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Category: Academic research with relevant results

Prosthetic device research - what to aim for [go for it!]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Prosthetic device research - what to aim for [go for it!]; published November 27, 2013, 13:58; URL: https://www.swisswuff.ch/tech/?p=2491.

BibTeX: @MISC{schweitzer_wolf_1574111167, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Prosthetic device research - what to aim for [go for it!]}}, month = {November},year = {2013}, url = {https://www.swisswuff.ch/tech/?p=2491}}


1 Comment

As we look back on decades of what appear to be functionally not too successful academic research into the construction of prosthetic arms, we can conclude that it is now the time to read them the riot act:

  • socket and suspension technology still is a myth for academic researchers; industrial developments are the only advancement that is notable in this domain [1];
  • mechanical wrist units and cable setups are the main problems affecting heavy duty task performers with their prosthetic arms; there is virtually no research done here whatsoever;
  • gripper, hand and hook shape is mostly not determined by any recent concise grip shape analysis or research that was done in that direction; if anything, most designs are probably the result of tinkering, experience and practical thinking;
  • myoelectric arms - anything that is commercially available - still operate with two electrodes, just as the Russian Arm did, so absolutely no advancement in over 70 years now, and
  • the same problems that affected the Carnes arm after 1908 (i.e., impressive appearance, circus style propaganda, everyday usefulness very limited, insanely overpriced) also affects modern "bionic" prosthetic hands.

So it is fair to say that...:

  • academic research into construction of prosthetic arms or hands has one systematical outcome (with a very few exceptions): it does systematically fail the users inasmuch as actually available prosthetic arms or hands are concerned; if however industry based research or tinkering lead to current solutions that actually work, state funded research such as by the SNF (see projects here) or NIH (projects here) should consider pulling their funds from their notoriously well known non-developer projects (i.e., not developing true answers to true questions) and direct their funds towards more appropriate work that actually deserves the title "prosthetic arm/hand research" ;
  • researchers that look at prosthetic hands or arms (or pretend that they do) must be really bad chess players; why? Because in chess, if the opponent starts to block your important chess pieces (not so much pawns but the others) then if this slows you down in further chess play, you should treat that with a very high urgency while respecting game rules; so any "myoelectric" device producer that cannot sell their dead stock would have to revise socket technology, and if just simply out of self preservation, as that is the most relevant limiting issue for these types of arms. Instead, prosthetic part producers try to belittle users of body powered arms personally, they sell really badly manufactured parts to discourage body powered arms, and overall exhibit vivid indication of absent strategies that work within acceptable rules of conduct and behavior.

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[1] R. D. Alley, W. T. Williams III, M. J. Albuquerque, and D. E. Altobelli, "Prosthetic sockets stabilized by alternating areas of tissue compression and release," J Rehabil Res Dev, vol. 48, iss. 6, pp. 679-96, 2011.
[Bibtex]
@article{alley2011prosthetic,
  title={{Prosthetic sockets stabilized by alternating areas of tissue compression and release}},
  author={Alley, Randall D and Williams III, T Walley and Albuquerque, Matthew J and Altobelli, David E},
  journal={{J Rehabil Res Dev}},
  volume={48},
  number={6},
  pages={679--96},
  year={2011}
}

APART - von Sub- und Objekten. Ein Magazin ueber Koerper und Identitaet (Diplomarbeit, Doreen Haedicke, 2012, Fachhochschule Potsdam) [Text zur Arbeit]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - APART - von Sub- und Objekten. Ein Magazin ueber Koerper und Identitaet (Diplomarbeit, Doreen Haedicke, 2012, Fachhochschule Potsdam) [Text zur Arbeit]; published November 17, 2013, 19:37; URL: https://www.swisswuff.ch/tech/?p=2319.

BibTeX: @MISC{schweitzer_wolf_1574111167, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - APART - von Sub- und Objekten. Ein Magazin ueber Koerper und Identitaet (Diplomarbeit, Doreen Haedicke, 2012, Fachhochschule Potsdam) [Text zur Arbeit]}}, month = {November},year = {2013}, url = {https://www.swisswuff.ch/tech/?p=2319}}


Doreen Haedicke hat mit ihrer Diplomarbeit [1] eine sehr anspruchsvolle, aus Betroffenensicht hervorragend ausgerichtete Arbeit zum Thema des Koerperbilds geschrieben.

Dass das Thema Korperbild im Rahmen beschaedigter Koerper und im Rahmen der Hinzunahme prothetischer Hilfsmittel nicht trivial bleibt, erschliesst sich bereits zwanglos jedem, dem hierzu das Smalltalkvokabular fehlt.

Umsomehr erschliesst es sich jedem, der wie ich ueber dieses Vokabular verfuegt - denn das Thema ist gleichzeitig extrem oberflaechlich und aeusserlich, wie es unser innerstes zutiefst betrifft.

Wer nicht versteht, warum man eine Armprothese gleichzeitig wie einen eigenen Koerperteil braucht und bei dessen Versagen und Zerfallen entsetzt, mit Grausen, Wut und Trauer reagiert, und sie doch abgrundtief hasst, wer nicht versteht, wieso diese Gefuehle auch kein Widerspruch sondern bedeutsame Realitaet sind, der versteht von der sich stellenden Frage wenig. Ich koennte hier Vertreter namhafter Prothesenteilhersteller nennen, denen herzeigbar jede derartige Einsicht abgeht - was weiterhin untermauern duerfte, dass es sich hier um ein aeusserst aktuelles Thema handelt.

Die nachfolgenden Ausfuehrungen beziehen sich auf diese Arbeit, und die Arbeit wird von mir aus, aus meiner Sicht, verwendet und zitiert, erklaert und kontexualisiert.

Dies ist weniger eine Rezension, als ein Text zur Arbeit [1], den ich mit eigenen Diagrammen bebildert habe.

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[1] D. Hädicke, "APART - von Sub- und Objekten. Ein Magazin über Körper und Identität (Diplomarbeit)," Fachhochschule Potsdam, Germany, 2012.
[Bibtex]
@article{haedicke2012,
    author = {H\"{a}dicke, Doreen},
     title = {{APART - von Sub- und Objekten. Ein Magazin \"{u}ber K\"{o}rper und Identit\"{a}t} ({D}iplomarbeit)},
      year = {2012},
    journal = {{Fachhochschule Potsdam, Germany}},
day={14},
}

Real Men Wear Red [hard facts]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Real Men Wear Red [hard facts]; published August 23, 2012, 22:04; URL: https://www.swisswuff.ch/tech/?p=737.

BibTeX: @MISC{schweitzer_wolf_1574111167, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Real Men Wear Red [hard facts]}}, month = {August},year = {2012}, url = {https://www.swisswuff.ch/tech/?p=737}}


This guy is like me when I was younger. Likewise, I completely go for Red Hands (see all these things I started along the development towards my Red Hand Series).

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Approaching social issues exploiting hormones- Sound Racer [science rant]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Approaching social issues exploiting hormones- Sound Racer [science rant]; published October 9, 2011, 23:07; URL: https://www.swisswuff.ch/tech/?p=493.

BibTeX: @MISC{schweitzer_wolf_1574111167, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Approaching social issues exploiting hormones- Sound Racer [science rant]}}, month = {October},year = {2011}, url = {https://www.swisswuff.ch/tech/?p=493}}


I was a firm supporter of the idea that we are surrounded by prosthetic items all around and anyway. I posted about this previously [here, here]. We are embedded in prosthetic artifacts that make up our culture - out technical, mechanical, communicative and also social values all hinge upon devices, contraptions, pieces and parts, items, objects and things. That was why it was so weird to see the Fondation de la Haute Horlogerie not understand that there are no real watches or fake prosthetic hands, or to see Hans Op de Beeck believe that his wide usage of airplanes, internet, website and other technology was still human whereas wearing a prosthetic was not.

The question of what prosthetic to buy is thus a very valid question.

Because in terms of prosthetic add-ons, they all compete. They *all* compete.

Recent new prosthetic arms [Otto Bock Michelangelo hand, BeBionic and BeBionic v2 hand, new Vincent hand, iLimb and iLimb pulse] cost more than a car. Their prices and cost are so high (ranging between 35'000 to 110'000 CHF) that no self respecting insurance should cover these given you can't even deliver a decent hedge cutting or furniture moving with these. These prosthetic arms are basically useless (practically speaking) items that are created to be paraded around. For that, their questionable value contradicts their massive prices. If anything their value is probably social and in fact exactly this social value was realized and exploited by a youngster who managed to get his iLimb branded by Mercedes' F1-team. Cool for a 15 year old, but not too interesting for a 44 year old such as myself.

Other products in that price range compete with prosthetic arms now that we do agree they will end up as self funded adventures. And given that, we wonder what social problems we have, and what social problems we want to solve. And given *that*, we wonder what cultural and technological prostheses might be at least as worthwhile getting than a prosthetic "bionic" arm or such.

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Sheila Advento embraces two transplanted hands [CNN article] [hand transplant risks and outcome follow-up::2019]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Sheila Advento embraces two transplanted hands [CNN article] [hand transplant risks and outcome follow-up::2019]; published September 25, 2011, 16:33; URL: https://www.swisswuff.ch/tech/?p=487.

BibTeX: @MISC{schweitzer_wolf_1574111167, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Sheila Advento embraces two transplanted hands [CNN article] [hand transplant risks and outcome follow-up::2019]}}, month = {September},year = {2011}, url = {https://www.swisswuff.ch/tech/?p=487}}


CNN posts an article with a letter of Sheila Advento where she appears to wholly embrace her transplanted hands1. Also, there is a video on Youtube to watch [link]:

Obviously she is a lot better in terms of progress as other transplant recipients some of which have almost no perceptible progress of function, and also, we have not seen the end of her story - - but come what may we wish everyone all the best all the time for anything they would wish for. Obviously.

But this is a right below elbow amputee blog and I am more interested in Waldorf & Statler type comments and so let's have a look at what else.

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Online Myoelectric Control of a Dexterous Hand Prosthesis by Transradial Amputees [science fiction, research]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Online Myoelectric Control of a Dexterous Hand Prosthesis by Transradial Amputees [science fiction, research]; published June 13, 2011, 12:31; URL: https://www.swisswuff.ch/tech/?p=435.

BibTeX: @MISC{schweitzer_wolf_1574111167, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Online Myoelectric Control of a Dexterous Hand Prosthesis by Transradial Amputees [science fiction, research]}}, month = {June},year = {2011}, url = {https://www.swisswuff.ch/tech/?p=435}}


Interesting piece of research.

It appears that dexterous hand control for prosthetic arms is definitely on the move. With 79% average accuracy for amputees they are not exactly targeting commercial success (no one ever did, actually) but they are definitely going in a good direction.

This type of research - giving percentage figures for accuracy rates - is interesting as it makes me ask a number of follow up questions:

  • How do we measure success, generally, when going about ADL / activities of daily living?
  • What is an average accuracy rate for a body powered arm? Given that this morning was basically spent eating several courses of a really extended breakfast, I did not drop anything except one tiny part of an eggshell (when making fried eggs), but also, my left hand feels strained and exerted, any type of value attribution would have to take into account a range of factors. Increased functionality of a prosthetic hand could alleviate a lot of problems even at the cost of more errors - but how that would be adequately quantified, I do not know.

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Individual Finger Control of a Virtual Prosthetic Device Using Surface EMG [research]

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Wolf Schweitzer: Technical Below Elbow Amputee Issues - Individual Finger Control of a Virtual Prosthetic Device Using Surface EMG [research]; published June 6, 2011, 00:13; URL: https://www.swisswuff.ch/tech/?p=429.

BibTeX: @MISC{schweitzer_wolf_1574111167, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Individual Finger Control of a Virtual Prosthetic Device Using Surface EMG [research]}}, month = {June},year = {2011}, url = {https://www.swisswuff.ch/tech/?p=429}}


It is indeed possible to control individual fingers, using surface EMG. There is absolutely no reason to not sell us individual finger control. Not from a user perspective.

That Johns Hopkins video is not even really new.

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WILMER Prosthetic Product Line [University of Delft]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - WILMER Prosthetic Product Line [University of Delft]; published June 6, 2011, 00:05; URL: https://www.swisswuff.ch/tech/?p=428.

BibTeX: @MISC{schweitzer_wolf_1574111167, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - WILMER Prosthetic Product Line [University of Delft]}}, month = {June},year = {2011}, url = {https://www.swisswuff.ch/tech/?p=428}}


A useful development is presented here: new body powered socket and gripper technology primarily aimed at children.

This development appears to avoid the 'single individual or competitive company charging into patent market derailment with a stalled / stalling product'. The thing is that rare / orphan disease rules play out. It is not acknowledged by many but the clever players play by these rules, for sure. Because one thing is for sure - below elbow amputees are rare - only half wear prosthetic arms - about half of which are probably body powered. Those are so few out and far that economic laws of free markets neither work nor play out. With any new patented invention you won't change shit. Rather, people that use conventional marketing of their usually not too inventive products are responsible for stale product ideas and stale products, for immature developments and bad manufacturing. Commercial prosthetic arms are one big proof for the term 'stale' - look around and ponder. Patent applications are harmful and keep products or solutions from the market for another few years until - how so often - just about nothing really happens. But, not here.

The Delft University of Technology is a government supported institution that works on a whole line setup that appears to be well researched and solves actual problems. Solutions are published and made available. Great stuff.

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Hand Amputation *Will* Result in Altered Perception Around the Hands

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Hand Amputation *Will* Result in Altered Perception Around the Hands; published January 10, 2010, 19:17; URL: https://www.swisswuff.ch/tech/?p=259.

BibTeX: @MISC{schweitzer_wolf_1574111167, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Hand Amputation *Will* Result in Altered Perception Around the Hands}}, month = {January},year = {2010}, url = {https://www.swisswuff.ch/tech/?p=259}}


Tamara Makin et. al report [link, link]: The space within reach of our hands is the medium for reaching, grasping, and avoidance movements. Accordingly, visual information in this action space is organized in hand?centered coordinates, generating a common frame of reference for perception and action. (...) We report here that amputation of a hand is indeed associated with a mild visual neglect of the amputated side: Participants with an amputated hand favored their intact side when comparing distances in a landmark?position judgment task. Importantly, this bias was absent when the targets were placed in far space. Our results thus demonstrate that the possibility for action within near space shapes the actor’s spatial perception. -- The findings suggest that losing a hand may shrink the action space on the amputated side, leading to permanent distortions in spatial perception. According to the researchers, This shows that the possibility for action in near space shapes our perception — the space near our hands is really special, and our ability to move in that space affects how we perceive it.

So I wondered what would influence this warped perception, this distortion, more: a static (cosmetic) or a functional prosthesis? From my own experience I prefer a static (cosmetic) prosthesis for walking or going to the movies or also for Tai Chi - when my shoulders, back and neck are important. But for feeling at least halfways symmetrical I also feel that wearing a body powered prosthesis makes me more aware of my disabled side. Also, I just recently started to increasingly use the disabled arm and the prosthesis - not just because I started to use appealing and powerful terminal devices but also, because this seemed to take time.

Intriguingly, I just got this statement from someone happily wearing a somewhat static but halfways functional arm that still allows to grasp and hold objects using minimized cable control: This "passive" arm helps me.  However, I built this arm like a tank and it weighs about 3 KG and it's protected.  My body is balanced, symmetrical.  My movement and power is spot on. Like me, he optimized between prosthetic parts he did not want to put up with and other parts that proved useful.

So I went to the supplementary data of this article [link, link] and, tada.

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Potential Influence of One-Handedness on Politics and Philosophy of the 20th Century

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Potential Influence of One-Handedness on Politics and Philosophy of the 20th Century; published October 14, 2009, 22:30; URL: https://www.swisswuff.ch/tech/?p=217.

BibTeX: @MISC{schweitzer_wolf_1574111167, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Potential Influence of One-Handedness on Politics and Philosophy of the 20th Century}}, month = {October},year = {2009}, url = {https://www.swisswuff.ch/tech/?p=217}}


This article is Copyright © 2009 Published by Elsevier Inc.

To the Editor:
Inspired by the article by Drozdov et al. Evolution of one-handed piano compositions, [1, Copyright 2008 American Society for Surgery of the Hand] we would like to add 2 annotations on the issue of hand loss and its potential influence on 20th-century politics and philosophy.

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Phantom sensations, phantom pain - Vilayanur Ramachandran: A journey to the center of your mind

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Phantom sensations, phantom pain - Vilayanur Ramachandran: A journey to the center of your mind; published October 14, 2009, 00:34; URL: https://www.swisswuff.ch/tech/?p=226.

BibTeX: @MISC{schweitzer_wolf_1574111167, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Phantom sensations, phantom pain - Vilayanur Ramachandran: A journey to the center of your mind}}, month = {October},year = {2009}, url = {https://www.swisswuff.ch/tech/?p=226}}


Vilayanur Ramachandran tells us what neurological observations can reveal about the connection between cerebral tissue and the mind, using three startling problems as examples.

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