The Upper Limb Bionics Problem

In this week’s discussion, our COO Marta Szymanowska and VP of Sales Matthew Parkinson take a look into the upper limb bionic problem: 

Marta: Hi Matthew! Looking at upper limb amputees, it seems that - despite the technology - there is still quite a low adoption rate of multi-articulated bionic prostheses and, worse still, quite high drop-out rates. What’s going on?

Matthew: Yes, Marta, it’s the elephant in the room. The high-end products seem to get more complex and more expensive all the time, yet actually “bionic” hands don’t seem to consistently deliver for the user.

Marta: But why? What can be done?

Matthew: There are a number of areas for improvement, from the ease of use, through strength – both in the sense of grip power and durability - to the ability to personalize the hand for each user. Put simply, it’s about outcomes; it’s not about how many grips you have or the bells and whistles a product has, but the actual outcome for the user - something the O&P world has rarely measured or even been able to measure. Once a user is fitted and out the door, how are they monitored?

Marta: Ease of use is clearly vital and work continues on pattern recognition and the like, so this should improve. But tell me more about the strength, personalization, and outcomes.

Matthew: I think some myo users are happy with the single-action open/close hand or even something more basic because it’s powerful and doesn’t break much. They can depend on it. The more moving parts, the more room for damage, and many earlier bionic hands were just too delicate and some today still break rather easily and - what’s more - can take an age to repair, as you have to send back off to the manufacturer. So, any hand has to be fit for purpose: strong enough to hold things confidently and not liable to breaking. If there is a problem, it needs to be able to be repaired quickly on the spot. But likewise just being strong isn’t enough if this is a bionic hand - it also needs to be precise and to have a light touch when required, and I don’t just mean proportional control.

Marta: So, like what? Can you expand?

Matthew: The Zeus has Soft Grip. This means that a user can have an incredibly light touch, but then, if they want to, can squeeze and crush the object. It’s that range, that we all take for granted, that is needed. 

Marta: You say more grips don’t necessarily mean better outcomes, but surely the more grips a user has access to, the better? 

Matthew: There are two main points: firstly, most users will only regularly use 4-5 grips, but more importantly are these grips exactly what they need in their lives? We all see the same pinch, tripod, and key grips, but how do they correspond to what each user actually does in real life? Here again, I think Zeus is tackling the problem. You can change the exact finger positions on each and every grip to exactly what the user requires and see what that looks like. But I’m biased!

Marta: Yes, we both may be a little biased. So how do we measure the outcomes, as you said at the beginning? That’s the key and eliminates personal bias.

Matthew: It’s what the industry needs. Not only to actually give the users a real solution, but even, long-term, to justify reimbursement. Aether is working on its Digital Therapy Platform, to follow the user’s journey, from start to finish. CPOs could remotely check and monitor the data to help decide the next steps for each person, to make sure that their quality of life is improving. 

Marta: It’s an exciting time. I think the important thing here is to keep the users front and center as we have always tried to do.

Thanks for your time today and have a good weekend!