Abstract
Upper Limb prosthetics is, by its nature, a small domain within prosthetics. Not only does it serve a less common loss, but the practicalities mean that some persons with an upper limb impairment will choose to live without a prosthesis. For those who wish to use a prosthetic arm the influence of technology is crucial to making the resulting device practical. For those of us privileged to work in any capacity in the field, the challenges and the rewards are considerable. The smaller number of users we see tends to dictate a smaller pool of professionals working in the area, and lower participation at conferences. Thus the pleasure of organising a specialist conference in this domain, include knowing all the people who are interested in the topic personally, irrespective of their position or location. I have been lucky to be involved in the production of five such international conferences, held on both sides of the Atlantic.
The Trent Prosthetics Symposium (TPS) was the vision of three clinicians from the Nottingham area in England: Vivian Ibbotson, Janet Kingston and John Ronald. TPS exclusively focused on Upper Limb Prosthetics and was also unashamedly clinical in its outlook. It enjoyed a reputation for a lively program and a friendly atmosphere. When the three colleagues retired, the local ISPO committee took on the responsibility, and created an international conference: Trent International Prosthetics Symposium or TIPS. TIPS is held roughly every three years and preparations are already underway for the next conference in March 2019.
The theme of this TIPS, held in 2016, was: Advances in Our Understanding. It recognised that with advances in compact computers and medical sciences, it is becoming possible to unlock how we control our limb and how people adapt to limb deficiency. We can use this knowledge to improve the control and comfort of the prosthetic limb.
What resulted was a high quality scientific programme. Alongside internationally renown keynote speakers were very many free papers. Due to space limitations, some were invited to contribute to this special edition of the journal. These papers were combined with some of the recent contributions in Upper Limb Prosthetics made to the journal directly. However, they follow on the same themes that we observed in the contribution to TIPS.
At the turn of this century, measurement of the function and performance of a prosthetic device was poorly understood an narrowly distributed. Through the work of many people in the field, we now have tools we can employ to study how people use their prostheses. Questions can be asked about how the way a prosthesis is designed or controlled, influences how they are used, or if they are rejected.
May readers will know that comparatively small damage to the hand can be more traumatic than a much more significant level of insult to other parts of the body. So being able to track more closely the impact of the loss and the device has the potential to improve provision more effectively. It has always been true that the most effective ways to create new prosthetic systems is to use existing new technology in novel ways. So the ability to track movement as part of a health monitoring system for the general public, can easily be redeployed in the prosthetics arena with only a small investment.
The spread of Additive Manufacturing techniques (so called 3D printing) has enabled more people to make prostheses. This is undeniable. What still needs to be demonstrated unequivocally, is that this ability can make a difference to the lives of the people using them. The investigation requires the tools of objective measurement. So just as a decade or more ago we began to see papers on new tools for assessment, we now are beginning to see the welcome arrival of objective studies on the use of this new technique. The questions we all ask concern how effective or useful these solutions are, and how long will they last. In this edition there are papers that attempt to begin to answer these concerns. Over the next few years we can hope the our understanding will grow.