Mark article
Apprentices work at the interface between people and high-tech
Digitization, sustainability, social media … the reality of our lives is currently changing at a breathtaking pace. This also applies to the job descriptions that arise from changing needs and requirements. In this series, we present state-of-the-art apprenticeships that are offered in Bremen companies and vocational schools. For example, orthopedic technology works at the interface between people and high-tech supplements for the body.
HB Orthopädietechnik is one of the largest specialist companies in the industry in Bremen. More than 30 experts for orthoses, prostheses and orthopedic shoe technology work there. Every year, up to three trainees start in the future professions of orthopedic mechanics or orthopedic shoe technology. There are many workbenches in the large hall on Kurt-Schumacher-Allee in Vahr. The master company calls the location its competence center. Among other things, the experts there model artificial extremities or adapt electrical pulse generators for arms and legs. An analysis center and a medical supply store on Pappelstrasse in Bremen’s Neustadt district are also part of the operation. Many of the experts are also on the road every day in the field in rehabilitation clinics, medical practices and the like.
“The field of work in our trade is huge,” says Leif Pahl from HB Orthopädietechnik. The manufacture and adaptation of wheelchairs, hospital beds, corsets, bandages, custom-made shoe inserts and shoes, prostheses (replacement body parts) and orthoses (external medical aids) form part of the trade. HB Orthopädietechnik focuses on the last three fields and uses high-tech to care for patients.
Soon everyday life in orthopedic technology: computer models and 3D printers
In a treatment room, there is a large scanner on the floor. This scans the feet of the person seeking help and displays them in detail on the PC monitor with load lines, elevations and depressions. The shoe insole is then also modeled on the PC. A computer-controlled milling machine then starts up in the workshop and autonomously cuts the insole to size – down to the micrometer.
Such scanners, PC modeling and milling are also used for replacement and assistance after the loss of parts of the arms and legs. “This method replaces the plaster cast that we used to take from the stump,” says Leif Pahl. For example, the milling machine creates a detailed model of the leg to which the orthopedic technician can adapt the prosthesis or orthosis.
For example, they use vacuum to lay carbon fibers, such as those used in airplanes, over the model. The carbon coating is then hardened at high temperatures. “The next step would be to skip the positive model of the leg and go straight to a 3D printer instead. He then makes the prosthesis,” says the specialist from Bremen’s orthopedic technology department, describing a vision for the future. He expects this technology to be available in a few years. A large 3D printer is already in operation.
Electrical impulses set muscles in motion
But this is only the beginning. The future has already begun in this industry. “We hardly have any patients who get purely mechanical orthoses. Most receive electronically controlled aids. Neuroorthetics is a central concept here,” explains Leif Pahl from Bremer Orthopädiertechnik. He cites support for drop feet as an example.
In the past, those affected were fitted with a fixed splint that kept the foot at a right angle to the leg at all times. Today, professionals equip them with an unobtrusive device that they attach to their calf with a cuff. It gives nerves and muscles an electrical impulse so that the foot lifts at the right moment when walking. “Such an orthosis is also available for the arms if they are immobile after a stroke, for example,” says Leif Pahl. Those affected can make a slight movement and trigger the impulse like with a switch. Then the hand closes or opens or the arm rises and falls. With a lot of luck and patience, the electrical stimulation can even regenerate the defective nerves.
Body suits – almost like science fiction
At the latest when Leif Pahl opens the cupboard with the orthotic full body suits, one feels reminded of science fiction. The bodysuits are intended for people with restricted mobility due to neurological diseases.
The integrated electrodes stimulate arms and legs at the right moment of the movement sequence, so that, for example, jerky, very sluggish or uneven walking is converted into a more flowing movement pattern. The so-called Exopulse Soft Suit by the manufacturer Otto Bock was presented in the TV show “Lion’s Cave” and even amazed the experienced specialist Leif Pahl. “It’s amazing what you can achieve with it. Wearing it regularly can even improve movement patterns without a suit,” he says.
The partial implantation of prostheses is another way forward. “For example, you can have a titanium pin inserted into the leg, onto which the prosthesis can be clipped. You then no longer need a shaft at the upper end,” says the specialist. “There are no pressure points and the prosthesis feels more like a real leg.”
In his opinion, this endo-exo-prosthetics will be combined with the methods of electrical impulse generation in the future, so that the prosthesis transmits a kind of touch sensation and can be controlled via the nerves like a real extremity. “In 20 to 30 years it will be time,” he estimates.
Orthopedic technology can change life completely
It doesn’t matter how futuristic the technology: people themselves are asked to make the best of the possibilities. Those affected have to train for many hours in order, for example, to be able to walk safely again with a thigh prosthesis or to be able to use the hand prosthesis to grasp. “Most of the time, the only alternative to a prosthetic leg is a wheelchair. This also applies if something goes wrong during production. Our trainees therefore have to be prepared to take on a lot of responsibility later on. In this sensitive profession, you get involved with those affected and you are more of a human being than an employee,” he says. “Our goal is to achieve the highest mobility and quality of life for patients.”
Leif Pahl shows the large hall in which prostheses and everyday aids for those affected are manufactured.
Individually manufactured prostheses and orthoses for extremities are one of the focal points of HB Orthopädietechnik.
The analysis center looks like a sports hall. Running analyzes are carried out there using video recordings.
