SWE

Magazine of the Society of Women Engineers

ASPIRE • ADVANCE • ACHIEVE w w w.swe.org WINTER 2013

The Potential
of Prosthetics

Women Engineers in Military Labs • Intersections • Black History • WE12 Summary

of Prosthetics
Are you aware of the engineering that allows your hand to manipulate scissors or grasp a cup of
hot coffee? Most of us aren’t. By researching how the human body works, however, engineers are
revolutionizing prosthetics.
By Charlotte thomas, Swe Contributor
“I
f you look at how your hand
operates when drinking a cup
of coffee, a lot happens, not just
the movement of the fingers,” explained
John Miguelez, president and senior
clinical director of Advanced Arm
Dynamics prosthetic care centers. List-
ing some of the engineering facets of this
simple gesture, he pointed to the compli-
ance of your fingers as they conform
around the cup. While you sip and the
cup becomes lighter, your grip decreases
because of the ability to detect its weight
in your hand. If the cup is made from
plastic foam, your grip adjusts to keep
from crushing it. Most of these actions
are unconscious; however, engineers
designing prosthetic hands must take
into account the amount of grip control-
ling each finger so the user can hold a
cup without dropping or crushing it.
What about your feet? How do you
communicate to your feet that you want
to walk down a flight of stairs or across
an uneven surface? Our brains confront
and solve all of these challenges and
countless more.
Perspective and context
Although today’s engineers who
design prosthetics address these kinds
of problems, prosthetics isn’t a new
engineering challenge. In an Oct. 2,
2012, Live Science® article, Jacky Finch,
Ph.D., a researcher from the University
of Manchester who studied two ancient
Egyptian artificial toes made out of
wood and leather, commented, “Several
experts examined these objects and
suggested that they are the earliest pros-
thetic devices in existence.” Since those
early efforts, the progress of engineering
prosthetics has been slow and steady.
It wasn’t until the 1950s that electricity
was used in prosthetics or the 1990s
that microprocessors were available for
external prostheses. From the 1990s on,
advances in prosthetics took a huge leap.
Several factors are responsible for
this fast-forward. Today, advanced
technology such as neural engineering,
laser sintering, miniaturization, and
even more powerful microprocessors are
revolutionizing prosthetics. “Engineer-
ing is improving with breakthroughs
in controllers. Processors are smaller
and faster, and materials for sockets are
improving,” stated Laura Miller, Ph.D.,
prosthetist at the Rehabilitation Insti-
tute of Chicago and assistant professor
in physical medicine and rehabilitation
at Northwestern University.
Veterans of the Iraqi and Afghanistan
wars have put a new, highly visible face
on issues surrounding the loss of limbs.
Increased public awareness of pros-
thetics has been important, but while
amputees from military combat number
a few thousand, diabetics and amputees
with other disorders number 1.5 million.
Government funding, particularly from
the Defense Advanced Research Projects
Agency (DARPA), is accelerating the
research, development, and manufactur-
ing of prosthetics. For example, in 2006,
DARPA began addressing the challenges
of upper-limb prosthetics with its
Revolutionizing Prosthetics program
to produce advanced anthropomorphic
mechanical arms and control systems.
The goals were a marketable arm control
system and the acceleration of research
on the viability of direct brain control.
The program targeted its research on
upper-limb prosthetics as lower limbs
present more difficult engineering and
medical challenges.
Engineers face significant challenges
as even the most state-of-the-art
technology doesn’t match the complexity
and “engineering” in a natural limb.
“Think about all that is involved in a
prosthetic device — the materials, the
powered devices with actuators and
control systems on the biomechanics
side, and then the modeling and simula-
tion technology,” remarked Glenn Klute,
Ph.D., research health scientist with the
Department of Veterans Affairs Puget
Sound Healthcare System, Seattle Divi-
sion, and affiliate associate professor of
electrical and mechanical engineering at
the University of Washington.
Brain-controlled prosthetics
Fortunately, evolving technology and
engineering insight offer much potential.
Perhaps the most futuristic are efforts to
return ability to an amputee’s brain so
that it can send a signal to the prosthetic
hand to “pick up that plastic foam cup
and don’t squeeze it too hard.”
In 2009, DARPA awarded the Johns
Hopkins University Applied Physics
Laboratory (APL) a four-year contract
to manage the development and testing
of the modular prosthetic limb (MPL)
winter 2013 • SWE 29
ThE poTEnTiAl of proSThETicS

that would include a brain-controlled
interface. Though still in the early stages
of testing, the MPL will allow amputees
to feel the heat of a cup of coffee or even
peel an egg. A May 2012 APL press re-
lease stated that this prosthetic arm was
controlled for the first time by brain sig-
nals recorded by electrocorticography,
which measures the electrical activity of
the human cerebral cortex.
“The technology itself is revolutionary
in its scale of motors that control the fin-
gers. The entire control of the MPL is in
the hand. Ultimately, the mechanics and
engineering are revolutionary,” stated
Courtney Moran, associate, professional
staff, and a certified prosthetic clinician
at the APL.
The modular arm fulfills many needs
as it fits a wide range of amputee levels,
from full arm to the hand or wrist rota-
tor. Currently it is in the usability testing
phase. “We are getting feedback from
the amputee and the clinician so that it
will work the way it’s supposed to work,”
said Moran. “We aim to make this arm
do all that a natural arm can do.”
To accomplish this technically, the
APL is in phase 3 of the program to de-
velop implantable microarrays to record
brain signals. Describing the technology
behind this, Moran said, “At the brain
level, which is the central nervous sys-
tem, the control using an implant picks
up neural signals and translates them to
message the limb.” She describes brain-
level research as a significant leap that
is at least 10 years out before becoming
available as a therapeutic selectable
item, but predicts that noninvasive
control could be much sooner.
Collaboration is a significant part
of the success of this endeavor. To
accomplish this breakthrough, the
APL is working with the University of
Pittsburgh and the California Institute
of Technology to take advantage of their
experience in brain computer interfaces,
both of which have conducted research
using chips with hair-like electrodes
that record neurological signatures
in the brain. The lab is also working
with the University of Chicago for
its expertise in sensory perception;
the University of Utah in developing
implantable devices for use with the
human brain; and HDT Engineered

Women in Prosthetics Research and Engineering

“i t’s a wild and crazy time to be in prosthetics,” observed Courtney

Shell, a graduate research assistant in the neuromuscular
Biomechanics Lab at the University of texas at Austin. She is currently
involved in the research of biomechanics and prosthetic foot design.
Much of her enthusiasm stems from the confluence of electrical,
mechanical, and chemical engineering with medicine. “there’s a lot
of opportunity where these two fields meet,” she said. As an engineer,
she wants to see how design choices affect the mobility of a patient, for
instance, the stiffness of the foot. She looks at the body as a mechanism
— the hip is a ball and socket joint, the knee and ankle can be viewed
as pin joints. Her goal is to ideally restore natural motion to amputees in
activities ranging from everyday walking to running an obstacle course.
Shell is not unique. when Courtney Moran began as a clinician to
complete her internship and residency, she was the first female clinician
in the three positions she held. now, as an associate, professional staff at
Johns Hopkins University Applied Physics Laboratory, she observed from
personal experience that more women are interested in this field. “when
i go to conferences and read publications, it feels like an even playing
field,” she said.
Laura Miller, Ph.D., a prosthetist at the rehabilitation institute of
Chicago and assistant professor in physical medicine and rehabilitation
at northwestern University, is involved in research at the neural
engineering Center for Artificial Limbs. regarding the increase of women
in prostheses research and engineering, she said: “Prosthetics used to
be the old boys club. the field has started to change. there is a definite
increase of women entering this profession. there’s a level of patient
involvement that draws many people because of the combination of the
sciences, building things, and caring directly for a patient.”
while searching for a university that fit her interest in mechanical
engineering, nydia Marzán-Harding discovered the field of prosthetics.
During a tour of the university, her cousin, who was a student, told her
about the myoelectric upper-limb prosthetics research being performed
there. Myoelectrics, the use of the electrical impulses of muscle tissue
to control prosthetic limbs, intrigued Marzán-Harding. She is currently
a lecturer in prosthetics and orthotics education at the northwestern
University Prosthetics-Orthotics Center, department of physical medicine
and rehabilitation.
“i felt like this field requires a bit of everything,” she said. “You have
to think on your feet.” She works with students in the launch of the
university’s master’s degree in prosthetics and orthotics. Her current
position teaching students involves much one-on-one in the lab doing
evaluations and fittings with patients. She, too, observed that women are
attracted to the health care field. “You are involved with patients, their
improvement, health, and life. You help them on their path to improving
themselves,” she said.
Glenn Klute, Ph.D., research health scientist with the Department of
Veterans Affairs Puget Sound Healthcare System, Seattle Division, and
affiliate associate professor of electrical and mechanical engineering at
the University of washington, can also vouch for the increase of women
in prosthetics. Of the nine people on his research team, five are women.
to illustrate the scope and diversity of prosthetic engineering, Dr. Klute
summarized contributions made by the female members of his team:
Ava Segal, M.S., mechanical engineering, lab supervisor, conducts
biomechanic studies to measure how amputees walk while wearing
different limb systems to discover whether novel prostheses improve
their mobility.
Katie Bates, M.S., mechanical engineering, measures the thermal
environment inside the prosthetic limb to develop a microcontroller-
operated cooling system to create a more comfortable prosthesis.
Katie Treadwell, M.S., mechanical engineering, explores the
structural properties of prosthetic feet and uses a robot that simulates
human gait to measure their performance.
Jocelyn Berge, M.S., bioengineering, uses a fiber-optic sensor
to measure the amount of oxygen in the residual limb tissue while
amputees wear different prostheses and perform different activities.
She is trying to identify which limb systems result in greater tissue
oxygenation, which leads to healthier limbs.
Rose Beemer, B.S., bioengineering, runs the lab’s motion capture
system and analyzes data to identify kinematic and kinetic differences in
amputee gait while they walk wearing different prototype prostheses.

30 SWE • winter 2013


Technologies, which has expertise in
building prosthetic limb systems.
Electric fingers
Another technological breakthrough
that has affected a broad range of
prosthetics is the miniaturization
of components. Previously, the tools
that made prosthetic limbs move were
strapped to the body or in another loca-
tion. Technology now allows for mobile
applications as computer power gets
stronger and batteries get smaller.
“Reality is beginning to catch up
with what we see in movies,” explained
Miguelez, comparing older prosthetic
hands that could only open and close to
the latest designs that allow for multiple
grasp patterns. “Prosthetics are becom-
ing more anatomically correct in size
as electrical and body-powered digits
advance. Compared to five years ago, we
are now light years ahead,” he added.
Electrically powered digits are a
factor in duplicating the movement and
dexterity of the human hand as each
finger now has its own motor. “A lot of
progress has been made to improve
input signals,” said Miguelez. “There
have been huge advances in technology
that allow motors to be smaller and
more robust.” In addition, smaller bat-
teries can be embedded in prostheses.
Anatomically correct electric fingers are
more proportional in size and have a
more natural feeling. New materials that
A selection of prosthetics from the 19th and 20th centuries
in the archives of the Science Museum in London. Photo by
Stewart Emmens; image courtesy of the Science Museum /
SSPL. Image from http://www.collectorsweekly.com/articles/
war-and-prosthetics/ War and Prosthetics: How Veterans
Fought for the Perfect Artificial Limb, Oct .29, 2012
ThE poTEnTiAl of proSThETicS
eDwArD wHitMAn, JOHnS HOPKinS APL
Courtney Moran, associate, professional staff at Johns Hopkins University Applied Physics Laboratory (center), talks with Air Force
Tech. Sgt. Joe Delauriers, left, who lost both legs and part of an arm serving in Afghanistan. In 2009, the Defense Advanced Research
Projects Agency awarded Johns Hopkins APL a four-year contract to manage the development and testing of the modular prosthetic
limb (MPL) that would include a brain-controlled interface. It has since been renewed twice, bringing the research to phase III.
include lightweight plastics, silicones, simulations of amputees participating in
and metals that are more durable and a variety of movement tasks.
lifelike offer additional improvements. With this knowledge, Dr. Neptune and
a team of graduate students will be able
A prosthetic designed for each to design and build lower-limb prosthet-
individual ics according to the variations in each
In a paper titled, “Clinical Investiga- patient’s height and weight, including
tions: Insight from Computer Modeling their walking characteristics. In the
and Simulation Techniques,” Richard November 2011 article, “Prosthetic
Neptune, Ph.D., professor in the me- Devices Give Injured Troops a Second
chanical engineering department at the Chance,” published by the University of
University of Texas at Austin, wrote that Texas at Austin Cockrell School of Engi-
“…modeling and simulation of human neering, Dr. Neptune noted that, “We’re
movement is an exceedingly powerful having them walk over uneven ground,
tool that provides a framework for going up and down stairs, running, and
significant advances in patient care and a whole battery of other tests to be able
clinical and biomechanical research.” to understand how they adapt to the
He is analyzing amputee locomotion different stiffness levels of these orthotic
through research collaboration with the and prosthetic devices.” He pointed to
Department of Veteran Affairs Center other advances in modeling and simula-
of Excellence for Limb Loss Prevention tion that make that possible, such as
and Prosthetic Engineering in Seattle. individual muscle actuators that make
The goal of the research is to understand the body move. This helps researchers
the multifaceted dynamic interactions determine whether a particular muscle
between the human musculoskeletal has a specific biomechanical function,
system and the design characteristics such as helping with balance control or
of prosthetic devices. To achieve this to take a step.
understanding, his research group To illustrate the complexity of
is developing and analyzing complex this research, Dr. Neptune noted the
musculoskeletal models and computer difficulties of getting a robot to walk
winter 2013 • SWE 31
 ThE poTEnTiAl of proSThETicS
reHABiLitAtiOn inStitUte Of CHiCAGO
The Rehabilitation Institute of Chicago tests the first neural-
controlled prosthetic leg that interacts with its user. Using
targeted muscle reinnervation, amputees have more natural
control with a powered knee and ankle that reads users’
intent and pushes back to propel them up the stairs.
with stability. “The human body is an
incredible design. We can’t come close
to replicating it,” he observed. When the
relationship between the prosthetic and
how a person walks is better understood,
designers can then produce precise
devices for the lower limb that will give
each person the appropriate device for
his or her particular needs.
To design specific devices, Dr.
Neptune and his students use an
advanced additive manufacturing
technique called selective laser sintering
that was developed at the University of
Texas at Austin. With this technology,
computers produce a 3-D design that is
then replicated by a laser process that
melts nylon powder layer by layer into a
hardened prosthetic device specific to an
individual’s way of walking and moving.
Overcoming the discomfort of
prosthetics
The comfort of a prosthetic device is
also a major obstacle for the user and
the engineer. “Our biggest challenge
is the interface with the user,” said Dr.
Miller, who pointed out that prostheses
“hang on the human body” so that the
wearer bears its weight with only skin
and muscle, not bones. While today’s
lower-limb devices weigh less, amputees,
32 SWE • winter 2013
particularly those with diabetes who
have poor circulation, say they are
too heavy. Addressing the difference
between upper- and lower-limb pros-
thetics, Dr. Klute compared the weight of
picking up a coffee cup to the power and
weight involved in lifting one’s leg while
walking for any length of time.
Upper- and lower-limb prosthetics
differ in comfort levels. Compared with
lower-limb prosthetics, upper-limb
prosthetics require less power to move,
so the electrodes to make the limb move
can touch the skin directly. Lower-limb
prosthetics require a suspension system,
which might be a rubber sock, for in-
stance, that is placed directly against the
skin. Putting a normal-size electrode in
this sock causes multiple problems that
can have serious side effects.
To address this problem and offer
comfort and usability, Dr. Klute and
other researchers at the VA Center of
Excellence for Limb Loss Prevention
and Prosthetic Engineering studied
the temperature of an amputee’s limb
inside the socket of a prosthesis by using
miniaturized and flexible temperature
sensors. When the amputee walked on
a treadmill, for instance, researchers
could determine the increase in skin
temperatures. Even with rest periods,
the temperature did not significantly
drop to give some relief to the amputee.
The future of prosthetics
Looking ahead, Dr. Klute noted,
“The next step is making devices that
communicate with the environment.”
Osseointegrated prosthetic limbs are a
direct connection between an amputee’s
bone and an artificial implant and are
already under research. Researchers at
the University of Utah, Salt Lake City,
and the George E. Wahlen Department
of Veterans Affairs Medical Center, Salt
Lake City, are involved in feasibility
trials. Without a socket, this device goes
through the person’s skin to the bone.
Predicting the possibilities 20 years
ahead, Dr. Klute talked about the need
for communications between a person’s
neural systems and the prosthetic limb.
No doubt engineering skills and technol-
ogy will make it happen. n
Bones as Beams:
The Human Body in
Engineering Terms
w hile engineers bring their skills
to the research, design, and
manufacturing of prosthetics, their
collaboration with doctors, clinicians,
and patients demands additional skills
and knowledge. Speaking of the team
of orthopedic surgeons, physiatrists,
rehabilitation psychologists, and
human motion biomechanists who
work with engineers, Glenn Klute,
Ph.D., research health scientist with
the Department of Veterans Affairs
Puget Sound Healthcare System,
Seattle Division, and affiliate associate
professor of electrical and mechanical
engineering at the University of
washington, advised engineers to
learn the clinician’s language by taking
classes in anatomy and physiology.
“Clinicians can’t communicate with
engineers about microcontrollers,”
commented Dr. Klute.
“the transition is hard at first,”
said Courtney Moran, associate,
professional staff at Johns Hopkins
University Applied Physics
Laboratory. to make the jump
between engineering and the
human body, she sees the brain as
a circuit, for example. “engineering
is directly applicable to medical and
rehabilitation applications. You have
to understand the materials properties
of skin and muscle and bone and
how they interact from a mechanical
standpoint.”
Courtney Shell, a graduate research
assistant in the neuromuscular
Biomechanics Lab at the University
of texas at Austin, refers to the body
in engineering terms, speaking of
the stresses and strains of bones and
beams. “Civil engineers design trusses.
we look at bone and body segments.
the physics are similar.” As an
engineer, she wants to know how the
design choices she makes will affect
the mobility of the patient she
is working with.