Limbformation will be a website for families and children with limb loss or limb difference and educators working with these families. Designed as an easy to use ‘one-stop shop,’ its purpose is to empower, support, and educate through factual information and personal stories.

It has been clear for some time that there needed to be a family-friendly website, with all the information available in one place. As such, Limbformation will be a child-specific, practical resource designed to connect all areas of life for a child living with a limb difference and to take a further step in fighting the isolation that many families feel.

Progress so far includes conducting extensive surveys across all stakeholder groups and running two family focus groups to establish website content. The team has also began working with a website builder and professional illustrator in response to this input from families. The next step will be for full website to be submitted for feedback and approval, followed by a full day of tutoring on CMS and website management. The team will then upload further text, images and information.

Key take away message:
Limbformation will be a ‘one stop shop’ for all families including a child with limb difference.

This project aims to develop a method to 3D print bespoke silicone liners for child prosthetics wearers in order to address issues of comfort and performance for those children as they grow.

The interface between a residual limb and a prosthetic can be considered an engineering challenge, as it requires a liner material that fits well and manages temperature in order to protect the skin. However, children can quickly outgrow their sockets or liners, and a prosthetic user’s body changes shape throughout the day. Our proposed solution is a bespoke silicone liner that is 3D printed. The liner will be printed in one piece containing breathable porous structures throughout the liner, along with active cooling channels. In the last stages of the project we hope to include growth tracking sensors in the liners.

The team have made considerable progress by using 3D scanning technology to create the desired shape of the liner, and have created a way to 3D print silicone into complex shapes including embedded sensors and cooling channels. The next steps of the project are to make a first prototype liner and to test its performance at Stanmore with a child lower-limb prosthetics wearer.

Key take away message:
Through our work we hope to improve the satisfaction of children with their prosthetics, reduce skin infections, and reduce rejection rates.

This project aims to develop affordable, high quality 3-D printed customisable covers for children’s prostheses that are easy to remove or change according to the child’s choice and activity.

Children who are happier with the appearance of their artificial limb may be inclined to wear the device and use it more. However, the majority of children’s prostheses are fixed in shape and hard to the touch with limited styles of cosmetic finishes. By using both scanning and 3-D printing technology, this project hopes to accommodate choice and interchangability of covers according to the child’s mood, situation or changing tastes. The design processes involved will also be fun and promote positive discussion between the family, friends and the child about the prosthesis and the rehabilitation journey.

So far, the team have conducted extensive background research, design work, software analysis, manufacture of prototypes and an ethical application to provide covers in a one centre trial. Next steps will include the purchase of software, IRAS ethics application and testing in an NHS limb centre.

Key take away message:
Designing a cover will be a fun process that improves the child’s engagement with the prosthetic rehabilitation process, promote positive discussion with the child’s family and friends, and we think will change the perception of the look and appeal of children’s prostheses.

This project aims to develop a robust and personalised prosthetic socket that is comfortable, suitable for exercise and play, and adaptable to limb growth.

Existing sockets have fixed shape and are, therefore, not fit for demanding sports and do not provide room for the limb to change shape through the day. Existing sockets also do not regulate heat or sweat during physical activity. Using digital manufacturing methods, new materials and clever design, the team has produced a prototype socket that is engineered to address these challenges. The socket, which can be manufactured on-demand, will have increased airflow and self-adjust its shape to fit the limb, facilitating wearing comfort and limb growth. The socket can also be customised in different colours, image icons and cosmetic designs to the child’s specific tastes.

To date, the team have focussed on researching adaptive structures for comfort and child growth. Individual socket designs are generated using automated software, developed by the project team, with an aim of manufacturing personalised, optimised prosthetic sockets with enhanced functionality.

Key take away message:
The project team is developing a scientifically-validated design and manufacture workflow to improve the wearing comfort for children and the ability to adapt for growth and physical activities, at a fraction of the current production cost of liners/sockets.

This project aims to develop a 3D-printed clip-on Lego device to sit on top of a children’s split hook, making it more playful and fun.

The split hook is functional, lightweight, durable, cheap, and easy to operate: ideal for children. Unfortunately, it is often rejected by parents and children because of the way it looks. In our practice, we have found that Lego blocks can be used to build a platform on top of the split hook to make it more playful, less clinical and more acceptable to children and their parents. This device produced positive results, so we developed a 3D printed Lego® plate (a ‘Play Attachment’) that can be easily clipped on to the top of a standard child’s split hook. Starworks funding is helping us develop the Play Attachment for wider use, and to run ‘Lego Play Date’ sessions to help us research and evaluate it in use.

Progress so far has included refining the existing prototype (from previous clinical practice) and the production of milled prototypes in left and right sides. Possible next steps include either applying for ethical approval for the 3D-printed version of the Play Attachment, or releasing instructions on how to make a DIY version from easily available materials.

Key take away message:
Transforming functional prostheses to be more accessible to children, and toward a more ‘toyful’ aesthetic.

This project aims to develop a first-of-its kind Socket Interface and fit Monitoring System (SIMS) for children with lower limb absence, which will use a system of sensors in the socket and a smartphone App to help identify the appropriate time for socket adjustments.

The high growth rate of children means that children who have lower limb loss also require prosthetics that can match their rate of growth. This creates a significant problem as it means that a “new” socket might be needed very often, just like children go through many pairs of school shoes due to growth spurts. Once a prosthetic socket is fitted to a child, it may soon be too small, and if left unaddressed may lead to skeletal development problems. With SIMS, the aim is to help ensure children always have good fitting and comfortable prosthesis so that they can participate fully in normal lives and most importantly have fun!

So far the team have engaged extensively with children with limb losses and their families as well as clinicians to identify the key design criteria. From this, a prototype was made to test Southampton’s novel interface sensors and a parent App, with positive initial feedback. Their next steps are to conduct a preliminary study with children and families, leading to the real world evaluation, development and optimisation of a SIMS prototype.

Key take away message:
A new socket fit monitoring tool to help alert children, their parents and clinicians for timely socket adjustments.

This project aims to develop 3D printable prosthetics for infants with upper limb differences.

Current prosthetics are limited in terms of design and functionality. As such, a multidisciplinary team comprising academics from Manchester Metropolitan University and clinicians from Manchester University NHS Foundation Trust are working together to develop next-generation 3D printable prosthetics for children under the age of 5 years. Using the latest 3D printing technology and the use of advanced materials, baby friendly prosthetics will be developed and will be designed to help with each of the infant’s developmental milestones, something which current NHS approaches are not able to offer.

So far, the project has developed the first iteration and designs that are now ready to be assessed for suitability within the medical team. The next step will be to iterate the designs a final time with the intention to improving the end products. A group of families in associations with Reach will then provide feedback to an independent panel assessment on the positive and negative aspect of the designs.

Key take away message:
The 3D printed prosthetics are developed to engage and inspire infants to help improve adoption comparable to the current NHS offering.

Our project aims to teach children how to control a robotic hand by playing an immersive computer game. Learning novel ways to control forearm muscles will be a core part of the gameplay. The goal is for children to understand how to use a modern robotic hand before they are provided with one.

Modern robotic hands can perform a variety of grips and gestures. However, if a child cannot control these movements, they are often better off using a simple gripping hook. We have chosen to focus on teaching hand control because we believe robotic hands have the potential to enhance children’s everyday lives in ways that gripping hooks cannot.

So far, the team have created a prototype game which trains the player how to use their muscles for interacting with a prosthesis. Their next steps are to gain feedback from children.

Key take away message:
We want all child who get prosthetic hands to be able to control them properly so that we can show that these hands can make a difference.

This project aims to develop a new prosthetic knee for children which uses the natural properties of specialist materials to more closely mimic a natural leg rather than relying on pistons, electronics and robotics typically employed in adult legs to compensate for their weaknesses.

Natural legs are very good at absorbing impacts when running, jumping and rapidly changing direction. Current prostheses are rigid, heavy and cumbersome – they are poorly suited to children. As such, Cambridge Prosthetics is developing a new generation of child-focused artificial legs that are more versatile, reliable, affordable and facilitate active play alongside their peers. It is a collaboration between a materials scientist and lifelong prosthesis user, a leading rehabilitation consultant and a social impact specialist.

So far, the team have produced a prototype knee which is lightweight, easily maintained, waterproof, and bends to 135 degrees thus providing extra flexibility for children in play. Some aspects of this design are currently being prepared for a patent application. The next stage is to optimise the design and produce pre-production samples which can be tested by volunteers.

Key take away message:
The key feature of the knee is that it is designed to enable children with an above knee amputation to take part in play and other activities alongside other children.

This project aims to develop a user-friendly, adjustable device that should improve the function of myoelectric (bionic) prosthetic arms for children.

Myoelectric arms are controlled by electrodes that are usually fixed within the prosthetic interface, called the ‘socket’. These electrodes require close, secure contact against the skin of the child’s residual limb to operate efficiently. However, prosthetic sockets for children are like children’s clothes; they often only last a few months, before they become too tight and new ones have to be made. When a new socket is made, with a small amount of growing room, the electrode may be too loose to work the hand effectively. Our design should enable parents to optimise the contact that the electrodes have on the remaining muscles within the residual limb, even when the socket itself is a little looser, thereby providing better levels of prosthesis control for the child.

So far, several design concepts have been proposed and are currently being prototyped while an ethics application for the pilot study has been submitted. Upon ethics approval, the finalised designs will initially be trialled on the team, then on professional patients and finally on children.

Key take away message:
We anticipate that by allowing adjustments to electrode’s pressure and orientation, the overall functionality and control of myoelectric prostheses will be improved.