Making a difference: CSU students travel to Ecuador to design and engineer prosthetics

CSU biomedical and electrical engineering student Katie Brown works with a patient to fit a prosthetic device in a clinic in Quito, Ecuador. Photo courtesy Ellen Brennan-Pierce
CSU biomedical and electrical engineering student Katie Brown works with a patient to fit a prosthetic device in a clinic in Quito, Ecuador. Photo courtesy Ellen Brennan-Pierce

Students in engineering and science majors often hear that their work can change the world.

For a group of Colorado State University students on a summer study abroad course in Ecuador, they put the extraordinary amount of knowledge they had learned in their courses to the test by helping create prosthetic devices.

Designing and engineering prosthetic limbs, creating molds and casts, and helping with physical therapy for amputees was all in a day’s work. But far more powerful lessons faced the students in Ecuador — the astounding perseverance of those who have lost so much and how technology could help patients lead an ordinary life.

“The patients seemed to be overwhelmingly grateful for what they had, with very little to no lamentation over what they’d lost,” said Jackie Foss, a biomedical and mechanical engineering student with the project. “It was extraordinarily humbling; it feels as though my world view has drastically shifted as a result.”

Creating prosthetic devices in a developing country

The senior design project evolved from a study abroad course in the summer of 2018, originally developed by biomedical engineering undergraduate advisor Deb Misuraca and research scientist Ellen Brennan-Pierce. Collaborating with the Range of Motion Project (ROMP), Misuraca, Brennan-Pierce, and 24 students worked at a clinic in Quito, Ecuador, creating prosthetic devices and interacting with patients.

CSU biomedical and mechanical engineering student Brooke Landoch works alongside David Krupa, ROMP co-founder and CEO, to modify a prosthetic device in a clinic in Quito, Ecuador. Photo courtesy Deb Misuraca
CSU biomedical and mechanical engineering student Brooke Landoch works alongside David Krupa, ROMP co-founder and CEO, to modify a prosthetic device in a clinic in Quito, Ecuador. Photo courtesy Deb Misuraca

Several students from the 2018 program took their experience from Ecuador and began a biomedical engineering senior design project over the 2018-2019 academic year. Four of the members of the project returned to Ecuador this summer, along with a second study abroad cohort, to test their prototype and ideas with ROMP.

The team did not simply bring prosthetic devices with them from the U.S. — students were hands-on with every part of the manufacturing process. Once onsite at the clinic, students were given an orientation with ROMP about the project and then worked directly with amputees to find out what was needed.

Students interviewed amputees and took measurements of the patient’s limbs. They then created molds of the limb, and began work on casting. During each step of the process, students manually sculpted, sanded, and created the prosthetic socket, all the way through manufacturing and adjusting the final plastic versions. At the end of the process, they worked with patients to make sure the prosthetic limb was comfortable and fit correctly.

“It was thrilling, I learned so much more from participating than I think we would have from simply observing,” Foss said. “I was shocked by the artisanal nature of the prosthetic creation process — it really is like sculpting.”

A profound experience greater than the science

With such a hands-on approach, students could put their knowledge to work while physically creating something with an immediate impact on a patient’s life. Working directly with a patient from beginning to end, students experienced every aspect of how life changing their work could become.

“From an engineering standpoint it was invaluable to see the process of recovery for an amputee,” said David Kimmey, a biomedical and mechanical engineering student on the project. “I really enjoyed being able to give someone something that I helped to build and create.”

Helping patients revealed a fascinating aspect about the amputees: They were less concerned with what they were unable to do and more interested in what a prosthetic would allow them to do. Misuraca said that the patients she met were not down about their situation, they just wanted to get back to their lives filled with hobbies and family interactions.

ROMP focuses on the mobility of patients, and working alongside ROMP staff gave students the opportunity to learn how a prosthetic device will help. Students and staff were fascinated with the way the patients approached both their situation and the prospect of having a prosthetic device.

“For patients, it’s more like ‘I want to get back to work, or I want to play with my grandchildren,’” Misuraca said. “It’s more about hope than being down about their current situation.”

CSU mechanical engineering student Alyssa Shepherd and CSU biomedical and mechanical engineering student Leslie DeLay, both standing, create a mold for a prosthetic device with help from a local ROMP volunteer. Photo courtesy Ellen Brennan-Pierce
CSU mechanical engineering student Alyssa Shepherd and CSU biomedical and mechanical engineering student Leslie DeLay, both standing, create a mold for a prosthetic device with help from a local ROMP volunteer. Photo courtesy Ellen Brennan-Pierce

Next year and future considerations

Part of the study abroad course objective was for students to look for problems and ways to improve the process. In some cases, the very thing that made the experience engaging for students was problematic.

Kimmey, now a senior leading a team for the second year of the senior design project, said students noticed that the artisanal and qualitative nature of manufacturing the prosthetics burdened clinical staff. The added time and repeated phases of the process also inconvenienced patients, many of whom traveled all day through rough terrain to get to the only clinic near them.

Students are considering new ways to use data and technology to improve the process. Where a prosthetist at the clinic usually needs to manually determine how a residual limb could best support a prosthetic, one focus would look at how to use data from probes and scans to gather the same information.

Using 3D printing and additive manufacturing with the data would provide more accuracy and improved customization options for the prosthetic device. Not only would the unique shape and load-bearing data create better fit and comfort, the process could lead to using different materials within the device.

“I’m excited to explore opportunities to make multi-material sockets, that can have soft material where needed and stiffer material when appropriate,” Kimmey said.  “Material research is very cool, and one day it would be amazing to see a material that could change shape with the socket.”

Creating clarity for a career path

For Foss, who graduated in May, choosing a biomedical engineering major might have led to a more traditional research and development path. But the opportunity to go to Ecuador changed her path into one focused on organizations driving social change.

Interviewing patients, testing prosthetics with them, and helping with physical therapy reinforced her already strong interest in global health initiatives and social change. She will continue her work this fall, during an internship with ROMP in Ecuador.

“I truly can’t imagine myself in any other field than global health,” Foss said. “I hope to make a difference, I hope to help people, and I hope to start that in Ecuador with ROMP.”

The 2018-2019 senior design team with their poster at E-days 2019. From left to right: Dolly Ricapor, Tyler Parker, David Kimmey, Grant Wulf, Luis Monterrosa, and Jackie Foss. Photo courtesy Ellen Brennan-Pierce
The 2018-2019 senior design team with their poster at E-days 2019. From left to right: Dolly Ricapor, Tyler Parker, David Kimmey, Grant Wulf, Luis Monterrosa, and Jackie Foss. Photo courtesy Ellen Brennan-Pierce