more importantly they feel relieved that they can fit in with a new limb while showing off a theme that they love.

II. The Wide Range of Prosthetic Applications

Prostheses are becoming a more common thing in the United States. Every population is using them from veterans scarred by war to young children born with an abnormality and everyone in between. When prosthetics are first talked about the first thing that commonly comes to mind is an artificial limb or maybe a couple of them however, prosthetics can be any external technology that can be used either internal or externally to improve someone’s living.

Some well known prostheses include implantable biofilm to damaged neural areas to reestablish a nerve connection to allow afferent and efferent signals to bypass the site of damage. Other prostheses may include the surgical implantation of electrodes or miniature computers most commonly into the brain to actively reverse a negative stimulus in the brain or to stimulate an area of the brain damaged by trauma to stimulate the signaling to a target tissue. These implants can do a lot more than send electrical signals through the body some have finite sensory applications. For example, a prosthetic retinal film can be put into the eyeball of someone who is completely blind and his or her vision may be restored fully depending on if they previously had full vision. A sensory prosthetic can only do so much for the recipient however, if the recipient for example was born blind then a prosthetic will restore function to the eye but the brain will have no idea how to process it because it never experienced that sensory input.  A prosthetic device has been invented for nearly every part of the body and its boundaries and rehabilitation methods are constantly being expanded.
               What about prosthetics that do not require invasive installation? Artificial limb prosthetics abilities have been stretched further than any sci-fi movie stated in this blogs introductory post. Within the last half-decade we have been able to develop prosthetic limbs that can fully be automated by a neural impulse but the advancements do not stop there. Within the last three years we have been able to produce an artificial skin for the artificial limb that can send sensory signals back to brain such as touch, heat, and grip. This connection allows for communication between the hand and brain in both directions. Well as you are reading this you’d imagine that this technology must cost an arm and a leg; no pun intended. What if I told you the symbiotic evolution of prosthetic limbs and the 3-D printing are heavily intertwined. As 3-D printing technological efficiency has developed the cost of a prosthetic limb has decreased. 3-D printing can print moving parts of a limb out of durable plastic cutting the cost of handcrafted limbs specific to the recipient. These fully bionic limbs that can sense heat and touch combined with the low manufacturing cost has made prosthetic limbs for attainable to every population. As these advancements continue to rapidly come to market the price of these updated prosthetics will remain relatively the same similar to the release of new Apple Iphones.

External prostheses also include exoskeleton technology. Termed for its external form of allowing for stability like a bugs skeleton, exoskeletons can be nonspecific to the recipients body measurements but can still offer support to the patient if they can not stand on their own while advance exoskeletons may preform the movement for the individual with little help from the individual. 

A pleased young boy with his 3-D printed prosthetic hand 

http://cdn.thedailybeast.com/content/dailybeast/cheats/2013/06/18/now-you-can-3-d-print-prosthetic-hands/jcr:content/image.img.2000.jpg/1371558697309.cached.jpg

Prosthetic hand equipped with temperature and touch receptors to allow user to apply his or her desired pressure. In this picture the user is applying enough pressure on a grape without splitting it.

http://wp.streetwise.co/wp-content/uploads//2014/05/DEKA-Arm-System-Details-Specs-of-DEKA-Arm-Prosthesis-1024x682.jpg

Performance prosthetic legs are commonly used by disabled track athletes

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Shown is a lower extremity exoskeleton. Its major role includes reducing stress on joints, improving posture, and walking assistance

http://www.arisplex.com/wp-content/uploads/2013/07/AP20130039.jpg

Retinal Film Prosthetic

Mind Controlled Hand

A Sense of Touch

Prosthetic Skin

3-D Printed Prosthetic Limb

Cheap Prosthetic Limb with Sensory Perception

Revolution in Prosthetic Allows Paralyzed Patient to Regain Feeling

I: Introduction

         Imagine a life where cyborg limbs are a common thing amongst everyday life. All patients with deformed or amputated limbs received robotic limbs that can be manipulated by their mind the same way a natural hand does. Originally theorized by sci-fi movies, such as Star Wars, robotic limbs helped the disabled hero like when Darth Vader slashed Luke Skywalker's hand off and Luke had to replace it later with a robotic prosthetic. Turns out, current technology has allowed prosthetic limbs to leap into the future. Current prosthetic hands are being controlled by brain electrode implants to allow for non-laggy movement that you would expect from older prosthetics. Not to mention a new film has been invented to allow the prosthesis controller to gain feeling and temperature sensation in the artificial limb.

         Not pleased with the idea of robotic limbs? What about an injection that could completely regrow and specialize into new cells to an area where the cells were previously destroyed? Once again, our medical technologies have been exponentially advancing allowing us to look into the future. Stem cell therapy, a highly debated subject in todays politics has the ability to regenerate new specialized cells to replace damaged ones. Sci-fi movies and reality are becoming one in the same; one day disease and disability will be a thing of the past.

         Some currently new treatment methods range from a video game console that promotes movement to a wearable robotic exoskeleton that reduces the stress of movement and all the way to a robotic physical therapist's assistance that aids the patient in safely doing the required rehabilitation exercises. The website Premier Orthopedics & Sports Medicine  is a website designed for patients and used by physical therapy professionals for alternative physical therapy treatments and sheds more light within the current status and techniques used in Orthopedics and Physical Therapy.
        This blog will explore some of the wide range of advancements in the physical therapy field with the use of new medical technologies as a mean of treatment. Rehabilitating the Disabled Future also aims to bring up treatments that still in their infancy lab stages and what implications it may have for patients in the future.