Bibliographic Reviews

Annotated Bibliography

Adee, Sarah. (2008). “Dean Kamen’s “Luke Arm” Prosthesis Readies for Clinical Trials.” IEEE Spectrum. Web. 3 March 2014.

http://spectrum.ieee.org/biomedical/bionics/dean-kamens-luke-arm-prosthesis-readies-for-clinical-trials

This report is published in 2008, before the clinical trails of DEKA arm. It introduced the advances in prosthetic arms by focusing on the new neural feedback technology of DEKA arm: the feedback is given by a small vibrating motor secured against the user’s, which vibrates slightly or intensely according to the signals from the sensors on the prosthetic hand.  Except for introducing the content of this new technology, the report also offered complete context of its development. Mentioning the increasing number of people requiring arm prostheses due to the war in Iraq, it showed the urgent need to fund clinical trials for this next-generation prosthetic arm. By analysing the problem of traditional prostheses – sweaty and slippery connections, low freedom degree – it argued that the prosthetic arms are still in the Flintstones. And by introducing the DARPA funding procedures and problems, it showed the difficulties for DEKA arm to be commercialised.

Burck, J. M., Bigelow, J. D., Harshbarger, S. D. (2011). “Revolutionizing Prosthetics: Systems Engineering Challenges and Opportunities”. Johns Hopkins APL Technical Digest, 30 (3), 186–197. Web. 29 March 2014.

http://techdigest.jhuapl.edu/TD/td3003/30_3-Burck.pdf

This report is published on Johns Hopkins APL Technical Digest in 2011. It introduces the Revolutionizing Prostheses project of Applied Physics Laboratory, which is sponsored by DARPA to create the world’s most advanced prosthetic limb to mimic the human arm and hand despite significant technical, organizational, and cultural challenges. The report introduces the whole research and development process (3 phrases) since 2005, and describes the systems engineering challenges 2009 team faced and the tools, techniques, and processes they used to overcome these challenges over the course of this unique program. From this report, readers can have a sense of the diversity of technical disciplines, geography, and organizational cultures involved in next-generation prostheses. Also, the graphs in this report well illustrated the develop system integration process, the latest structure and basic components of the arm, and how the neural interfaces work.

“By Restoring Sense of Touch to Amputees, HAPTIX Seeks to Overcome Physical and Physiological Effects of Upper Limb Loss.” DARPA RSS. 24 April 2014. Web. 28 April 2014.

http://www.darpa.mil/NewsEvents/Releases/2014/04/24.aspx

DARPA has recently started a new program called the Hand Proprioception and Touch Interfaces (HAPTIX) program. The program builds off the developments of the Revolutionizing Prosthetics program and the Reliable Neural-Interface Technology (RE-NET) program. The HAPTIX program specifically focuses on developing prosthetics with sensory feedback. The article discusses the goals of the HAPTIX program, which are to help amputees regain function and sensation in the limb that they have lost.

Ehrenberg, Rachel. (2012). “For coffee break, woman guides robotic arm with her thoughts”. Science News, 181 (12), 5-6. Web. 19 March 2014.

http://www.jstor.org.proxy.library.georgetown.edu/stable/41697593

This journal article talks about the “Braingate system”. This systems is a computer/brain interface and works when a chip is implanted into the users brain. The chip is able to translate thoughts into actions that are carried out by a robotic arm. Unfortunately the technology is not advanced enough to be used outside of the lab due to the fact that the chip implanted in the brain is currently connected to a computer via a large amount of wires.The team working on this project hopes that this technology in the future can be used for people in need of prosthetics but also for individuals  who are quadriplegics who would have control of an apparatus outside of their body.

Halverson, Nic. 24 April 2014. “Top Prosthetic Limbs Bring Hope to Amputees.” Discovery News. Web. 27 March 2014.

http://news.discovery.com/tech/robotics/top-prosthetic-limbs-bring-hope-amputees-130424.htm 

The article discusses some of the major breakthroughs in prosthetic technology. It talks about five major robotic prosthetics; three of these are lower-limb prosthetics and two are upper-limb prosthetics. The upper limb prosthetics are iLimb and the DEKA Arm. The iLimb is the first prosthetic hand that can be controlled by a smartphone. The hand comes with 24 pre-progammed motions. The user can simply use the app to carry out the motion. However the arm has no sensor system or a sensory feedback system. The article then talks about the DEKA Arm. It mentions that the DEKA Arm and the APL Arm provide greater range of motion, dexterity and control options than any existing arm. The article also talks about how upper-limb prosthetics are lagging far behind lower-limb prosthetics. That is why DARPA initiated a $150 million program to improve the quality of upper-limb prosthetics.

Meyer, Bertolt. 30 August 2013. “Ethical questions are looming for prosthetics”. Wired. Web. 29 March 2014.

http://www.wired.co.uk/magazine/archive/2013/09/ideas-bank/now-we-need-to-talk-about-our-bionic-future

This article is published the September 2013 issue of Wired magazine. It rose up the ethic questions that might be caused by prostheses in the future, including: Who is entitled to get benefit from this obviously unaffordable technology (problem of fairness of medical treatment)? Will people be allowed to replace their natural arms or legs with stronger or more efficient prosthetic ones (boundary of people’s right to treat their own body and commercialization of prostheses)? How to avoid hacking activities toward prosthetic body parts (problem of personal and public security)? The author, as one who has a long history of using prosthetic limb, gave out plenty examples to illustrate the possibilities of these problems. Although prosthetic arms with neural feedback are still far away from surpassing natural arms, it is important to ask these questions, have discussions and find out guidelines before bionic technology is widely adopted and out of control.

Otto, Judith. February 2013. “DARPA’S RP Arms Progress, Nurture Related Wonders.” OANDP. Web. 3 March 2014.

http://www.oandp.com/articles/2013-02_01.asp

This article talks about the DARPA funded projects, the DEKA Arm and Johns Hopkins’s Applied Physics Lab’s Revolutionizing Prosthetics program. The article briefly discusses how long it takes testers to learn how to use the prosthetic arms being developed. In the case of the APL arm, it took the test subject about thirty days to learn how to control the arm only by thinking about moving his arm. The article also discusses different aspects of the prosthetics. The article goes on to discuss some aspects of the prosthetics. Specifically the degrees of freedom and the surgery required to embed the sensors in the testers arm. It explains that one degree of freedom means that the arm can move in a single plane. Six degrees allows the person to move their wrist. The developers hope to eventually build in twelve degrees of freedom because they believe the person will then have a prosthetic that can function as a human hand.

Resnik, Linda. 10 January 2012. “Research Update: VA Study to Optimize DEKA Arm”. Journal of Rehabilitation Research and Development. Web. 18 March 2014.

http://www.rehab.research.va.gov/jour/10/473/resnik.html

This article introduces and outlines one particular study of the DEKA Arm. Its prime objective is to “provide user and clinician feedback to support optimization of the DEKA Arm System to best suit patient needs.” Using data collected from subjects, prosthesis, and therapists, this study aimed to further refine the design of the DEKA arm and hopefully move it one step closer to a commercially available (and affordable) prosthetic. Most of the activities tested are centered on assessing hand dexterity—measuring and pouring flour, reaching into overhead cabinets, and using a nail clipper.

Resnik, L., Etter, K., Klinger, S. L., Kambe, C. (2011). “Using virtual reality environment to facilitate training with advanced upper-limb prosthesis”. Journal of Rehabilitation Research and Development, 48 (6), 707-718. Web. 4 April 2014.

http://www.rehab.research.va.gov/jour/11/486/page707.html

This journal article discusses how a DARPA team is using Virtual Reality systems as a way to train potential users of the DEKA arm. The reason for this is that potential users may have to retrain their minds to be able to control the DEKA arm and other similar sensory feedback prosthetics.  The researchers in this article state the staunch support for the use of Virtual reality to train prospective users of the DEKA arm due to the amount of time needed to learn to control a new apparatus attached to the body. This article shows that the DEKA arm is not simply a “plug and play” option and that it requires the user to retrain themselves in order to use the arm.

Resnik, L., Latlief, G., Klinger, S. L., Sasson, N., Walters, L. S. 2013. “Do Users Want to Receive a DEKA Arm and Why? Overall Findings from the Veterans Affairs Study to Optimize the DEKA Arm.” Prosthet Orthot Intl. Web. 20 March 2014.

http://www.ncbi.nlm.nih.gov/pubmed/24286806

This article chronicles and quantifies data gathered from a  study on DEKA arm users. The main question explored here was, after going through the study and trial period, would the patients want to own their own DEKA arm. The study involved the second and third generations of the prosthetic, and the feedback was heavily in favor of wanting the DEKA arm. 79% of second-generation arm users and 85% of third-generation arm users indicated that they “either wanted to receive, or might want to receive, a DEKA arm.” Over 90% of all subjects in the study indicated that the DEKa arm enabled them to perform new activities that had not been able to do with their previous prosthetic device.

Talbot, David. 5 February 2014. “A Robotic Hand, This Time with Feeling”. MIT Technology Review. Web. 18 February 2014.

http://www.technologyreview.com/news/524286/a-robotic-hand-this-time-with-feeling/

This report is published in the latest February. It showed that except the efforts made for next-generation prosthetic in USA, such as the DEKA arm, there are also some great advanced innovations globally, such as the new robotic hand with feeling developed in Switzerland, which has been successfully implanted on a Dutch man. Different from DEKA arm developers, the Swiss researchers inserted electrodes into two of the patient’s three major arm nerves: the ulnar and median, then forces detected on the fingertips of an artificial hand are translated into electrical stimuli delivered to the electrodes.  This graded sensation is done in real time, and the amputee can immediately feel the difference. The report showed the great progress in prostheses made by this innovation, but it also pointed out that the earlier studies in rats the Swiss implant lasted only nine to 12 months, so the next concern of this technology is the long-term stability.

“U.S. Marine First Subject in FDA Study for Highly Anticipated IMES System.” Alfred Mann Foundation, 15 January 2014. Web. 16 April 2014.

http://www.multivu.com/mnr/65112-alfred-mann-foundation-u-s-marine-subject-fda-study-for-imes-system

The article talks about the Implantable Myoelectric Sensor (IMES) Arm. It explains that the arm has myoelectric sensors placed on the amputees nerves, which allow the amputee to control the arm simply by thinking about it. The IMES research is a FDA approved study. The article explains that the arm is meant to help develop prosthetics that can have long-term use. The article goes on to explain how the IMES arm works. The IMES sensors are placed on the residual muscles of the tester’s amputated hand. The sensors catch signals from the brain and send them to a decoder box. The box decodes the signals and causes the arm to move. Currently the arm has only three degrees of freedom but developers hope to reach upto thirteen.

Walsh, Fergus. 5 February 2014. “Bionic hand allows patient to “feel’”. BBC News. Web. 18 February 2014.

http://www.bbc.co.uk/news/health-26036429

This article details the story of Dennis Aabo. Dennis Aabo is a Danish man who lost his hand due to fireworks accident ten years ago. He was recently fitted with a bionic hand that allows him to feel objects with the hand. The hand was surgically attached to him and is connected to nerves in his upper arm.  The effort to create arm was an interdisciplinary one, as a team of neuroscientists, engineers, surgeons and robotics experts worked together in the effort to create this arm. During the surgery “four electrodes were implanted onto nerves in the patient’s upper arm. These were connected to the artificial sensors in the fingers of the prosthetic hand, so allowing touch and pressure feedback to be sent direct to the brain (BBC)”. Unfortunately this bionic hand is only a prototype but it signifies the progress that is being made in this arena. This is just one example of sensory feedback prosthetics that are being development all around the world.

Wolfe, Jonathan. 25 March 2014. “Groundbreaking Technology Lets Amputees Control Prosthetics Like Natural Limbs.” OpposingViews.com. Web. 27 March 2014.

http://www.opposingviews.com/i/technology/groundbreaking-technology-lets-amputees-control-prosthetics-natural-limbs

The article talks about the Implantable Myoelectric Sensor (IMES) Arm. It explains how the users can carry out everyday tasks. Sgt. James Sides the tester of the IMES arm, in this article says that he has gained back nearly as much function with this arm as he had with his human hand. The IMES arm allows the person to control it by thought alone but it does not provide sensory feedback. The article goes on to discuss the future of IMES and arms that will provide the sense of touch.

Vorhees, Carla. 13 February 2012. “DOD Working Toward Fully Functional Prosthetic Arms.” Armed With Science. Web. 3 March 2014.

http://science.dodlive.mil/2012/02/13/dod-working-toward-fully-functional-prosthetic-arms/

This article gives in-depth detail about the DEKA arm and its development by DARPA. This arm is internally referred to as the “Luke” arm. The “Luke arm” title is in reference to the famous scene in Star War where Luke Skywalker is fitted with a new fully functional prosthetic arm that works just like the one he had before sustaining an injury. The goal of the development of this arm is to “to restore functionality for individuals with upper extremity amputations. (Vorheese, 2012)” The article details how the depictions of day prosthetics in popular media (Star Wars, Terminator, etc)  has confused the general public as to the actual capabilities  of modern day prosthetics. In addition there is discussion of the difficulty in terms of calibrating the DEKA arm to pick up different objects. For example the difference between picking up a glass of water versus using the arm to use a power drill was discussed.

Additional Sources

Dize, Chad. “Chad Dize Interview.” Online interview. 4 April 2014.
Giuffria, Angel. “Angel Giuffria Interview.” Online interview. 21 April 2014.
McLoughlin, Michael. “Michael McLoughlin.” Personal interview. 11 April 2014.
Sides, James. “Sergant James Sides Interview.” Online interview. 21 April 2014.

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