TOG Process Book

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Process Book Low-Tech Rehab Fall 2011 Daniel Orbach

“Design a low-tech rock-climbing and hiking Prosthesis for an above knee amputee�


Table of Contents Research Sketching Validation Modeling The Design Exploded Views & Engineering


Let’s Talk About Amputees Active Amputees have a better quality of life relative to those who are less active

of amputees do 0-1 of the activities they did before the amputation

of lower leg amputees report moderate to severe pain while wearing a prosthesis

Barriers to sports participation for amputees: pain, embarrassment, and a lack of special organized programs for amputees There are over 1,000 Amputees coming back from the wars in Iraq and Afghanistan

70% of all amputations occur below the waist, and 39% occur below the knee

For every step you take, an amputee has to use around 1.5 times the amount of strength as you do. As the day goes on, the effect intensifies.

These facts were pulled from over 50 scholarly articles and interviews I read as part of my research. Citations available upon request


What is happening in the world of prosthetics now?

Prosthetics are becoming more high tech every year. Low-Tech options are largly falling by the wayside, but there is a huge need for extreme sport prosthetics, as only one knee currently exists, and there is no complete solution

2007: the first 3d printed prosthetic socket

2008: XT-9 extreme sports knee hits the market

2009: The 4th annual Extremity Games are stages. This was the first time the mainstream media covered the games.

2009: outside magazine published 7 articles about different active amputees

fall 2011: Innovation Magazine Issue discussing prosthetics at length

2010: OttoBock releases the second C-leg, it makes 1,000 calculations per second

2011: The VA builds a theraputic rock climbing wall for recovering amputees


What comprises a prosthetic leg? Protip: Though not visible, suspensions

are a critical part of a prosthetic. They help keep the socket on the leg, and often involve the user wearing a silicone “sock� as well as using air valves and belts for suction and security

Socket The part of the leg that interacts directly with the residual limb. Most amputee pain happens here.

Attachment point The point where the prosthetic is suspended from the socket

Knee/Calf Nowadays most knees are fully mechanized, complex structures. This is a computerized knee, and needs a lot of room for mechanisms

Ankle

Foot The foot is usually covered and made of carbon fiber and other composites

Many prosthetics don’t have an articulating ankle because they inrease the propensity to stumble


So what is out there now? Sport related prosthetics

XT-9 Extreme Sports Knee

Cheetah Leg by Ossur

Eldorado Z-axis climbing foot

pros

pros

pros

Absorbs and gives back energy waterproof the most durable prosthetic knee

Top of the line running leg lightweight

shortened foot the only foot on the market

cons

cons

cons

Doesn't articulate heavy adjustable only using special tools not a complete solution

not for use with climbing can't navigate uneven terrain expensive not a complete solution

no shock absorption foot is still forwards not a complete solution can't be used to hike


So excersize is critical for amputee rehabilitation, especially for our returning veterans. What kinds of prosthetics exist for what sports? Right Now, Specialty Prosthetics Are available for: Aerobics / Dance / Gymnastics Hockey Archery / Bowhunting Pool / Billiards / Snooker Baseball / Softball Photography Basketball Bicycling Skip Ropes Canoeing / Kayaking Sparring / Martial Arts Snow Skiing Fishing Swimming & Surfing Firearms Musical Weight Lifting Football / Soccer / Volleyball Wind Surfing Golf Climbing


A curiously relevent study

Comparing the energy expenditures of an above knee amputee in climbing a rockwall when put in five different prosthetic conditions When asked to subjectively rate their climbing experience with the different prosthetics:

Volume of Oxygen consumed during the climb (lower is better):

Climbing times, from fastest to slowest.

1: shortened prosthesis, foot backwards

1: shortened prosthesis, foot forwards

1: shortened prosthesis, foot backwards

2: no prosthesis

2: shortened prosthesis, foot backwards

2: shortened prosthesis, foot forwards

3: shortened prosthesis, foot forwards

3: no prosthesis

3: no prosthesis

4: articulated prosthesis, knee unlocked

4: articulated prosthesis, knee unlocked

4: articulated prosthesis, knee locked

5: articulated prosthesis, knee locked

5: articulated prosthesis, knee locked

5: articulated prosthesis, knee unlocked


But I didn’t stop there, I went to UCs rock wall, and climbed with a straightened leg.

Starting the Climb is not an easy task, it’s mostly arms in the begining since footholds are limited.

Getting over ridges is very difficult, because the straight leg cannot bend, or apply force to assist the climber.

on some occasions it would have been nicer of the straight leg was shorter, so the climber has a wider range of motion

near the top things can get tiring, because of the deadweight of the leg, combined with the stress on the muscles.


Interviews

Mike Lagerstrand

Patrick Taylor

A prosthetist at the VA

The head of prosthetics at the VA

“What you really need to do is keep this thing as simple as possible. Especially if they’re going to be wearing it for a long time.”

Clifford Robbins A prosthetist at J.F Rowley

“And actually for rock climbing you’d wanna make sure the suspension was good. You’d probably want a sleeve, with suction and a pin” Got to sit in on a patient fitting, and see how sockets are made

“You know, there really is a need. A big need. These veterans are coming home, and they want that outdoor experience.”

Andrew Meyer

An active above knee amputee

“I have the XT-9 Knee, and when I climb it’s great, but since it doesn’t swing hiking with it is horrible” “I try to stay as active as possible, and I’m actually doing some new things I never thought I could do.”


Photos from interviews

Trying a socket sleeve on my arm to see how tight the fit is. The amount of friction was far greater than I had initially realised

Taking a look at the JF Rowley workshop. Carbon fiber was everywhere. They still use many techniques most of us would think of as antiquated. They are in fact still used widely throughout the prosthetic world.


Photos from interviews A workstation for handcarving negative and positive socket shapes.

Taking a look at various prosthetics they had lying around the shop. One of which was ottobocks state of the art C-leg


Photos from interviews

Some of the equipment used to currently make prosthetics. There were just drawers filled with components


Photos from interviews


The equation of opportunity

Prosthetic Legs are getting more and more high tech Returning Veterans hike and climb as part of therapy. A climbing and hiking camp for amputees has recently been established There is no total solution for amputees who wish to both climb and hike Physical activity improves the QOL for amputees A need for a low-tech, low-cost rock climbing & hiking prosthetic.


Design Requirements

Durable The leg needs to be built out of standard prosthetic materials, but can incorporate extra reinforcment in certain areas. often times the simpler it is the more durable it will be

Comfortable The biggest reason amputees won’t wear a new prosthetic is simply because it isn’t comfortable. Extra pains will be taken to ensure this prosthetic is as comfortable as any.

Modular If this is to be used for both hiking and climbing, it should have a hiking mode and a climbing mode. However, Modularity should affect weight as little as possible

Lightweight

No one wants to climb with any extra dead weight. Making this leg as light as possible is paramount to its success.


Design Inspiration


Climbing Culture


I did my homework. A lot of it. After reading over 50 scholarly articles, and interviewing a myriad of professionals it was time to draw my heart out.


Rapid Ideation


Rapid Ideation


Rapid Ideation


Rapid Ideation


Rapid Ideation


After all this sketching and researching I figured it was about time to validate my ideas. So I narrowed them down into 3 concepts:


Concept One: The Lightweight

The simplest and lightest of all three concepts this concept would have up to 9 inches of telescoping motion, and potentially include a free swinging knee.

Hits The Simplicity Socket Bumper Height Change is Large Integrates With Existing Parts

Misses “Not As Visually Exciting” No Failsafe Suspension “That Shock Matters A Lot”


Concept Two: The Welterweight

This concept sits right in the middle of the spectrum. It utilizes a shock to absorb impact, but the suspension is not as extreme. This concept was consistently ignored during validation

Hits The Valve Placement Shock Absorber

Misses Too Much Mass Shock Limits Height Offset Shock Too Complicated


Concept Three: The Heavyweight

The most intense of all the three, this concept features a quadruple suspension system, and a protective rollcage for a heavy duty shock.

Hits The Suspension Fabric Lip With Pocket for Tools A Big Hit Aesthetically Rugged Overmolded Socket

Misses No knee Potentially Very Heavy Shock Limits Height Lots of Parts


Concept [X]: The Auxiliary

Prosthetics are complicated and tend to have a lot of parts. This page is an effort to simplify and help explain the final foot and socket direction.

The socket will ultimately utilize three forms of suspension. A sleeve, an air valve, and foam. The foam will also help guard against the effects of volume loss. A lamination process will allow for a simple construction, with all of the necessary parts

This two part foot was consistently succesful during validation. It has an inner, foot for climbing, with an outer chassis for hiking.A shoe won’t be necessary. The concept was green-lit by an engineer. However, this concept will end up being simplified for the final


Final Direction: The Lightweight Ultimately, this leg formed the base of the final design. it’s weight ended up being crucial in this decision. Another large influence was the fact that the leg did not need as much “protection” as initially anticipated. Though the leg would not stay this simple, simplicity remained a driver for the rest of the process


Validation: done. It’s time to get real and make some models. (I love sketching as much as the next designer, but sometimes you just need to see things in 3d.)


Models were made for the foot, calf, and knee. Many of the knee models were functional in nature, while the other models were mostly costmetic.


3D modeling iterations

Getting started on the 3D model was a bit daunting. Before deciding to move the shock from the calf to the knee, I built a base model, and began to experiment with different housings. This direction was eventually nixed. But It’s always good to show process!


3D modeling iterations

More nixed alias iterations. Unfortunately, they didn’t all end up being saved, but many of them were built against a human form, as you can see above.


3D modeling iterations

After working in alias for a lot of the back-end 3D modeling, the model was rebuilt in solidworks from scratch. Here you can see form studies produced in both solidworks and alias for various parts of the design. Test rendering was critical in determining the color finish and materials. Every model made was not only built to test the form, but to test the paint and metals as well


Full Scale Plot

After producing close to final geometry, full scale plots were made using orthographic drawings. These drawings were then compared to measure of man drawings, and adjusted to make sure that the prosthetic fitted the shortest woman all the way up to the tallest man


All of these models are great, but my product needed a brand to help tell its story. So I created one. Meet Tรถg:


so what is TOG ? Tรถg is a brand focused on creating experiences for amputees in an outdoor and active setting. It does this mainly by providing prosthetics geared towards outdoor activites. For this project Tรถg is producing a rock climbing and hiking prosthetic. Adjacent products might include a kayaking prosthetic, or a scuba diving prosthetic.


Branding Opportunities High End

outdoor

indoor

Low End


Visual Options


Form Cues

using raw materials, and employing a powerful on-product brand presence are some of the things Tรถg needs to do in order to become a succesful brand


All that process led to a final product. Allow me to introduce you to the Everest Leg, by Tรถg


socket is reinforced with plastic bumpers to increase durability

free swinging knee with a manual lock *

Total Estimated Weight is Less than 8.25 LB, this is in line with industry leading prosthetic legs slim profile 1 way valve helps make the leg easier to manage under clothes

*Calf allows leg to shorten up to 6.75 inches easy push button for shortening leg

durable titanium telescoping pole Foot connects using industry standard mechanics Carbon fiber foot has a rugged rubber outsole so no shoes are needed

Bungee cord acts as a safety in case the pole falls out *foot turns 180 degrees to climb, this climbing surface is engineered to take up to 2400 pounds of force

*This feature is a completely new innovation



Socket contains a ring of foam in order to counteract the effects of volume loss during physical activity. This is a feature unique to this product.

Rubber gasket protects assembly joint, and reinforces it as well

Shock integrated into knee column

Pole shortened 6.75 inches

Rubber coated steel can withstand up to 2400lb of force



Foam Insert for socket

ABS plastic bumber Laminated Carbon Fiber

Molded Plastic Air Valve Titanium Knee

Cast Titanium

IM Rubber

Rubber Coated Plastic Button

Painted Titanium Column

Steel Joint Rubber Coated Steel Anodized Steel Hardware Carbon Fiber PU outsole

Laminated Logos


Hike freely with the everest leg

2 simple pushbuttons on either side of the calf control leg length

A fully articulating knee allows the user to sit down for breaks as well as various prosthetic adjustments

An allen wrench is all it takes to lock the free swinging knee in place for a climb


"this design is better than a lot of the things people in the field have come up with" -Cliff Robbins (Prosthetist with over 20 years of experience)


"the foot on this thing is a really good idea. I mean really good. You should be proud" -Christina (Practicing prosthetist at JF Rowley)


"for someone in my position to sit here and see something this awesome, is really encouraging" -Andrew Meyer (Above knee amputee)


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