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Prosthetics take the high-tech route

06 Aug, 2008 11:30 PM

LEN SNOWDON has two right arms. Depending on what he is going to be doing that day, the South Coast father attaches one of his two prosthetic upper limbs.

Most days, it's his state-of-the-art, myoelectric prosthesis, which he manoeuvres using electro-sensors attached to the muscles around his shoulder. Since he lost both his right arm, leg and hip in a work accident 16 years ago, the high-tech replacement limb has allowed him to resume many of the activities he once took for granted, such as turning the pages in a book or pouring a drink.

But when Snowdon is going fishing, he still prefers to wear "the old claw".

"It's been around since Captain Cook," he says, "but it's the ideal prosthesis to use. I can hold a fishing rod and I have no problem taking fish off the hook," he says with a laugh.

While the old models can still come in handy, artificial limbs have come a long way.

Advances in engineering, computer programming and manufacturing, particularly in the past 10 years, have allowed scientists to come closer to replicating natural movement.

In the US, more money than ever is going into developing smarter, lighter and more comfortable prosthetic limbs, partially driven by the huge number of amputee soldiers returning from Afghanistan and Iraq - at least 900, according to the US Department of Defence.

One of the biggest improvements has come in myoelectrics.

Myoelectric protheses work by electric sensors that are attached to a person's muscles, which trigger movement of the prosthesis. Though the technology has been around since the late 1960s, it has only become widely used in Australia in the past five to 10 years.

Developments in Bluetooth technology have also made it possible for people to control these movements.

"I can computer program it to do certain tasks, at different speeds and sequences," Snowdon says. "There's no wires, I just have to be in the room with the computer."

Researchers are refining this technology, hoping to make even delicate manual tasks possible for amputees.

In artificial legs, some of the biggest improvements have come in materials. The use of carbon fibre and hydraulics has vastly improved the stability and range of movement.

This year a South African double amputee, Oscar Pistorius, made headlines when his bid to run alongside able-bodied athletes at the Olympics was initially refused on the grounds that his prosthetic legs, made from carbon fibre and shaped like curved blades, would give him an unfair advantage.

But the manufacturers say there is still a long way to go.

Stephen Harland, a prosthetist who works for the world's largest prosthetics manufacturer Otto Bock, says one of the next important areas of research will be in sensory feedback.

"Many people with a prosthetic arm can't grip objects or grip them too hard," he says. "So often they will squeeze and break things like polystyrene cups."

Finding ways to make the sockets of artificial limbs more comfortable is also a priority, Harland says.

Scientists are also working on osteointegration, which would allow them to graft the artificial limb under the patient's skin to their bones.

But, says Rowan English, the head of the National Centre for Prosthetics and Orthotics, affordability is the real problem.

Most of the estimated 250,000 amputees in Australia are older people who have lost the lower half of their leg due to diabetes or vascular disease, he says. In 2004-05, there were 2393 leg amputation procedures in hospitals, 72 per cent of which were aged older than 65, Australian Institute of Health and Welfare data shows. Unlike accident victims, English says, these people are rarely covered by insurance.

"Under the public system everybody gets a basic prosthesis, but if they want a higher-end product they have to pay, or pay the difference," he says.

With top of the range, lower-leg prostheses costing between $15,000 and $20,000 and requiring replacement every two to four years, they are out of reach for most amputees.

But the improvements in technology are enormously comforting for those who can access them.

Snowdon's myoelectric arm, worth about $80,000, allows him to be involved in local community and sporting groups, work as a safety officer at BlueScope Steel and care for two young daughters.

"They assist me sometimes by bringing my prosthetic arm and leg to me, because I take them off at night or in the shower," he says.

He is enthusiastic about upgrading his artificial limbs in the next month to have realistic coatings, which replicate human skin and hair.

"It's mind boggling," he says.

TECHNOLOGY

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