Loomio
Tue 19 Mar 2019

Upper Limb Prosthetic Design Handbook For Makers & Hobbyists

JB
Jason Bender Public Seen by 222

My name is Jason Bender and I am a Certified Prosthetist from the United States now living and working in Myanmar. I am seeking to between $1,500-1,900 (now $2,400-$3000 see comments) to complete a design handbook/reference targeted hobbyists and makers to hopefully catalyze them in developing new devices and pathways for the limb-loss community. Formal proposal to follow after discussion.

The Global Need
According to the World Health Organization, 9 out of 10 people globally do not have access to the assistive devices they need. With an estimated 4-12 million people living with upper extremity limb-loss and 300,000 new upper-limb amputations occuring every year, it is imperative that we find new innovative pathways of delivering quality and effective prosthetic devices and services to the underserved limb-loss community around the world.

A New Source For Ideas
An emerging source for innovative approaches to prosthetic care is the global hobbyist, maker, or “hacker” community. Disruptions emerging from this cohort include both methods of delivery as well as functional devices--some of which have even been approved and accepted by traditional healthcare systems.

Equipping New Designers
Therefore, the purpose of this handbook is to equip people from more diverse backgrounds to join the work of imagining and creating new prosthetic devices and services. Using theory and principles from over 200 years of prosthetic history, this handbook seeks to provide resources and tools that will help hobbyists, makers, and “lay” designers to not only avoid repeating the mistakes of the past, but be better equipped to provide meaningful contributions to the global limb-loss community.

Beginning with a proper framework for prosthetic care provision and historical background, the handbook will cover various aspects of device design, including: upper limb anatomy and function, useful biomechanics, mechanical hand design, device control methods, and design-for-manufacturing with a focus on 3D-printing.

A brief sample is attached.

Let me know your thoughts. As I mentioned in the Facebook group, while I'd love to do this for free, our existence in Myanmar is dependent on keeping our fledgling small business going. Full support from e-Nable will also allow to keep the work 100% free and available to the entire maker community. Can discuss multiple funding strategies.

Have a look at the sample, especially the intro and TOC and let me know what you think. Good to hash it out a bit before the formal proposal.

JS

Jon Schull Tue 19 Mar 2019

This is very exciting! I urge you to go forward! I hope you will be able to get input from other e-NABLErs with some prosthetic training as well @changliu1. Here are some issues for you consider.

Perhaps it should be a project in wikifactory so we can track and provide input, feedback,, etc. (Personally I think e-NABLE Fund funding should not prevent you from owning the copyright with an appropriate open-source license. I would not consider this a work-for-hire, though as an open-source project we would be able make our own versions etc..)

JB

Jason Bender Wed 20 Mar 2019

I was actually considering this. Developing it as a Wikifactory project would be a great way to stay accountable and solicit input from others. Obviously would need a full funding commit for that but could even break funding up into multiple, benchmark-dependent disbursements to reduce e-nables risk. Wikifactory seems like a logical to keep everything open and accountable.

E

ebubar Wed 20 Mar 2019

I think this resource will be fantastic. I might suggest getting a input from some eNABLE designers on chapters as they're written as well as from those with formal prosthetic training. I would imagine Peter Binkley, Skip Meetze, Jack Buchanon (and others) who are all responsible for some of eNABLEs strongest designs may create some awesome improvements to their designs based on this work. Have you also considered getting some support for this from something like kickstarter? I personally think its worth more than what you're asking and you may be able to attract donations for such a resource through another crowdfunding platform?

JB

Jason Bender Wed 20 Mar 2019

Thanks Eric. My only challenge w/ kickstarter is it helps if the end poduct is not free, which I'm hoping to avoid. Unless I could get some champions to drum up support from eNablers.

You're right about getting input from eNablers. Really need help particularly on the 3d printing section--will probably reach out to many of the people you mentioned.

YM

Yoav Medan Wed 20 Mar 2019

I am in favor of having an open-ended handbook where e-nablers can add the accumulating wisdom as edited chapters, reviewed by peer e-nablers.

BR

Bob Rieger Wed 20 Mar 2019

I share the positive sentiment of Jon andEric and I support this funding and need. I personally welcome more professional information about prosthetics, and I'm sure most other volunteers will, also. I am also intrigued about Yoav's suggestion of an open-ended handbook, although I would not want to see the handbook's professional presentations distorted in any way by opinion or anecdotal evidence that is not properly vetted.

JB

Jason Bender Wed 20 Mar 2019

Agreed. I think an eNable Wikipedia of sorts sounds enticing, but policing to keep level of evidence at an acceptable standard is not a trivial task. "I tried this and it didnt have any issues" is not the same as an industry-standard best practice.

Maybe there is a place for both? When I was developing the Hintha Hand half the group didnt even known castration rings were having durability issues. Having a common place for these kinds of things would be nice.

BR

Bob Rieger Wed 20 Mar 2019

Absolutely, Jason. I believe professional guidance is what is needed at this point, not a compendium of everyone's opinions. Having said that, I do agree there is a place for both. Perhaps a section on Wikifactory for the sharing of ideas, practices and experiences?

E

ebubar Wed 20 Mar 2019

Another thought may be to include STL designs for some of the mechanisms that you'll likely be describing. For example, a mechanical four-bar-linkage STL as you describe for the bebionic finger could be used as an excellent educational tool. This comes from imagining how I may use something like this in training my students in designing prosthetics. It may be a good opportunity for opening educational opportunities and/or design challenges for the community to create representations of the concepts from the manual. Makers gonna make after all. :)

JB

Jason Bender Wed 20 Mar 2019

I'm really glad you brought this up. As fun as the old-school handbook vibe is, can't help but feel this maybe should be a web-based (self-hosted page?) resource with gifs, videos, and STL links. Would make some concepts WAY easier to grasp--and thats the ultimate goal.

JS

Jon Schull Wed 20 Mar 2019

Agree 100% re 21st century media and process. Wikifactory's editor is easy and wysigyg. WF would work well for early creation and collaboration, and the team could then figure out how to develop and disseminate further. By the way, this French Prosthetics text from 20s should be a good resource.

This could be an important project. I'm hoping it can help "both sides" appreciate the complementariy between time-honored but innovation-retarding principles of standard practice vs user-oriented fresh-canvas "substantially better than nothing" design practices.

I also agree that your "ask" is unnecessarily modest. If you do it installments, and it is open-source from the start, and you are willing to act as manager/editor/curator, you will need more to be able to launch and sustain the effort.

BR

Bob Rieger Wed 20 Mar 2019

I agree with the interactive web-based format......I suspect you used the word "handbook" in a conceptual sense.........

JB

Jason Bender Wed 20 Mar 2019

If I can summarize the discussion up until now, and add my thoughts:

1) Overall support is quite positive -- Great!

2) Web-based over paper-based -- Question is whether to be Wikifactory-based in the beginning or not (i.e start on a self-hosted or other platform). Don't feel strongly either way, my only concern would be if and when the time comes to export from WF, will it be compatible with self-hosted site or are we creating more work in long run by starting on WF?

3) Funding ask is too modest -- You caught me, didn't want to scare everyone away on my first proposal, but I appreciate your honesty here. Open to input from SPC on what they think this project may be worth to the community. Ideally, I need to make at least $800-$1000/month of "business-related activities" to maintain our visa, the rest is subsidized through an NGO. So for me, a robust funding situation would be:

  1. Initial grant of est. months of initial work * $800-$1000/month (e.g 3 months work ~$2,400-$3,000) (doesn't mean it will be done in 3 months, I have other responsibilities too, but the estimated total burden of the work).

  2. Then a much, much smaller ongoing maintenance fee (~$80 month??)

In such a scenario I could feel really comfortable at being the "lead curator" of this project. But happy to hear your thoughts as well.

JS

Jon Schull Wed 20 Mar 2019

re #2, I suggest you reach out to Christina Rebel at Wikifactory and see what she thinks. She'll love the project and may, for example, prioritize some features on the roadmap (like incorporation of google docs or authoring in Markdown) in order to keep you in the tent. Under the hood, Markdown is what they use, and is the right format, I suspect.

#3. You caught ME! $800-1000 / month is a big jump up from your initial offer. Given our current bank balances, I don't think we could support that and wouldn't support it.

JB

Jason Bender Wed 20 Mar 2019

re #2. Good idea. I'll reach out to her and see what she thinks.
re #3. Woops! Maybe my comment wasn't clear. $800-1000/month would just be for the "estimated months of work" to get the first edition up and running. So let's say its 3 months or ~450hrs of work to do first edition. That's $2,400-$3,000 one time. Then for ongoing editing/curation the fee could be much, much less, say 0.5 days/week so...like $80/month. I'll update my comment.

JS

Jon Schull Wed 20 Mar 2019

That might fly (with me) depending on the goals you set for the first month and the notion that each month is renewable or not by the community. Or something. I say "with me" because I don't mean to give the impression that you are negotiating with me. (You're discussing with the community and I'm meddling more than I'd like.) I'm just trying to help coach this to success. We need other input (Signing off now.)

JB

Jacquin Buchanan Wed 20 Mar 2019

I would definitely use a resource like this. Though I have to say as the conversation builds I can see a lot of value beyond just "developing new devices". There are probably a dozen, certainly less than 100, designers in the e-nable community. In a pinch you could get them all in a room for a workshop. There are many thousands of fabricators and fitters of these devices. I think a reference from someone like yourself that informs and helps that larger group could have a greater impact on this community. Maybe I am speaking of two different things. If so then I hope you can "help" with both.

JB

Jason Bender Thu 21 Mar 2019

I agree a sort of fab & fitting best practices manual would be very beneficial to the community but it is not something I as a certified professional could be part of.

Being seen to encourage non-professionals to involve themselves in direct care w/o any enforcement mechanism is not something my profession would smile on (nor am I fully supportive of).

JB

Jacquin Buchanan Fri 22 Mar 2019

OK, I see your point. Curious if I could find a traditional prosthetics manufacturer to write this other manual.

JS

Jon Schull Fri 22 Mar 2019

@changliu1 a prosthetics student has been writing materials to advise non-professionals like us on best practices. As her professors insist we make clear, this is non-professional advice, and professional involvement is a good thing. But she's VERY VERY GOOD, and she's working on fitting techniques intended to require less expertise than prosthetists assume and require.

I believe she will soon provide some links and a roadmap to her work.... ;-)

JB

Jason Bender Sat 23 Mar 2019

You, Jeff and I have gone round and round on this before (and probably will again), we'll have to agree to disagree I think.

FWIW i am also working on some devices that may push things closer to "off the shelf" too. Lowering entry barriers is vital, but different than no barriers.

JS

Jon Schull Sat 23 Mar 2019

:thumbsup:

SM

Skip Meetze Thu 21 Mar 2019

Jason, your Hintha Hand design shows your mastery of many design elements presented over the history of e-NABLE. That with your mastery of the O&P profession and your obvious talent as a writer makes you an ideal author for the handbook you propose. In the Hintha Hand, I see elements going back to 2014 like the thumb in Ali Lemus’s GalileoHand, through 2016 with Blies Ingram’s Drinky Pinky and with contemporary designs like the Gripper, the Kwawu and the TuuTree. With the flurry of excellent design activity in the community at present, we need this book! The sooner you get started the better!

RV

Richard VanderMey Fri 22 Mar 2019

I second that Skip, we need a Handbook mostly for New Members but one we can all use as well.

E

ebubar Sat 23 Mar 2019

Posted a Facebook messenger message to you for a possible additional funding avenue. Cheers!

SS

Saiph Savage Mon 8 Jul 2019

hi Jason, with @jonschull we are leading a study to understand how OT work with makers etc. Would it be possible to interview you to get your perspective? Thank you for all the hard work!