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DARPA: Giving Back Life and Movement with the Revolutionizing Prosthetics Program

DARPA: Giving Back Life and Movement with the Revolutionizing Prosthetics Program

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[Dr. Geoffrey Ling] Another parallel, but unrelated project, is the Revolutionizing Prosthetics program. This is a program that had nothing to do with traumatic brain injury but everything to do with wounded warriors. One of the most devastating injuries of war, naturally, is losing a limb. If you lose your leg or you lose your arm, that's pretty devastating. And again, because of the remarkable advances in body armor and advances in care, a lot of the soldiers that would have been dying before are not. And so they're surviving, and they're surviving with diseases that probably would have been considered irrelevant because they died, one of which of course is loss of a limb. Losing your leg is bad, but the prostheses that are currently available for a leg loss are actually quite, quite good. They're very effective, they give you a tremendous level of function— enough that you can actually go back and be a soldier again if that is your choice. Contrast that with the arm. If you lose any part of your arm—any part of your arm—you will lose your hand. Your hand is a truly remarkable biological tool. Look at your hand. It has five fingers. They all move independently. They have touch, they have sensation, and they conform in so many different ways. They allow you to interact with your environment in a very unique way and then allow you to manipulate your environment. So loss of your hand is a particularly devastating thing. If you actually think about your leg, your leg actually has four important joints: your big toe, your ankle, your knee, and your hip. If you had those four joints and all they had to do was go forward and backward or open and close in real life as with a hinge, you could do most things. You could walk, you could run. You might not be able to play basketball—doing the shifting and all— but you could walk, you could run, you could stand up. That's all you ask your leg to do. But what do you ask your arm and your hand to do? You ask it to write, you ask it to open and close doors, you ask it to make music, you ask it to compose. You ask it to do all these things. And if you lose it, the ability to actually restore it is, at least up until now, almost virtually impossible. And it's because the hand is just so complex—just so complex. How do you control that hand? So in the Revolutionizing Prosthetics program, our goal was to, number one, develop a replacement arm, a mechanical arm that looks like an arm, weighs as much as an arm— you don't want the thing to weigh so much that you're tilted to one side, right?— and actually can do all the things that an arm and hand can do. And it meant develop a hand—a hand with five independent moving fingers, a thumb on a rotating joint and so on and so forth. Then the question became, how do you control it? So the thought was to control it one of two ways. Control it in the most minimally intrusive way possible. So we chose to control it using what we call body control or external control, and I'll explain that in a moment. The other way to control it is of course the way we control our own arms and hands: with our brains—get our brain to directly control our arms and our hands. That actually was a very revolutionizing idea. So when we embarked on this project—this was about five years ago— we set out, and we were on our way. Five years later, we have succeeded. Again, patients are waiting. This is not a 20- or 30- or 40-year process. This needed to be a five-year process. And it was. We were highly successful and very proud of that. The arm is developed. The mechanical arm is really a wonder of engineering. It's a beautiful thing. It takes advantage of all the advanced engineering that we know today and packages it such that you can actually have a prosthetic arm with a hand that looks like an arm and a hand, weighs eight pounds, and is comfortable to wear. Furthermore, it's modular. If you've lost your hand at the wrist, we'll give you just the hand. If you've lost your hand and arm above the elbow, I'll give you an elbow and a wrist and a hand. If you lose the whole apparatus, I'll give you a shoulder, wrist, and hand. So it's a modular basis. This was meant for everybody who needs one. That device is already built, and it is now in its third iteration. It's ready for manufacturing. It's before the Food and Drug Administration, as we speak, for approval, so that we will be able to release it for manufacturing and distribution. So it's before the FDA as we speak. So it went from an idea to a commercial product in five years. I'm very proud of that and the team that did it. How is that one controlled, the easy one? It's controlled by the way you turn your body, the way you orient yourself, and by a foot switch that rotates it through hand grips. So you don't need any surgery. You just put the thing on, you flick a switch, and off you go. I like to call it the strap-and-go arm. You can open and close doors, you can feed yourself. It's so good you can pick up an M&M and put it in your mouth and eat it. It's really great. What can't you do with it? It doesn't have the dexterity to play the piano, to work a keyboard, to do a lot of the things that we equate with really interacting with our environment. It gives you functionality for activities of daily living, but it really isn't yet a naturally functioning arm and hand. So to do that, we felt we had to really learn how to make an interface between the brain and that robot arm so that it's just like the brain and our natural arm. And that would be the bridge that's very far, and that does require some surgery. Our team had to develop some small interfaces that you put on the surface of the brain to measure the brain signals that are telling the arm what to do because that part of the brain still exists and then exporting those signals directly into the arm using an onboard computer chip and the like. And I'm happy to say that we've been successful. Already we have human patients with one of these little brain chips in controlling the arm the way that you and I would control it. They think about reaching out, they reach out. They think about opening and closing the hand, they open and close their hand. And so we actually have two different approaches: one that requires surgery, one that does not. But if you don't want surgery, you still have a lot of function. If you are willing to accept surgery, you'd actually have a very functional arm that's going to be just like the one you and I have. Our dream is really to have an arm like Luke Skywalker in 'Star Wars' or Del Spooner in 'I, Robot' had. That is a dream. But if you don't dream dreams, you'll never get there. And so to me, the Revolutionizing Prosthetics program is a parallel effort to our traumatic brain injury project, but again, it is some of the good things that are coming out of this war. War is a terrible thing. It is a terrible thing. We want to avoid it as much as possible. Sometimes it's not avoidable. We know that. But in adversity, there's opportunity, and this is an adverse situation that gave rise to this remarkable opportunity to really advance medical care, and I'm glad that both of these programs are doing just that. You know what it does? Is this a miracle? I would say that it's an inspiration. It shows us what man can do—the innovation of men. It's really exciting, and it shows you what man can do when they really put their mind to doing something good. It's really breathtaking. To me, I'll tell you what it's like. It's like watching the Kitty Hawk fly in 1908. If you and I could have stood there and watched Wilbur and Orville Wright fly the Kitty Hawk in 1908, we would say, "That is amazing!" "Forever and ever man has dreamed of flight, and these guys did it. It was a 14-second flight. Isn't that cool?" But you know what's even cooler? If you and I were only 10 years old then so we could really appreciate it, when we were 70 years old, we would have watched on TV Neil Armstrong walk on the moon. In just 60 years, they went from Kitty Hawk to landing on the moon. And I submit to you, this is a Kitty Hawk moment.

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Dr. Geoffrey Ling shares his work on the Revolutionizing Prosthetics Program, especially on the mechanical arm that allows a soldier or veteran to open a door, feed himself, even pick up an M&M and place it in his mouth.

See more videos with Dr. Geoffrey Ling>>

 

Produced by Noel Gunther, Ashley Gilleland, and Erica Queen, BrainLine.


Geoffrey Ling, MD, PhD, Col. (Ret.)Geoffrey Ling, MD, PhD, Col. (Ret.), Geoffrey Ling, MD, PhD is a program manager at the Defense Advanced Research Projects Agency, where he has responsibility for a broad research portfolio. Dr. Ling is an authority on traumatic brain injury, especially as it pertains to the military.


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