Bespoke Bodies

The Design and Craft of Prosthetics

Advancements in medicine, robotics, and 3D printing have transformed the intersection between the human body and technology.

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For the researchers and innovators around the world working to improve the field of prosthetics, design plays a critical role in humanizing new technology, allowing people to customize and integrate devices into their lives like never before. From sculpting ocular prostheses to crowdsourcing affordable 3D-printed hands, this exhibition surveys the past, present, and future of prosthetic design on a global scale. Over 35 case studies featuring real stories from professional athletes, veterans, kids learning to live with limb difference, and more consider contemporary prosthetic design from functional, aesthetic, and social perspectives. Spanning DIY-inventions to the development of mind-controlled bionic limbs, stories from patients, clinicians, designers, and artists demonstrate the meaningful impact of human-centered design on our lives, and ultimately, the future of our mobility.

 

Anatomy of Prostheses

 

A. Transradial:
Prostheses that attach below the elbow and function as forearms and hands.

B. Facial Prostheses: 
Custom designed and fitted devices to modify, replace, or support defects or differences in ears, noses, and other facial components.

C. Ocular Prostheses:
Artificial fabricated eyes designed to restore, support, and protect the orbital cavity, and improve cosmetic appearance with custom-matched colors and sizes.

D. Internal Prostheses, Example: Prosthetic Heart Valve:
When one of the four heart valves malfunctions, an artificial heart valve can be implanted in a patient through surgery.

E. Transhumeral:
Prostheses that attach above the elbow and function as both arm and elbow joint.

F. Transfemoral:
Prostheses that attach above the knee and function as full legs.

G. Transtibial:
Prostheses that attach below the knee and function as lower legs and feet.

Powering Prostheses

 

Passive

Passive prostheses are primarily used for cosmetic purposes, to provide natural body symmetry, and to protect residual limbs. Examples include passive prosthetic arms designed with veins and freckles, facial prosthetics, or a prosthetic breast used after a mastectomy.

Body-powered

Body-powered prostheses are controlled with the power of an individual’s residual limb, cables, harnesses, and sometimes manually. Although sometimes restrictive in functionality, these systems are the most commonly used devices among upper limb amputees.

Powered and Myoelectric

Robotic or motor-powered prosthetic limbs use microprocessors to carry out intended movements. Myoelectric prostheses utilize electrical signals from muscle contraction to determine the movement.

Performance

Leading performance and prosthetics manufacturers are working closely with amputees to research and create devices that enable them to resume their active lifestyles and compete in the athletic arena. New technology has sparked advancements in adaptive design and improved the functionality of running prostheses to the point where amputees have surpassed non-amputees in athletic performance, granting individuals with limb differences the abilities they require to succeed through state of the art design. From recreational users to paralympic champions, athletes are customizing are using advanced prosthetic design to reclaim active lifestyles and even beat world records.

 

Wilson Smith and his student discuss prototypes and material selection at the University of Oregon’s Product Design lab.

University of Oregon

The University of Oregon is improving athletic wear design for adaptive athletes thanks to a unique curriculum launched as part of their Product Design Program. The studio, called Adaptive Products: Enabling Para-Athletic Performance, was first offered in 2012.

The course began as a collaboration among Nike, Inc. designers working as adjunct instructors and UO faculty members. Wilson Smith, Design Director at Nike and adjunct instructor for the class, leads students through the adaptive design process, pushing them to think of each challenge in a new ways while keeping the end-user experience in mind.

They collaborate directly with the athletes they design for, creating a dialogue that allows for modifications, prototype development, and ultimately designs that enable athletes to compete at their highest potential with greater safety and comfort.

They work with athletes ranging from wheelchair fencers and double-leg amputee snowboarders to paralyzed competitive rowers. In 2016, the class focused on creating gear for wheelchair rugby, working closely with members of the Portland Pounders and the USA Wheelchair Rugby team. Student Becky Chierichetti collaborated closely with world-class rugby wheelchair athlete Seth McBride. Seth is on the U.S. National Paralympics wheelchair rugby team, and provided ideas and feedback to the design team. Becky’s final glove design to enables Seth to both pull up and push down on wheelchair wheels, a necessity for those with varying degrees of locomotion torso control. They are made of a stretchy understructure fabric that is self-sealing and contains an exoskeleton for form and stability. The lobster claw finger design allows for easier manipulation, and its easy access zipper and ergonomic pulls are designed for ease.

The design course not only improves athletic experience for people of all abilities, serves to show how bringing innovative design to athletes with mobility challenges can develop strong ties in the adaptive athlete community and provide students with a real-world look at the product design process.

Global Impact

80% of people in need of prosthetic care live in the developing world where limb-loss is frequently caused by war, violent conflict, natural disasters, unsafe working conditions, or lack of healthcare. Many individuals in both impoverished regions and more developed countries often lack the means to afford prosthetic devices, and amputees can also face debilitating social stigmatization. New organizations, however, have devoted themselves to providing affordable prostheses and aid to regions in need of economic development, ensuring that people receive the care they need to help reclaim their independence and place in society. Using 3D printing technology and new affordable materials to provide low-cost prostheses is paving the way for a better future in which all individuals with limb differences will have access to quality care and improved lives.

The ReMotion knee is adaptable to many functions, even riding motorcycles!

ReMotion Knee

D-Rev is a non-profit institution that designs and delivers medical technologies that close the quality health care gap for underserved populations. Their recent innovations with the ReMotion Knee are a huge leap forward in producing accessible devices that improve upon previous design concepts.

For amputees in low-resource settings, modern prosthetics are prohibitively expensive. To combat both cost and a lack of access to prosthetic clinics, D-Rev provides rehabilitation services and affordable prosthetic devices to the developing world. Their ReMotion Knee is a durable polycentric knee designed with a high range of motion in mind—and it only costs $80.

In 2008, Students at Stanford University began developing the Jaipur Knee—a precursor to the ReMotion Knee—for the Jaipur Foot Organization. With this D-Revprototype, Joel Sadler, Eric Thorsell, and Vinesh Narayan co-founded ReMotion Designs and were acquired by D-Rev in 2011 to continue their work. The ReMotion Knee now sells for one tenth the market price of a similar device and is able to withstand high temperatures and humidity as well as the rough, dirty terrain of a large city. Many patients using the knee, however, were often making modifications to their devices. Observing how patients began implementing noise dampeners and wrapping cloth around the knee for a more natural appearance, D-Rev updated their design. They installed a soft bumper to reduce unnecessary noise in the joint, and then further modified the ReMotion Knee by smoothing rough edges so that the device wouldn’t stick out of the user’s clothing.

Although the knee joint is typically the most expensive and complex component of a lower-limb prosthesis, a full system contains a foot, a pylon, and a socket that require custom fitting and care from trained clinicians. By partnering with D-Rev, prosthetic clinics gain access to world-class design and engineering capabilities while continuing to provide in-depth patient care and local expertise

LimbForge is bringing affordable and quickly fabricated devices to places around the world where previously, cost and location were barriers to patients.

LimbForge

LimbForge is an organization dedicated to aiding the shortage of prosthetic rehabilitation in the developing world. The non-profit group builds tools for clinicians to quickly provide patients with customized high-quality and cost-effective prostheses that help address the unmet needs of millions of people with limb loss around the world. Prosthetic rehabilitation is vital to enabling people with amputation related disabilities to remain in or return to their home, live independently, and return to school, work, and civic life. LimbForge works with clinicians and those with limb loss to understand each patient’s physical needs and greatest perceived loss. They collaborate with both to design and fit prosthetic devices using 3D technologies to address their individual needs.

Conventional prosthetic fabrication can be expensive and time consuming. By creating a design tool that only makes prostheses, LimbForge is dramatically reducing the time both to train clinicians and to deliver highly customized devices that are manufactured on site. Their model makes it possible to create highly affordable prostheses that are custom fit for each patient and more culturally acceptable than higher priced alternatives. Clinicians can—using a web-based application to input the patients measurements—select the design and immediately put a 3D printer in motion. Early access to prosthetic rehabilitation can reduce subsequent use of health and welfare services. It not only improves physical function but also promotes self-esteem, economic productivity, health, and overall quality of life. LimbForge also understands that successful device delivery is the beginning of a life long process that requires continued access to trained clinicians. The LimbForge team plans to help build capacity by creating an Aligned Action Network of trained clinicians and non-profit humanitarian groups committed to sustainable forms of care.

Custom Style

Artistic expression is increasingly becoming a focal point of prosthetics, and a new shift in bringing style and aesthetics to otherwise mechanical and robotic devices is ushering in a creative movement in bespoke design. Prosthetics can now be painted with matched skin tones and individualized features, personalized with unique patterns and photos, and even adorned with graphics and crystals. Obstacles become inspiration for prosthetic design as wearers and artists alike are enabled to collaborate and pave the way for an increasingly innovative process centered on artistic creation over ability. Through transforming devices into fashion accessories and bespoke pieces of art, people are redefining their prostheses as forms of self expression and individuality.

The Alternative Limb Project incorporates aesthetics and art into prosthetic devices. The people who wear the one-of-a-kind pieces collaborate on the entire process.

The Alternative Limb Project

In 2011, Sophie de Oliveira Barata began The Alternative Limb Project with the goal of helping individuals channel artistry and expression through their prostheses. Merging cutting-edge technology with traditional materials, she crafts artificial limbs that look to the future by means of incorporating alternative processes and themes.

Sophie de Oliveira Barata studied Special Effects at the London School of Fashion, where she learned about using different materials and sculpting techniques, casting, and the human body. She worked at a company that provided realistic prosthetic limbs for 8 years before transitioning to her more artistic designs. Unlike other prosthetic manufacturing services, Sophie collaborates with artists, designers, and more to craft unique artificial limbs that strive to reflect the personality and individuality of the wearer, delving into themes of transhumanism and diversity among individuals with and without limb differences. From delicate porcelain legs to limbs encrusted with gold leaves and decadent lace, Sophie designs pieces that embody both functionality and artistry, all the while challenging societal misconceptions about disabilities.

To begin the design process, Sophie’s clients are asked to bring in a selection of images that convey the mood and style they wish their artificial limb to reflect. They then work out practical requirements for the prosthesis and brainstorm ideas that will be adjusted throughout the design process. After the consultation, Sophie takes 3D scans and casts of the person’s limb to ensure symmetry and accuracy. The actual production process varies from client to client as each individual has a different vision for what they would like their prosthesis to embody, requiring Sophie to work with a variety of unconventional materials, techniques, and artists.

New Tech

Prosthetic technology has advanced considerably over the past decade as designers and engineers collaborate to produce increasingly innovative and functional devices. Until recently, the technology required to operate the upper extremities was not mature enough to support the needs of amputees. However, developments in myoelectric design are getting closer to mirroring the intricacies of the human hand; new methods and materials have led to waterproof innovations; 3D printing and scanning technology enable designers to prototype and distribute prostheses faster than ever before; and software and smartphone apps are increasingly integrated into designs, allowing advances mobility to be easily accessed through the touch of a screen. As advancements in prosthetics and bionics continue to evolve structurally, neurologically, and dynamically, new design continues to spark conversation about just how far these innovations can extend the capabilities of the human body.

The i-limb is one of the most advanced myoelectric devices on the market, allowing for many natural changes in hand function and shape.

i-limb

Össur is a world leader in innovative upper limb prosthetic solutions, offering advanced myoelectric full and partial hand solutions, as well as realistic silicone prostheses designed to closely match the wearer’s skin.

A variety of prostheses are available to accommodate users’ needs, including i-digitsTM quantum for people with partially retained limbs.

Full-limb solutions include the advanced i-limb® quantum and i-limb®ultra, which are externally powered “smart” prostheses that can be controlled either by responding to the user’s muscle movement or designated smart phone app.

Touch Bionics by Össur’s i-limb quantum is the new standard for myo-electric prosthetic hands. Incorporating their patented i-mo™ technology, i-limb quantum is the only upper limb prosthesis that can change grips with a simple gesture.

Gesture control enables an automated grip to be accessed by moving the i-limb quantum in one of four directions. The hand can also be controlled via mobile app driven by grips™ technology which provides instant access to 24 pre-programmed and 12 custom grip patterns, allowing huge versatility and flexibility in customizing the hand for a variety of daily activities.

For the advanced user, triggers are specific muscle signals that are used to instruct an i-limb™ to activate a specific grip. While the i-limb is extremely durable and crafted from the highest quality materials available, it is necessary to protect it from dirt, dust and moisture by wearing a specially made covering, and Touch Bionics offers a variety durable of options that can be compatible with touch screens and even customized to match individual skin tones.

The main exhibition at PNCA’s Center for Contemporary Art & Culture.

Bespoke Bodies features interactive elements too, such as body powered prosthetic arms so every visitor can try daily tasks, like zipping a jacket with prostheses.

As technology grows, so do the capabilities for design and prosthetics. Bespoke Bodies features live 3D printing of prosthetic hands, thanks to LimbForge.

Learn More

Thank you for viewing the digital Bespoke Bodies exhibition preview.

To see more of the full exhibition and programming from the 2018 installation at PNCA’s Center for Contemporary Art and Culture, visit us on Facebook. To contact us, email info@designmuseumfoundation.org.

Want to see where the exhibition is heading next? Check our website or follow the hashtag #BespokeBodies!