Give Him a Hand -- No, Really

When I read The Washington Post article about how a Tennessee high school student’s engineering class built him a prosthetic hand, my immediate reaction, of course, was to be touched, but my bigger reaction was, wait – high school students can now create prosthetics? 

If you haven’t been paying attention, the world of prosthetics has been changing in amazing ways, and it’s not done. 

Image by Omkaar Kotedia, co-created with Dani Clode

The student, Sergio Peralta, was born with his right hand not fully formed, and for much of his life it was a problem.  As he wrote in his own account in Newsweek: “When I got bullied at my old school, the bullies would always compare me to them and make me feel like I am less of a person because of my right hand.”  His high school engineering teacher noticed his limitations, got permission from his mother to create a prosthetic for him, and assigned three students to the project.

Within a week, they’d used a 3D printer to create a prototype, and over the next couple weeks they’d iterated it to a version Sergio was happy with. “As he was adjusting it, I felt very happy,” Sergio writes.  “It looked cool and robotic, and it was grey and blue. We then tested weather [sic] I was able to grip objects with it…My teacher was so happy that the hand worked. It was exciting for him to see me catch a ball for first time in 15 years.”

Sergio and his classmates with the new hand(s). Credit: Kelly Flood

3D printing has been one of the big breakthroughs for prosthetics. The Afghan and Iraq wars unfortunately created a huge demand for them, and the military health services stepped up. Dr. Peter Liacouras, the Director of Services for the 3D Medical Applications Center at Walter Reed, says: “Over the past ten years, we have concentrated on filling the gaps in prosthetics through 3D printing. 3D printing has been highly flexible and applicable for specialty solutions of limited production needs.”  Ukrainian soldiers are now benefiting from this expertise.

Mr. Peralta’s classmates are not the only students helping to pave the way to more available, affordable prosthetics. For example, last September a group of students from a structural engineering class at University of California San Diego started LIMBER, whose mission “is to provide prosthetics and orthodic devices to the 9 out of 10 people who are left behind.”  

Their approach is “to integrate imaging, modeling, simulation, testing, and additive manufacturing to create affordable, unibody prosthetic devices that can be tailored specifically to each user’s needs.”  So far LIMBER has served 17 patients, in 3 countries, and expects to start selling more broadly in early 2024. 

The World Health Organization estimates that only 1 in 10 people who need assistive products have access to them, with cost often a major barrier in the case of prosthetics. 3D printing is lowering that barrier but hasn’t eliminated it yet. More needs to happen.

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I think it’s great that 3D printing is making prosthetics cheaper and faster to produce, but what particularly intrigues me is how people are personalizing them – not just for fit but also for style, for aesthetics, even for new purposes. Joanna Thompson writes in MIT Technology Review about “alternative prosthetics” – “a form of assistive tech that bucks convention by making no attempt to blend in.”

Well, that doesn't blend in. Credit: The Alternative Limb Project

Take Open Bionics, with its Hero Arm^TM, which it describes as “an advanced, lightweight, 3D printed bionic arm, with multi-grip functionality and empowering aesthetics.”  It comes with multiple grips, removeable covers “inspired” by characters from Disney, Marvel, and Lucasfilm, along with “a group of lights, sounds, and vibrations that give you feedback on the status of your bionic arm.” 

Or take The Alternative Limb Project, founded by artist Sophie de Oliveira Barata, to use “the unique medium of prosthetics to create highly stylised wearable art pieces.”  The website says: “Sophie’s creations explore themes of body image, modification, evolution and transhumanism, whilst promoting positive conversations around disability and celebrating body diversity.” 

Ms. Barata recently told Creative Bloom that she wants to help amputees: “To embrace your difference and send out a message without speaking, to say how you feel about your body."  She aims to balance comfort, function, and aesthetics, “But if you push one to the extreme, sometimes to other two suffer. For example, if it's a performance art piece, then it's not for everyday use.

Performance art prosthetics?  Just ask Sara Hughes, whom The New York Times recently profiled. Ms. Hughes got a new arm from The Alternative Limb Project for her wedding. “For me, it wasn’t a fancy gown. It was having a really cool arm.”  She and Ms. Barata worked on a design that deliberately didn’t attempt to look like a “real” arm. “There’s definitely a dreamlike quality about it,” she told NYT. “I’d like people to think that I was a freethinker and a dreamer.”  She feels there is a power in wearing an arm that deliberately tries to look different.

Or take Nerdforge’s Martina, who used an open source design from Danger Creations to replace a missing little finger:

Ms. Thompson profiled the work of Dani Clode, from the University of Cambridge Plasticity Lab. Her designs “include a clear acrylic forearm prosthetic with an internal metronome that beats in sync with the wearer’s heart and an arm made with rearrangeable sections of resin, polished wood, moss, bronze, gold, rhodium, and cork.”  She’s also been working on a “third thumb” to augment a user’s grip.

It turns out that the brain can adapt to prosthetics that don’t try to mimic the “normal” body template. Tamar Makin, who heads The Plasticity Lab, used fMRI scans to see how the brain responded to prosthetics. She found: “Prosthetics were not represented like hands, but they were also not represented like tools.”  They’re something in-between, “suggesting that most people can readily adapt to a wide variety of artificial-limb configurations, provided the device remains useful in their daily lives.”

Ms. Thomson also highlighted an artist who’d worked with The  Alternative Limb Project, Viktoria Modesta, to replace her conventional prosthetic leg with something more imaginative, “a gem-encrusted lower limb inspired by Hans Christian Andersen’s classic fairytale “The Snow Queen.”  Ms. Modesta says: “My leg went from life sentence to an object of love and desire.”

Wow.

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I view the work of organizations like The Alternative Limb Project, Open Bionics, The Plastics Lab, and Danger Creations as a form of biohacking, not using biology but still using technology to reimagine/expand what being “human” means/looks like.  After all, maybe we could all use that third thumb.