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Duke eNable

Enabling the Future at Duke University

Welcome to Our Blog!

Hi Everyone,

Thanks for checking out our Duke e-Nable Blog. We’ll use this to keep you up to date on all the cool projects we’re working on. Check back often for new posts!

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Featured post

NC AAOP Conference

Earlier this month, four members of the eNable team traveled to Charlotte to attend the annual meeting of the North Carolina state chapter of the American Academy of Orthotists and Prosthetists (NC AAOP). The conference agenda was packed with discussions on clinical practice, presentations on innovative research methods, and demonstrations of the newest technology in the field.

We heard from researchers at the Bao Lab (Stanford) and the Hugh Herr lab (MIT-Harvard) about really exciting technology and procedures that will one day revolutionize how prosthetic devices integrate with the body. We also had a few hands-on (pun intended) opportunities to learn about the Neofect Smart Glove, a wearable rehabilitation tool, and the Coapt pattern recognition system, which integrates myoelectric sensing and motor control into a system that allows a range of movements, speeds, and adaptability.

Also on the lineup was a panel on 3D printing in the O&P field — featuring two of our members! Emily and Gabriel participated in this panel to contribute to a discussion on the unique role of 3D printing in this field, and to add the mission and philosophy of Duke eNable to this conversation.

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Gabriel and Emily on the 3D panel, alongside Richard Chi, Tyler Dunham, Jeff Erenstone, Brent Wright, and Barry Hand.

The panel opened our eyes to a critical nuance in the language we use. Our members are neither prosthetists nor medical professionals, and as such we are not building “prostheses” or working with “patients.” Rather, we are designing and fabricating recreational or adaptive devices for our recipients. Another key takeaway from the discussion is the importance of maintaining positive relationships with prosthetists. We are lucky to have already made connections in this community, and through this conference we were introduced to many more people who could be great assets to our organization. At the end of the day, we believe that we have very similar goals to prosthetists themselves – we want to use our skills and resources to improve someone’s quality of life. As long as we are aware of our abilities and limitations, and open to constructive feedback, we are confident that Duke eNable can continue making a positive impact.

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HANDS down, ONE of the best experiences we’ve had with Duke eNable!

We would like to thank the NC AAOP chapter president, Brittany Stresing, for the invitation to attend this meeting. We are also grateful to the Duke Engineering Alumni Council and the Lord Foundation for their financial support, which made this experience possible.

Duke eNable starts its 2017-2018 season!

Hello all! Duke eNable has started our 2017-2018 season strong with a successful first interest meeting and general body meeting. We have split into several electrical teams and teams for our recipients Kaylyn and Nathan, and we have begun working on our first few projects. Looks like our members are excited for a productive year!

Getting to Know Brooke Reagan

Since we last introduced you to Brooke, she has graduated pharmacy school, accepted a full time pharmacy position in New Jersey, and has told us about how she became a pharmacist.

Hailing from North Carolina, Brooke has one sister who went to the University of North Carolina at Chapel Hill. Born with a congenital amputation, she came to Duke around the age of 5 and received a hook prosthetic arm, but she never got used to it. She tried to wear it for about a week, but in the end found that she was better off without it.

Brooke majored in history with a concentration in women’s studies, focusing on women in Africa and the Middle East. She went to graduate school with hopes of becoming a history professor, but while working part time as a cashier at a pharmacy during her second semester, she realized her true calling and switched into pharmacy. She went back to community college and completed the prerequisites for Pharmacy School, an arduous task.

Before she went off to Pharmacy school, Brooke tried her chances with an aesthetic prosthetic hand, but unfortunately the lack of functionality forced her to leave the hand in the glove compartment of her car for most days.

She enjoys leisurely traveling and recently got a Great Dane puppy named Turtle! She plans to move back to North Carolina in the future with her fiancee who is the director of a hospital.

We’re excited to meet with Brooke again and deliver her arm!

Haiti Trip 2

Our second trip to Milot was a resounding success. We spent about 4 full days there and were able to deliver a functioning arm to Chris and his family. We arrived in Haiti on Monday evening and attempted to get a good night’s sleep before we started our work with Chris (though the noise outside, the heat, and the crazy Malarone dreams made that a bit tricky!).

No time to loose

On the first day, our goal was to test the fit of the arm and make adjustments from there. The arm itself looked great on Chris; the positioning and length were correct and looked natural, which was a huge step forward from the first prototype. As the socket was loose in places, extra foam had to be added around the top rim and at the base to improve the fit. The straps and the harness were not sewn before the trip because we felt it best to sew the final product when the fabric could be positioned properly. We placed the harness and straps on Chris and pinned them where they were best fitting and most comfortable. Later in the day, everything was sewn together.

Hold on…

Compared to the first trip, the hand was adjusted to make gripping larger objects easier. This was accomplished by curving the thumb to hold round objects; our standard test was holding a plastic water bottle. The design was successful, though not without its faults. Chris was able to hold a bottle with the hand, but struggled with initially grabbing it and sometimes maintaining the grip. When he attempted to hold the bottle in the gripper thumb hand and unscrew the top with his other hand, the bottle would rotate because there was not enough nonslip material. We decided to make some adjustments to the hand and test again the next day.

{Non}slip and slide

The second day was spent implementing and testing adjustments from the first day’s observations. The harness was sewn together and the elastic straps were sewn onto the socket. Additional Dycem was added to the inner side of the thumb to increase the amount of nonslip material in contact with the object being held. After making these adjustments, we went to visit Chris again and tested everything out. The additional Dycem made it easier for him to maintain grip on the bottle while twisting the cap with his other hand. However, he still struggled with the motion of grabbing with the hand, because it requires the application of force at a specific angle. We spent the next bit of the day brainstorming a way to solve this problem, and ended up adding a small patch of Dycem to the upper part of the thumb. With this added material, the thumb was less likely to slip once it was positioned on an object. When we brought this idea back to Chris, it was noticeably easier for him to activate the gripper thumb hand and grab the water bottle. He and his family were happy with these adjustments, so we decided that this would be the final version of the arm!

Armed and ready

On our last full day, we assembled a second arm for Chris and compiled all the extra parts and tools that the family would need to maintain it. We delivered these things and explained to the family what the next steps would be, describing how to replace foam and Dycem, how to change out the socket for a wider one if needed, and how to make adjustments to the thumb. The most important thing we stressed is that Chris will need to practice with the arm to increase his strength and get more comfortable with how it works. He has the resources and information to make the most of what we have been able to give him, and the ball is in his court now!

Haiti Updates: August 13

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Bonswa tout moun! (Hello everyone) Our travelers made it back to the states late Friday night after a tiring but successful trip to Haiti. Be on the lookout for a longer post soon with stories and pictures from Milot!!

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Haiti Updates: August 7

Well, it’s time once again to pack up everything and head down to Haiti! It has been a little over a month since our last trip and we are ready to present Chris with his final device. We have packed many things including …

  • The complete arm
  • 3 spare sockets
  • 3 spare forearms
  • 1 spare gripper hand
  • Extra foam
  • Harnesses, straps, and extra material
  • A variety of tools including screwdrivers, calipers, and a protractor
  • A hairdryer
  • Paint and paintbrushes
  • 3D structure scanner
  • Camera and GoPro
  • Soccer ball
  • A partridge in a pear tree

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Emily and Joel will arrive in Milot this afternoon and depart on Friday. This week, the goal is to fit the new arm, test its efficacy in different scenarios, and make final adjustments. We will also begin to plan for the next steps in our work with Chris.

You have to hand it to these strapping young students that they have a firm grasp on what will enable their success. (I will not apologize for this sentence)

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Haiti Updates: August 1

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After a rather eventful month, we have finished the new arm for Chris! The updated version is printed in skin-toned filament and makes use of the modifications we have been working on since the first trip.

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On Monday, Emily and Joel will travel to Milot to meet with Chris again and test out the updated arm design. As the departure date approaches, we are working hard to print extra parts — some with larger dimensions — and acquire additional pieces of hardware and tools that could be useful during this trip.

Haiti Updates: July 25

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Many hands make light work

As we approach the deadline for the second trip to Haiti, things are really starting to come together. The socket and forearm are just about done and only need some minor adjustments. Besides the overall fit of the socket, two of the major problems that we wanted to fix were the length and angle the arm. The length needed to be decreased and the angle needed to be brought more towards the body. After some adjustments to the location of the screw holes, we are pretty confident that these problems are solved. Moreover, we decided to add an additional screw hole to both pieces so that we have two options for the angle, depending on how the screws are placed. The two pictures below show these options.

The most recent modification involved adapting the location of the screw holes in order to embed the screw heads beneath the inner surface of the socket. This design will enhance the integrity of the connection and make the bottom of the socket more comfortable by moving the hardware out of the way. Once this is finalized, we are ready to print the final arm and various extra pieces in skin-colored filament.

Get a grip

The final hand is also just about completed. In order to further increase the grip capabilities of the hand some sticky grip material was added on the inside of the thumb. This should prevent larger objects from slipping once grabbed. The material we will be using for the final arm has arrived as well, and as a test we printed the final hand design out with it.

Buckle up kids

This week we solidified the design for the detachable piece between the harness and socket.The black webbing in a V-shape provides integrity to the apparatus by combining a high strength, durable material with a configuration that adequately distributes the weight of the arm. The bottom two straps will be adjustable using simple rectangular buckles, and the top two straps will be sewn onto the harness once we fit it to Chris.

Lastly, we adapted the design for the straps on the socket itself. In order to provide a user-friendly and effective fastening system, we decided to affix elastic straps to one side of the socket, with Velcro patches on the bottom that attach to the other side. In this way, we can still use the elastic to provide a compressive force that helps stabilize the socket, while allowing Chris to adjust the fit with his other hand.

Haiti Updates: July 18

Since returning from Haiti, we have been working on the individual pieces of the device to make specific modifications. Once these are finalized, we will reassemble the device and prepare for the next trip!

Put a sock (in) it

The laser scan was imported into the CAD software to allow for a virtual fitting. With this, the original socket was edited in order to better fit the arm. Some adjustments still have to be made to the socket, as the fit was tight in a few places when the foam was added to the interior wall. All in all, things are coming along well, and a finalized socket should be done within the week. Ensuring the forearm will be angled naturally will be the harder portion of the design.

Need a hand?

For the most part, the hand did not need any adjustments. One thing that we did want to change, however, was the shape of the thumb. The first thumb design was mostly straight and would tend to slip on larger curved objects, such as water bottles. To fix this problem we decided to rotate and curve the thumb so that it will wrap around objects more. We also plan to add grip to the inside of the thumb to further prevent slipping.

Sew it goes

The overall design of the harness succeeded in transferring the weight of the device from Chris’s arm to his back and shoulders. The main change we want to make is to connect the socket by straps with buckles, so that Chris can put the harness and socket on separately. This way it will give him the flexibility of wearing the harness underneath his shirt if he wants. Another slight variation to this version involves adjusting the angle at which the straps cross in the back. Shoutout to Iris for being our model!

The new version has been sewn together, and the next step will be finalizing the design for the detachable connection to the socket. Below are some of the options.

Casting call

Last week we used the plaster cast, made from wrapping plaster gauze around Chris’s residual limb, to make a replica of his arm. A mixture of Plaster of Paris and water was poured into the mold and allowed to dry; then the gauze cast was cut away to unveil the final result. While the surface is still rough from the texture of the gauze, the shape is consistent with the 3D scan of the arm, which we scaled and printed out. We can now use both models to test the fit of the socket.

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