Social ranking wins over function for "bionic" hands [this & that]

The actual and real performance of "bionic" hands (i.e., simple myoelectric hands that now offer what Becker hands offered since many decades, which is, an adaptive grip) is not anywhere near cool.

  • They are known to break, assumedly at first sight,
  • They suck out batteries within as little as a few hours of usage.
  • They do not offer anything close to a reasonable pinch force.
  • They are more heavy than useful.
  • Recent price estimates for a "bionic" arm range from 60'000 US$ do 120'000 US$.
  • Their marketing sucks up all company funds that would be far better invested in long-term prosthetic function such as better body powered technology. Instead, short lived gadgetry is marketed that is of extremely limited functional and otherwise probably no orthopedic help at all.

One may not even be able open a bag of popcorn and I would suggest it is quite correct to state that one might be at least as disabled with a "bionic" hand than without one - with the difference of all that money gone.

Hints for this being a rather correct assessment are out and about.

  • For example, the actor that demonstrated the Otto bock Michelangelo hand recently here in Zuerich [link] did not at all keep a symmetric posture, nor did he put that anchor to any use, before his show had started - instead he pulled up the shoulder of his amputated arm that had the Otto Bock Michelangelo hand on it, and he grabbed the cables he was about to plug into a computer into his own mouth. All nice and sweet but I can do that without "bionic" arm.
  • It has also been claimed several times now that an iLimb should be very useful to type or to "hold a bottle". For typing, what does count is a good symmetric back, neck and shoulder postur. But it is rather obvious that typing with an iLimb will cause painfully elevated shoulders and abnormally twisted elbows whereas typing with a prosthetic hook is far more relaxed, precise, fast and healthy. Facts are clear here, let there be no doubt [link, re-posted from link].

Given that these facts are sky clear and that I know of exactly no one who would ask for a "bionic" prosthesis from a functional view point, there are two very noteworthy recent stories to read and to learn from:

  • [1] A Florida judge of compensation claims ordered an employer to provide a worker with the i-LIMB hand prosthesis and therapy to assist him with the use of the prosthesis. [link] [link] [reference: Bond v. Superior Mulch, Inc., 18 FLWCLB 95 (Fla. JCC, West Palm Beach 2011)]
  • [2] 14-year-old Matthew James sent a tongue-in-cheek letter to the head of Mercedes' F1 team asking for ¬£35,000 (~$57,000) for a bionic hand, which they could brand like an F1 car. Mercedes' response? They made him "the most advanced prosthetic hand in the world". [link] [link] [link] [link]

What do we learn from that?

Most noteably, the document "Final Compensation Order filed" (6/13/2011) [link] documents that "after requesting more information from the manufacturer of the i-Limb, Dr. Kinchelow opined that the i-Limb was medically necessary to maximize Claimant's recovery and provide a greater level of function. The i-Limb would improve and aid in Claimant's recovery by enabling Claimant to use a pointing finger for key stroke purposes and by providing fine motor precision where all five digits can independently control grip strength, capabilities Claimant's current prosthetic devices do not have".

This is most interesting as anyone who knows these prosthetic hands knows that there is exactly one comfortable way to type on a keyboard using a prosthetic hand (regardless of the model of hand that you are wearing) - and that is by squeezing a pen into the hand. The iLimb's extended finger is a great example of how not to type as in fact you will always elevate and tens your elbow and abduct and tense your shoulder, which is rather obvious if you watch it on video even without being a medical doctor. However for real world typing, no prosthetic hand is super good - using a prosthetic hook is worlds better as hooks tend to be a lot lighter, they are better shaped for a symmetric upright posture and shoulders and elbows relaxed as much as possible [link, re-posted from link].

So by all means conceivable, had Dr. Tosca Kinchelow and the court done their research well, they would have suggested the Claimant to be fitted with an aluminum hook and a Becker hand. That would have really have helped the bodily recovery of the Claimant.

However this is obviously not about prosthetic function at all. This is about an individual's race for a prized possession, a race for a "precious item" so to speak. Social etiquette provides that the amputee should rob the accused company of something that is considered "worthy" by society, and worth nowadays seems to be measured in gold or currency - regardless of what he needs from a technical view point. It is most refreshing to see that courts (less than insurances) actually seem to ignore clear facts and go with the social value of such a case.

Furthermore, this is a professional drama. Arm amputees are a rarity and instead of doctors and specialists founding a rare disease / orphan disease center that collects and offers actual knowledge for upper extremity amputees (which is easily justified based on numbers alone), arm amputees are scattered and disorganized, any doctor thinks they can offer evidence or opinions when in fact these don't even stand up to a first glance on simple web videos. To not organize rare disease / orphan disease patients and the medical knowledge necessary to deal with their issues properly directly results in such (factual) disasters - that, nevertheless, are rather  fascinating to observe.

Indeed, and against all functional or efficiency considerations, "bionic" hands are obtained first and foremost to increase social ranking. To pass someone else - rank-wise- also called "pulling rank". This 14-year old thus "pulls rank" on his peers by getting the premier department of Mercedes (the F1 race team) within the widely accepted premier brand (Mercedes) to fund him a premier luxury gadget branded hand (TouchBionics). The social status of Touchbionics - certainly to his peers and probably also to anyone else - is close to zero and just buying an iLimb as that is socially worthless - but it the social relevance of TouchBionics as a brand is massively increased by getting Mercedes's F1-team to re-brand the iLimb. Puma, Nike or Adidas would have been acceptable but a Formula 1 race team knocks the bottom out here, it is cooler than getting NASA or the American President to issue a seal of approval. While this is dumb as a bag of hammers from any functional and practical viewpoint, it is most brilliant from a social point of view - this guy understands how brands, pubescent brains of peers and how marketing guys function. He has gone far already. There also is a study that highlights that branding, brand appearance and brand acceptance tops ANY other aspect of prosthetic function or appearance when investigating pubescent and adolescent minds in context of prosthetic arms.

So in a world full of difficulty for decisions we are now navigating court and insurance space, gadget and social rank space. Who'd ever have thunk it. This means that prosthetic hands now become mainstream consumer articles as these rules so far extended only to cars, houses, shoes, watches, glasses, coffee machines, lamps, jeans, shirts, sneakers, grills, computers and cell phones.

Remember where you are? this is a single right below elbow amputee blog and you are the one that came here. This here is my personal opinion that bases on reports, experiences, things I checked myself and other sources.

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Social ranking wins over function for "bionic" hands [this & that]; published August 25, 2011, 17:40; URL: https://www.swisswuff.ch/tech/?p=475.

BibTeX: @MISC{schweitzer_wolf_1582453274, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Social ranking wins over function for "bionic" hands [this & that]}}, month = {August},year = {2011}, url = {https://www.swisswuff.ch/tech/?p=475}}