When Americans are wounded in Afghanistan or Iraq, no expense is spared to
save their lives. But once they're home, if they have suffered an
amputation of their arm, they usually end up wearing an artificial limb
that hasn't changed much since World War II.
In all the wonders of modern medicine, building a robotic arm with a fully
functioning hand has not been remotely possible.
But as 60 Minutes correspondent Scott Pelley reports, that is starting to
change. One remarkable leap in technology is called the DEKA arm and it's
just one of the breakthroughs in a $100 million Pentagon program called
"Revolutionizing Prosthetics."
Fred Downs has been wearing the standard prosthetic arm since 1968, after
he stepped on a landmine in Vietnam.
"It's a basic hook. And I can rotate the hook like this and lock it,"
Downs told Pelley, demonstrating the limited movement ability of his
prosthetic arm. "In those days they didn't have a lot of sophistication
about it. They fit you and say, 'This is your arm, this is your leg.' And
it was the best technology in those days and you just had to make yourself
learn how to use it and I did."
Today, Downs is the head of prosthetics for the Veterans Health
Administration. He told Pelley the technology used for his arm was
developed during the World War II era.
"There's a hook, something out of Peter Pan. And that's just
unacceptable," Dr. Geoffrey Ling, an Army colonel and neurologist who's
leading the Revolutionizing Prosthetics program, told Pelley
Col. Ling is a physician with big dreams and little patience, especially
when touring Walter Reed Army Medical Center and meeting the troops he's
working for. "We have a saying in the military, 'Leave no one behind.' And
we are very serious about that. And that doesn't mean just on the
battlefield, but also back at home," he said.
Ling told Pelley they've made great strides in artificial legs, but a good
arm has never been within their grasp. "If you look at your hand, it's an
incredibly complex piece of machine. What nature provides us is
extraordinary. The opposable thumb, the five finger independently moving,
articulating fingers. It's fantastic what this does."
"And when you lose your hand you've lost something that makes you human,"
Pelley remarked.
"You're so right Scott. Because, think about what makes us separate from
every other animal species. We have an opposable thumb. That is, in fact,
what makes us human," Ling said.
Ling is determined to give that humanity back. His project is run out of
DARPA, the Defense Advanced Research Projects Agency--the same group that
oversaw the creation of night vision, stealth aircraft, and GPS.
Ling told Pelley it's a very large-scale project. "It is very much like a
Manhattan Project at that scope. It is over $100 million investment now.
It involves well over 300 scientists, that is engineers, neuroscientists,
psychologists."
One of the scientists Ling asked to join the team
is Dean Kamen, a sort of rock star in the world of inventors. His
creations include dozens of medical devices, and the Segway.
They are inventions which have made him a multimillionaire.
"When the folks from the Defense Department came to this office and said,
'Here's what we need,' what did they tell you?" Pelley asked.
"We want these kids to have something put back on them that will
essentially allow one of these kids to pick up a raisin or a grape off a
table, know the difference without looking at it. That is an extraordinary
goal," Kamen explained.
"He basically said, 'You're crazy.' That's what he told us," Ling
remembered. "He said flat out, he and he himself, who's a crazy guy
himself, I mean he is very innovative thinking. He's a brilliant man,
totally brilliant man, but a mad scientist."
Kamen told Pelley he thought the Pentagon and DARPA were unbelievably
optimistic in their expectations and that he told them that.
"He said to us, he said, 'I can do my, you're crazy. But, we're willing to
rise to this, rise to the challenge because it's important,'" Ling
remembered.
Kamen took 60 Minutes behind the scenes at DEKA, his company in New
Hampshire, to show Pelley how inspiration becomes invention.
"Engineers design a part on a computer, he fires it up here on our
network," Kamen explained.
His team of 40 engineers spent a year working on the problem. What they
came up with was a high-tech, wired attachable arm and hand.
"When you first started this, did you sit down at your desk and look at
your hand? And figure out how it worked?" Pelley asked.
"Well,
most good engineering is some adaptation of what nature does," Kamen
replied.
It all began by creating dozens of gears, joints and computers that mimic
nature's design. But then came the hard part: meeting DARPA's demand for
an arm no larger than the average human's and no heavier than nine pounds.
Kamen showed Pelley a part of the DEKA arm which contained three
processors. "Think of this as three PCs worth of computing power. And all
of this just fits, it's round because it just fits in the wrist joint."
Asked what the toughest part of the engineering process was, Kamen
replied, laughing, "All of it."
The prototype had 25 circuit boards and 10 motors. But it would be no good
at all unless the patients were willing to accept it.
"We went and started talking to the real patients, the potential users,
down at places like Walter Reed. And immediately, we were shocked to
learn, even just the hollow plastic shell that they wear when they're out
and about, it sweats, and it hurts, and it irritates. And we came back and
realized that if we build the world's best nine-pound arm, but nobody will
wear it because 24 hours a day, or 12 hours a day, of wearing a nine-pound
arm is going to be irritating, and frustrating, we said, 'We've got a way
bigger problem here,'" Kamen remembered.
So Kamen's team created a new way to connect the DEKA arm to the body
using tiny, round balloons.
"And you'll notice now, if I hit this button, these things are inflating.
And that's a nice, gentle pressure there. But if that's displaced all over
your whole shoulder, that's an enormous amount of structure," Kamen said,
demonstrating how the balloons work.
"So, now the arm is gripping tight on the whole shoulder...so you can lift
something heavy," Pelley observed, watching the arm in action.
"Right. And as soon as he's not gripping tight and heavy, one or the other
might just deflate," Kamen explained.
Trying on the DEKA arm
Kamen asked Fred Downs, the VA official in charge
of prosthetics, to take off the hook he'd been wearing for 40 years and
give the new arm a try.
The arm Downs tried out is controlled by flexing the shoulder and pressing
buttons built into his shoes - almost as if he's typing with his toes.
Downs told Pelley he was very skeptical. "Because I've seen lots of
inventions come along in my years of being in charge of prosthetics, and
so some great stuff, but in the long run it doesn't really work because
your body only has so much tolerance for gadgetry."
After practicing for ten hours, Downs showed Pelley what he could do. He
picked up a soda bottle, using his toes to control the grasp.
He was then able to open the bottle and take a drink from it.
"The feeling is hard to describe. For the first time in 40 years, my left
hand did this. I almost choke up saying it now. It was just--it was such
an amazing feeling. I was 23 years old the last time I did that," Downs
said.
"It felt so good to move my arm again--to do things with it. Not as fast,
but it worked," Downs remarked.
"You just said 'move my arm...again.' Did it feel like your arm, all of
the sudden?" Pelley asked.
"It did. It did. It felt like my arm. It was me," Downs said.
"You're sure I can't take this arm with me? I'm ready for this arm," Downs
joked, after trying out the DEKA arm.
If he is eager to have the DEKA arm, imagine what it would mean to Chuck
Hildreth, who lost both arms at the age of 18 in an electrical accident.
He's been volunteering at DEKA for nearly two years.
"Now, it seems to me that one of the issues here would be that you don't
have any feeling in this hand. So the question becomes, I mean, how do you
pick up an egg? How do you pick up something that you might crush? How do
you know?" Pelley asked.
"I have a vibrator sensor here that tells me how tightly I'm grabbing
things. The more intense the grasp, the more intense the vibration is,"
Hildreth explained.
In an experiment using a plate of grapes, Hildreth managed to pluck off a
grape, without crushing it with his robotic arm.
Consider Hildreth hasn't eaten like this in nearly 30 years--using the
arm, it did take him a moment to eat it.
Many of the innovations in robotics that make this possible are already at
work in artificial legs. "These are the latest and greatest. These are the
'Power Knees.' They actually have a motor inside them. They help propel
me," explained Josh Bleill, who lost his legs in 2006 to a roadside bomb
in Iraq.
Last year he became the first person in the world to walk on two of the
power knees. They're legs that propel themselves and talk to each other to
keep a constant speed and stride.
Asked how fast they can go, Bleill told Pelley, "Faster than I can
control, to be honest with you. Not to a run yet, but they do have a lot
of power."
Connecting to the nervous system
Now making a robotic arm move as naturally and
effortlessly as Bleill's high-tech legs is the next step in
revolutionizing prosthetics. Col. Ling says the key is connecting the
artificial limb straight into the nervous system.
"Remember, they lost their arm. But that big bundle of nerves that came
out of the spinal cord still exists in their shoulder," he explained.
"So the nerves that control the arm are not necessarily lost with the arm
and the brain continues to send those signals to those nerves when a
person imagines moving their missing limb," Pelley asked.
"That is correct," Ling replied.
Jonathan Kuniholm is uniquely qualified to figure out how to tap into
those signals. He's a biomechanical engineer at Duke University who lost
his arm to a roadside bomb in Iraq.
"Explain to me what you're doing with your right arm and the sensors, and
how that relates to your new right hand," Pelley asked.
"I'm imagining performing movements with my right hand, and when I do that
I am moving the muscles that remain here in my arm. When those muscles
move they make little electrical impulses that we can detect with these
electrodes," Kuniholm explained.
He controls a robotic arm simply by thinking about moving his own hand
that no longer exists.
Asked how much training is involved to learn how to move the hand,
Kuniholm told Pelley, "I'm not really learning, so much as the computer
is. I'm doing what I imagine I'd like to do. And we've taught the computer
to interpret the signals and do what it is."
He said it almost feels natural to him.
After four years and $100 million, arms controlled by thought are still a
work in progress. But in the meantime, the DEKA arm is headed to the VA
for clinical testing in the hope that is will soon becomes available to
the nearly 200 arm amputees from Iraq and Afghanistan.
"Nobody ever wants to put a price tag on making a soldier or a Marine
whole again. But, you're talking about $100 million," Pelley remarked.
"It's a big number."
"It's a huge number. But it does a number of things. Number one is, of
course, it fulfills our commitment to these fine your men and women who
the issue of money compared to what they have done for the service of the
nation becomes immaterial," Ling replied. "However, this is not a
classified, military weapons system. This is an advancement in medical
technology. And the beauty of this particular effort is that this is
another gift of the American taxpayer to the entire world.
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posted by Larry Scott Founder and Editor
VA Watchdog dot Org
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