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Design and development of new rehabilitation technologies

Lower limb prosthetics

For a number of years we have been working on methods to characterise the behaviour of prosthetic feet (1, 2), allowing us to identify one of the key problems with passive devices, their inability to provide the positive work seen at the anatomical ankle at push-off (3). This work formed the background to an EPSRC project led by Professor David Howard in which we further developed our analysis methods (4) and demonstrated the potential for hydraulic technology to enable controlled storage, transfer between joints, and return of energy in lower limb prostheses (5). Our results have encouraged us to pursue further work in this area and we are also exploring exploitation routes.

Rig for characterisation of amputee independent prosthesis properties (AIPP).

Upper limb prosthetics

We are taking a similar approach to the design and development of new upper limb prosthetic devices, focusing first on better understanding the problems with myoelectric prostheses. John Head’s PhD thesis investigated the role that poor socket fit can play in determining functional capability (6) and this work has been extended in Alix Chadwell’s PhD work (7).

Exp RT Chadwell

Reaction time experimental setup used in Chadwell’s PhD.

Functional electrical stimulation

Our group has a long standing interest in the design and development of improved functional electrical stimulation systems. The work dates back to the late 1990s when Professor Laurence Kenney worked in the Netherlands on the development and evaluation of an implantable drop foot stimulator (8), later commercialised under the trade name StimUStep. Since then we have worked on two projects to develop new FES systems. In the first project we worked with the Sheffield team, led by Professor Tony Barker and Dr Ben Heller, on the design of an array-based stimulator with automated setup for dropfoot correction (9), believed to be the world’s first CE marked system of its kind. The first ever take-home study of such a device was led by our group (10) and showed that the technology can be used by patients without technical support. More recently we have been working with Odstock Medical to develop an upper limb functional electrical stimulation system to enable FES-supported functional task practice (11). Through a series of NIHR-funded projects we have progressed to the stage of a regulatory-approved trial of the system.

FES Sys New2
Upper limb FES system developed by in a collaboration between our group and Odstock Medical.

Advanced kinematics for characterisation of impairment and synthesis of robotic rehabilitation solutions

This area of interest builds on the expertise of our newest member, Dr Gouwu Wei. His background is in advanced robotics and he applies state-of-the-art kinematics to the analysis and synthesis of human movement. He is working to design and develop affordable institutional/domestic assistive robots and rehabilitation devices based on the concept of reconfigurability.

  1. Major MJ, Kenney LP, Twiste M, Howard D. Stance phase mechanical characterization of transtibial prostheses distal to the socket: a review. J Rehabil Res Dev. 2012; 49(6):815-29.
  2. Major MJ, Twiste M, Kenney LP, Howard D. The effects of prosthetic ankle stiffness on ankle and knee kinematics, prosthetic limb loading, and net metabolic cost of trans-tibial amputee gait. Clin Biomech (Bristol, Avon). 2014;29(1):98-104.
  3. Gardiner J, Bari Z, Howard D, Kenney L Energy storage and return prosthetic feet have only marginally improved trans-tibial amputee gait efficiency compared to that with solid ankle cushioned heel feet. J Rehabil Res Dev. 2016;53(6):1133-1138.
  4. Weinert-Aplina RA, HowardD, Twiste M, Jarvis HL, Bennett AN, Baker RJ. Energy flow analysis of amputee walking shows a proximally-directed transfer of energy in intact limbs, compared to a distally-directed transfer in prosthetic limbs at push-off. Med Eng Phys. 2017;39:73-82.
  5. Gardiner J, Bari Z, Kenney L, Twiste M, Moser D, Zaheedi S, Howard D. Performance of optimised prosthetic ankle designs that are based on a hydraulic variable displacement actuator (VDA). IEEE Trans Neural Sys Rehabil Eng (in press).
  6. Head JS, Howard D, Hutchins SW, Kenney L, Heath GH, Aksenov AY. The use of an adjustable electrode housing unit to compare electrode alignment and contact variation with myoelectric prosthesis functionality: A pilot study. Prosthet Orthot Int. 2016;40(1):123-8.
  7. Chadwell A, Kenney L, Thies S, Galpin A, Head J. The reality of myoelectric prostheses: Understanding what makes these devices difficult for some users to control. Front Neurorobot 2016; 10:7.
  8. Kenney L, Bultstra G, Buschman R, Taylor P, Mann G, Hermens H, et al. An implantable two channel drop foot stimulator: initial clinical results. Artif Organs. 2002;26(3):267-70.
  9. Sha N, Kenney LP, Heller BW, Barker AT, Howard D, Moatamedi M. A finite element model to identify electrode influence on current distribution in the skin. Artif Organs. 2008;32(8):639-43.
  10. Prenton S, Kenney LP, Stapleton C, Cooper G, Reeves ML, Heller BW, et al. Feasibility study of a take-home array-based functional electrical stimulation system with automated setup for current functional electrical stimulation users with foot-drop. Arch Phys Med Rehabil. 2014;95(10):1870-7.
  11. Sun M, Kenney L, Smith C, Waring K, Luckie H, Liu A, Howard D. A novel method of using accelerometry for upper limb FES control. Med Eng Phys. 2016;38(11):1244-1250.