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Journal of NeuroEngineering and Rehabilitation
Published in: Journal of NeuroEngineering and Rehabilitation 1/2018

Open Access 01-12-2018 | Research

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

Authors: Wolf Schweitzer, Michael J. Thali, David Egger

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2018

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Abstract

Background

Prosthetic arm research predominantly focuses on “bionic” but not body-powered arms. However, any research orientation along user needs requires sufficiently precise workplace specifications and sufficiently hard testing. Forensic medicine is a demanding environment, also physically, also for non-disabled people, on several dimensions (e.g., distances, weights, size, temperature, time).

Methods

As unilateral below elbow amputee user, the first author is in a unique position to provide direct comparison of a “bionic” myoelectric iLimb Revolution (Touch Bionics) and a customized body-powered arm which contains a number of new developments initiated or developed by the user: (1) quick lock steel wrist unit; (2) cable mount modification; (3) cast shape modeled shoulder anchor; (4) suspension with a soft double layer liner (Ohio Willowwood) and tube gauze (Molnlycke) combination. The iLimb is mounted on an epoxy socket; a lanyard fixed liner (Ohio Willowwood) contains magnetic electrodes (Liberating Technologies). An on the job usage of five years was supplemented with dedicated and focused intensive two-week use tests at work for both systems.

Results

The side-by-side comparison showed that the customized body-powered arm provides reliable, comfortable, effective, powerful as well as subtle service with minimal maintenance; most notably, grip reliability, grip force regulation, grip performance, center of balance, component wear down, sweat/temperature independence and skin state are good whereas the iLimb system exhibited a number of relevant serious constraints.

Conclusions

Research and development of functional prostheses may want to focus on body-powered technology as it already performs on manually demanding and heavy jobs whereas eliminating myoelectric technology’s constraints seems out of reach. Relevant testing could be developed to help expediting this. This is relevant as Swiss disability insurance specifically supports prostheses that enable actual work integration. Myoelectric and cosmetic arm improvement may benefit from a less forgiving focus on perfecting anthropomorphic appearance.
Footnotes
1
WS, dominant sided right below elbow amputation 2008, board certified specialist in forensic medicine
 
2
detailed notes across the years on www.​swisswuff.​ch/​tech
 
3
From Wikipedia: “Industrial and manual workers often wear durable canvas or cotton clothing that may be soiled during their work. Navy and light blue colors conceal potential sweat, dirt or grease on the worker’s clothing, helping him or her to appear cleaner.”
 
4
Swiss Insurance Law UVG article 11 contains that supportive measures [incl. prosthetic arms] must be simple and efficient [as to their intended purpose].
 
5
From [47]: “Health professionals offered little real help. Farmers in this study reported that health professionals assigned to assist them in their recovery were stymied because they lacked basic knowledge and understanding of farming.”
 
7
According to KHMI (Kreisschreiben über die Abgabe von Hilfsmitteln durch die Invalidenversicherung), paragraph 1036, Swiss laws provide that “instruction to use of the prosthesis is contained in the price at purchase” [215].
 
8
Internet query performed in September 2016
 
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Metadata
Title
Case-study of a user-driven prosthetic arm design: bionic hand versus customized body-powered technology in a highly demanding work environment
Authors
Wolf Schweitzer
Michael J. Thali
David Egger
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2018
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/s12984-017-0340-0

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