Happenings

University of Utah researchers have developed a prototype exoskeleton to reduce above-knee prosthesis users’ exertion when walking. Led by Tommaso Lenzi, PhD, assistant professor of mechanical engineering and director of the university’s Bionic Engineering Lab, the research team is testing the lightweight exoskeleton, funded by a grant from the Congressionally Directed Medical Research Program.

“Most of the research effort in the last 10 years has focused on restoring ankle pushoff with powered prostheses. This approach is sound but has some intrinsic drawbacks,” explains Lenzi. “Available powered prostheses are two or three times heavier than their passive counterpart, and the added mass of a powered prosthesis is distally suspended through the socket, which makes it feel even heavier than what it is.” His team sought alternatives and discovered that powered hip exoskeletons, which can be made very lightweight, could be effective because most of the compensatory movements in amputee gait happen at the residual hip, above the amputation.

The new exoskeleton wraps around the wearer’s waist and leg, connecting to the user’s thigh above the amputation. The exoskeleton’s AI understands how the person moves by interpreting the information from the integrated position and load sensors, according to Lenzi. Then, it sends a command to the battery-powered electric motors assisting the residual limb in flexion and extension while adapting to the user’s gait speed and cadence. “In our study with individuals with above-knee amputation,” he said, “we found that our lightweight exoskeleton reduces the metabolic cost of walking by 15%, which is equivalent to taking off a 26-pound backpack.” The assistive technology would serve as an extra tool for clinicians, offering prosthetists “the freedom to use whatever prosthesis they believe is the most appropriate for their patients.”

While the exoskeleton was developed primarily for individuals with above-knee amputation, “in general, anyone who may benefit from some extra assistance during walking can use it,” Lenzi said. His team is currently testing the exoskeleton with people with hemiparesis due to stroke. “We are quickly realizing that our lightweight exoskeleton has the potential to help many different people to walk further and with less effort, improving their mobility in the community.”

Lenzi’s team also is extending the use of the exoskeleton to more activities, like climbing stairs and slopes. “From a development standpoint, we are working on a new generation of our technology that will incorporate the feedback we have received from the research participants that have used our current prototype,” he said. “The goal is to partner with leaders in prosthetics and orthotics to make this technology available to the people who need it.”

The researchers found the lightweight exoskeleton reduces the metabolic cost of walking by 15%. A study subject with above-knee limb loss walks on a treadmill using his prosthesis and wearing a lightweight exoskeleton.

The American Board for Certification in Orthotics, Prosthetics, & Pedorthics (ABC) is leading a multiyear effort to raise awareness of the orthotics, prosthetics, and pedorthics professions among high school and college students in an effort to build a strong pool of talent and build a diverse, robust talent pipeline.

The board of directors of ABC hired a professional healthcare marketing and communications firm to help identify the tactics and methods for meeting the goal of raising awareness of the OP&P profession. The organization conducted quantitative research, with a large-scale national survey of over 1,000 respondents aged 14-28 years, as well as qualitative research through a series of virtual focus groups with participants ages 14-24.

Through this research, ABC discovered the following: • More than two-thirds (68%) of respondents decided their career path in high school. • At least 82% of respondents are unaware of OP&P professions. • Of those who are aware of

OP&P, familiarity is highest (52%) with prosthetics. • Online research (44%) and family/friends (38%) are far more influential than career counselors

(12%) or career fairs (6%). • Respondents want jobs where they know they can make a difference (84%) and work with different types of people (79%) more than jobs with competitive pay.

Based on the research completed to date, ABC is creating a multifaceted plan for reaching the target audience through personal interactions, a robust career website, focused digital advertising, and social media engagement. ABC also is encouraging OP&P professionals from across the country who would enjoy helping young people understand the dynamic, flexible, and personally rewarding nature of the OP&P profession to join this effort. Interested clinicians can learn more about serving as ambassadors, who would share their personal experiences with young people through speaking opportunities, mentorship programs, high school career days, and more, by emailing ambassadors@abcop.org.

U.S. healthcare spending increased 9.7%, to reach $4.1 trillion in 2020—a much faster rate than the 4.3% increase in 2019. The acceleration is attributed to a 36% increase in federal expenditures in healthcare that occurred largely in response to the COVID-19 pandemic.

SOURCE: “National Healthcare Spending in 2020,” CMS, Health Affairs, Dec. 15, 2021.

The 2022 Medicare DMEPOS Fee Schedule will increase by a net total of 5.1% for claims with a date of service on or after Jan. 1, 2022, the largest annual increase in more than 30 years. The increase is the result of a CPI-U increase of 5.4% from June 2020 to June 2021 and a -0.3% productivity adjustment.

SOURCE: CMS

A new study from researchers at the University of Pittsburgh found that 34% of U.S. children under age 18 were “underinsured”—insured, but with policies that fail to address their overall health needs or ensure access to preferred providers; that their insurance plan came with high out-of-pocket costs; or that it wasn’t in effect at all times. That number is up from 30.6% in 2016, which means 2.4 million more children are underinsured. The researchers pointed to “unreasonable” out-ofpocket expenses as the main problem.

SOURCE: “Underinsurance Among Children in the United States,” Pediatrics, Dec. 6, 2021