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Monday, August 22, 2022

Bionic Hand Arms Race

 Quite interesting developments are at hand at hand.  Good overview of the space, linking to more. 


The prosthetics industry is too focused on high-tech limbs that are complicated, costly, and often impractical.

N JULES VERNE’S 1865 NOVEL From the Earth to the Moon, members of the fictitious Baltimore Gun Club, all disabled Civil War veterans, restlessly search for a new enemy to conquer. They had spent the war innovating new, deadlier weaponry. By the war’s end, with “not quite one arm between four persons, and exactly two legs between six,” these self-taught amputee-weaponsmiths decide to repurpose their skills toward a new projectile: a rocket ship.

The story of the Baltimore Gun Club propelling themselves to the moon is about the extraordinary masculine power of the veteran, who doesn’t simply “overcome” his disability; he derives power and ambition from it. Their “crutches, wooden legs, artificial arms, steel hooks, caoutchouc [rubber] jaws, silver craniums [and] platinum noses” don’t play leading roles in their personalities—they are merely tools on their bodies. These piecemeal men are unlikely crusaders of invention with an even more unlikely mission. And yet who better to design the next great leap in technology than men remade by technology themselves?

As Verne understood, the U.S. Civil War (during which 60,000 amputations were performed) inaugurated the modern prosthetics era in the United States, thanks to federal funding and a wave of design patents filed by entrepreneurial prosthetists. The two World Wars solidified the for-profit prosthetics industry in both the United States and Western Europe, and the ongoing War on Terror helped catapult it into a US $6 billion dollar industry across the globe. This recent investment is not, however, a result of a disproportionately large number of amputations in military conflict: Around 1,500 U.S. soldiers and 300 British soldiers lost limbs in Iraq and Afghanistan. Limb loss in the general population dwarfs those figures. In the United States alone, more than 2 million people live with limb loss, with 185,000 people receiving amputations every year. A much smaller subset—between 1,500 to 4,500 children each year—are born with limb differences or absences, myself included.

Today, the people who design prostheses tend to be well-intentioned engineers rather than amputees themselves. The fleshy stumps of the world act as repositories for these designers’ dreams of a high-tech, superhuman future. I know this because throughout my life I have been fitted with some of the most cutting-edge prosthetic devices on the market. After being born missing my left forearm, I was one of the first cohorts of infants in the United States to be fitted with a myoelectric prosthetic hand, an electronic device controlled by the wearer’s muscles tensing against sensors inside the prosthetic socket. Since then, I have donned a variety of prosthetic hands, each of them striving toward perfect fidelity of the human hand—sometimes at a cost of aesthetics, sometimes a cost of functionality, but always designed to mimic and replace what was missing.

In my lifetime, myoelectric hands have evolved from clawlike constructs to multigrip, programmable, anatomically accurate facsimiles of the human hand, most costing tens of thousands of dollars. Reporters can’t get enough of these sophisticated, multigrasping “bionic” hands with lifelike silicone skins and organic movements, the unspoken promise being that disability will soon vanish and any lost limb or organ will be replaced with an equally capable replica. Prosthetic-hand innovation is treated like a high-stakes competition to see what is technologically possible. Tyler Hayes, CEO of the prosthetics startup Atom Limbs, put it this way in a WeFunder video that helped raise $7.2 million from investors: “Every moonshot in history has started with a fair amount of crazy in it, from electricity to space travel, and Atom Limbs is no different.”

We are caught in a bionic-hand arms race. But are we making real progress? It’s time to ask who prostheses are really for, and what we hope they will actually accomplish. Each new multigrasping bionic hand tends to be more sophisticated but also more expensive than the last and less likely to be covered (even in part) by insurance. And as recent research concludes, much simpler and far less expensive prosthetic devices can perform many tasks equally well, and the fancy bionic hands, despite all of their electronic options, are rarely used for grasping.  ... ' 

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