Intro: Superhero Arm
I met nine-year-old Aidan Robinson at a summer camp he attended called Superhero Cyborgs. This camp, run by KIDmob, is a place where kids with a variety of limb differences design their own prosthetic and orthotic devices. Each kid's design was impressive, but Aidan's playful ideas really resonated with me. To me, Aidan's ideas were a model for how prosthetic devices could and should be more appropriate, useful, and fun than those typically used for both children and adults.The typical prosthetic arm has a robotic hand or a hook that does not adapt well to a variety uses.
Aidan was born without a left arm below the elbow and has had many different types of prosthetics, all leaving him feeling almost better off without them. Despite these hurdles, and like the resilient and creative kid he is, Aidan adapted extremely well to life with a limb difference and is more active than most kids his age. Because the prosthetic is a part of him, we both felt that he needed a device that accurately reflected his personality and interests.
Aidan and his mom had two main goals for his new device. Aidan wanted access to multiple task specific attachments on one device, like a swiss army knife. Aidan had specific-enough interests to know exactly the tools he wanted on his arm, mostly consisting of things that helped him play favorite games or do everyday tasks. Aidan's mom, Jill, wanted something that would grow with him. Prosthetics are often expensive and custom fit. To be worth the cost, Aidan had to get long-term use and be more satisfied with the device overall.
I took the ideas Aidan and his mom came up with, and together we designed the following prosthetic device.
Step 1: Aidan's Ideas
The Superhero Cyborgs workshop was structured so that Aidan could work like a real designer, allowing him to be a creative Superhero and realize some of his ideas. He started off with some brainstorming sketches and moved on to do some really great prototyping work to test out some of his ideas. Aidan's sketch shows he has some really big ideas for a super adaptive, multifaceted device. But to get started, he kept it simple but cool and made himself a yellow LEGO character hand and a custom molded socket.
Step 2: The Socket Part 1: Thermoforming
Prosthetic sockets are traditionally expensive and fixed-size, even when they're designed for use by rapidly growing and changing kids. The expense of keeping a kid in clothes and shoes that fit is challenging enough, but adding on many thousands for a new prosthetic device can be financially overwhelming for some families. In addition, constantly having to use a device that doesn't quite fit is frustrating and can be painful.
The goal for the socket portion of the prosthetic device was to have something that could be reshaped and reformed to grow with Aidan.
My solution to this problem was to build the socket out of PLA plastic. PLA is printable on a Makerbot or similar 3D printer and can be reshaped with hot water. I named the parts of the socket the barnacle and the starfish. The barnacle is the part of the socket that has direct skin contact and extends to the outside and accepts the attachments. The starfish is the part that wraps around the end of Aiden's arm and gives the assembly most of it's structure.
The bottom part of the socket, the barnacle, works best if it is printed in two materials: PLA and Ninjaflex. To print in both materials, I switched out the filament about a third of the way through the print.
The file for both of the plastic socket parts are attached below.
Plastic parts can be formed with 180 degree Fahrenheit water on a plaster cast of the residual limb or directly on the skin. Let the part cool slightly after submerging it in water and before forming it onto the arm. During the fitting process, try not to deform details such as the receptacle for the ratchet wheel or the holes on the ends of the starfish's arms.
Step 3: The Socket Part 2: Sewing the Sock
In order to achieve good suspension (keeping the prosthetic on) a well-fit sock is very important. The sock is the fabric portion of the prosthetic socket that extends past the elbow.
I have done a fair amount of sewing in the past but I am not exactly a professional, so this part was hard for me.
I was able to get samples of a fabric from the company that used to make a product called Fabrifoam. I chose this material because it has a high coefficient of friction against skin on one side and it accepts Velcro very well on the other. Fabrifoam can be ordered here.
The sock is made from two pieces of fabric and a piece of Velcro. The first piece is a circle, about 3 inches in diameter, with about 10 slits cut around the edge towards the center to form a more dome-like shape. This circular piece has a 3/4 inch hole cut in the center to allow for the end of the barnacle to pass through it. The second piece of Fabrifoam is a rectangular piece that is sewn around the circular piece to create a tube. The seam between the two edges of the tube is connected by the Velcro strip.
Just like people's arms, not all socks will look the same, and they shouldn't necessarily. The point is to create something that will fit comfortably on the body, so feel free to make size and cut modifications as needed.
Step 4: The Socket Part 3: Assembly
Assembly of the socket is fairly simple.
First, take apart the ratchet knob. Take all the internal parts, along with the knob portion, out of the bottom housing and screw it into the top portion of the socket. Thread the cable through the holes in the ends of each of the starfish arms. If the cable is not long enough, longer lengths are available on McMaster Carr.
Second, cut small pieces of sticky-back Velcro to the ends of the starfish's arms.
Next, place the barnacle on the end of the residual limb. Pull the fabric sock over the limb so that the end of the barnacle extends out of the hole.
After adjusting the position of the barnacle and sock so that it fits comfortably, place the starfish over top of the limb. Tighten the ratchet knob so that it is comfortable but secure.
Finally, you can place a quick release clamp over the end of the barnacle and tighten it with the lever. The quick release knob holds everything together and creates an easy way to change out the attachments.
Step 5: Attachments Intro
This device has a flexible and simple attachment system and user-need driven attachments. We wanted Aidan to be able to change out the attachment by himself without help, and to realize anything he could dream up as an attachment in the future. For this reason, I kept the interface between the socket and the attachments simple.
The end of the socket has a 1/2 inch hole in it and each attachment mounts on a 1/2 inch rod. The attachments clamp on with a seat post clamp from a bicycle. Anything that mounts to a 1/2 inch rod can become an attachment for Aidan's prosthetic arm. So, when you're doing this yourself, have fun imagining the possibilities! The following attachment instructions are ideas inspired by and for Aidan, but feel free to change or adapt them to better suit your purposes.
Step 6: Attachment 1: Wii Nunchuck
One of Aidan's priorites was to get a Wii nunchuck as his prosthetic. Wii is a video game platform that often requires two-handed game play. By mounting the nunchuck controller to the end of Aidan's prosthetic, he would be able to experience and play Wii games more fully. Creating an interface for all buttons on the Wii nunchuck was outside the scope of this project, but engaging the accelerometer functions of the nunchuck made important progress towards increased access to what the game platform offers.
Translation: Aidan can now have more fun playing Wii.
In order to securely attach the Wii remote to the 1/2 inch rod, I cut the cord of the Wii remote, threaded it though a tube and re-soldered it together. I used epoxy putty to connect the tube to the remote.
Step 7: Attachment 2: Fork and Spoon
Aidan's a smart kid, and has already adapted well to eating with one arm. But, he wanted to be able to hold food in place more easily for cutting. I designed a fork attachment to make the process easier.
The fork attachment was made on a manual mill and drill press.
First, I milled down the end of an 8-inch piece of aluminum rod so that it had a flat section to bolt a fork. Next, I drilled a hole in middle of a fork handle and in the flat section of the aluminum rod. Finally, I tapped the hole in the aluminum rod and bolted the fork to it with the appropriately sized socket head cap screw.
The bolted joint gives Aidan the flexibility to adjust the fork's angle to best suit his needs in the moment.
Step 8: Attachments 3: Violin Bow
In Aidan's 4th grade class everyone learns to play the violin. Before this attachment, Aidan couldn't hold both the bow and violin at the same time.
Aidan and I chose to make a bow attachment because he would need more dexterity to use the fingerboard of the instrument than to use the bow and play successfully. The 3-D printed parts of this attachment are held together with 8-32 bolts. These bolts clamp onto the end of the violin bow. The spring in the base of the parts help to keep a relatively constant pressure on the violin's strings.
The file for the 3-D printed parts is attached below. As with the fork attachment, the aluminum rod for this part needs to be milled to a semicircle on one end.
Step 9: Attachments 4: Bike Riding Arm
Aidan's mom requested an attachment to help him ride a bike. All he needed was a second point of contact on the handle bars for steering and balance. This attachment provides him with that stability. It is intentionally reminiscent of Aidan's original LEGO character prototype that he built at the Superhero Cyborgs workshop.
The bike riding arm was made out of wood and painted with yellow spray paint. I drilled a hole in the back of the hand and inserted a 1/2 inch tube to interface with the socket.
Step 10: Attachment 5: LEGO Hand
The LEGO hand is my favorite attachment for a number of reasons. First of all, LEGO are a great building toy and this hand allows for a childhood dream of mine: the ability to build with LEGO on your own body! Secondly, this was one of Aidan's original ideas. Lastly, and most importantly, this attachment acts as a platform for Aidan to prototype future improvements or attachments to his prosthetic device with an already familiar medium.
Step 11: The Future
Before working on this project I had never thought much about prosthetics. When I saw how easy it was for the kids in the Superhero Cyborgs workshop to dream-up and realize ideas that fit their lives, it highlighted how unsatisfying commercially available designs could be. Looking at Aidan's sketches in comparison to the devices he had been using, it was clear that the "one-size fits all" approach was almost more limiting than his limb difference for him. I couldn't help thinking that those kids should have devices as awesome and unique as they are; that whenever possible, prosthetic devices can and should be a platform for showing-off the user's identity and interests as well as being a useful tool. Aidan had clearly done plenty of creative thinking on his own and was brimming with ideas for newer and better devices that fit his needs. I was lucky to work directly with him during the design process so we could put his thoughts and feedback straight to work.
I plan to refine the socket portion of Aidan's device and to work with him to create new attachments he can now prototype on his LEGO hand. Some in-progress ideas for future attachments include a water gun arm and a set of vice grips to hold onto anything that fits in their jaws...and have the firmest handshake of all time. I am excited to see more people try out this system so it can continue to develop and the list of awesome attachments can grow. Be sure to leave lots of comments when you try it!
Moving forward, my biggest hope for this project is that the attitude towards people with limb differences shifts from thinking they need a "replacement" for something that's "missing" from their body, to thinking their difference reveals a blank canvas to be filled with devices that are personalized, useful, and fun for the user.