Nicaragua

After successfully establishing a thriving PT practice for an orphanage in Costa Rica the Marymount University Doctoral of Physical Therapy Program had begun to conduct a yearly trip to help bring medical services to individuals in need in Nicaragua. A core goal of these trips is to provide locals with the tools they will need to setup their own successful PT practice. As part of this trip, the state of prosthetics technology within the country was recognized to need serious upgrades. By partnering with the 3D printing research lab of the Marymount Biology and Physical Sciences department, we hope to update the technical resources in Nicaragua to allow patient needs to be more effectively met.

This page will track the progress of this project and contains resources that we are developing to make this partnership possible.

Basics of 3d printer operation tutorials - AssEMBLY, SETUP AND SOFTWARE INSTALLATION

The 3D printer chosen for deployment in Nicaragua is the Original Prusa I3 MK3S. It was chosen for its ease of use, power recovery features, robust support for various materials and thorough documentation and user community. Assembly of the printer should follow the most updated materials provided through a purchase of the printer kit.

The installation guide here provides full assembly instructions in multiple languages. We have seen success in building three for our printing lab. The intention is to order a kit and assemble it on site in Nicaragua in January of 2020. Questions about the procedure can be directed to the Prusa Community forums. A full build video can also be viewed while assembling: part 1 and part 2.

Once the printer is assembled, the following page has ALL the information you might need about its operation: NEW PRINTER USER

For simplicity, here is a video walking you through your first print:

And here's one about using the software to get your print setup:

Prosthetic's specific information

The primary purpose of bringing 3D printers to the PT practices in Nicaragua are to simplify and improve the quality of devices that can be fabricated. With 3D printing, task specific devices, check sockets and customized designs can all be relatively easily fabricated. This will serve as a clearinghouse of information on such projects.

First, thingiverse is a resource for 3D printable designs. I maintain a collection of UPPER LIMB and LOWER LIMB devices from thingiverse that appear to have some semblance of documentation and/or have some proof of being printable. This is a potentially good start for finding devices to print and assemble or to get a base design to build further off of.

The eNABLE Hub is another great resource for ideas on designs. This is possibly the most active group of volunteers collaborating online to bring upper limb assistive devices to where they're needed using 3D printing and design. Of particular interest is the self-suspending socket design methodology posted here.

To get the designs directly from eNABLE with links to instructions go here: https://hub.e-nable.org/s/e-nable-devices/wiki/overview/list-categories

MATERIALS INFORMATION

3D printers can print with a variable of materials. The primary materials of interest being used in Nicaragua, however, are:

• PLA+: for rapid prototyping and quick test prints. PLA is easy to print with and can be used for optimizing print orientations and printing some task specific devices that don't take heavy loads. This is the "bread and butter" printing plastic used in most 3D printing laboratories.
• ABS: this is a well known 3D printing material and is what lego bricks are made of. This material will NOT be used. Its inclusion here is for completeness, but it should be avoided as it is more difficult to work with, emits questionable particulates and the properties that make ABS useful are covered by PETG.
• PETG: for printing most devices that are to be actually utilized mechanically. PETG prints similarly to PLA+ but has better impact resistance making it a more robust material for longer lasting parts (note: 3D printed pieces on the Prusa MK3S are printing in PETG). Many labs are starting to switch to using PETG instead of PLA.
• TPU/TPE: for printing flexible joints/"sockets". TPU and TPE are flexible plastics. They can have excellent elasticity (depending on the shore hardness rating - a measure of how stiff they are) or can be tough, yet have some give. They are great materials for printing strong, durable parts that need to have a little bit of give (like a tire, for example). These materials are good for finished prototypes as well. They are not, however great for rapid prototypes as the material is a little more expensive and takes significantly longer to print.
• More extensive material listings can be found here and this list will be updated as we start using materials and determining what is most practically useful for our partners in Nicaragua.