Upper Limb Prosthetics

Upper Limb Prosthetics

Much of the early years of the bioengineering in Edinburgh were devoted to the provision of upper limb prosthetics. The service initially served a population of around 60 children many of whom were followed from birth into young adulthood.

The first prosthesis with ‘extended physiological proprioception’ EPP was fitted to a child in 1964. It had three movements; elbow flexion, pronation/supination and prehension. This was developed further with the addition of shoulder elevation and circumduction/humeral rotation. The arms were gas powered as opposed to electrically powered as electrical components, such as batteries and motors, were too heavy for practical use at that time.

Research and development continued alongside the clinical service, and included the development of a complete adult arm prosthesis with endoskeleton construction and the functioning PMR hand with a cosmetic glove. The development of a child’s hand prosthesis and partial hand prostheses followed.

In 1979/80, the centre along with the local prosthetists were involved in the clinical trial of the Swedish System Teknik hand prosthesis for young children that went on to become routinely used. By the mid-1980s a database on an Apple microcomputer was being used to store patient records. By the time the centre celebrated its 25th anniversary the original patient group were all adults and this aspect of the centre’s work had waned. Research nevertheless continued in the area of upper limb prosthetics, though now electrically powered, and cosmetic gloves.

On 26th August 1998, after 11 years of research and development (with funding from the Scottish Chief Scientist’s Office) the first complete powered electrical arm prosthesis, know as the Edinburgh Modular Arm System (EMAS), was fitted at the centre. The fitting was witnessed by 7 television crews and over 30 journalists and photographers from all over the world (BBC report). The user continued to use the arm for 18 months and worked with the team to develop and improve its functionality and several other arms were manufactured and fitted. The arm is now on display at the National Museum of Scotland.

The core component of the EMAS was a patented powered lever system which was used in 2006/7 in the so called “International Arm Fittings” in Chicago, including the world’s first female powered arm wearer.

In 2002, TouchEMAS Ltd was the first spin out company to be launched via Scottish Health Innovations from the NHS in Scotland. It was subsequently, renamed TouchBionics and was awarded most promising new Life Sciences Company in Scotland in 2005. It is now based in Livingston and continues to develop and launch new products and has fitted hundreds of upper limb prostheses across the globe. In 2008, David Gow and TouchBionics were awarded the prestigious Royal Academy of Engineering’s MacRobert Award for the development of the i-LIMB hand.

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Selected Further Reading

Lamb DW, Simpson DC, Schutt WH, Speirs NI, Sunderland GD, Baker G.
The management of upper limb deficiencies in the Thalidomide Type Syndrome.
Journal of the Royal College of Surgeons of Edinburgh 1965;10(2):102.

Simpson DC.
The choice of control system for the multi-movement prosthesis: Extended physiological proprioception (e.p.p.).
In The Control of Upper-Extremity Prostheses and Orthoses, edited by P. Herberts, R. Kadefors, R. Magnusson, and I. Petersen. Springfield, Ill, Charles C. Thomas, 1974, pp 146-150.

Simpson DC, Smith JG.
An externally powered controlled complete arm prosthesis.
Journal of Medical Engineering & Technology 1977;1(5) :275-7.

Lamb DW, Dick TD, Douglas WB.
A new prosthesis for the upper limb.
Journal of Bone & Joint Surgery [British] 1988;70-B(1):140-144.

Campbell GS, Gow D, Hooper G.
Low cost cosmetic hand prostheses.
The Journal of Hand Surgery: British & European 1992;17(2):201–203.

Gow DJ, Douglas W, Geggie C, Monteith E, Stewart D.
The development of the Edinburgh modular arm system.
Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 2001;215:291-98.

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Written & compiled by Dr Michael J Dolan, SMART Centre, NHS Lothian, Edinburgh.

First published 15th March 2013. Last updated 15th March 2013. Version 1.0.