Dr. Fae Azhari attaches a sensor to a West Park patient's prosthetic before monitoring his gait.
By: Michelle Rowe-Jardine; Communications Coordinator, West Park Healthcare Centre
As an engineer, assistant professor and amputee, Dr. Fae Azhari is taking an important step towards research that could revolutionize the fit and comfort of lower limb prosthetics, improving the life of amputees.
Azhari's research at the University of Toronto primarily looks at structural health monitoring of structures such as bridges and buildings using sensors. But after a serious accident in 2018 caused the amputation of her right leg, she developed a passion for another engineering structure: prosthetics.
While recovering at West Park Healthcare Centre, clinicians were observing how amputees walk to identify any anomalies affecting their movement. That's when she began observing too – not as a patient, but as an engineer looking to solve a problem.
Sometimes, there are differing opinions among these skilled clinicians about the state of a patient's gait or prosthesis fit. Azhari asked her physiotherapist whether there was technology to measure a patient's gait that would help clinicians reach a consensus.
Similar to other rehabilitation hospitals, West Park has a gait mat, a large piece of equipment that takes up a lot of space and even more time. Clinicians seldom use it for these reasons and because there needs to be someone who knows how to interpret the results. There is newer wearable technology, but the cost can climb in to the thousands.
“There was a gap where we needed something quick and easy that could provide basic information about an amputee's gait," says Azhari, a cross-appointed professor between the Civil and Mineral Engineering and the Mechanical and Industrial Engineering Departments at U of T.
With her familiarity of using sensors to monitor engineering structures, Azhari took the first step toward research at West Park that would combine her expertise with her own lived experience to hopefully, one day, help other amputees.
Bridging the gap
In 2020, Azhari began researching a more convenient and affordable way to use sensors in a clinical setting to monitor a patient's gait. Using relatively cheap sensors attached to a shoe cover, the information provides basic data that can help clinicians confirm their suspicions.
“I was always exposed to monitoring of prosthetic devices, and now I'm intimately aware of everything that goes on in the field, so it has become a major part of my research," she says.
West Park has decades of experience as a leader in amputee rehabilitation, which made it the perfect setting for Azhari to conduct her research.
Azhari has been working with West Park scientist Dr. Crystal MacKay and several graduate students on this project, partially funded by The War Amps, as well as West Park amputee patients who help test the sensors.
Wearable gait parameter tech already exists, but they run from a few thousand dollars up to $25,000, there's a lot of calibration involved and they're not size-adjustable between patients.
The prototype Azhari and her team are developing is less than $200, it's adjustable and it goes over the shoe rather than an in-sole, which also negates hygiene issues.
“This research is exciting because the novelty in what Dr. Azhari is doing is using cheap sensors that can provide valuable information to clinicians quickly, with minimal training required," MacKay says.
Another component to this research was born out of issues Azhari was having with her socket; a very common problem for amputees. The socket is the device that joins the residual limb to the prosthesis. A common complaint among amputees is that there is a lot of pressure at certain points of the socket, which can cause discomfort and irritation.
A socket is like a black box from the outside, so most of the diagnoses a clinician makes is based on how a person walks, Azhari says. She has been working with her team to develop another sensor that fits inside of the socket which could potentially help a prosthetist understand whether a socket was too loose or too tight.
“We're looking at sensors for in-socket pressure measurements and wearable sensors for gait analysis. Hopefully we can combine the two into a nice interface that would be useful in a very practical way," she says.
Azhari and her team have concluded their first round of research at West Park and are analyzing the data. They are planning to return to West Park next year, with a new prototype, to continue this exciting research.
“I've had a lot of really great support from West Park with this research," Azhari says.