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Category: Academic research (review)

User perspective on the rubber hand illusion in a wider sense – prosthetic arm and ownership for real use [reflection and consideration]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - User perspective on the rubber hand illusion in a wider sense – prosthetic arm and ownership for real use [reflection and consideration]; published January 2, 2019, 22:16; URL: https://www.swisswuff.ch/tech/?p=8882.

BibTeX: @MISC{schweitzer_wolf_1568598781, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - User perspective on the rubber hand illusion in a wider sense – prosthetic arm and ownership for real use [reflection and consideration]}}, month = {January},year = {2019}, url = {https://www.swisswuff.ch/tech/?p=8882}}


The year 2018 was interesting in relation to the rubber hand illusion subject.

I had participated in an extensive interview study regarding embodiment just a year before [link]. Then, I had been identified as a prosthesis "super user" [link] - these people wanted to investigate my type of "embodiment" through fMRI, but we quickly identified my prosthetic arm design (not my brain) as the key aspect regarding the question of why I have a prosthesis that I can actually use rather than just pose with as so many others. My own view here clearly is that if you are after embodiment, you have to go all Sherlock Holmes, you have to go all forensic, all CSI and all crime mystery: and as in "cherchez la femme" when looking for a motive in a crime, it is "cherchez le bras" when studying embodiment: for all issues that center around prosthetic use, go for the core physical aspects first. There are extremely bad things that may, can, and will happen if you do not make that your real first priority. The "rubber hand illusion" is an extreme variation of body ownership of a rubber hand that does not even touch a person and still that person thinks they are being touched if that rubber hand is touched. The illusion to make an amputee believe they embody or bodily own a prosthetic hand is quite different. But both pose risks, whereas the risk that an amputee faces when getting a prosthetic arm that is integrated into his body image has not been considered yet. My slightly experience based consideration proposes that the body image is tyrannically governed, for good and for bad, and if the prosthetic body part - already starting with bad cards, body image wise - craps out, and it always does so far too often, then it draws the hot red angry ire, the depressed disappointment, the falling apart of the cyborg body, of the amputee - and definitely not the cool "oh a neutral object just disintegrated" that one will wish for from a societal, insurance or repair view. The integration into a body image brings with it that the device becomes subject to totally tyranically governed bodies. When it is difficult enough to make any device ready for real world usage, making it ready to survive tyrannies of that nature will be even harder. I proposed an unforgiving approach to failure testing in a recent paper (link) but I cannot say that paper has been greeted with any enthusiasm by the industry that actually builds prosthetic arm components. Because they get to directly face the anger, hate, and rejection of all the users that they had not informed well of just how fragile their prosthetic arm parts really are (link), and they are in absolutely no position to technically improve these parts. So, manufacturers go into hiding. They do not want many users - they want users that buy and do not complain. The last thing they need is a hard bright unforgiving look into just how bad their engineering is. Every non-user, every rejector, should be cautiously left alone, not recruited to wear a prosthesis - because the risk is considerable (link). Researchers currently have the problem that amputees run away, everywhere (link), also because we are continously treated as mentally incompetent. So in essence, we are a group of people that increasingly realizes the extent to which we are being fooled, being had, told stories, and increasingly, we are getting critical. Potential rubber hand illusion switches, dragged to market to be soldered into prosthetic arms, if ever they are a medical treatment or a part thereof, will have negative effects as well: what are these? What do we know about deeply problematic aspects of bodily ownership? I had been invited to talk about that aspect for a group of people interested in robotic control and user interfaces, on December 7th 2018, in Mannheim (Germany). The presentation that I gave now is typed out here in more detail for further reference.

Rubber hand illusion is an idea that, by and large, was somehow transformed into multi-sensory rubber hand illusion, and they now want to put it into prosthetic arms to make users believe the prosthesis belongs to their bodies.

With that, rubber hand illusion goes to market1)As in: piggy goes to market..

This is not really that fascinating. While I am not interested in prosthetic arms because I find the field fascinating, I have been drawn into the field due to circumstances. And as much as you feel that I am locked into this constraint space of shared idiocies, dreams, hopes and failing hardware together with you, in some type of brotherhood by bad fate, you may also realize you are locked into this with me, as consequence of bad fate. Those then are also circumstances. As I deal with it, you may also have to find a way. If you think that is uncomfortable, send me a mail, so we may talk about uncomfortable a bit.

The ultimate consquence of this piece of reflection is not at all bad, however. We will see just how too much "ownership" has bad aspects as well. It risks to slip prosthetic hands into a domain where it is subject to the most vicious decision making that there is: tyrannic and wilful, impulsive and emotional decision making within one's own very personal domain of body or body image with owned body part dependent urgencies and requirements. To withstand these storms, a  prosthetic arm has to withstand not only the physical requirements of real life use (which it normally does not to a degree that will make your jaw drop), it also has to be acknowledged in that capacity by manufacturers and care-givers, emergency teams or repair units, where none of similarly urgencies are currently provided.

To even reach a level of "tool", to be useful enough to be accepted as technical solution (not as embodied "owned" limb), a typical prosthetic arm may have to undergo a most serious metamorphosis, from commercial parts (link)(link) to tuned and optimized parts (link). If you are in R&D and want to do something good in support of arm amputees, it may be relevant to address actual issues such as failing devices or phantom pain (link), before going all out on a limb and drag ill-defined concepts to a domain where they may wreck more than they really help.

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Footnotes   [ + ]

1. As in: piggy goes to market.

Disability and the public - prosthetic arms and more: do we appear "competent"? (review)

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Disability and the public - prosthetic arms and more: do we appear "competent"? (review); published December 7, 2018, 15:50; URL: https://www.swisswuff.ch/tech/?p=8812.

BibTeX: @MISC{schweitzer_wolf_1568598781, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Disability and the public - prosthetic arms and more: do we appear "competent"? (review)}}, month = {December},year = {2018}, url = {https://www.swisswuff.ch/tech/?p=8812}}


The current view of us, what the general public thinks of us, seems to be a major aspect. Of "us", yes.

The research question for this armchair analyst thus will be: are we - arm amputees in specific, and, as people with a visible physical handicap more generally, more broadly as disabled people generally, seen as competent people?

Generally, the answer seems to be a clear "NO" right from the outset.

This should not come as a shock. There are good reasons to believe that, great reasons to make that plausible, perfect reasons to justify that statement. With that, there may be exceptions to that -  people that see through society's fairytales of disability, horror and fears, but they are usually the exception.

As I had figured out quite early into my enquiries into that issue, that this aspect is of absolutely no further practical concern not because it is not disconcerting - but because I cannot change it. And that is a rapid, lean and cynical logical consequence, that I stopped caring about what other people think of me based on, say, visual impression of my prosthetic arm. I may thus safely focus on function and comfort, sustainability and cost, without worrying too much about whether other people treat me as more or less competent based on my looks. Not because it would not be cool to take influence but because it is of no matter as to the target dimension: the tendendy to disregard any mental capacity of people with physical handicap appears to be implemented in many people's thinking outside of any actual experiences. And regardless of what type of prosthesis I wear.

If anything, I might optimize my appearance by simply trying to look reasonably neat.

But to bend over backwards for what really we have to concede are actually strange people? If anything, can we hack their brains?

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Sensory robot hand feedback: not so necessary for amputees but definitely necessary for tele-operators [why sensory feedback is military research and not rehabilitation research]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Sensory robot hand feedback: not so necessary for amputees but definitely necessary for tele-operators [why sensory feedback is military research and not rehabilitation research]; published October 28, 2018, 19:21; URL: https://www.swisswuff.ch/tech/?p=8751.

BibTeX: @MISC{schweitzer_wolf_1568598781, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Sensory robot hand feedback: not so necessary for amputees but definitely necessary for tele-operators [why sensory feedback is military research and not rehabilitation research]}}, month = {October},year = {2018}, url = {https://www.swisswuff.ch/tech/?p=8751}}


Why is so much effort going into sensory feedback type military research and not rehabilitation research?

  • Myoelectric control is inherently and unfixably unreliable anyway in daily use by amputees - but possibly not so much of an issue when used by an anatomically intact individual in an army robot control room.
  • Myoelectric grippers are caught between sufficiently light (and far too weak) and sufficiently strong (but too heavy) without way out, from view of a prosthetic arm wearing community.
  • They are a niche product even in terms of actually sustainable prosthetic fitting, from view of applied usage.

Logically, all the research effort that significantly helps military applications, but does not significantly help a real prosthetic arm, clearly marches into one direction only: army development, military research.

And because no one looks and no one cares, research money for rehabilitation of amputees can easily be siphoned off for military applications.

The background for asking these questions is that there must be very distinct reasons why in 2018, a body powered hook is still the only prosthetic type that can be reliably used in strenuous physical applications.

And now, we are starting to get interested in the sociological reasons why that is.

A recently discovered surprisingly high degree of cynicism towards disabled people and particularly those with an amputation by those that claim to technically improve rehabilitation very clearly points towards a non-rehabilitative sociological setting, whereas cynicism in army circles is to be expected [1].

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[1] L. Braithwaite and S. R. Sonnad, "Cynicism amongst military police personnel in Western Europe," Justice Quarterly, vol. 1, iss. 3, pp. 413-436, 1984.
[Bibtex]
@article{braithwaite1984cynicism,
  title={Cynicism amongst military police personnel in Western Europe},
  author={Braithwaite, Lloyd and Sonnad, Subhash R},
  journal={Justice Quarterly},
  volume={1},
  number={3},
  pages={413--436},
  year={1984},
  publisher={Taylor \& Francis}
}

Understanding and informing design issues of a prosthetic arm for below elbow amputation by way of "taxonomy" [literature review, reality check]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Understanding and informing design issues of a prosthetic arm for below elbow amputation by way of "taxonomy" [literature review, reality check]; published July 26, 2018, 21:18; URL: https://www.swisswuff.ch/tech/?p=7651.

BibTeX: @MISC{schweitzer_wolf_1568598781, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Understanding and informing design issues of a prosthetic arm for below elbow amputation by way of "taxonomy" [literature review, reality check]}}, month = {July},year = {2018}, url = {https://www.swisswuff.ch/tech/?p=7651}}


The academic and industrial attempts to approach prosthetic arms so far have been met with less success than the providers must have hoped for. Far less, in fact so little that we wonder what is going on.

Possibly, design issues are the key to this as however vaguely put, some analytic approach needs to inform better design - but how to really inform better design from issues based on analysis? What is a suitable analysis? If we cannot see any better designs anywhere in practice, real life, then what is the analysis worth? Can we analyze analyses to get a better understanding of what might be going on there?

We might best start with what we know to be true.

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Case-study of a user-driven prosthetic arm design: bionic hand versus customized body-powered technology in a highly demanding work environment [article out]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Case-study of a user-driven prosthetic arm design: bionic hand versus customized body-powered technology in a highly demanding work environment [article out]; published January 4, 2018, 14:29; URL: https://www.swisswuff.ch/tech/?p=8066.

BibTeX: @MISC{schweitzer_wolf_1568598781, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Case-study of a user-driven prosthetic arm design: bionic hand versus customized body-powered technology in a highly demanding work environment [article out]}}, month = {January},year = {2018}, url = {https://www.swisswuff.ch/tech/?p=8066}}


 


This is a blog post of one of the rare focused and well based scientific journal articles that really explains how real work, body powered and myoelectric arms relate and go together for a unilateral right below elbow amputee in a physically demanding work environment.

The prior presentation of this paper [poster at Cybathlon symposium 2016], which had been more pragmatically worded (with me thinking people would know anyway), this was now written up as article and published. During that process, the reviewers clearly made great points of all kinds of aspects I never knew were not sky clear to everyone.

So maybe, writing a ~ 30 page case study with > 210 references does clarify stuff, at least potentially and for those that actually read it. But possibly, it still requires attention to even just read it.

Knowledge does not come easy, Highlander! (Nakano, in: Highlander III The Final Dimension)

 

If you are more interested in visionary posts, read about the gadget features of the prosthetic arm in Kingsmen: The Golden Circle [link]. And technically, myoelectric control did have it coming. That technology remained uncool for four decades [link].

Publication [link]

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Scientific approach taken for implementing a successfully marketable microprocessor-controlled knee - history of Otto Bock C-leg [lessons for prosthetic arms?]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Scientific approach taken for implementing a successfully marketable microprocessor-controlled knee - history of Otto Bock C-leg [lessons for prosthetic arms?]; published January 2, 2018, 15:10; URL: https://www.swisswuff.ch/tech/?p=7790.

BibTeX: @MISC{schweitzer_wolf_1568598781, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Scientific approach taken for implementing a successfully marketable microprocessor-controlled knee - history of Otto Bock C-leg [lessons for prosthetic arms?]}}, month = {January},year = {2018}, url = {https://www.swisswuff.ch/tech/?p=7790}}


This blog post takes a few relevant observations, and assumptions, throws them up in the air and sees if they turn into sunshine.

  • If anything has brought us forward, it is also the ability to find relevant short cuts. We do not always have to invent the wheel when really we just want a variation of it.
  • If there is any acutal success story where academic research was required to leverage consumer market for a prosthetic limb, it is that of Otto Bock's C-leg.
  • If we can understand what the concepts are for getting a C-leg successfuly built, marketed and sold, we should be able to take generalized aspects of it to formulate success elements for prosthetic hands, grippers or arms.

Background

While the idea of a microprocessor controlled knee was created earlier [link], no marketable solution was available in due course. "In the early 1990s, Kelly James, an engineer at the University of Alberta, Edmonton, Canada, developed the C-Leg, the first leg with microprocessor-controlled swing and stance phases. Buying the rights from the university, he traveled around the world to interest prosthetic manufacturers in his invention ("A Leg Up," by Isabelle Gallant, U of A Engineer, Spring 2011). However, he didn't receive any commercial interest until German manufacturer Ottobock bought the patent in 1992 and launched the groundbreaking technology.".

Then, based on work betweeen 1995 and 1998, a doctoral thesis at the ETH Zurich described an intelligently, microprocessor controlled knee for above knee prostheses built from available and affordable materials [1].

That research was performed 1995 to 1998, financially supported by Otto Bock, and Otto Bock presented its first C-Leg in 1997.

The rest is history. If ever there was a leap in performance of prosthetic function, ever, it was the C-Leg. No prosthetic hand ever came close to achieving this level of success.

So this particular doctoral thesis seems to contain some possibly interesting ingredients worthwhile looking at. As any doctoral thesis here is public record, and a copy of it must be made available at the public library, I borrowed a copy for further information.

There are some other prosthetic developments, however, nowhere else is academic research anywhere near that successful as in the instance of the C-leg:

  • Otto Bock Michelangelo hand; the mechanism seems to come from American DARPA or other army research and probably was just built, the first glove was a great design work. So there is no analytical approach comparable to the C-Leg. It is too heavy, it does not work with prosthetic gloves really, it is not sturdy.
  • i-Limb: This cannot possibly have suffered too much analytical thought. The device looks more like it was born out of something else. While it does not always function as maybe intended, it is really lovable. It does not have a reliable precision grip, it is really weak, it tears up its paper thin gloves within minutes.
  • TRS prosthetics: Bob Radocy as end-user himself developed by far the greatest useful solutions. But they are not the result of extensive academic efforts, so they cannot be compared to the C-Leg. They are extremely good though and any analysis must start there.
  • Toughware PRX: These devices are extremely well made, mechanics wise - but we lack an analytical model that precedes the engineering there as well, comparing this to the C-leg approach.
  • Becker Mechanical Hand: Also the Becker hand was clearly built by someone with great practical and pragmatic understanding. No analytical effort of the magnitude of a C-Leg preceded it though.
  • Hosmer hooks: they came out of a practical development, no scholarly work appeared to be prepared for these either.

 

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[1] D. Zlatnik, "Intelligently controlled above knee prosthesis," PhD Thesis, 1998.
[Bibtex]
@phdthesis{zlatnik1998intelligently,
  title={Intelligently controlled above knee prosthesis},
  author={Zlatnik, Daniel},
  year={1998},
 school={ETH Zuerich, Switzerland}
}

Normalizing prosthetic arms and media: the role of 3D printing - official statement

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Normalizing prosthetic arms and media: the role of 3D printing - official statement; published July 7, 2016, 18:59; URL: https://www.swisswuff.ch/tech/?p=6226.

BibTeX: @MISC{schweitzer_wolf_1568598781, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Normalizing prosthetic arms and media: the role of 3D printing - official statement}}, month = {July},year = {2016}, url = {https://www.swisswuff.ch/tech/?p=6226}}


It is intriguing that overly massive media pressure can bring proponents of new ideas in prosthetics to crawl back.

If, as typical in prosthetic arms since over 100 years (e.g., Carnes Arm, or, Russian Arm), "new products" are hyped up to no end, this can be a logical result: expectation and reality differences are stretched until a snap occurs.

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Constraints in prosthetic arm research (literature review)

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Constraints in prosthetic arm research (literature review); published June 1, 2016, 12:11; URL: https://www.swisswuff.ch/tech/?p=6068.

BibTeX: @MISC{schweitzer_wolf_1568598781, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Constraints in prosthetic arm research (literature review)}}, month = {June},year = {2016}, url = {https://www.swisswuff.ch/tech/?p=6068}}


A recent literature review  [1] lists apparent priorities and requirements for prosthetic arms. It mentions the fact that a prior literature review, dated 20 years earlier, already contained some of these requirements.

The necessary conclusions however are not presented; they really boil down to two reasons why that could be:

  • it should be evaluated whether the reasons given 20 years ago and again now just present excuses and not actual requirements;
  • it should be evaluated exactly who focused on practically resolving these issues through research or components, and why, possibly, they failed.
  • it should be evaluated inasmuch academic research now follows its own self-made "requirements" that, really, have absolutely no relevance in everyday life

Let us look at the research assumptions and these apparent requirements, point by point.

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[1] [doi] F. Cordella, A. L. Ciancio, R. Sacchetti, A. Davalli, A. Cutti, E. Guglielmelli, and L. Zollo, "Literature review on needs of upper limb prosthesis users," Frontiers in Neuroscience, vol. 10, iss. 209, 2016.
[Bibtex]
@ARTICLE{cordella2016review,  
 AUTHOR={Cordella, Francesca  and  Ciancio, Anna Lisa  and  Sacchetti, Rinaldo  and  Davalli, Angelo  and  Cutti, Andrea  and  Guglielmelli, Eugenio  and  Zollo, Loredana},   
TITLE={Literature review on needs of upper limb prosthesis users},      
JOURNAL={Frontiers in Neuroscience},      
VOLUME={10},      
YEAR={2016},        
NUMBER={209},         
URL={http://www.frontiersin.org/neuroprosthetics/10.3389/fnins.2016.00209/abstract},       
DOI={10.3389/fnins.2016.00209}
}

Uncanny valley and its vicious impact on researchers, media and amputees [projected vision spaces]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Uncanny valley and its vicious impact on researchers, media and amputees [projected vision spaces]; published November 11, 2014, 18:42; URL: https://www.swisswuff.ch/tech/?p=3677.

BibTeX: @MISC{schweitzer_wolf_1568598781, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Uncanny valley and its vicious impact on researchers, media and amputees [projected vision spaces]}}, month = {November},year = {2014}, url = {https://www.swisswuff.ch/tech/?p=3677}}


Appearances and social effects are closely interlinked. As one example, clothes have always had a major impact on social interactions. Read a good book if this is new to you. Along the same lines, even appearances of cars, computers, gadgets et cetera are often heavily discussed. Manufacturers spend a lot of money for looks of consumer goods. If you want to buy a bicycle today, one selling point is the color being particularly robust - even though the frame cannot rust and the color is of really no practical use. So, appearances and social effects are a real thing these days. They create major ripples.

With that, re-enter the uncanny valley.

Appearances are the end-all-be-all for many aspects of prosthetic hands and arms. At first, every now and then, or whenever, you just do not want to stand out as arm amputee, and, with that, you want to look and be enabled. Appearance - looking inconspicuous, looking enabled - every now and so often are a prosthetic arm's sole raison d'etre. Also, and painfully so, that is where prosthetic hands and arms all die that sudden instantaneous all encompassing total death of utter failure. There is just no way to get this really right. Of course, no one ever made an uncompromising attempt at building a realistically appearing prosthetic hand, but then, that problem is intractable. Read a good blog entry about prosthetic arm appearance testing, if that is new to you.

As appearance requirements for prosthetic hands, wrist and arms are massive in their impact overall, it pays well to now dedicate some more attention to this aspect rather than considering the big picture [link].

Because if you cannot get the looks of your prosthetic arm right, you start out as the outcast no matter what. You may not end up there but that is a bit of the problem - negotiating back "apparent" competence. And so from that moment on, the deck of cards is dealt in a totally different way. Look at it like that: if I am already put into the awkward position to explain the ill disposition of my handicapped arm, total wreckage enabled hooks are a far better and plausible display of "enabled" than a high pitched stir of slowly animated fragile 70s B-movie appealing pansy boy hand. That is, if I am already put into that awkward position to explain that.

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A Transhumanist Fault Line Around Disability: Morphological Freedom and the Obligation to Enhance [consideration]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - A Transhumanist Fault Line Around Disability: Morphological Freedom and the Obligation to Enhance [consideration]; published October 8, 2014, 01:48; URL: https://www.swisswuff.ch/tech/?p=3398.

BibTeX: @MISC{schweitzer_wolf_1568598781, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - A Transhumanist Fault Line Around Disability: Morphological Freedom and the Obligation to Enhance [consideration]}}, month = {October},year = {2014}, url = {https://www.swisswuff.ch/tech/?p=3398}}


Body shapes, or appearance, or morphology, are not free. Not in any everyday sense or pragmatically speaking. Morphology is not free to choose, it is not free in terms of being available, it is not free in that one does not just snap something on and off, and it certainly comes with a set of very tight constraints in any sense conceivable. Let us look at and excerpt and discuss a current discussion [1]. Read More

[1] [doi] H. G. Bradshaw and R. Ter Meulen, "A Transhumanist Fault Line Around Disability: Morphological Freedom and the Obligation to Enhance," Journal of Medicine and Philosophy, vol. 35, iss. 6, pp. 670-684, 2010.
[Bibtex]
@article{Bradshaw01122010,
author = {Bradshaw, Heather G. and Ter Meulen, Ruud}, 
title = {A Transhumanist Fault Line Around Disability: Morphological Freedom and the Obligation to Enhance},
volume = {35}, 
number = {6}, 
pages = {670-684}, 
year = {2010}, 
doi = {10.1093/jmp/jhq048}, 
abstract ={The transhumanist literature encompasses diverse nonnovel positions on questions of disability and obligation reflecting long-running political philosophical debates on freedom and value choice, complicated by the difficulty of projecting values to enhanced beings. These older questions take on a more concrete form given transhumanist uses of biotechnologies. This paper will contrast the views of Hughes and Sandberg on the obligations persons with “disabilities” have to enhance and suggest a new model. The paper will finish by introducing a distinction between the responsibility society has in respect of the presence of impairments and the responsibility society has not to abandon disadvantaged members, concluding that questions of freedom and responsibility have renewed political importance in the context of enhancement technologies.}, 
URL = {http://jmp.oxfordjournals.org/content/35/6/670.abstract}, 
eprint = {http://jmp.oxfordjournals.org/content/35/6/670.full.pdf+html}, 
journal = {Journal of Medicine and Philosophy} 
}

Feeling with a prosthetic “bionic” hand [research review] II

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Feeling with a prosthetic “bionic” hand [research review] II; published August 26, 2014, 12:42; URL: https://www.swisswuff.ch/tech/?p=3350.

BibTeX: @MISC{schweitzer_wolf_1568598781, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Feeling with a prosthetic “bionic” hand [research review] II}}, month = {August},year = {2014}, url = {https://www.swisswuff.ch/tech/?p=3350}}


I had participated in an experimental sensory feedback trial [1-s2.0-S0028393213004144-main]  [1] primarily conducted by two of the authors, a while back. In autumn 2009, to be exact.

Incidentally, I now found the publication on-line, in 2014, to be exact. The researcher, despite me writing several mails (like, in 2010, or, 2011), did not find it necessary to inform me of the publication. The author list contains Francesco Marini, Chiara F. Tagliabue, Ambra V. Sposito, Alejandro Hernandez-Arieta, Peter Brugger, Natalia Estévez and Angelo Maravita.

I guess in research with arm amputee test rabbits such as me, not everyone owes the other one respect. This is living proof why signing up for trials may be total nonsense! Respect may be low, return may be zero, and all we are left with are cryptic riddles and writings beyond reality. Not universally, no, there are really laudable exceptions.

So here, as research test rabbit, further information went lacking. So then, I might just reciprocate this attitude and level of respect. What about a bit of a review about this bit of writing.

I mean, after all, they do complain about amputees not signing up for trials. Do we not wonder why!

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[1] [doi] F. Marini, C. F. Tagliabue, A. V. Sposito, A. Hernandez-Arieta, P. Brugger, N. Estévez, and A. Maravita, "Crossmodal representation of a functional robotic hand arises after extensive training in healthy participants ," Neuropsychologia , vol. 53, pp. 178-186, 2014.
[Bibtex]
@article{marini2014,
title = "Crossmodal representation of a functional robotic hand arises after extensive training in healthy participants ",
journal = "Neuropsychologia ",
volume = "53",
number = "0",
pages = "178 - 186",
year = "2014",
note = "",
issn = "0028-3932",
doi = "10.1016/j.neuropsychologia.2013.11.017",
url = "http://www.sciencedirect.com/science/article/pii/S0028393213004144",
author = "Francesco Marini and Chiara F. Tagliabue and Ambra V. Sposito and Alejandro Hernandez-Arieta and Peter Brugger and Natalia Estévez and Angelo Maravita",
keywords = "Crossmodal interactions",
keywords = "Visuo-tactile interference",
keywords = "Peripersonal space",
keywords = "Prosthesis",
keywords = "Visuomotor control",
keywords = "Plasticity ",
abstract = "Abstract The way in which humans represent their own bodies is critical in guiding their interactions with the environment. To achieve successful body–space interactions, the body representation is strictly connected with that of the space immediately surrounding it through efficient visuo-tactile crossmodal integration. Such a body–space integrated representation is not fixed, but can be dynamically modulated by the use of external tools. Our study aims to explore the effect of using a complex tool, namely a functional prosthesis, on crossmodal visuo-tactile spatial interactions in healthy participants. By using the crossmodal visuo-tactile congruency paradigm, we found that prolonged training with a mechanical hand capable of distal hand movements and providing sensory feedback induces a pattern of interference, which is not observed after a brief training, between visual stimuli close to the prosthesis and touches on the body. These results suggest that after extensive, but not short, training the functional prosthesis acquires a visuo-tactile crossmodal representation akin to real limbs. This finding adds to previous evidence for the embodiment of functional prostheses in amputees, and shows that their use may also improve the crossmodal combination of somatosensory feedback delivered by the prosthesis with visual stimuli in the space around it, thus effectively augmenting the patients' visuomotor abilities. "
}

Ripping through the SHAP Southampton Hand Assessment Procedure [DAFUQ - executive summary: SHAP probably useless for prostheses]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Ripping through the SHAP Southampton Hand Assessment Procedure [DAFUQ - executive summary: SHAP probably useless for prostheses]; published May 30, 2014, 19:55; URL: https://www.swisswuff.ch/tech/?p=3043.

BibTeX: @MISC{schweitzer_wolf_1568598781, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Ripping through the SHAP Southampton Hand Assessment Procedure [DAFUQ - executive summary: SHAP probably useless for prostheses]}}, month = {May},year = {2014}, url = {https://www.swisswuff.ch/tech/?p=3043}}


The SHAP Southampton Hand Assessment Procedure - as anyone might know - is an ill devised test for the purpose of prosthetic hand testing inasmuch as real prostheses used for actual jobs and tasks are concerned [link].

As we shall see right from the outset, a clear understanding of the problem at hand (what constitutes a useful test for bi manual activities?) is crucial. And I should know because of activities that leave any "extreme load" prosthesis far behind:

  • IKEA Pax system (total of over 540 kg materials installed in 2 days) [link] (measurable activity with standard object and defined goal)
  • Trimming hedges in direct sun and summer heat at over 37 degrees C [link] (clear task definition, precisely definable tools and physical environment)
  • Biking up the Stelvio Pass (highest paved alpine passroad, over 2700 meters above sea level) [link] (very standardized task, suitable for competitive bike races as well)
  • ah, search this site yourself, will you; there is a sitemap [link] or at least read through all the way to the bottom here

The Cybathlon 2016 [link]  currently is aimed towards using the SHAP with the goal to push the development of "bionic" lookalike prostheses, that is, to push development not of actually functional prostheses per se, but to promote the overpriced gadget track that so many manufacturers have fallen for recently. A more detailed review can be found here (in German) and here.

Initially, they wrote: "B. SHAP Course ADL -- This course is based on the Southampton Hand Assessment Procedure (SHAP), which incorporates different object shapes and sizes that require the use of different grips (spherical, tripod, power, lateral, tip, extension)" [link].

They amended this in the meantime, but that does not change the fact that the test goal for prosthetic arms is elsewhere altogether.

Thus, we read the very revealing ANSI note (link):

New York, May 16, 2014 - In most athletic competitions, using technology to give yourself a competitive edge over other athletes could get you disqualified. That’s not the case for participants in the Cybathlon, an international athletic event scheduled to be held in Switzerland in October 2016. The event – which will feature athletes with disabilities who make use of prosthetics, exoskeletons, and other assistive devices – will award medals to the winning athletes, known as “pilots,” and to the companies that developed the technologies they used. In the run-up to this unprecedented competition, standards can provide manufacturers and others with useful guidance regarding the safety and effectiveness of the devices used by the event’s athletes. The Cybathlon will feature six different events involving a wide range of technologies and athletic disciplines, including a foot race featuring pilots with leg prostheses. An International Standard developed by the International Organization for Standardization (ISO) can provide prosthetics manufacturers and others with important guidance. ISO 10328:2006, Prosthetics - Structural testing of lower-limb prostheses - Requirements and test methods, includes strength tests for lower-limb prostheses, including above-knee and below-knee devices. The standard was developed by ISO Technical Committee (TC) 168, Prosthetics and orthotics; ASTM International, an American National Standards Institute (ANSI) member and audited designator, serves as the ANSI-accredited U.S. Technical Advisory Group (TAG) administrator to ISO TC 168. The Cybathlon’s planned bicycle race will feature athletes with spinal cord injuries using Functional Electrical Stimulation (FES) to pilot their vehicles around the race track. ASTM F2711-08(2012), Standard Test Methods for Bicycle Frames, could provide important support for the manufacturers of the FES bicycles needed for the event. The standard, developed by ASTM International, establishes procedures for testing the structural performance properties of bicycle frames. Another planned event will require participants to maneuver powered wheelchairs backwards and forwards through an obstacle course. The Rehabilitation Engineering and Assistive Technology Society of North America (RESNA), an ANSI member and accredited standards developer, has developed an American National Standard that provides important guidance related to the seats used in wheelchairs. ANSI/RESNA WC-3:2013, RESNA American National Standard for Wheelchairs - Volume 3: Wheelchair Seating, is focused on postural support and tissue integrity management assistance for wheelchair users. Perhaps the most unusual event planned for the Cybathlon is the brain-computer interface race, where paralyzed pilots will control vehicles in a computer game with their mind. One promising method of mind-to-computer communication uses electroencephalographs to record electrical brain activity, providing a basis for mind-driven control of computers and other machines. IEC 60601-2-26 Ed. 3.0 b:2012, Medical electrical equipment - Part 2-26: Particular requirements for the basic safety and essential performance of electroencephalographs, provides safety and performance requirements for electroencephalographs in the clinical environment. This standard was developed by International Electrotechnical Commission (IEC) TC 62, Electrical equipment in medical practice, Subcommittee (SC) 62D, Electromedical equipment. The U.S. plays a strong leadership role in the work of TC 62, with Dr. Rodolfo Godinez of the United States serving as chair. ANSI member the Advanced Medical Technology Association (AdvaMed) serves as the United States National Committee (USNC)-approved TAG Administrator for IEC TC 62. The U.S. also holds the secretariat duties for SC 62D, which the USNC has delegated to the Association for the Advancement of Medical Instrumentation (AAMI), an ANSI member and accredited standards developer; AAMI also serves as the USNC-approved U.S. TAG Administrator to SC 62D. This exciting event promises to give athletes with disabilities an important new opportunity to showcase their skills while also encouraging the creation and refinement of technologies beneficial to many other persons with disabilities. And when developing the devices that will assist Cybathlon pilots in their athletic feats, participating companies will have an array of helpful standards to draw from. To learn more about the Cybathlon, visit its official site.

Interestingly, the ANSI author does not mention the prosthetic arm / hand race with one single word. Not one word! This in plain American English is as clear a statement as there can be a statement. However, this blog-website here is more verbally explicit.

Instead of just keeping my mouth shut, though, I will critique the attempt of using the SHAP or such, the publicizing, the maneuver so to speak, as there are rather constructive insights to be gained by doing so [link].

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Understanding Human Enhancement from view of disability? [counter arguments]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Understanding Human Enhancement from view of disability? [counter arguments]; published May 4, 2014, 10:43; URL: https://www.swisswuff.ch/tech/?p=5884.

BibTeX: @MISC{schweitzer_wolf_1568598781, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Understanding Human Enhancement from view of disability? [counter arguments]}}, month = {May},year = {2014}, url = {https://www.swisswuff.ch/tech/?p=5884}}


Some people that are hired to get the job as bioethicist done seem to think it is helpful to use (!) "disability" to help the hairy and somewhat futuristic discussions related to "human enhancement".

The attempt to employ "disability" - as state, as condition, as social issue, as practical problem, as visual disfigurement, as undefended position - to "base" a "debate" regarding human enhancement on, is, however, an ill fated attempt, a doomed approach, an illogical start, a confusion of worlds and ultimately, should be abandoned.

As we now shall find out, a key deviation from practical logic occurs at the moment when bioethicists believe that they can "see" the world, visually. These people look at disabled people such as me, and believe that by looking at an amputated arm "that they see", in a sense, that "they understand"; they then "see" that I wear a prosthetic arm, possibly with a hook device, then they "see" me grabbing a piece of meat off the grill and they go "aw... that is how enhancement must feel". Really, however, my favorite shirt slogan goes "it only looks like that". They "see" nothing. What they visibly see seems to mislead them in so many ways. That is where they take the wrong turn on the road to discussing "human enhancement".

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