Photo courtesy of Otto-Bock, Inc.
As designer and fitter of residual prostheses, the Prosthetist is a member of the rehabilitation team that must optimize the connection between limb and prosthetic device. Her professional role requires not only advanced technical knowledge, but manual and clinical abilities. Prosthetists are key members of the team composed of Orthopedic Surgeons, Rehabilitation Specialists, Physical & Occupational Therapists, Special Education Teachers , and Health Care Managers and Insurers.
There are at least 1.5 million Americans who now receive service on their prosthetic or orthotic device from fewer than 3000 facilities, typically staffed by a single Practitioner. While medical treatments are advancing rapidly for these conditions, many patients can benefit from well-designed mechanical or mechano-electrical devices, such as orthoses or prostheses. For example, energy-dissipating orthoses can suppress intention tremors, knee and hip braces can improve mobility after injury or arthritis, advanced limb prosthetics can restore near-normal mobility, and support appliances can allow the severely disabled to sit and stand. The Prosthetist is the designer and fitter of these devices, and works at the design and manufacturing level to optimize the match between patient and appliance. He identifies and analyzes physical body forces that are maladaptive, and designs treatments to transfer or re-distribute these body forces to more adaptive locations. Treatments usually involve the application and custom fitting of appropriate devices to the body, in order to optimize patient function, prevent further disability and provide cosmesis. Many Prosthetists work at one of the more than 2800 manufacturing companies providing products for orthotics and prosthetics. He therefore plays a pivotal role in reducing the burden of musculoskeletal disorders.
Students in this program are enrolled as graduate students in Biomedical Engineering working toward the M.S. and Ph.D. degree. The program also accepts highly qualified non-matriculated students who are engaged in technical aspects of prosthetics and orthotics in Industry. The curriculum consists of 5 didactic courses plus a clinical practicum, to be completed in two semesters. Core courses are scheduled for late afternoons and early evenings. Qualified students may take elective courses within the Biomedical Engineering curriculum.
Graduates will be prepared for certification by the American Board for Certification in Orthotics and Prosthetics (ABC) while working toward their M.S. degree in Biomedical Engineering. The first year of course work and clinical training is designed to satisfy Licensure requirements for Prosthetics in New Jersey. The curriculum consists of the Biomedical Engineering Core, with emphasis on biomechanics and biomaterials, combined with a standard curriculum in prosthetics. Completion of an M.S. Thesis on a research project supervised by one of the Faculty is expected in the second year.
| Course Title and Number | SEMESTER | Time Slot | |
| Biomechanical Measurements 125:541 This course teaches techniques for measuring biomechanical properties of limbs, organs, and tissues, as well as prosthetic devices, both at rest and during ambulation. Topics include experimental and statistical methods, clinical research study design, mechanical properties and behaviour of tissues, use of transducers, imaging modalities, including x-ray, magnetic resonance, infrared, ultrasound, structured light, and tomographic methods. Demonstration projects include use of computer programs for statistics, CAD/CAM and FEM.
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Fall (Generally from day after Labor Day to first week of December) |
Tuesdays and Thursdays Period 6 4:30 P.M. to 5:50 P.M. |
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| Prosthetics for the Lower Limb-I 125:543 Prosthetics for the Lower Limb-I : Anatomy of the lower limb; muscle testing; patient evaluation; biomechanics of trans-tibial socket; casting for PTB, PTS, SCSP; lower limb componentry partial foot and Symes casting; suspension systems; soft inserts; BK adjustable leg: static and dynamic alignment; exoskeletal and endoskeletal componentry; evaluation and check-out; pre-and post-operative care; gait training; initial fitting; recommended modifications; casting measurements; prescription principles.
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Fall | Tuesdays and Thursdays Period 7 6:10 P.M. to 7:20 P.M. |
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| Special Problems in Biomedical
Engineering 125: 621 This course is a clinical practicum to be done at an approved Industrial/Clinical Affiliate specializing in limb prosthetics. There are currently 5 approved clinical affiliates within short driving distance of campus. A minimum of 250 hours must be completed at the Affiliate site. Training will include patient handling and rehabilitation, prosthetic fabrication, and all aspects of clinical prosthetics. Progress and performance of students will be monitored and assessed by both the Affiliate and the course instructor. |
Fall | To be arranged. 8-1/3 hours per week |
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| Prosthetics for the Lower Limb-II 125:544 Causes and levels of trans-femoral amputation; evaluation and prescription criteria for the trans-femoral amputee; introduction to trans-femoral componentry; biomechanics of trans-femoral prosthetic sockets: quad, modified ischial containment, ischial containment, and CAD/CAM.; review of normal human locomotion; trans-femoral socket suspension systems; trans-femoral knee mechanisms: Manual, pneumatic, and fluid control; gait analysis and evaluation principles; pre- and post-operative care; initial fitting of the trans-femoral amputee; casting and measuring techniques from mechanical cast systems to scanning by computer; trans-femoral adjustable leg and dynamic alignment tools; transferring and duplication of trans-femoral alignments; prosthetic principles in the hip disarticulation prosthesis; prescription principles and medical terminology review.
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Spring | Tuesdays Periods 6 & 7 4:30 P.M. to 8:00 P.M. |
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| Introduction to Prosthetics 125:540 Part I covers issues such as basics of prosthetic practice, ethics, health economics, and professionalism. Part II presents lectures and slides on neuropathology and orthopathology, as they relate to limb prosthetics. |
Spring (Generally from day after MLK day to first week of May) |
Wednesdays, Periods 6 and 7 4:30 P.M. to 8:00 P.M. |
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| Prosthetics for the Upper Limb 125:542 Lectures and laboratories on the fabrication of prostheses for the upper-limb amputee. Students will learn evaluation and measurement of patients, and fabrication methods, both traditional and modern, including myoelectrics, for limb prostheses. Projects will include measurement and casting, socket lamination, fitting, harnessing, and modifications. |
Spring | Thursdays Periods 6 & 7 4:30 P.M. to 8:00 P.M. |
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| Special Problems in Biomedical
Engineering 125: 622 ( Same as 621) |
Spring | To be arranged. 8-1/3 hours per week |
Rutgers, The State University of New Jersey, was chartered in 1766 as Queen's College. Today, Rutgers is a member of the Association of American Universities and is a major research University, with 47,000 students on campuses in New Brunswick, Camden and Newark. The University of Medicine and Dentistry (UMDNJ) was founded in 1984 when Rutgers Medical School joined with the College of Medicine and Dentistry of New Jersey. The joint UMDNJ-Rutgers program in Biomedical Engineering was founded in 1986 with a Core Faculty drawn from 10 departments of both institutions. It is one of 8 joint programs of UMDNJ-Rutgers. Today, Rutgers is a member of the Association of American Universities and is a major research University, with 47,000 students on campuses in New Brunswick, Camden and Newark. The University of Medicine and Dentistry of New Jersey has one of the nation's top ten medical schools in the Robert Wood Johnson Medical School. Both schools are authorized to provide post-secondary education programs; the Biomedical Engineering program is a joint degree program of both institutions and the only Ph.D. program in Biomedical Engineering program in the State of New Jersey.
The Training Program in Prosthetics inaugurated in Fall 1996 and will graduate its first class in Spring of 1996. An outstanding Faculty of nineteen has been recruited representing 6 Departments of UMDNJ-RWJMS, 3 Departments of the College of Engineering, and several affiliated medical clinics.
Students in this training program will receive exposure to the clinical practice of prosthetics and orthotics in laboratory and clinical facilities under the direction of a Certified Prosthetist-Orthotist affiliated with the training program. The clinical exposure will be a minimum of 250 hours in Prosthetics . Formal arrangements must be made in advance detailing roles and responsibilities of the student and mentor.
Core teaching hospitals in New Brunswick are the Robert Wood Johnson University Hospital and St. Peter's Hospital. Several affiliated hospitals are within short driving distance of the main campus. The affiliated clinical Prosthetics/Orthotics Laboratories include JFK Lifestyles, of UMDNJ; JFK Rehabilitation Center of UMDNJ; C-G Medical (New Brunswick); Kessler Institute; the Department of Veterans' Affairs Medical Centers in Brooklyn, NY and East Orange, NJ; Manfredi O & P Affiliates, Morristown, NJ; Apex Foot Health Care Systems, S. Hackensack, NJ ; Garden State Alliance of Orthotic Services, Long Branch, NJ.
Primary training facilities are located on two campuses, the Busch (Piscataway) campus and New Brunswick Campus, separated by a short inter-campus bus ride. Lecture rooms and basic science and engineering laboratories are on Busch Campus . Laboratories for instrumentation, diagnostic imaging, and basic science are within the Biomedical Engineering complex. The teaching O&P laboratory is within the college of Engineering, Room C121. Laboratories for Biomechanics and Biomaterials are in the Research areas of Robert Wood Johnson Medical School-UMDNJ. Some of the UMDNJ laboratories are located on the Busch campus, and others are in the Medical Science Building at the New Brunswick campus. All labs are serviced by campus buses or are within walking distance of each other. Several affiliated hospitals, including St. Peter’s and JFK Hospital are within short driving distance of the main campus. The core clinical Prosthetics/Orthotics Laboratories include JFK Lifestyles, affiliated with UMDNJ, C-G Medical (New Brunswick), and the Department of Veterans' Affairs Medical Centers in Brooklyn, NY and East Orange, NJ.
All participating Faculty have a research laboratory for their ongoing work. In addition, several laboratories are dedicated for shared student use. The key trainee laboratories are described below:
Quantitative Imaging Laboratory. This Lab was established in 1988 within the Department of Biomedical Engineering with grants from the State of New Jersey, University of Medicine and Dentistry of New Jersey and Rutgers University. Currently the laboratory facilities include a Sun Sparc 5 File Server with 4 GigaBytes of disk space, Sun 3/50 and 3/110 X terminal clients and 2 Pentium based image processing workstations. Three High resolution CCD cameras and a structured light apparatus are available. Infrared eye racking equipment for eye movement and observer performance studies are in an adjacent Lab. Several compound phase-contrast microscopes are available, including a Nikon Diaphot with fluorescence apparatus.
Laurie Imaging Center. This facility is on the New Brunswick campus, accessible by campus bus. It has 2 MRI imagers (1.5 T and 0.6 T), one dedicated for research. The Center is housed in a 7300 square feet building close to Robert Wood Johnson University Hospital. The Department of Radiology has a compatible GE Medical Systems Highlight Advantage CT scanner. The Laurie Imaging Center includes a short-term holding facility for small animals; computer systems: Sun workstations and a 3D interactive work station.
CAD/CAM Laboratory . Located in the Engineering complex, this lab, under the direction of Dr. N. Langrana, provides the CAD software development environment relate to mechanical design, biomechanics, and finite element modeling. This laboratory is connected to the Rutgers Network, providing high speed access to other computer systems within the University and throughout the United States. The laboratory is cooperating on a wide variety of research projects with the laboratory of Computer Science Research (LCSR) at Rutgers and is a part of the Rutgers Design group. The CAD/CAM Laboratory includes, 5 SUN Microsystems workstations, 2 Tektronix 4125 color terminals, IBM 320H PowerStation, 2 laser printers. The following software packages have been developed in this laboratory: RENDER restoration of engineering drawings into CAD database, DPMED Design of mechanical components using expert system, L'SID learning shell for iterative design , Feature-based component design. The lab also accesses : IBM RISC 6000, IBM 550 PowerServer, 7 320H PowerStations, CAEDS, ANSYS finite element modeller, PATRAN, and CADCAM.
Ultrasonic Imaging Laboratory . Located at UMDNJ, this lab uses ultrasonic imaging to study diverse tissue micromechanics Equipment for ultrasonic imaging includes a low frequency ultrasonic scanning microscope for determining microstructural and materials properties and a dedicated microcomputer for image processing. Other equipment includes electronic design and repair equipment, electronic measurement and recording equipment, photographic equipment and equipment for photoelastic stress analysis.
Tissue Mechanics/Biomaterials Laboratory. Located at UMDNJ, this lab conducts materials fabrication and mechanical studies. Equipment for materials fabrication and mechanical studies include a biaxial MTS hydraulic dynamic closed loop feedback test machine, metallographic microscope, equipment for metallographic specimen preparation (diamond saw, automatic specimen polisher, etc.), lathe grinder and other shop equipment. A small area is also set up for simple electronics fabrication.
Histology and Tissue Preparation Laboratory . Located at UMDNJ, this lab has equipment for tissue preparation and histology including surgical dissection equipment, a precision Harrington bone saw for sectioning large specimens with implants in situ and a complete system for plastic embedding. For plastic embedding of large specimens, temperature controlled vacuum and pressure vessels are in use to enhance infiltration of monomers and prevent the formation of bubbles. Histology equipment includes an automatic tissue processor, a paraffin embedding center, slow speed diamond saws, standard microtomes, and slide quality microscopes are available for histological evaluation and photography. these scopes are fluorescent, phase and polarized light capable. Additionally, these scopes have CCD cameras attached and they are connected to a MacIntosh Iici with image analysis hardware and software.
Anatomy Laboratories . On a cooperative basis, the electron microscopic and specimen preparation equipment of the Anatomy Department of the New Jersey Medical School (UMDNJ) are available. Equipment includes both scanning and transmission electron microscopes and a Zeiss-MOP 3 image analyzer for light microscopic morphometric analysis.
Necropsy and Microsurgical Lab. This laboratory is at UMDNJ and includes microsurgery equipment and two operating microscopes. Small animal necropsy and isolated human specimens are dissected in this area prior to mechanical testing procedures or being sent on to histology.
Orthopedic Communications Laboratories . Twenty microcomputers at UMDNJ are networked with Rutgers University Busch campus by ethernet connection. This permits access to the CAD/CAM and Quantitative Image Analysis facilities. The network is also linked to two MacIntosh LaserWriter Plus Printers, an Epson Stylus Inkjet Printer, a Montage color slide maker and an HP scanner.
Confocal Microscope Laboratory. A Bio-Rad confocal microscope is located in the Engineering Building. It is supported by a small user fee.
Supercomputer Remote Access Center (SRAC). This is in the computer science center on Busch (see map) and remotely accesses the Cray vector computers at the National center for Scientific Computing Applications at the Pittsburgh computer Center. It was provided by the New Jersey Commission on Science and Technology. It SRAC operates a Convex C-1/XP mini- supercomputer, 25 SUN Series 3 workstations and printers. SRAC is staffed with full-time support for students.
Electronic Instrumentation Laboratories. Instrumentation and microprocessor laboratories (1000 Square feet) are located with the Biomedical Engineering Building. It has standard test equipment, emulators, a fiber optics lab, and assembly stations.
Cell and Tissue Physiology Laboratory. Tissue culture facilities are in the Engineering Building. Laboratories include a clean room with CO2 incubators, laminar flow hoods, a cold room, and standard equipment: balances, microscopes, centrifuges, meters. Electrophysiological lab includes 2 full patch-clamp set-ups with computer and software, stimulators, Nikon Diaphot and TMS microscopes, ultraviolet imaging optics, manipulators, anti-vibration table, microelectrode puller, CCD camera, video recorder and imaging computer. Lab space available to this project will include approximately 1500 square feet.
Computer and Graphics Laboratories. These labs, on the Busch campus, have scanners, video digitizers, plotters, printers, and high resolution digital photography. All equipment is accessible from anywhere in the University, via several networks.
Teaching O&P Laboratories. Located within the Department of Biomedical Engineering, the teaching O&P lab has six student stations for producing plaster and plastic limb prototypes, an Instructor's area, shop, radiant oven, and material preparation area. A patient exam room is nearby. Handicapped entries and parking are nearby.
Clinical O&P Laboratories. Two Clinical O&P laboratories are located within a 5 minute drive of the campus: JFK Lifestyles, affiliated with UMDNJ, and C-G Medical Supply. Both are complete prosthetic and orthotic manufacturing facilities and patient fitting sites. JFK lab has a CAPOD CAD/CAM system for contactless patient scanning and digitally controlled milling. Several other cooperating O&P facilities are within a 30 mile radius, including both the Brooklyn and East Orange Veteran’s Administration.
Utility Labs. These are located at UMDNJ and include a photography Dark Room, with a MP-4h copy stand system and a negative enlarger; a large Animal Operatory , including air-driven power tools, autoclaves, and Xray facilities; animal quarters, staffed by two full-time veterinarians oversee this excellent facility, which is accredited by the American ssociation for Accreditation of Laboratory Animal Care.
Industrial Laboratories. Approximately 20 O&P manufacturing firms are located within a 40 mile radius of the campus, and several have already agreed to take student interns. These include Manfredi O & P Affiliates, Morristown, NJ, Apex Foot Health Care Systems, S. Hackensack, NJ ; Garden State Alliance of Orthotic Services, Long Branch, NJ. Internship will also be possible at JFK Lifestyles and C-G Medical Supply.
General Student Space. Students will have full access to the Biomedical Engineering Building, containing 11,000 square feet of labs and offices. A student computer room is available, with SUN workstations and PCs. Student mailboxes, a conference room, are available. The Department and Program are staffed by 2 full-time Secretaries and a Technician.
Libraries. The Library of Science and Medicine is proximal and contains extensive Journals and books in Engineering, Chemistry, Mathematics, Physics, Biology, and Medicine. There are about 500,000 bound volumes, 6600 subscriptions, 433,000 government documents and 437,000 microforms. Separate Chemistry and Mathematics libraries are also on Busch campus. The O&P library is in the Biomedical Engineering Building.
Applicants should have a B.S. degree in a related discipline, with a GPA minimum of 3.0. Students should have completed courses in, Biology, Chemistry, Psychology, Computer Science, Mathematics, and Human Anatomy and Physiology (with Laboratory). Applicants lacking these prerequisites must complete them prior to graduation from the program.
Selection criteria for Trainees include scholastic record as indicated by grade point average, GRE scores, previous experience, letters of recommendation, but also an interest and aptitude for working with the physically challenged. Undergraduate preparation should be a standard engineering curriculum, including biological science and general and organic chemistry courses, although exceptional students from other science majors will be considered. Candidates will be interviewed by the admissions committee prior to acceptance. The certificate program will accept a maximum of 15 students for the graduating Class of 1998. In addition to tuition, a laboratory fee is required to cover the cost of personal tools and materials. Candidates should submit their applications to Graduate School, Rutgers, the State University of New Jersey, New Brunswick, NJ 08903. For more imformation please call Kathy Dimeo at 908-445-3706 or e-mail Program Director William Craelius at craelius@rci.rutgers.edu.
The Rutgers/UMDNJ certificate program in Prosthetics and Orthotics follows the Essentials and Guidelines for accredited educational progams in Prosthetics and Orthotics, accepted by the American Academy of Orthotists and Prosthetists, the American Orthotic and Prosthetic Association, and the American Medical Association. The program has preliminary accreditation from NCOPE. The program is administered by the Graduate School of Rutgers University. Certification can be given only by the American Board for Certification in Orthotics and Prosthetics (ABC), that is composed of members of the American Academy of Orthotists and Prosthetists (AAOP), and the American Othotic and Prosthetic Association (AOPA), after examination by them.
Three main areas of research are active within the program:
1. TISSUE INTEGRATION
This research area aims at understanding and improving the integration of tissue, mainly bone, with prostheses. The future goal is to attach limb prostheses directly to bone and tissue, and is a topic of intense research internationally. A natural application of this work in basic science is the field of prosthetics, and therefore, by bringing practicing prosthetists into the research environment, we believe it will stimulate research that can be directly applied to these clinical problems. Several Faculty have worked on the problem of osseointegration of materials with load-bearing bones for the past 10 years.
2. INSTRUMENTATION AND IMAGING
This area involves research and development of sensors and actuators for O&P, new image modalities, and new algorithms for 3-D visualization of limbs.
3. O&P TECHNOLOGY
The area directly involves study and development of prostheses or orthoses. Research is centered on incorporating new basic technology into clinical devices.
Last Updated 1/27/97
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craelius@rci.rutgers.edu