Advancements in Prosthetic Technology - Essay Example

?RUNNING HEADER: Advancements in Prosthetic Technology Advancements in Prosthetic Technology BY YOU YOUR SCHOOL INFO HERE HERE Advancements in Prosthetic Technology Introduction Prosthetics is the technology for assisting individuals missing limbs, using a combination of “appropriate materials, alignment, construction and design to match the functional needs of the user” (Georgia Tech, n.d., p.1). Prosthetics are used for reaching and grabbing for upper limbs with walking and running for lower prostheses. Prosthetics are designed to improve the functional challenges facing those without upper and lower limbs and even provide a more satisfactory cosmetic appearance. Prosthetic technology has come a long way since its introduction in 4000 B.C. when Egyptians utilized fiber to fashion prosthetic limbs. Throughout history, adaptations to prosthetics occurred as a result of industrial advancements and scientific research. Archaeologists have discovered bronze pegs used to simulate lost limbs (Levy, 2012). During the Dark Ages, individuals used wooden peg legs with fashioned wood, metal and leather crutches for support (Levy). By the 1500s, iron was used to simulate limbs with a new ability to use metallurgy to fashion joints to allow for more flexible movement. By the 1900s, rubber technology, robotics, and microprocessor technologies contributed to a revolution in prosthetic technology that brought a better lifestyle to people missing arms and legs. 21st Century advancements in prosthetic technology have far overshadowed the rather primitive breakthroughs all throughout history, giving amputees or those born missing limbs due to genetic irregularities more freedom toward living a normal life. Such advancements even give individuals requiring prosthetics sensation and nearly 100 percent viability in certain limbs that can simulate regular movement. Despite these rather marvelous advancements, however, there is not currently enough sociological or psychological research being conducted to provide additional support for those using modern prosthetics. Advancing Technologies Significant modernized advances in prosthetic technology include the use of micro-processors to assist in the functionality of prosthetic devices. Known as the power knee, this type of prosthetic maintains computerized systems that align the function of the device with the tangible movement of the leg, ensuring coordination (Levy, 2012). For those with below-knee amputations, similar technology includes a motorized ankle that also coordinates movement using a form of sensor technology (Levy). Furthermore, the iLimb hand prosthetic is able to detect electrical signals from the users’ brains, allowing for self-motivated opening and closing of the prosthetic’s fingers to further their mobility and function. Electrodes are also fashioned to many prosthetic devices manufactured in recent years allowing for spontaneous motion from the user’s brain on spring-loaded feet (Levy). Scientists are also working on bionic technology that maintains a brain-user interface that allows for instantaneous movement at the users’ whim (Zhou, 2010). This device is partially based on previous research studies from the 1960s and 1970s involving research with neurons in monkeys and then attempting to reprocess these signals through computerized software. One of these prosthetic devices currently in prototype testing is the Modular Prosthetic Limb, an artificial arm that is controlled with a thought (Zhou). The goal is to create a micro-array that is implanted directly into the user that stimulates the mind with direct sensory feedback from the prosthetic device (Zhou). This would revolutionize the relationship between user and the prosthetic device, theoretically providing for more realistic movement and normal lifestyle. Another method being developed and run through testing is the direct implantation of the device itself directly into the patients’ bones (Zhou). Using this method, a titanium bolt is used with the hopes that the bone will directly fuse itself around the bolt. This is intended to give a much more versatile walking and running experience and greater control over their movements. This direct implantation method is also designed to remove some of the traditional problems associated with prosthetics, including skin irritation that often occurs when real skin meets the rubber socket. It would also prevent the need for routine adjustments to the socket of the device due to fluctuations in size that often occurs at the site of the stump. Another recent development in prosthetic technology is referred to as Targeted Muscle Reinnervation. This scientific approach to prosthesis development is to create new nerve-ending attachments to muscles not normally used in creating leg and arm motion. For instance, the individual user would have micro-implants attached into their chest muscles, which would then serve as signals to the artificial limb that it was desired to move or grasp (Schultz, 2009). Through this process, the user of the prosthetic contracts their shoulder or chest cavity muscles, thereby training themselves to move at will. Over time, Targeted Muscle Reinnervation allows the user to become more independent in movement and become more effective in prosthetic mobility. When Reinnervation has been tested, it has been discovered that the brain becomes accustomed to these new nerve and muscle connections and begins to stimulate the brain as if functioning as the missing arm or leg. For instance, when the chest is touched, the individual reports a sensation that the feeling is coming directly from a limb that is not really there. People involved in this testing have reported temperature sensory experiences, sharpness of objects, and even different pressure variances when chest or shoulder muscles are stimulated (Singer, 2007; Schultz). By using this information, scientists have been able to create a theoretical map of human sensory experiences to assist in identifying the best reinnervations to stimulate specific fingers and toes. Having identified these revolutionary and largely ingenious technological advances in this field of study, it needs to be reiterated that there is not enough research being undertaken in psychology or sociology to supplement new prosthetic devices. Individuals that have lost their limbs or are forced to live their difficult lives, due to genetic problems, differently than others face considerable psychological problems trying to adjust. According to one researcher in prosthetic technology, “the future of medicine and its integration with mechanical advancements shows great promise for the many who use artificial limbs” (Zhou, 2010, para. 8). However, does it really show such promise and is this based on the scientific principle or the clinical set of values? Psycho-Social Difficulties with Prosthetic Users Individuals facing life with prosthetic limbs are likely to develop issues associated with their own vanity and cosmetic needs. According to psychological theory, individuals must have a sense of social belonging and feel as though they fit in before they can begin to experience the higher needs of love and intimacy. According to these theories, the individual cannot be fulfilled socially until they become comfortable with their position in society. If they are not satisfied in this dimension of psychological development, they cannot achieve the self-esteem necessary for a self-actualized lifestyle. None of the aforementioned technological revolutions indicated advancements in psycho-social understanding to develop the varieties of options or technologies that would better assist in building comfort and belonging in the prosthetic user. Clearly, the ability to manipulate an artificial limb with just a thought would establish a sense of normalcy and, likely, build up some dimension of self-confidence. However, it is rather commonly known that individuals in society that witness prosthetic users are left with feelings of shame, uncertainty, or even fear. These scientific and clinical researchers should consult with sociologists and psychologists to determine more effective cosmetic design. It is likely they will have a difficult time finding a meaningful social and intimate-based relationship due to their disability, which will impede growth in self-esteem and social belonging. Through consultation with experts in psycho-social needs development, the prosthetic user will not only be assessed for their viability in implantation and interface usage, these same technologies can also enhance their mental condition through micro-processor usage and, perhaps, even by releasing certain endorphins in the brain that provide positive emotional sensation. Implantation exposes the brain to foreign objects, thus creating risk to human health both short- and long-term. Psycho-social theory often discusses the importance of recognizing an individual’s fears or perceived lack of security, which are some of the most fundamental needs of the human. Again, the research heralds itself for its revolutionary concepts and sophistication, without making mention to the long-term impacts on human mental health that must be addressed. Television watchers, as one example, often witness the prosthetic user surrounded by family and friends that applaud when the individual makes significant strides in their mobility or lifestyle. However, not all prosthetic users maintain this strong social and support bond and therefore must strive to be a successful user on their own volition. In the event that implantation maintains short- or long-run complications, what are the support mechanisms to ensure that fear is alleviated? Who is going to deal with their psychological problems arising from health concerns over failed medical procedures? The research literature available on this topic simply does not address these more fundamental psycho-social needs of the prosthetic user in any worthwhile detail. Scientists seem to have a rather reserved or discounting view of the human condition when considering their next new scientific development. In many ways, emotional and some cognitive needs are disregarded by clinical and scientific researchers in favor of promoting their next breakthrough. It is well-known that prosthetic technology is a significant profit machine; is this the reason behind this lack of acknowledgement over the human condition as it relates to prosthetic technology? Scientists and Clinicians will Certainly Disagree Clinical researchers and those in the scientific community that continue to devote research to the more technical improvements in prosthetics are highly-specialized and expert-advised career positions. These professionals would argue that they do not maintain the skills and aptitudes needed to provide psycho-social enhancements in the prosthetics and, instead, these should be left to sociologists and psychologists after the implantation is complete or the enhanced prosthetic is fitted. They would utilize the argument that differences in field specialization and education would limit these types of advances and that it would be unrealistic to assume that they could blend the technical with the intangible. But, is this wholly true? Physicians who will ultimately be charged with fitting prosthetic devices and ensuring their regular follow-up and maintenance are trained in the fundamental basics of psychology during their tenure at the university. The basic curriculum for a career in a clinical environment deal with leadership theory, sociology, and psychology as there are many different demands placed on the physician for providing emotional and social support to patients. Those in the research community holding degrees in clinical work also maintain these same fundamental learnings from the school. Why are these fundamental experiences being discounted in prosthetic technological development in order to better serve the sensitivity and affections of the prosthetic user? To better answer this question and to refute the potential arguments of scientists and clinical researchers a quantitative research study was undertaken to gain real-life practical knowledge of the world of prosthetics and user relationship development. Study Design A non-biased survey was constructed that dealt with the fundamentals of science and revolution in prosthetic technology, alongside questions dealing with emotional make-up of prosthetic users. A simple ranked survey instrument was created in which 0= (not at all) and 9 = (to the extreme). Three individuals involved in prosthetic design, fitting and clinical care were selected to represent the sample population. Numerous phone calls and walk-ins were conducted at regional prosthetic-oriented organizations and health care facilities to identify three individuals that would provide the most valuable statistical data. The sample consisted of a nurse, a physician involved in prosthetic fitting, and a design specialist in prosthetics. All of the three participants devote much of their career to prosthetics and orthotic care working with very diverse user character and socio-economic profiles. The intention of the study was to prove whether elements of psycho-social needs were, in actuality, being considered or whether they were perceived to be included throughout the research and innovation processes. Research Findings Analysis of the surveys indicated a majority consensus that there was not enough research in psycho-social needs being included in modernized prosthetic technology development. The sample was asked, “To what degree do you believe that prosthetic design elements maintain features or benefits to improve emotional well-being?”. The mean score of the sample was 3.5, illustrating an average sentiment in support of these failings in research. The survey also asked the question, “To what extent do you believe an individual is rewarded emotionally in terms of self-esteem development upon receipt of a revolutionary prosthetic device?”. The mean score of the sample was 6.7, illustrating an above-average support for those who might argue that research is actually considering these complex needs. In order to remain unbiased, these data findings should be publicized. However, the survey also asked, “To what extent do you believe that researchers and clinicians are providing input on improvements to prosthetic technology to improve mental health?”. The mean score was 2.8, illustrating a very below average majority sentiment. All three participants in the study listed below average sentiment about the viability of the argument that such efforts were being consulted by psychological or sociological experts. The other questions focusing on the same balance of questions in favor and against the arguments in this study maintained relatively average sentiment, giving neither clout to the scientific community or to those who argue that emotional needs are not considered effectively in prosthetic technology development. The participant group did not feel strongly in either direction as a means of justifying the research. However, post-survey discussion with the physician (an opportunity for qualitative analysis) about these new technologies indicated a strong dissatisfaction with the lack of improvements in sustaining emotional health. The physician offered that the development group responsible for manufacturing, fitting and upgrading prosthetic devices provided minimal customer support and would not respond with empathy when patient needs and emotions were used to justify certain upgrades. The physician participant often had to chase down these prosthetic design and production specialists in the event of urgent patient needs or for those who were suffering emotional negativity due to misfit or discontent with design. Opportunities for using new features and options that would bring greater emotional satisfaction were swiftly rejected when proposed and never distributed to the research and development departments or quality assurance. This often left patients with significantly-long waiting periods for their new or upgraded prosthetic or be forced to accept inferior limb tools. The Damage is Done This portion of the research study identified some interesting findings not necessarily considered when constructing the study design. It appears that there is a significant disparity between the service dimensions of prosthetic device production, fitting and distribution and the actual research and development community. The service dimensions of prosthetic design, regardless of the device’s revolutionary or innovative design concepts, are some of the most fundamental in improving patients’ lives and, thus, emotional well-being. If these researchers and clinicians are not even consulting their own industry professionals in providing better service, are they consulting the external psycho-social experts in society for design improvements? Post-discussion with the prosthetic developer and fitter would indicate a very strong negative in this case. Prosthetic development and retrograding is a very specialized and scientific field that is disparate from both design and the physician responsible for patient care, however this individual must maintain knowledge of changing technology to adapt their own internal production capabilities. This particular participant indicated, upon request, that sociology and psychology are rarely involved in development and prototyping with learning being “emergent” rather than proactive. This means that learning about emotional satisfaction occurs long after the prosthetic has been fitted and the user has experienced long-term follow-up and refit. Even in this case, only the basics and fundamentals of attitude, emotion and behavior are described and not put into the next generation of prosthetic designs. The reality of this industry, unfortunately, is that development occurs primarily based on financial investment, profit expectations, and product life cycle estimates (Personal Interview, August 2012). Prosthetic developers that are funded by corporate officials are limited to their design and testing prototyping on live users by financial issues which often do not include market research on end user profiles and emotions (Personal Interview). When will it Improve for the User? The quantitative analysis, personal interview, and lack of scientific and clinical research materials illustrating advisement by sociologists and psychologists are disturbing. The goal of prosthetic devices are to improve mobility and overall user lifestyle quality, of which these involve some of the most primal and essential needs and emotions of the user. However, the data received from the prosthetic developer, especially, paints a new light on the mechanisms and systems that drive research and development for prosthetic technology. It is a world of profit-generation and scientific self-marveling that seems to have a certain tunnel vision when it comes to making design concepts that sustain the emotional state of the prosthetic user. Lack of service support is backed by lack of market research on prosthetic user needs and characteristics in favor of product life cycle and profit balance. This would ultimately explain why the research data simply does not promote psychological or sociological input for better user satisfaction. Conclusion Despite the arguments about the realistic and rational separation of psycho-social consultation with scientific and clinical research in prosthetic technology, the needs of the user simply are not being considered adequately. Physicians and nurses, as well as independent prosthetic producers, are left with the arduous task of working with users post-fitting and must therefore be the support for their complicated needs. Will this ever end for the prosthetic user? Based on the research, it does not look as if psycho-social needs will be fitted into the next revolution in prosthetics, which is a terrible outcome for the needy without adequate self-esteem, security or social belonging. Despite these revolutions in technology, the user is on their own in sustaining positive emotional development. References Georgia Tech. (n.d.). “What is Prosthetics and Orthotics?”, School of Applied Physiology. Retrieved August 17, 2012 from http://www.ap.gatech.edu/mspo/pandomain.htm Levy, Eric. (2012). “The History of Prosthetics: Artificial Limbs Past and Present”. Retrieved August 16, 2012 from http://www.disaboom.com/amputations-information/the-history-of-prosthetics-artificial-limbs-past-and-present Personal Interview. “Prosthetic Design Expert”. August 2012. Schultz, Aimee. (2009). “New Prospects for Prosthetics”, Science in Society. Retrieved August 19, 2012 from http://scienceinsociety.northwestern.edu/content/articles/2009/kuiken/new-prospects-for-prosthetics Singer, Emily. (2007). “Prosthetic Limbs that can Feel”, MIT Technology Review. Retrieved August 16, 2012 from http://www.technologyreview.com/news/409100/prosthetic-limbs-that-can-feel/ Zhou, Katherine. (2010). “Advances in Prosthetic Limbs”, Yale Journal of Medicine and Law. Retrieved August 17, 2012 from http://www.yalemedlaw.com/2010/10/advances-in-prosthetic-limbs/ Read More