So today, I would like to talk with you about bionics, which is the popular term for the science of replacing part of a living organism with a mechatronic device, or a robot. It is essentially the stuff of life meets machine. And specifically, I'd like to talk with you about how bionics is evolving for people with arm amputations.
Dakle, danas bih želeo da sa vama razgovaram o bionici, što je popularan naziv za nauku koja se bavi zamenjivanjem delova živog organizma mehatroničkim uredjajima, ili robotima. To praktično znači da se živa materija spaja sa mašinom. I posebno bih želeo da vam govorim o tome kako bionika napreduje u odnosu na ljude kojima je amputirana ruka.
This is our motivation. Arm amputation causes a huge disability. I mean, the functional impairment is clear. Our hands are amazing instruments. And when you lose one, far less both, it's a lot harder to do the things we physically need to do. There's also a huge emotional impact. And actually, I spend as much of my time in clinic dealing with the emotional adjustment of patients as with the physical disability. And finally, there's a profound social impact. We talk with our hands. We greet with our hands. And we interact with the physical world with our hands. And when they're missing, it's a barrier. Arm amputation is usually caused by trauma, with things like industrial accidents, motor vehicle collisions or, very poignantly, war. There are also some children who are born without arms, called congenital limb deficiency.
To je naš motiv. Amputacija ruke je uzrok velikog invaliditeta. Mislim, jasno je da dolazi do narušavanja funkcije. Naše šake su zadivljujući instrumenti. I ako izgubite jednu, ili još gore obe, mnogo je teže raditi stvari koje fizički moramo da radimo. Postoji takodje i ogroman emotivni efekat. Ja, zapravo, provodim isto toliko vremena u klinici baveći se emotivnim prilagodjavanjem pacijenata, koliko i baveći se samim fizičkim invaliditetom. I konačno, postoji i značajan socijalni efekat. Mi govorimo šakama. Pozdravljamo se šakama. U kontaktu smo sa fizičkim svetom preko svojih šaka. A ako nam šake nedostaju, to predstavlja prepreku. Najčešći uzrok amputacije ruke je povreda, nastala u industrijskim nesrećama, sudarima motornih vozila ili, što je vrlo žalosno, u ratu. Postoje takodje neka deca rodjena bez ruku, što se naziva kongenitalna deficijencija ekstremiteta.
Unfortunately, we don't do great with upper-limb prosthetics. There are two general types. They're called body-powered prostheses, which were invented just after the Civil War, refined in World War I and World War II. Here you see a patent for an arm in 1912. It's not a lot different than the one you see on my patient. They work by harnessing shoulder power. So when you squish your shoulders, they pull on a bicycle cable. And that bicycle cable can open or close a hand or a hook or bend an elbow. And we still use them commonly, because they're very robust and relatively simple devices.
Na žalost, ne ide nam sjajno u vezi sa protezama gornjih ekstremiteta. Postoje dva opšta tipa. Takozvane proteze-koje-pokreću-mišići izmišljene su neposredno posle Gradjanskog rata a usavršene u Prvom i Drugom svetskom ratu. Ovde vidite patent za ruku iz 1912. godine. Ne razlikuje se mnogo od one koju vidite na mom pacijentu. Ove proteze koriste snagu ramenih mišića. Pa tako, kad stisnete ramena, to povlači kabl iz bicikla. I taj kabl iz bicikla može da otvara ili zatvara šaku ili kuku ili da savije lakat. I dalje ih često koristimo, jer su to vrlo čvrsti i relativno jednostavni uređaji.
The state of the art is what we call myoelectric prostheses. These are motorized devices that are controlled by little electrical signals from your muscle. Every time you contract a muscle, it emits a little electricity that you can record with antennae or electrodes and use that to operate the motorized prosthesis. They work pretty well for people who have just lost their hand, because your hand muscles are still there. You squeeze your hand, these muscles contract. You open it, these muscles contract. So it's intuitive, and it works pretty well.
Najsavremenije su takozvane mioelektrične proteze. To su motorizovani uredjaji kontrolisani putem slabih električnih signala iz mišića. Svaki put kad se mišić kontrahuje, to proizvodi slabu struju koju možemo da zabeležimo pomoću antena ili elektroda i da koristimo da bi upravljali motorizovanim protezama. Ove proteze rade prilično dobro kod ljudi koji su upravo izgubili šaku, jer su mišići šake i dalje prisutni. Kada stisnete šaku, ovi mišići se kontrahuju. Kada je otvorite, ovi mišići se kontrahuju. vrlo je intuitivno i radi prilično dobro.
Well how about with higher levels of amputation? Now you've lost your arm above the elbow. You're missing not only these muscles, but your hand and your elbow too. What do you do? Well our patients have to use very code-y systems of using just their arm muscles to operate robotic limbs. We have robotic limbs. There are several available on the market, and here you see a few. They contain just a hand that will open and close, a wrist rotator and an elbow. There's no other functions. If they did, how would we tell them what to do?
Ali, šta je sa slučajevima kada je amputacija veća? Ako ste izgubili ruku iznad lakta. Nedostaju vam, ne samo ovi mišići, nego i šaka i lakat. Šta ćete tada? Pa, naši pacijenti moraju da koriste neke zastarele sisteme koji koriste samo mišiće ruke da upravljaju robotičkim ekstremitetima. Imamo robotičke ekstremitete. Na tržištu ih ima nekoliko, i ovde vidite neke od njih. Sastoje se samo od šake koja se otvara i zatvara, od obrtnog ručnog zgloba i lakta. Nema drugih funkcija. A i da imaju druge funkcije, kako upravljati njima?
We built our own arm at the Rehab Institute of Chicago where we've added some wrist flexion and shoulder joints to get up to six motors, or six degrees of freedom. And we've had the opportunity to work with some very advanced arms that were funded by the U.S. military, using these prototypes, that had up to 10 different degrees of freedom including movable hands. But at the end of the day, how do we tell these robotic arms what to do? How do we control them? Well we need a neural interface, a way to connect to our nervous system or our thought processes so that it's intuitive, it's natural, like for you and I.
Mi smo našu ruku napravili na Institutu za rehabilitaciju u Čikagu (IRČ) u koju smo dodali funkciju savijanja ručnog zgloba i ramene zglobove i dodali smo šest motora, odnosno šest stepeni slobode. A takodje radimo i sa nekim vrlo naprednim veštačkim rukama koje je finansirala američka vojska, koristeći ove prototipe, koji su imali i do 10 različitih stepeni slobode uključujući i pokretne šake. Ali, sve u svemu, kako reći ovim robotičkim rukama šta treba da rade? Kako da ih kontrolišemo? Pa, potreban nam je nervni priključak način da se povežu sa našim nervnim sistemom ili sa našim procesima mišljenja tako da to bude intuitivno, prirodno. kao što je za vas ili za mene.
Well the body works by starting a motor command in your brain, going down your spinal cord, out the nerves and to your periphery. And your sensation's the exact opposite. You touch yourself, there's a stimulus that comes up those very same nerves back up to your brain. When you lose your arm, that nervous system still works. Those nerves can put out command signals. And if I tap the nerve ending on a World War II vet, he'll still feel his missing hand. So you might say, let's go to the brain and put something in the brain to record signals, or in the end of the peripheral nerve and record them there. And these are very exciting research areas, but it's really, really hard. You have to put in hundreds of microscopic wires to record from little tiny individual neurons -- ordinary fibers that put out tiny signals that are microvolts. And it's just too hard to use now and for my patients today.
Dakle, telo radi tako što započne komandu za pokret u vašem mozgu, i to se spušta niz kičmenu moždinu, ide kroz nerve u periferne delove. A potpuno obrnuto se dešava kad imate neki osećaj. Dodirnete sebe, to je stimulus, koji se penje kroz one iste nerve gore do vašeg mozga. I kad čovek izgubi ruku, taj nervni sistem i dalje radi. Ti nervi mogu da šalju komandne signale. I ako dotaknem nervni završetak kod veterana iz Drugog svetskog rata, on će i dalje osećati šaku koja mu nedostaje. Prema tome, moglo bi se reći "pa, 'ajmo u mozak" i moglo bi da se nešto stavi u mozak da beleži signale, ili na krajeve perifernih nerava da tamo beleži signale. I to su sve vrlo uzbudljiva područja istraživanja, ali to je veoma, veoma teško. Morali biste da stavite stotine mikroskopskih žica da snimaju iz malih, sićušnih pojedinačnih neurona - običnih vlakana koji provode sićušne signale koji se nazivaju mikrovolti. I prosto rečeno, suviše je teško da se to sada koristi za pacijente.
So we developed a different approach. We're using a biological amplifier to amplify these nerve signals -- muscles. Muscles will amplify the nerve signals about a thousand-fold, so that we can record them from on top of the skin, like you saw earlier. So our approach is something we call targeted reinnervation. Imagine, with somebody who's lost their whole arm, we still have four major nerves that go down your arm. And we take the nerve away from your chest muscle and let these nerves grow into it. Now you think, "Close hand," and a little section of your chest contracts. You think, "Bend elbow," a different section contracts. And we can use electrodes or antennae to pick that up and tell the arm to move. That's the idea.
Tako da smo razvili drugačiji pristup. Koristimo biološki pojačivač da bismo pojačali ove nervne signale -- mišiće. Mišići će pojačati ove nervne signale oko hiljadu puta, tako da možemo da ih zabeležimo na površini kože, kao što ste videli ranije. Dakle, naš pristup je nešto što nazivamo ciljanom reinervacijom. Zamislite, kod nekog ko je izgubio celu ruku, i dalje imamo četiri glavna nerva koji idu do ruke. Pa tako, uklonimo nerve iz grudnog mišića i omogućimo ovim nervima iz ruke da urastu u grudni mišić. I sada ako se pomisli "Zatvori šaku", mali deo grudnog mišića će se kontrahovati. Ako se pomisli "Savij lakat," kontrahovaće se drugi deo. I možemo da koristimo elektrode ili antene da to zabeležimo i da naredimo ruci da se pokrene. To je ideja.
So this is the first man that we tried it on. His name is Jesse Sullivan. He's just a saint of a man -- 54-year-old lineman who touched the wrong wire and had both of his arms burnt so badly they had to be amputated at the shoulder. Jesse came to us at the RIC to be fit with these state-of-the-art devices, and here you see them. I'm still using that old technology with a bicycle cable on his right side. And he picks which joint he wants to move with those chin switches. On the left side he's got a modern motorized prosthesis with those three joints, and he operates little pads in his shoulder that he touches to make the arm go. And Jesse's a good crane operator, and he did okay by our standards.
Dakle, ovo je prvi čovek na kome smo to probali. Zove se Džesi Salivan. On je pravi svetac -- 54-godišnji monter strujnih kablova koji je pipnuo pogrešnu žicu zbog čega su mu obe ruke tako jako izgorele da je bilo neophodno da se amputiraju u ramenu. Džesi je došao kod nas u IRČ da bi dobio ove savremene uredjaje, i ovde ih vidite. I dalje koristim tu staru tehnologiju sa kablom iz bicikla na Džesijevoj desnoj strani. I on bira koji zglob hoće da pomeri preko ovih prekidača koje pritiska bradom. Sa leve strane, Džesi ima modernu motorizovanu protezu sa ova tri zgloba, i koristi male jastučiće u ramenu koje dodiruje da bi pokrenuo ruku. Džesi dobro upravlja dizalicama, i dobro mu je išlo, po našim standardima.
He also required a revision surgery on his chest. And that gave us the opportunity to do targeted reinnervation. So my colleague, Dr. Greg Dumanian, did the surgery. First, we cut away the nerve to his own muscle, then we took the arm nerves and just kind of had them shift down onto his chest and closed him up. And after about three months, the nerves grew in a little bit and we could get a twitch. And after six months, the nerves grew in well, and you could see strong contractions. And this is what it looks like. This is what happens when Jesse thinks open and close his hand, or bend or straighten your elbow. You can see the movements on his chest, and those little hash marks are where we put our antennae, or electrodes. And I challenge anybody in the room to make their chest go like this. His brain is thinking about his arm. He has not learned how to do this with the chest. There is not a learning process. That's why it's intuitive.
Takodje, Džesiju je trebala dodatna operacija na grudnom košu. To nam je dalo priliku da izvršimo ciljanu reinervaciju. Dakle, moj kolega, dr Greg Dumanijan, je uradio operaciju. Prvo smo odsekli nerve za Džesijev mišić, onda smo uzeli nerve za ruku i, na neki način, smo ih samo preusmerili ka grudnom košu i završili operaciju. I posle oko tri meseca, ti nervi su pomalo urasli i mogli smo da dobijemo grčenje mišića. A posle šest meseci, nervi su već dobro urasli, i mogle su se videti jake kontrakcije. I evo kako to izgleda. Evo šta se dešava kada Džesi pomisli da otvara i zatvara svoju šaku, ili savija i ispravlja lakat. Mogu se videti pokreti grudnog mišića, i ovih malih oznaka gde smo stavili naše antene, ili elektrode. I, ne verujem da bi iko iz publike mogao da ovako pokreće grudne mišiće. Njegov mozak misli o njegovoj ruci. Džesi nije naučio kako da ovo radi preko grudnih mišića. To nije naučen proces. Zato je to intuitivno.
So here's Jesse in our first little test with him. On the left-hand side, you see his original prosthesis, and he's using those switches to move little blocks from one box to the other. He's had that arm for about 20 months, so he's pretty good with it. On the right side, two months after we fit him with his targeted reinnervation prosthesis -- which, by the way, is the same physical arm, just programmed a little different -- you can see that he's much faster and much smoother as he moves these little blocks. And we're only able to use three of the signals at this time.
I evo ga Džesi u našem prvom malom testu za njega. Na levoj strani se vidi njegova originalna proteza, i kako on koristi te prekidače da pomera kockice iz jedne kutije u drugu. Tu ruku ima već oko 20 meseci, pa je prilično dobro koristi. Sa desne strane, dva meseca pošto smo ga opremili ovom protezom sa ciljanom reinervacijom -- koja je, uzgred, fizički ista kao ova druga, samo programirana na malo drugačiji način -- vidite da je Džesi mnogo brži i pokreti su mu ravnomerniji dok pomera te kockice. A u to vreme smo mogli da koristimo samo tri signala.
Then we had one of those little surprises in science. So we're all motivated to get motor commands to drive robotic arms. And after a few months, you touch Jesse on his chest, and he felt his missing hand. His hand sensation grew into his chest again probably because we had also taken away a lot of fat, so the skin was right down to the muscle and deinnervated, if you would, his skin. So you touch Jesse here, he feels his thumb; you touch it here, he feels his pinky. He feels light touch down to one gram of force. He feels hot, cold, sharp, dull, all in his missing hand, or both his hand and his chest, but he can attend to either. So this is really exciting for us, because now we have a portal, a portal, or a way to potentially give back sensation, so that he might feel what he touches with his prosthetic hand. Imagine sensors in the hand coming up and pressing on this new hand skin. So it was very exciting.
I onda se desilo jedno od onih malih iznenadjenja u nauci. Znači, mi smo svi motivisani da usmerimo komande za pokret da bi upravljali robotičkim rukama. A, posle nekoliko meseci, ako biste dotakli Džesijev grudni koš, on bi osetio šaku koja mu nedostaje. Osećaj posedovanja šake se ponovo javio u njegovom grudnom mišiću verovatno zato što smo uklonili i dosta masnog tkiva, pa je koža bila neposredno uz mišić i takodje smo de-inervisali njegovu kožu. Tako da, ako dotaknete Džesija ovde, on oseća svoj palac; ako ga pipnete ovde, oseća svoj mali prst. Oseća i vrlo blag dodir čak i samo pritisak od jednog grama. Oseća vruće, hladno, oštro, tupo, sve to u šaci koja mu nedostaje, ili u obe šake i u grudnom košu, ali ne može da reaguje ni na jedno. Dakle, ovo je zaista uzbudljivo za nas, jer sada imamo portal, portal ili način da, eventualno, vratimo osećaj, tako da on može da oseti šta dodiruje svojom prostetičkom rukom. Zamislite senzore u šaci koji se penju i pritiskaju ovaj novi prikaz šake. To je bilo vrlo uzbudljivo.
We've also gone on with what was initially our primary population of people with above-the-elbow amputations. And here we deinnervate, or cut the nerve away, just from little segments of muscle and leave others alone that give us our up-down signals and two others that will give us a hand open and close signal. This was one of our first patients, Chris. You see him with his original device on the left there after eight months of use, and on the right, it is two months. He's about four or five times as fast with this simple little performance metric.
Takodje smo nastavili sa onim što je prvobitno bila naša primarna populacija ljudi sa amputacijama iznad ramena. I tu smo de-inervisali, odnosno odsekli, nerv iz samo malog segmenta mišića, a druge smo ostavili tu, druge koji prenose signale gore-dole i još dva druga koji će prenositi signal za otvaranje i zatvaranje šake. Ovo je jedan od naših prvih pacijenata, Kris. Vidite ga sa njegovim originalnim uredjajem sa leve strane, posle osam meseci upotrebe, a sa desne strane je posle dva meseca. Tu je oko četiri ili pet puta brži sa ovim jednostavnim malim sistemom.
All right. So one of the best parts of my job is working with really great patients who are also our research collaborators. And we're fortunate today to have Amanda Kitts come and join us. Please welcome Amanda Kitts.
Dobro. Dakle, jedna od najboljih strana mog posla je to što radim sa zaista sjajnim pacijentima koji su takodje i naši saradnici u istraživanju. I danas imamo privilegiju što će Amanda Kits doći da nam se pridruži. Molim vas pozdravite Amandu Kits.
(Applause)
(aplauz)
So Amanda, would you please tell us how you lost your arm?
Pa, Amanda, možeš li nam, molim te, reći kako si izgubila ruku?
Amanda Kitts: Sure. In 2006, I had a car accident. And I was driving home from work, and a truck was coming the opposite direction, came over into my lane, ran over the top of my car and his axle tore my arm off.
Amanda Kits: Da, naravno. Imala sam saobraćajnu nesreću 2006. godine. Vozila sam kući sa posla, a kamion je dolazio iz suprotnog smera, skrenuo je u moju traku, prešao je preko krova mog automobila i osovina kamiona mi je otkinula ruku.
Todd Kuiken: Okay, so after your amputation, you healed up. And you've got one of these conventional arms. Can you tell us how it worked?
Tod Kuiken: U redu, i posle amputacije, oporavila si se. i dobila si jednu od onih konvencionalnih proteza za ruku. Možeš li nam reći kako je to funkcionisalo?
AK: Well, it was a little difficult, because all I had to work with was a bicep and a tricep. So for the simple little things like picking something up, I would have to bend my elbow, and then I would have to cocontract to get it to change modes. When I did that, I had to use my bicep to get the hand to close, use my tricep to get it to open, cocontract again to get the elbow to work again.
AK: Pa, bilo je pomalo teško, jer su mi preostali samo biceps i triceps. Tako bih, za proste stvarčice, kao što je podizanje nečega, morala da savijam lakat, onda bih morala da ga ponovo savijam da bi promenio način kretanja. Kada sam to radila, morala sam da koristim biceps da bih zatvorila šaku, i da koristim triceps da bih je otvorila, pa ponovo da kontrahujem da bi lakat ponovo funkcionisao.
TK: So it was a little slow?
TK: Znači bilo je pomalo sporo?
AK: A little slow, and it was just hard to work. You had to concentrate a whole lot.
AK: pomalo sporo i bilo je vrlo teško da se radi s tim. Morali ste da se dobro koncentrišete.
TK: Okay, so I think about nine months later that you had the targeted reinnervation surgery, took six more months to have all the reinnervation. Then we fit her with a prosthesis. And how did that work for you?
TK: U redu, onda posle otprilike devet meseci imala si operaciju za ciljanu reinervaciju, trebalo je još šest meseci da bi se uradila sva reinervacija. Onda smo joj dali protezu. I kako je to funkcionisalo?
AK: It works good. I was able to use my elbow and my hand simultaneously. I could work them just by my thoughts. So I didn't have to do any of the cocontracting and all that.
AK: Dobro funkcioniše. Mogla sam da koristim lakat i šaku u isto vreme. Mogla sam da upravljam njima samo preko misli. Tako da nisam morala da radim sve ono grčenje i kontrahovanje.
TK: A little faster?
TK: Bilo je malo brže?
AK: A little faster. And much more easy, much more natural.
AK: Malo brže. I mnogo jednostavnije, mnogo prirodnije.
TK: Okay, this was my goal. For 20 years, my goal was to let somebody [be] able to use their elbow and hand in an intuitive way and at the same time. And we now have over 50 patients around the world who have had this surgery, including over a dozen of our wounded warriors in the U.S. armed services. The success rate of the nerve transfers is very high. It's like 96 percent. Because we're putting a big fat nerve onto a little piece of muscle. And it provides intuitive control. Our functional testing, those little tests, all show that they're a lot quicker and a lot easier. And the most important thing is our patients have appreciated it.
TK: U redu, to je i bio moj cilj. Već 20 godina, moj cilj je da omogućim ljudima da koriste lakat i šaku na intuitivan način i to u isto vreme. I sada imamo preko 50 pacijenata širom sveta koji su imali ovu operaciju, uključujući preko desetine naših ranjenih vojnika u službi američke vojske. Uspešnost ovih nervnih transfera je vrlo visoka. Oko 96 odsto. Jer stavljamo veliki debeli nerv na mali komad mišića. I to omogućava intuitivnu kontrolu. Naše funkcionalno testiranje, ti mali testovi, svi pokazuju da su pacijenti mnogo brži i da im lakše ide. I najvažnija stvar je to što i naši pacijenti to potpuno prepoznaju.
So that was all very exciting. But we want to do better. There's a lot of information in those nerve signals, and we wanted to get more. You can move each finger. You can move your thumb, your wrist. Can we get more out of it? So we did some experiments where we saturated our poor patients with zillions of electrodes and then had them try to do two dozen different tasks -- from wiggling a finger to moving a whole arm to reaching for something -- and recorded this data. And then we used some algorithms that are a lot like speech recognition algorithms, called pattern recognition. See.
Dakle, to je sve bilo veoma uzbudljivo. Ali, želeli bismo da radimo još bolje. U tim nervnim signalima ima mnogo informacija, i hteli smo da dobijemo još više. Svaki prst može da se pomera. Palac može da se pomera, može i zglob. Možemo li dobiti još više? Pa smo tako uradili eksperimente gde smo stavili našim sirotim pacijentima milijarde elektroda i onda im dali da rade desetine različitih zadataka -- od vrtenja prsta do pokretanja cele ruke i dohvatanja nečega -- i to smo sve beležili. I onda smo koristili neke algoritme koji su slični algoritmima za prepoznavanje govora, što se naziva prepoznavanje obrasca. Vidite.
(Laughter)
(smeh)
And here you can see, on Jesse's chest, when he just tried to do three different things, you can see three different patterns. But I can't put in an electrode and say, "Go there." So we collaborated with our colleagues in University of New Brunswick, came up with this algorithm control, which Amanda can now demonstrate.
I ovde možete videti, na Džesijevim grudima, kad pokušava da uradi tri različite stvari, možete videti tri različita obrasca. Ali, ne mogu da ubacim elektrodu i da kažem, "Idi tamo." Zato smo saradjivali sa kolegama na Univerzitetu u Nju Bransviku, formulisali smo ovakvo kontrolisanje algoritma, koje Amanda sada može da demonstrira.
AK: So I have the elbow that goes up and down. I have the wrist rotation that goes -- and it can go all the way around. And I have the wrist flexion and extension. And I also have the hand closed and open.
AK: Dakle, lakat može da ide gore i dole. Ovaj obrtni zglob koji ide ovako -- može da napravi pun krug. I mogu da vršim savijanje i opružanje ručnog zgloba. I mogu da zatvorim i otvorim šaku.
TK: Thank you, Amanda. Now this is a research arm, but it's made out of commercial components from here down and a few that I've borrowed from around the world. It's about seven pounds, which is probably about what my arm would weigh if I lost it right here. Obviously, that's heavy for Amanda. And in fact, it feels even heavier, because it's not glued on the same. She's carrying all the weight through harnesses.
TK: Hvala ti, Amanda. Ovo je ruka korišćena u istraživanju, ali je napravljena od komercijalnih komponenti odavde do dole i nekoliko koje sam pozajmio širom sveta. Ima oko 3.2 kilograma što je, verovatno, slično težini moje ruke ako bih je odavde izgubio. Očigledno, to je teško za Amandu. I u stvari, deluje još teže, jer nije zalepljeno na ostatak ruke. Ona nosi svu težinu preko sistema kablova.
So the exciting part isn't so much the mechatronics, but the control. So we've developed a small microcomputer that is blinking somewhere behind her back and is operating this all by the way she trains it to use her individual muscle signals. So Amanda, when you first started using this arm, how long did it take to use it?
Dakle, uzbudljivi deo nije toliko u vezi sa mehatronikom, već u vezi sa kontrolom. Mi smo napravili mali mikrokompjuter koji svetluca negde iza njenih ledja i koji upravlja svim ovim, a ona ga trenira da koristi njene pojedinačne mišićne signale. Dakle, Amanda, kada si prvi put počela da koristiš ovu ruku, koliko dugo ti je trebalo da je zaista koristiš?
AK: It took just about probably three to four hours to get it to train. I had to hook it up to a computer, so I couldn't just train it anywhere. So if it stopped working, I just had to take it off. So now it's able to train with just this little piece on the back. I can wear it around. If it stops working for some reason, I can retrain it. Takes about a minute.
AK: Trebalo je oko tri do četiri sata da je istreniram. Morala sam da je prikačim za kompjuter, pa nisam mogla da je treniram bilo gde. Tako da, ako bi prestala da radi, morala sam da je skinem. A sada može da se trenira samo ovim malim delom na ledjima. To mogu svuda da nosim. Ako, iz nekog razloga, prestane da radi, mogu da ponovo istreniram ruku. u roku od oko jednog minuta.
TK: So we're really excited, because now we're getting to a clinically practical device. And that's where our goal is -- to have something clinically pragmatic to wear. We've also had Amanda able to use some of our more advanced arms that I showed you earlier. Here's Amanda using an arm made by DEKA Research Corporation. And I believe Dean Kamen presented it at TED a few years ago. So Amanda, you can see, has really good control. It's all the pattern recognition. And it now has a hand that can do different grasps. What we do is have the patient go all the way open and think, "What hand grasp pattern do I want?" It goes into that mode, and then you can do up to five or six different hand grasps with this hand. Amanda, how many were you able to do with the DEKA arm?
TK: Mi smo veoma uzbudjeni, jer sada praktično dolazimo do uredjaja za kliničku primenu. A to je upravo naš cilj -- da imamo nešto što je klinički upotrebljivo. Takodje smo omogućili Amandi da koristi neke od naših naprednijih proteza koje sam vam ranije pokazao. Evo Amande dok koristi protezu koju je napravila "DEKA" Istraživačka korporacija. I mislim da je Din Kejmen prezentovao ovu protezu na TEDu pre nekoliko godina. Dakle, Amanda ima, kao što vidite, vrlo dobru kontrolu. To je sve prepoznavanje obrazaca. A, sada imamo šaku koja može da izvodi različite načine hvatanja. Ono što radimo je da pustimo pacijenta da potpuno otvori šaku i da pomisli, "Na koji način želim da uhvatim ovom šakom?" I proteza kreće u taj proces, i sa ovom protezom je moguće izvesti do pet ili šest različitih zahvata šakom. Amanda, koliko si ti mogla da izvedeš sa "DEKA" rukom?
AK: I was able to get four. I had the key grip, I had a chuck grip, I had a power grasp and I had a fine pinch. But my favorite one was just when the hand was open, because I work with kids, and so all the time you're clapping and singing, so I was able to do that again, which was really good.
AK: ja sam mogla da uradim četiri. Mogla sam da uhvatim bočno, da uhvatim sa tri prsta mogla sam da snažno obuhvatim i da nežno uštinem. Ali moj omiljeni zahvat je bilo kad mi je šaka potpuno otvorena, jer radim sad decom, i sve vreme ima tapšanja i pevanja, pa sam tako mogla da to sve ponovo radim, što je bilo stvarno dobro.
TK: That hand's not so good for clapping.
TK: Ta ruka nije baš dobra za tapšanje.
AK: Can't clap with this one.
AK: Ne može se tapšati sa ovom.
TK: All right. So that's exciting on where we may go with the better mechatronics, if we make them good enough to put out on the market and use in a field trial. I want you to watch closely.
TK: Dobro. Dakle to je uzbudljivo u smislu kuda bismo mogli da idemo sa boljom mehatronikom, ako ih napravimo da budu dovoljno dobre da bismo mogli da ih pustimo na tržište i za upotrebu u praksi. Želeo bih da pažljivo pogledate.
(Video) Claudia: Oooooh!
(Video) Klaudija: Uuuuuu!
TK: That's Claudia, and that was the first time she got to feel sensation through her prosthetic. She had a little sensor at the end of her prosthesis that then she rubbed over different surfaces, and she could feel different textures of sandpaper, different grits, ribbon cable, as it pushed on her reinnervated hand skin. She said that when she just ran it across the table, it felt like her finger was rocking. So that's an exciting laboratory experiment on how to give back, potentially, some skin sensation.
TK: To je Klaudija, i to je prvi put kada je osetila nešto kroz svoju protezu. Imala je mali senzor na kraju proteze koji je trljala na različite površine, i mogla je da oseti različitu strukturu šmirgle, raznih vrsta šljunka, trakastog kabla, kad bi nešto od toga pritisnulo njen reinervisani prikaz šake. Rekla je da kad samo prelazi protezom preko stola, ima osećaj da joj se prst ljulja. Dakle to je uzbudljiv laboratorijski eksperiment koji pokazuje kako mogu da se, potencijalno, vrate neki osećaji preko kože.
But here's another video that shows some of our challenges. This is Jesse, and he's squeezing a foam toy. And the harder he squeezes -- you see a little black thing in the middle that's pushing on his skin proportional to how hard he squeezes. But look at all the electrodes around it. I've got a real estate problem. You're supposed to put a bunch of these things on there, but our little motor's making all kinds of noise right next to my electrodes. So we're really challenged on what we're doing there.
Ali, evo drugog video snimka koji pokazuje neke od naših izazova. Ovo je Džesi, stiska penastu igračku. I što jače stisne -- vidite crnu stvarčicu u sredini to jače pritiska na njegovu kožu, srazmerno tome koliko jako on stiska. Ali, pogledajte sve te elektrode okolo. Imam pravi prostorni problem. Trebalo bi da stavimo gomilu svih tih stvari tu, a naš mali motor pravi razne zvukove tačno pored mojih elektroda. Tako da je to što radimo priličan izazov.
The future is bright. We're excited about where we are and a lot of things we want to do. So for example, one is to get rid of my real estate problem and get better signals. We want to develop these little tiny capsules about the size of a piece of risotto that we can put into the muscles and telemeter out the EMG signals, so that it's not worrying about electrode contact. And we can have the real estate open to try more sensation feedback. We want to build a better arm. This arm -- they're always made for the 50th percentile male -- which means they're too big for five-eighths of the world. So rather than a super strong or super fast arm, we're making an arm that is -- we're starting with, the 25th percentile female -- that will have a hand that wraps around, opens all the way, two degrees of freedom in the wrist and an elbow. So it'll be the smallest and lightest and the smartest arm ever made. Once we can do it that small, it's a lot easier making them bigger.
Budućnost je svetla. Uzbudjeni smo time gde se sad nalazimo i mnogim stvarima koje želimo da uradimo. Tako na primer, jedna od stvari je da se rešim mog prostornog problema i da dobijem bolje signale. Hoćemo da razvijemo ove malecke kapsule, otprilike veličine komadića iz rižota koje možemo da stavimo u mišiće i da prenosimo EMG signale, tako da nema brige o kontaktu sa elektrodom. I možemo da oslobodimo prostor i pokušamo da dobijemo bolju povratnu reakciju za osećaj. Hoćemo da napravimo bolju ruku. Ova ruka -- uvek se prave za 50 procenata muškaraca -- što znači da su prevelike za 5/8 svetske populacije. I tako, umesto super snažne ili super brze ruke, mi pravimo ruku, tačnije -- počinjemo sa, 25 procenata žena koje će imati šaku koja može da obuhvati, može da se potpuno otvori, ima dva stepena slobode u zglobu i laktu. Tako da će to biti najmanja i najlakša i najpametnija ruka ikad napravljena. Jednom kad budemo mogli da to napravimo tako malo, mnogo je jednostavnije posle ih napraviti veće.
So those are just some of our goals. And we really appreciate you all being here today. I'd like to tell you a little bit about the dark side, with yesterday's theme. So Amanda came jet-lagged, she's using the arm, and everything goes wrong. There was a computer spook, a broken wire, a converter that sparked. We took out a whole circuit in the hotel and just about put on the fire alarm. And none of those problems could I have dealt with, but I have a really bright research team. And thankfully Dr. Annie Simon was with us and worked really hard yesterday to fix it. That's science. And fortunately, it worked today.
Dakle, to su samo neki od naših ciljeva. I stvarno cenimo što ste svi vi danas ovde. Želeo bih da vam ispričam nešto i o mračnoj strani, sa jučerašnjom temom. Znači Amanda je stigla sa džet-legom od puta, koristi ruku, i sve ide naopako. Desio se kvar na kompjuteru, pukla je žica, transformator je varničio. Izvadili smo celo strujno kolo u hotelu i skoro aktivirali požarni alarm. I nijedan od ovih problema ne bih mogao da rešim, da nemam zaista sjajan tim istraživača. I, na sreću, Dr Eni Sajmon je bila sa nama i juče smo se stvarno naradili da to sredimo. To je nauka. I srećom, danas radi.
So thank you very much.
Hvala vam mnogo.
(Applause)
(aplauz)