The seaside setting of Bournemouth University might seem a world away from Afghanistan and the improvised explosive devices (IEDs) that the Taliban are using there to injure British troops. But a group of Bournemouth academics hope that the work they are carrying out at the university's Design Simulation Research Centre might one day transform the lives of the rising number of amputee soldiers injured in Iraq and Afghanistan, and potentially return them to active service.
It's not war theory that Professor Siamak Noroozi, 54, and his team are working on, but practical design and engineering work. Using artificial intelligence and new technology, they are developing a "smart" prosthetic socket that is able to measure the individual interactions between the socket and the stump of a limb and, they hope, will transform the lives of amputees.
"We came across this project because we know that a lot of people are very dissatisfied with current prosthetic sockets," Noroozi, a mechanical engineer, explains. "Currently, prosthetic limbs are made of two components: the leg – the mechanical part, which connects the person to the ground – and the socket, which connects the mechanical part to the body. But that interface can be very comfortable or very painful and can definitely generate pain if not designed properly.
"You cannot create the perfect prosthetic socket that has the same feeling as your normal leg, but you should be able to get a socket with a profile that can be modified to create an optimum comfort level, and then maintain that whether the person is walking, sitting and so on." At the moment, since sockets are not "intelligent", they can't account for changes in the residual limb due to sweat or fluid build-up, for example, and can become uncomfortable or painful.
Noroozi learned that prosthetists rely on their own experience to fit a patient with a prosthetic limb, but "there was no tool available to quantify that fit by giving data or feedback to ensure that the wearer does not experience pain or discomfort from the artificial limb." As a result, he and his team decided to try to create one.
"For many years, research has been carried out to try to improve the fitting process for prosthetic limbs, but from what we know, none of this research resulted in a clinical tool that can inform processes about the quality of the fit, or the changes made during the fitting process, or what happens as a result of those changes," Noroozi explains. "So, if you modify the socket – making it better or worse – there's no qualitative tool that can tell you the variation of the resultant pressure after the changes you make to it."
In a bid to create that tool, Noroozi and his team at the Design Simulation Research Centre are using their knowledge of engineering and artificial intelligence to create a "virtual" socket, which can record data to see how it reacts to different loads, and react to the incoming information to ensure the socket maintains a state of comfort for the user at all times.
"The socket can be used to monitor the progress of the person, telling us what is happening when they are static, or walking, or running, or going up stairs, to create a load profile and then judge whether those load profiles result in a comfortable or painful socket," says Noroozi. "That would mean we could transform every individual socket so it suits the person specifically and any required adjustments can be done very quickly. This should reduce the time it takes to fit each individual socket and possibly extend the life of sockets from six to nine months, as at the moment, to several years." As a result, the academics expect the socket to save the NHS significant amounts of money. "One of the reasons that the cost of fitting is so high at the moment is that you are paying for the experience of the prosthetist," says Noroozi. "With our new tool, that experience can be encapsulated, which means we'll be able to better visualise the effect of any corrections to the socket and, we hope, get things right the first time."
The engineers on the project, which has received funding from the Engineering and Physical Sciences Research Council and the medical charity Remedi, are now working with Blatchford, a private company that works with the Ministry of Defence Medical Rehabilitation Centre at Headley Court, Surrey, where soldiers are sent following injury in the Afghanistan and Iraq conflicts.
"When we started work on this project, we had all of the population in mind," says Noroozi. "But more recently there are, sadly, larger numbers of younger people with amputations who want to be more active once they've had their limb amputated. Many of these are soldiers returning from conflicts like Afghanistan whom Blatchford are working with to improve the quality of their lives."
Noroozi and his team hope that better-fitting limbs could help thousands of amputees around the world to enjoy a fuller life. "It is our hope that we will be able to help many people – including soldiers – with our smart socket to give them as much of a return to normal life as possible," he says.
"Comfortable sockets allow amputees to return to an active life, and, in the case of soldiers, to return to active duties. One of our colleagues is specifically working on research related to prosthetic limbs for people who wish to be more engaged in Paralympic activities." For now, the academics are focusing on "miniaturising" their work, as well as making it wireless and optimising the number of points for collecting data. Blatchford is currently manufacturing a socket that integrates the smart technology, which will then be tested by amputees. That hope – that the new socket could make a difference to the lives of soldiers and other amputees – inspires his work, says Noroozi. He adds: "If I can improve the quality of life for one person with an outcome that is beneficial and sustainable, that is where the passion for my job comes from."