Real Cyborgs: Robo-Inspired Implants to Re-Engineer the Human Hand

Robo-Inspired Implants to Re-Engineer the Human Hand

Humanity will eventually combine sensing, computation, and actuation (ie. robots) and human biology to create more-capable human "cyborgs" (for lack of a better word). There are a number of good examples of this already: Contact lenses that change their focus, exoskeletons to provide superhuman strength, and even some special prosthetics. By and large, these advances are non-invasive. However, I think we're nearing an era where that will no longer be a restriction -- people will have elective surgeries to add robotic elements to their bodies. My friend Ravi Balasubramanian from Oregon State (recent NSF CAREER Award winner!) is already making great strides in this vein; Ravi designs implantable robotic mechanisms that re-engineer the human hand to restore adaptive grasping capabilities to patients who have lost range-of-motion or grasp strength -- read on for details. This is just the beginning; some day, I imagine technologies where we can programmatically change muscle-tendon connections to trade off dexterity vs. strength (much like humans vs. chimps). Warning: This post contains photos of surgical implants in human cadavers; some people may find such images disturbing.

I think there are a lot of good examples of "cyborg" technologies already: Contact lenses that change their focus as our biological lenses degrade with age, the Equipois "anti-gravity" balancing arm to let manual laborers work without muscle fatique, exoskeletons to provide superhuman strength or restore mobility to older adults, and even some prosthetics (legs, eyes, and fingertips) which extend the capabilities of disabled folks. 

exoskeletons cyborg fingertip restores sense of touch Equipois anti-gravity arm support


However, I think we're nearing an era where people will begin to have elective surgeries, much like electing to get Lasik corrective eye surgery, to implant robotic elements that extend their innate human capabilities. And it's not as far away as you might think.

My friend Ravi Balasubramanian from Oregon State is already making great strides in this vein, and he recently won a prestigious NSF CAREER Award for his work. Ravi designs implantable, robotic mechanisms that re-engineer the human hand to restore adaptive grasping capabilities to patients who have lost range-of-motion or grasp strength. He's got a long road ahead to get these implanted in living patients (FDA regulations for implants are tough!)... but in my mind, this is just the beginning; some day, I imagine technologies where we can adaptively change our muscle-tendon connections to programmatically trade off dexterity vs strength -- so that we can have super-human dexterity for fine motor skills, and then moments later have the strength of a chimpanzee.

Anyway, it's worth checking out Ravi's work, like this paper: "Implanted passive engineering mechanism improves hand function after tendon transfer surgery: a cadaver-based study." Here's how it works:

Implantable adaptive grasping mechanism

Implantable adaptive grasping mechanism


The best part of Ravi's work: It's not just theoretical. He works with doctors to test these mechanisms on real, human and animal cadavers:

Implantable adaptive grasping mechanism


Here is what Ravi told me:

Tendon-transfer surgeries are conducted to restore hand function for a large number of individuals disabled by stroke, paralysis, spinal, brain, and nerve trauma, and congenital disorders. The surgery involves re-routing one or more tendons from an affected muscle and directly suturing it to the tendon of a functioning muscle. However, there is a fundamental problem with current surgical practice. The suture that attaches the muscle to the tendon(s) directly couples the muscle and tendon(s) and cannot scale up or preferentially distribute the muscle's force and movement across the tendons.

For example, in the tendon-transfer surgery for restoring finger flexion for high median-ulnar nerve palsy, all four finger-flexor tendons are directly sutured to one muscle.  This couples the movement of all four fingers and results in weak gripping forces.  This affects all aspects of daily life for the patient.

[Note from Travis: The same problems we experienced with old robotic grippers that didn't have a mechanical clutch or passive compliance!]

Utilizing insights from robotics, we developed novel passive implants in the form of a miniature biocompatible links for reconstructive orthopedic surgery. When surgically utilized with the patient's own muscle and tendons, the passive implant converts the human hand into an underactuated "robotic" gripper capable of adaptive grasping.  Specifically, even though all four fingers are driven by one muscle, the implant enables the fingers to preferentially conform to the object's shape using less muscle effort. The implant-based surgery will greatly improve the patient's hand gripping ability and quality of life.  The implants have been validated in humans and animal cadaver experiments and biomechanical simulations. This work is part of a larger effort that seeks to develop implantable passive mechanisms including passive links, tendon networks, and pulleys, for all reconstructive orthopedic surgery. If successful, my research will bring a paradigm shift in reconstructive orthopedic surgery because the implants enable customizable and superior force and movement transmission within the body.


For those of you who follow Hizook, Ravi is essentially building the human equivalent of underactuated, adaptive grippers that are becoming increasingly common in robotics -- like those produced by Aaron Dollar, formerly by Meka Robotics, and by RobotIQ:

Meka Robotics Hand Underactuated adaptive gripper RobotIQ Underactuated adaptive gripper


Generally speaking, Ravi's research appeals to my SciFi sensibilities.  Unlike robotic exoskeletons, Ravi's work is seeking to blend the barriers between man and machine to enhance human capabilities -- ie. creating real cyborgs. The passive mechanisms are a good first capability, with the opportunity to impact millions of disabled individuals. Having spoken to Ravi on multiple occasions, I know that he is actively seeking collaborations to incorporate communications, sensing, and active mechanisms.... the future is awesome!



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