DCSIMG

The bionic hand that behaves as though it was real thing

STEVE Austin, the bionic man, was hero to a generation of children who grew up in the 1970s. "We can rebuild him. We have the technology" ran the introduction to The Six Million Dollar Man, the cult TV drama starring Lee Majors as a test pilot whose wrecked body was reconstructed at considerable cost, enabling him to run at 60 miles per hour and lift a car with one hand.

Yesterday a Scottish company, Touch Bionics, also declared: "We have the technology," with their announcement that they had successfully developed the world's first commercially available bionic hand. While the i-LIMB Hand may not bequeath its user with the strength of Mr Austin, it has transformed the lives of patients around the world and comes with a more reasonable price tag of 9,000.

The prosthetic device offers greater mobility and authenticity than any previous artificial hand. It allows users to perform far more nimble tasks such as holding a card or turning a key in a lock. The hand has five individually powered digits that can bend like natural fingers and has revolutionised the abilities of patients.

Among the first to use the i-LIMB were members of the American military, where amputations have increased dramatically as a result of the Iraq war. Juan Arredondo, a retired Sergeant with the 2nd Infantry Division, 1/506 Destroyer Company, lost his hand in 2004 after his patrol vehicle was struck by an improvised explosive device.

"Every day that I have the hand, it surprises me. Now I can pick up a Styrofoam cup without crushing it. With my other hand, I would really have to concentrate on how much pressure I was putting on the cup. The i-LIMB hand does things naturally. I can just grab the cup like a regular person."

The development of prosthetic limbs spans centuries, from the peg legs of pirates to the solid wooden hands fitted to veterans of the First World War. In Britain development of artificial limbs picked up pace in the 1960s as the NHS coped with the armless victims of Thalidomide, the drug taken by mothers to suppress morning sickness which resulted in birth defects.

In the 1970s a new form of prosthetic arm was developed using a technology called myoelectric, which connected the muscle signals in a patient's arm to an artificial hand which could then open and close at will. Unfortunately this device was rudimentary, and was often shaped like a claw or pincer. Although it allowed a person to hold an object, there was little subtlety of movement.

By comparison the i-LIMB Hand offers a unique, highly intuitive control system that uses the traditional myoelectric signal input to open and close the hand's lifelike fingers, but has more facilities. Myoelectric controls use the electrical signal generated by muscles in the remaining portion of a patient's limb. This signal is picked up by electrodes that sit on the surface of the skin. As a result users of existing, basic myoelectric prosthetic hands can quickly adapt to the system.

The system does not involve surgery. Two small electrode plates, which detect the minute electrical signals generated by the remaining muscles in the limb stump, are placed against the skin to pick up signals. Traditionally, one electrode is placed on the top of the forearm and one on the bottom.

Patients usually have a sensation that their hand still exists despite it being amputated, something often referred to as phantom feelings. When encouraged to generate a strong signal, patients are often asked to move and flex their missing hand to generate a strong control signal. Before too long, these reflexes become intuitive, and the i-LIMB Hand and patient interact in a symbiotic way.

As each finger can move individually it offers each person a different range of grips such as using the index finger and thumb to pick up small objects, while the addition of a rotating wrist enables the patient to turn keys in a lock, an impossibility under the previous system.

"It is a paradigm shift," said David Gow, the director of rehabilitation engineering services at NHS Lothian, who invented the hand. "It will change the face of prosthetics forever. It is now much more human."

The research for the i-LIMB was initially carried out by Mr Gow for the NHS, but to receive extra funding from the department of Trade and Industry it was necessary to set up a separate company, Touch Bionics, in 2002. The NHS took shares in the company and agreed to Mr Gow's secondment two days a week. Over the past five years, Touch Bionics has expanded and now occupies premises in Livingston with a workshop, assembly room, offices and clinic.

In order to maximise the commercial potential of the company it was necessary to target the largest market: the United States, which averages 20,000 amputations each year. Over the past year the i-LIMB has been tested with successful results. John German, 40, a medical salesman and clinical technician from Altoona, Pennsylvania, who lost his hand in 1987, was recently fitted with the i-LIMB Hand. He insists it is far superior to the other prostheses he has used over the past 20 years. "My previous hand was no better than a wireless mechanical hook, whereas the i-LIMB Hand is a dynamic hand. I'm doing things now I couldn't do a month ago. I'm eating my dinner with a knife and fork. I have not been able to do that for 30 years."

Lindsay Block, 26, of Oklahoma City, has had a lifetime of experience with prosthetics. Born missing the lower part of her left arm as the result of a birth defect, Ms Block has used almost every new generation of prosthetic technology since being fitted with her first one when only six months old. She is particularly impressed both by the lifelike look of the i-LIMB and by its extensive range of motion. "When I'm wearing the i-LIMB Hand, I'm pretty sure that someone who doesn't know me wouldn't even guess that it wasn't my own hand," she said. "It's cool how it can adjust to whatever it is grabbing on to. You don't have to strategise so much because it's not limited and will adjust, depending on what it's gripping on to."

The hand is powered by batteries that drive the five internal motors which, like a mobile phone, can be recharged overnight. Yet despite the i-LIMB's success, there is an ironic twist: it is not yet available on the NHS. "The NHS doesn't take on a new product without careful testing, so it could between two to five years before it is available," said Mr Gow.

‘Amazing how quickly I could learn things’

IN 1977, Donald McKillop underwent an amputation of his right hand due to complications from an accident nine years previously . After some basic rehabilitation, he was quickly fitted with a body-powered prosthesis so he could begin working again as a welder.

"You have to get on with your life. You can't go on thinking that you'll wake up the next morning and your hand has started to grow back," Mr McKillop, 61, said. "I'm always a positive person. Of course there are frustrations, but you can always find ways to do things."

The developments in his life caused him to take an interest in the development of prosthesis, and Mr McKillop became involved with The National Centre for Training and Education in Prosthetics and Orthotics at the University of Strathclyde.

For the past 30 years, he has been a willing participant in the research activities of the centre, and it was this connection that first brought him into contact with Touch Bionics.

In 2006, he was one of the first patients to be fitted with Touch Bionics' i-LIMB Hand - and he immediately experienced the benefits.

"I was amazed by how quickly I could learn to do things with the i-LIMB Hand, even only an hour after being fitted with the hand and being talked through some basic exercises," he said.

"The most important thing is the movement of the fingers - that's what really makes the difference. It's truly incredible to see the fingers moving and gripping around objects I haven't been able to pick up before. The hand does feel like a replacement for my missing hand and it is now natural for me to pick up all sorts of objects. It makes everyday activities much easier."

Since being fitted with the i-LIMB Hand, Mr McKillop says he is better able to do things such as cooking, gardening and woodworking.

Q&A

Q: What is the i-LIMB Hand?

A: The hand is the world's first commercially available multi-articulating bionic hand. It has five independently powered digits that open and close around objects. It supports amputees in their everyday lives. In medicine, bionics means the replacement or enhancement of organs or other body parts by mechanical means.

Q: What are ProDigits?

A: ProDigits, short for Prosthetic Digits, are the self-contained fingers that are individually powered and controlled to provide new fingers for partial-hand patients. The i-LIMB Hand is effectively a chassis for five ProDigits. Individual ProDigits are used for patients who have lost part of their hand and/or a whole finger or fingers.

How is the i-LIMB Hand controlled?

A: The i-LIMB Hand relies on some of the most advanced control software yet seen in the prosthetics industry. This software provides speed and grip-strength control, while patients generate signals to control the device in a way that doesn't differ from how traditional devices have operated in the past.

Q. Is surgery required? Does it connect to nerves?

A. No. A traditional myoelectric system is employed. Two small metal electrode plates, which detect the minute electrical signals generated by the remaining muscles in the limb stump, are placed against the skin to pick up signals. Traditionally, one electrode is placed on the top of the forearm and the other on the bottom.

Q. Is the i-LIMB Hand controlled by thought?

A. No, it is controlled by sensing electrical impulses in the forearm. Patients usually have a sensation that their hand still exists, despite it being amputated, something often referred to as phantom feelings. When encouraged to generate a strong signal, patients are often asked to move and flex their missing hand to generate a strong control signal. Before too long, these reflexes become intuitive, and the i-LIMB Hand and patient interact in a symbiotic way.

 
 
 

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