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Design and fabrication process for the prosthetic arm. (a) The affected and non-affected arms of the patient in a semitransparent view. (b) 3D surface reconstruction of the CT scan images. (c) Mirrored right arm aligned with the left limb according to the anatomic position of elbow joint, and the ulna and radial bones. (d) A 3D reconstruction of the arm was done. (e) The four-part model of the mould where the bones were substituted with a single supporting structure. The assembled model of the mould design showing the cavity for pouring the liquid silicone material. (f) The 3D printed models of the mould. After the liquid silicone cures, the cup-like part (in red) is detached to position the socket. (g) The assembled mould fixed by bolts and nuts. (h) The volar side of the fabricated prosthetic arm.
Source publication
Limb amputation creates serious emotional and functional damage to the one who lost a limb. For some upper limb prosthesis users, comfort and appearance are among the desired features. The objective of this work is to develop a streamlined methodology for prosthesis design by recreating the shape and size of an amputated arm with high accuracy thro...
Contexts in source publication
Context 1
... 3D printed skeleton of the hand, the arm, and the four- part split mould are shown in Fig. 2f. The assembled mould and skeleton structure are shown in Fig. 2g with bolts and nuts to fix them in place. The mould provides a cavity for the liquid silicone material (Dragonskin, Smooth-On Inc, PA, USA) to be poured. The silicone cured after 24 hours at room temperature. The prosthetic arm is shown in Fig. 2h. It took 5 days to complete the prototype. The cost of the expended filament and the silicone material is around $20. Henceforth, we will refer to the mirrored version of the uninjured arm as the patient's ...
Context 2
... 3D printed skeleton of the hand, the arm, and the four- part split mould are shown in Fig. 2f. The assembled mould and skeleton structure are shown in Fig. 2g with bolts and nuts to fix them in place. The mould provides a cavity for the liquid silicone material (Dragonskin, Smooth-On Inc, PA, USA) to be poured. The silicone cured after 24 hours at room temperature. The prosthetic arm is shown in Fig. 2h. It took 5 days to complete the prototype. The cost of the expended filament and the silicone material is around $20. Henceforth, we will refer to the mirrored version of the uninjured arm as the patient's ...
Context 3
... 3D printed skeleton of the hand, the arm, and the four- part split mould are shown in Fig. 2f. The assembled mould and skeleton structure are shown in Fig. 2g with bolts and nuts to fix them in place. The mould provides a cavity for the liquid silicone material (Dragonskin, Smooth-On Inc, PA, USA) to be poured. The silicone cured after 24 hours at room temperature. The prosthetic arm is shown in Fig. 2h. It took 5 days to complete the prototype. The cost of the expended filament and the silicone material is around $20. Henceforth, we will refer to the mirrored version of the uninjured arm as the patient's ...
Context 4
... patient's CT data were imported to a 3D modeling software (3-Matic, v10.0, Materialise NV, Leuven, Belgium) for visualization and editing ( Fig. 2a and 2b). This was valuable to develop the design strategy for the replication of the arm's geometry. The software was used to create a mirror image of the right arm to the left arm (Fig. 2c). To obtain an accurate anatomic position of the missing left forearm, the remaining radius and ulna bones were used as reference markers for the mirrored left ...
Context 5
... patient's CT data were imported to a 3D modeling software (3-Matic, v10.0, Materialise NV, Leuven, Belgium) for visualization and editing ( Fig. 2a and 2b). This was valuable to develop the design strategy for the replication of the arm's geometry. The software was used to create a mirror image of the right arm to the left arm (Fig. 2c). To obtain an accurate anatomic position of the missing left forearm, the remaining radius and ulna bones were used as reference markers for the mirrored left ...
Context 6
... structural support was designed ( Fig. 2d) to prevent the arm from being excessively deformable after the casting of the silicone material. Additionally, this part served as a structural support for the fingers. For this support structure, it was not necessary to replicate the radius and ulna bones. Hence, a single shaft was designed. Fig. 2e shows the four-part computer model of the mould, which allowed us to create a one-piece arm with the build volume limitations of a desktop 3D printer (Replicator 5 th Generation, MakerBot Industries LLC, Brooklyn, NY, USA; 29.5 x 19.5 x 16.5 mm 3 ...
Context 7
... structural support was designed ( Fig. 2d) to prevent the arm from being excessively deformable after the casting of the silicone material. Additionally, this part served as a structural support for the fingers. For this support structure, it was not necessary to replicate the radius and ulna bones. Hence, a single shaft was designed. Fig. 2e shows the four-part computer model of the mould, which allowed us to create a one-piece arm with the build volume limitations of a desktop 3D printer (Replicator 5 th Generation, MakerBot Industries LLC, Brooklyn, NY, USA; 29.5 x 19.5 x 16.5 mm 3 ...
Context 8
... 3D printed skeleton of the hand, the arm, and the four- part split mould are shown in Fig. 2f. The assembled mould and skeleton structure are shown in Fig. 2g with bolts and nuts to fix them in place. The mould provides a cavity for the liquid silicone material (Dragonskin, Smooth-On Inc, PA, USA) to be poured. The silicone cured after 24 hours at room temperature. The prosthetic arm is shown in Fig. 2h. It took 5 days to complete the prototype. The cost of the expended filament and the silicone material is around $20. Henceforth, we will refer to the mirrored version of the uninjured arm as the patient's ...
Context 9
... 3D printed skeleton of the hand, the arm, and the four- part split mould are shown in Fig. 2f. The assembled mould and skeleton structure are shown in Fig. 2g with bolts and nuts to fix them in place. The mould provides a cavity for the liquid silicone material (Dragonskin, Smooth-On Inc, PA, USA) to be poured. The silicone cured after 24 hours at room temperature. The prosthetic arm is shown in Fig. 2h. It took 5 days to complete the prototype. The cost of the expended filament and the silicone material is around $20. Henceforth, we will refer to the mirrored version of the uninjured arm as the patient's ...
Context 10
... 3D printed skeleton of the hand, the arm, and the four- part split mould are shown in Fig. 2f. The assembled mould and skeleton structure are shown in Fig. 2g with bolts and nuts to fix them in place. The mould provides a cavity for the liquid silicone material (Dragonskin, Smooth-On Inc, PA, USA) to be poured. The silicone cured after 24 hours at room temperature. The prosthetic arm is shown in Fig. 2h. It took 5 days to complete the prototype. The cost of the expended filament and the silicone material is around $20. Henceforth, we will refer to the mirrored version of the uninjured arm as the patient's ...
Context 11
... patient's CT data were imported to a 3D modeling software (3-Matic, v10.0, Materialise NV, Leuven, Belgium) for visualization and editing ( Fig. 2a and 2b). This was valuable to develop the design strategy for the replication of the arm's geometry. The software was used to create a mirror image of the right arm to the left arm (Fig. 2c). To obtain an accurate anatomic position of the missing left forearm, the remaining radius and ulna bones were used as reference markers for the mirrored left ...
Context 12
... patient's CT data were imported to a 3D modeling software (3-Matic, v10.0, Materialise NV, Leuven, Belgium) for visualization and editing ( Fig. 2a and 2b). This was valuable to develop the design strategy for the replication of the arm's geometry. The software was used to create a mirror image of the right arm to the left arm (Fig. 2c). To obtain an accurate anatomic position of the missing left forearm, the remaining radius and ulna bones were used as reference markers for the mirrored left ...
Context 13
... structural support was designed ( Fig. 2d) to prevent the arm from being excessively deformable after the casting of the silicone material. Additionally, this part served as a structural support for the fingers. For this support structure, it was not necessary to replicate the radius and ulna bones. Hence, a single shaft was designed. Fig. 2e shows the four-part computer model of the mould, which allowed us to create a one-piece arm with the build volume limitations of a desktop 3D printer (Replicator 5 th Generation, MakerBot Industries LLC, Brooklyn, NY, USA; 29.5 x 19.5 x 16.5 mm 3 ...
Context 14
... structural support was designed ( Fig. 2d) to prevent the arm from being excessively deformable after the casting of the silicone material. Additionally, this part served as a structural support for the fingers. For this support structure, it was not necessary to replicate the radius and ulna bones. Hence, a single shaft was designed. Fig. 2e shows the four-part computer model of the mould, which allowed us to create a one-piece arm with the build volume limitations of a desktop 3D printer (Replicator 5 th Generation, MakerBot Industries LLC, Brooklyn, NY, USA; 29.5 x 19.5 x 16.5 mm 3 ...
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... The hand could resist significant disarticulation and robust impact, according to experiments. The hand could execute a variety of adaptive grasps as well as in-hand manipulations, indicating that the suggested design would be an effective option for a powerful prosthetic hand [56]. A method for specifying upper limb prostheses that were sized and shaped to closely resemble a patient's amputated arm was described. ...
A partial hand amputation can significantly change a person's life for the
better. Partial amputees must be fitted with a prostheses, which is one way to
enhance their function and solve some of the issues they confront. The
purpose and aesthetics of partial hand prosthetics range widely to help people
perform their tasks. There isn't a perfect replacement item available yet that
can replace what was lost. The comprehensive study examined the variations
in partial hand prosthetics using experimental approaches that explain the
physical characteristics that include weight, grip characteristics, design
flexibility, shape, adaptability, and pinching action those are used for
engineering requirements and formal system analysis. This review article
examines and characterizes various prosthetic solutions that have been
researched and offered by academics.
... Advances in the field of 3D Printing offer opportunities for rethinking the ways designers and medical teams conceive medical solutions for people (i.e., Cabibihan et al., 2018). Beyond methodological and procedural improvements offered by technical developments such as flexibility, affordability, development of complex geometries, etc. , 3D printing can also stimulate deeper reflections on producing cultural advances in the creation of artificial body parts. ...
Prostheses are fundamental tools to improve the quality of life of people with physical impairments. However, the way prostheses are designed and produced follows traditional design and manufacturing processes tied to conventional industrial methods. Additive manufacturing (AM) technologies employed through inclusive-oriented design angles can support designers in the creation of enabling – re: inclusive – medical solutions helping patients to live better whilst mitigating the social stigma of living with a medical device in replace of a body part. The inclusive design and production of transradial prostheses using AM is examined in this paper, as well as the effects that the change from conventional manufacturing methods is having on the procurement process, the potential for design developments, and how these affect the perceptions of users and society. Research was done into some relevant case studies of transradial prostheses in order to comprehend how AM was being employed and how Inclusive Design practices can improve AM processes.This study demonstrates how the combination of Inclusive Design and AM has benefited the creation of enabling upper limb prosthesis in numerous ways. Some features include the fact that the availability of AM technologies (i.e., printers) allows for the production of prostheses at lower costs and in remote places with quicker turnaround times and less highly trained workers than traditional methods. General discussions on the suitability of using an Inclusive Design angle for AM are included at the end of the work.
... Cabibihan observed the variation of the 3D printed arm with the CAD modeled arm. The prosthetic arm had a higher volume and had an error of 0.67% with mirrored CAD model while undergoing Boolean investigation [83]. The use of FDM for prosthetics is still in its early phase to replicate the exact motion of the arm. ...
The manufacturing process has changed through the years, especially, with changes in the need for better-manufacturing flexibility, customization, and efficiency. The ability of additive manufacturing to develop customized rapid prototypes with complex geometrical configurations has transcended the manufacturing scenarios. Development in additive manufacturing has allowed people of different fields to reap their benefits. Prosthetic manufacturing is a field that has seen a lot of progress with the recent development in additive manufacturing. The review paper focuses on the use of additive manufacturing in the field of prosthetics. The paper compares, correlates, and explains the variation of different manufacturing techniques and processes of prosthetics manufacturing. It dives deeper into the additive scope of manufacturing focusing on each key aspect of the manufacturing system highlighting the ‘fit-to-function’ ability of additive manufacturing. Additionally, a deeper dive is taken into the more common additive manufacturing modality used for prosthetic manufacturing at the current time. The review paper also focuses on the possible incorporation of additive manufacturing to prepare operable prosthetics and performs a brief description highlighting commercial industrial prosthetics manufactured through additive manufacturing. Through extensive review and discussion, it is found that the incorporation of different additive manufacturing techniques allows people who have lost body parts to improve their quality of life and accept prosthetics as part of their own. However, at the current time, it is deemed that prosthetics manufactured through the additive process cannot completely mimic the operation of a real arm and further research in different additive manufacturing technology is required to improve the prosthetic manufacturing industry in the future.
Graphical abstract
... A 3D-printed modular design was created of the turbine, transmission, and anthropomorphic TD. Additive manufacturing was selected for several components (such as the turbine) as it has matured substantially in the last decade and now offers the potential to be integrated directly into the prosthetics field [108][109][110][111]. This utility of additive manufacturing is predominantly driven by the opportunity for personalisation, and the promise of improving device accessibility in low-resource settings [46,112]. ...
Globally, the most popular upper-limb prostheses are powered by the human body. For body-powered (BP) upper-limb prostheses, control is provided by changing the tension of (Bowden) cables to open or close the terminal device. This technology has been around for centuries, and very few BP alternatives have been presented since. This paper introduces a new BP paradigm that can overcome certain limitations of the current cabled systems, such as a restricted operation space and user discomfort caused by the harness to which the cables are attached. A new breathing-powered system is introduced to give the user full control of the hand motion anywhere in space. Users can regulate their breathing, and this controllable airflow is then used to power a small Tesla turbine that can accurately control the prosthetic finger movements. The breathing-powered device provides a novel prosthetic option that can be used without limiting any of the user’s body movements. Here we prove that it is feasible to produce a functional breathing-powered prosthetic hand and show the models behind it along with a preliminary demonstration. This work creates a step-change in the potential BP options available to patients in the future.
... Upper extremity prostheses can be grouped into one of two categories: passive or active prostheses [4]. Passive devices can either serve as a cosmetic purpose or provide limited functional assistance such as pushing, pulling, and light grasping [5], [6]. On the other hand, an active prosthesis is a biocompatible mechatronic device that aims to restore anthropomorphic physiological functions following limb difference [7]. ...
The rejection rates of upper-limb prosthetic devices in adults are high, currently averaging 26% and 23% for body-powered and electric devices, respectively. While many factors influence acceptance, prosthesis training methods relying on novel virtual reality systems have been cited as a critical factor capable of increasing the likelihood of long-term, full-time use. Despite that, these implementations have not yet garnered widespread traction in the clinical setting, and their use remains immaterial. This review aims to explore the reasons behind this situation by identifying trends in existing research that seek to advance Extended Reality "X-Reality" systems for the sake of upper-limb prosthesis rehabilitation and, secondly, analyzing barriers and presenting potential pathways to deployment for successful adoption in the future. The search yielded 42 research papers that were divided into two categories. The first category included articles that focused on the technical aspect of virtual prosthesis training. Articles in the second category utilize user evaluation procedures to ensure applicability in a clinical environment. The review showed that 75% of articles that conducted whole system testing experimented with non-immersive virtual systems. Furthermore, there is a shortage of experiments performed with amputee subjects. From the large-scale studies analyzed, 71% of those recruited solely able-bodied participants. This paper shows that X-Reality technologies for prosthesis rehabilitation of upper-limb amputees carry significant benefits. Nevertheless, much still must be done so that the technology reaches widespread clinical use.
... 3D printing especially Fused Deposition Modeling (FDM) comes into role to overcome the challenges faced in the conventional production process of prosthetic arms. It can be used to produce user customized prosthetics at very affordable price ranging from $300 to $2000 (Cabibihan et al., 2018). A sudden shift in the cost to produce prosthetic devices can be attributed to expiry of first patent on Fused Deposition Modeling in 2007 (Takagishi & Umezu, 2017). ...
... Conventional measurement methods for measuring the amputee body parts are time taking and less accurate. For accurate prosthetic dimensions, computed tomography (CT) scanning can be used to get accurate dimensional parameters of the affected and unaffected arms, based on which the prosthetic arms with the better dimensional accuracy can be 3D printed (Cabibihan et al., 2018). The patient does not have to get measured by the prosthetists or designers because the measurements are directly taken from the CT data. ...
... It was found that the proposed method has shown a high dice similarity coefficient of 0.96. Which implies that prosthetic arm is in close agreement with the mirrored image of the patient's injured arm (Cabibihan et al., 2018). ...
The Advanced Manufacturing Student Conference (AMSC) represents an educational format designed to foster the acquisition and application of skills related to Research Methods in Engineering Sciences. Participating students are required to write and submit a conference paper and are given the opportunity to present their findings at the conference. The AMSC provides a tremendous opportunity for participants to practice critical skills associated with scientific publication. Conference Proceedings of the conference will benefit readers by providing updates on critical topics and recent progress in the advanced manufacturing engineering and technologies and, at the same time, will aid the transfer of valuable knowledge to the next generation of academics and practitioners.
... Most of the studies were design studies (11). 1,2,5,[9][10][11][12][13][14][15][16] Other study types included reviews (2), 17,18 descriptive studies (3), 19-21 case reports (1), 22 and case series (1). 23 The entire study population included 47 patients with amputations (range 1-12 patients per study). ...
... Generally, the specified 3D-printers were commercial (relatively inexpensive) printers. 1,5,10,11,16,[21][22][23] However, most of the studies (10/18) 2,9,12-15,17-20 did not report the type of 3D-printer used. ...
Background:
According to the World Health Organization, only 5%-15% of people in lower-income countries have access to prostheses. This is largely due to low availability of materials and high costs of prostheses. 3D-printing techniques have become easily accessible and can offer functional patient-specific components at relatively low costs, reducing or bypassing the current manufacturing and postprocessing steps. However, it is not yet clear how 3D-printing can provide a sustainable solution to the low availability of limb prostheses for patients with amputations in lower-income countries.
Objective:
To evaluate 3D-printing for the production of limb prostheses in lower-income countries and lower-middle-income countries (LLMICs).
Study design:
Systematic Review.
Methods:
Literature searches, completed in April 2020, were performed in PubMed, Embase, Web of Science, and Cochrane Library. The search results were independently screened and reviewed by four reviewers. Only studies that examined interventions using prostheses in LLMICs for patients with limb amputations were selected for data extraction and synthesis. The web was also searched using Google for projects that did not publish in a scientific journal.
Results:
Eighteen studies were included. Results were reported regarding country of use, cost and weight, 3D-printing technology, satisfaction, and failure rate.
Conclusion:
Low material costs, aesthetic appearance, and the possibility of personalized fitting make 3D-printed prostheses a potential solution for patients with limb amputations in LLMICs. However, the lack of (homogeneous) data shows the need for more published (scientific) research to enable a broader availability of knowledge about 3D-printed prostheses for LLMICs.
... The proposed work involves the design of the prosthetic arm focusing on sketching and 3D modelling tasks using CAD software. The CT images of the amputated and non-amputated arm were taken in order to determinethe dimensions of the prosthetic arm [6]. The segmentation of both arms is carried out using the thresholding technique by using Mimics software [4]. ...
This paper proposes the design of the prosthetic arm by reconstructing the structure and proportions of an amputated arm using high precision methods and dimensions. To achieve this, CT images of the patient’s amputated and non-amputated arm are collected from the Rehabilitation centre. The patient CT data were imported to a 3D modelling software i.e., Mimics Innovation Suite version 22.0 Materialise 3-Matic version 14.0 original licensed software. The exported file is given to the Computer-Aided Design software, the geometry of the socket and the prosthetic arm were designed according to the mirrored geometry of the non-affected arm. 3D rendering for various degrees of movement has been carried out for animation.
... Fig. 9 in [23]) where this section of the finger was found to have a similar skin compliance as that of a human finger (i.e. a 1 N indentation force corresponds to 1-2 mm skin displacement). The phantom finger was constructed from the computed tomography (CT) data of a subject's right index finger using techniques described in earlier works [23] [24]. From the CT data, the bone structure and the external surface of the finger were 3D printed (Replicator 5 th Generation, MakerBot Industries LLC, Brooklyn, NY, USA). ...
Feedback from sensory modalities is crucial for the precise grasping of tissues during minimally invasive robotic surgery. The aims of the study are to determine the influence of visual and haptic feedback on the detection of threshold forces and to evaluate the applicability of the sensory integration model to a surgical grasping task. A sensorized surgical grasper and a fingertip haptic force feedback device were used. Three types of stimuli were presented (i.e. visual-alone, haptic-alone, and bimodal visual and haptic stimuli). Threshold forces of 125.6 mN and 84.9 mN were detected for visual and haptic feedback, respectively. When bimodal feedback was provided, the participants detected a threshold force of 85.1 mN. The mean threshold force for the bimodal condition was 38.7% lower than the visual-alone feedback stimulus. Our results did not agree with sensory integration model as there was a 19% difference between the experimental and theoretical results. The threshold force discrimination was strongly influenced by the haptic force feedback. It is likely that the tissue stiffness can be more intuitively perceived through the direct force stimulation of the fingertip. Cues, like small deformations or changes in the grasping angles of the surgical tool are more difficult to interpret visually as compared to the haptic modality.
... There is patient-specificity for each prosthetic device. An emerging technology for the fast production of low-cost prosthetics is three-dimensional (3D) printing (Cabibihan et al., 2015;Cabibihan et al., 2018;Alhaddad et al., 2017;Alturkistani et al., 2020). The 3D printing process is the additive deposition of material in a layer-by-layer manner to construct parts from a 3D computer-aided design (CAD) model (Hull, 1986). ...
The field of rehabilitation and assistive devices is being disrupted by innovations in desktop 3D printers and open-source designs. For upper limb prosthetics, those technologies have demonstrated a strong potential to aid those with missing hands. However, there are basic interfacing issues that need to be addressed for long term usage. The functionality, durability, and the price need to be considered especially for those in difficult living conditions. We evaluated the most popular designs of body-powered, 3D printed prosthetic hands. We selected a representative sample and evaluated its suitability for its grasping postures, durability, and cost. The prosthetic hand can perform three grasping postures out of the 33 grasps that a human hand can do. This corresponds to grasping objects similar to a coin, a golf ball, and a credit card. Results showed that the material used in the hand and the cables can withstand a 22 N normal grasping force, which is acceptable based on standards for accessibility design. The cost model showed that a 3D printed hand could be produced for as low as $19. For the benefit of children with congenital missing limbs and for the war-wounded, the results can serve as a baseline study to advance the development of prosthetic hands that are functional yet low-cost.
