Giving people the chance to reclaim their independence after an amputation

I’ve always been fascinated by mechanics, the how and why things move, from the planets and stars surrounding us, to the waves in the ocean and the runner jogging by.

My drive to understand and enhance human movement from both physiological and mechanical perspectives led me on a path through performance sport and human ageing research to my current position as a PhD candidate in the Department of Biomedical Engineering at the University of Melbourne.

Around the time I started my PhD, my supervisor, Professor Peter Lee, and I had a conversation about his involvement in the 100 Limbs Project, which is providing 100 limbs to people with amputations in remote areas of Tanzania.

The Project is led by Global Peace Network, a Canada-based charity, in partnership with Magu District Hospital, Tanzania, the University of Melbourne and UK-based charity STAND.

The 100 Limbs Project was established because musculoskeletal disabilities are now the largest health care burden for African economies. And in rural areas, amputation is often the first line of intervention for significant limb injuries, due to the lack of advanced surgical facilities.

Sciences & Technology

‘You don’t need fancy equipment to make good prostheses’

So, we started thinking about how wearable technology, like smartwatches, could improve treatment outcomes in these patients.

There are more than one million limb amputations globally every year, or around one every thirty seconds. Worldwide, most are caused by vascular disease and diabetes, but traumatic causes, including traffic and work accidents, are the leading causes in lower-income countries.

In fact, an estimated 80 per cent of all people with amputations live in lower to middle-income countries.

Restoring mobility enables people with amputations to access education and employment, as well as enjoy family and social life.

However, up to 46 per cent of people with lower limb amputations are unable to use their current prosthetic device, according to a report on prosthesis provision in Rwanda. In order for prosthetic services to make a real difference, long-term outcomes must be better.

Patient follow-up is vital for long-term success after a health intervention like an amputation. But in resource-limited settings, this is often not possible due to inadequate practitioner numbers and resources.

As the World Health Organization recommends, “Follow-up is required at certain intervals to review outcomes and ensure that there are no problems with the fit, comfort, function or durability of the device. Follow-up improves outcomes and is an indispensable part of service delivery.”

Sciences & Technology

A new leg to stand on

As part of this follow-up, patients need monitoring to ensure their rehabilitation is successful. We realised that wearable devices would allow us to measure things like heart rate, sleep and movement.

Remote and non-invasive monitoring of patients’ health metrics and movement using wearables could help health professionals to differentiate between people who respond positively to the prosthetic and those in need of targeted care, whether this be wound treatment, physical therapy or counselling.

Over the next year, the 100 Limbs Project aims to deliver 100 prosthetic legs to people with amputations in Magu district, Tanzania. The partnership will supply prosthetic components and training to local healthcare providers.

Most patients in the region have lost their lower leg due to road traffic accidents involving motorbikes or infections gone undetected due to diabetes, eventually requiring amputation.

My research measures the impact of these services on individuals through quality-of-life surveys, specific questionnaires for evaluating prosthesis user outcomes, and functional walking assessments.

The innovation lies in using wearable devices to track heart rate, sleep and movement. Machine learning will then analyse the data to build models that predict patient outcomes for future patients.

Similar approaches have been taken in predicting patient outcomes from wearable data in cancer, osteoarthritis and Parkinson’s disease, but this is the first time wearables will be used to predict outcomes for people with amputations.

Sciences & Technology

Using virtual reality to treat real-world injuries

In June, I spent four weeks in Tanzania, working closely with the prosthetist in Magu and training clinical officers to use questionnaire tools reliably, conduct mobility assessments on patients and collect data using wearables.

Research into people with amputation outcomes and prosthetic services in under-resourced settings is still scarce, and collecting reliable patient data comes with no shortage of challenges.

In Magu, we faced daily power cuts, language barriers, and even delays of several months while prosthetic components were held up in customs.

Additionally, ensuring patients adhere to wearing and charging wearable devices isn’t always straightforward, especially when smartwatches are unfamiliar technology.

What made the difference was the commitment of local healthcare workers. Their trust with patients, their knowledge of the community, and their resilience in the face of limited resources were invaluable.

Without them, gathering meaningful data in such an environment simply wouldn’t have been possible.

One of the patients who presented at the Magu clinic was a woman who lost her right leg below the knee due to diabetes. She had been without this leg or a prosthesis for over 18 years and entered the clinic shuffling on the floor.

After years of supporting her bodyweight using crutches, she had developed deep sores on her underarms, meaning that crutches were no longer a comfortable option.

Health & Medicine

Do you think better when you’re moving?

Since receiving her prosthetic leg, we can see from the wearables that she uses it every day and from the mobility assessments that she can walk over 100 metres in two minutes – which is really impressive for someone who has not walked in 18 years.

Across all patients, initial results from the quality-of-life surveys show improvements in self-reported sleep, physical activity and social activities as well as reductions in reported anxiety and depression levels following limb provision.

Looking ahead, the potential impact of this research extends beyond the 100 patients in Magu district.

For patients, it means better outcomes, fewer complications, and a better chance to reclaim independence after limb loss.

For clinicians and researchers, wearable data offers a powerful tool to guide care, highlighting which patients need early intervention and optimising the distribution of scarce healthcare resources.

This research points to a future where affordable, non-invasive technologies can aid rehabilitation, even in regions with limited access to specialist care.

By combining local expertise with readily available technology, this project is developing a model of care that could be replicated across a multitude of communities and conditions.