TEDGlobal 2011
Todd Kuiken: A prosthetic arm that "feels"
陶德 奎肯: 義肢也能“有感覺”
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復健師兼工程師陶德奎肯正在研發一個能與人類神經系統結合，改善行動力、控制力，甚至感覺的義肢。在講台上，病人艾曼達基茨幫助演示下一代機器手臂。
Todd Kuiken - Biomedical engineer
A doctor and engineer, Todd Kuiken builds new prosthetics that connect with the human nervous system. Yes: bionics. Full bio
A doctor and engineer, Todd Kuiken builds new prosthetics that connect with the human nervous system. Yes: bionics. Full bio
Double-click the English transcript below to play the video.
00:15
So today, I would like to talk with you
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今天我想和你們談談
00:18
about bionics,
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生物工學
00:20
which is the popular term
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這個流行的專有名詞
00:22
for the science of replacing part of a living organism
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意指藉機電裝置或機器人
00:25
with a mechatronic device, or a robot.
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來取代生物體部份機能的學問
00:28
It is essentially
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本質上就是
00:30
the stuff of life meets machine.
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生命和機器結合的東西
00:33
And specifically, I'd like to talk with you
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我要特別跟你們談談
00:35
about how bionics is evolving
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生物工學對使用義肢的人
00:38
for people with arm amputations.
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如何地進展
00:41
This is our motivation.
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這是我們的動力來源
00:44
Arm amputation causes a huge disability.
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手臂截肢會造成極度不便
00:47
I mean, the functional impairment is clear.
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在功能上的損傷是很明顯的
00:49
Our hands are amazing instruments.
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我們的雙手是驚人的工具
00:51
And when you lose one, far less both,
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我們不要說失去雙臂，光是失去一隻手臂
00:54
it's a lot harder to do the things
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在生理上執行事情
00:56
we physically need to do.
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就困難許多了
00:58
There's also a huge emotional impact.
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在心理方面的影響也非常巨大
01:00
And actually, I spend as much of my time in clinic
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事實上，我在診所處理
01:02
dealing with the emotional adjustment of patients
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病人情緒調節的時間
01:05
as with the physical disability.
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和他們身體功能障礙的時間一樣多
01:07
And finally, there's a profound social impact.
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最後，還有廣大的社會衝擊
01:10
We talk with our hands.
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我們說話時以手為輔
01:12
We greet with our hands.
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我們用手打招呼
01:14
And we interact with the physical world with our hands.
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我們用手摸索物質世界
01:17
And when they're missing,
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沒有手
01:19
it's a barrier.
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就會產生障礙
01:21
Arm amputation is usually caused by trauma,
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手臂截肢通常由創傷所導致
01:24
with things like industrial accidents,
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例如工業意外
01:26
motor vehicle collisions
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機車衝撞
01:28
or, very poignantly, war.
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或殘酷的戰爭
01:30
There are also some children who are born without arms,
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也有些小孩是生來殘缺的
01:33
called congenital limb deficiency.
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稱做先天性肢體缺失
01:36
Unfortunately, we don't do great
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可惜我們在
01:38
with upper-limb prosthetics.
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上肢義肢方面沒有做得很好
01:40
There are two general types.
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有兩種主要類型
01:42
They're called body-powered prostheses,
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一種是身體動力型義肢
01:44
which were invented just after the Civil War,
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發明於南北戰爭過後不久
01:46
refined in World War I and World War II.
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又在第一次和二次世界大戰時經改良
01:49
Here you see a patent
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你現在看到的是
01:51
for an arm in 1912.
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1912年的一項義肢專利
01:53
It's not a lot different
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和我病人身上的義肢
01:55
than the one you see on my patient.
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沒有太大差別
01:58
They work by harnessing shoulder power.
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它們運用肩膀力量來帶動義肢
02:00
So when you squish your shoulders, they pull on a bicycle cable.
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所以當你擠壓肩膀時，就會帶動腳踏車鋼索
02:03
And that bicycle cable can open or close a hand or a hook
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而鋼索就會將手鉤打開、關上
02:06
or bend an elbow.
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或使手肘彎曲
02:08
And we still use them commonly,
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這種義肢仍然相當普遍
02:10
because they're very robust
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因為它們算是非常穩健
02:12
and relatively simple devices.
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相對來說也較為簡便的裝置
02:14
The state of the art
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第二種較為先進的技術
02:16
is what we call myoelectric prostheses.
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則是我們所謂的肌電義肢
02:18
These are motorized devices
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這些機動裝置
02:20
that are controlled
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會偵測
02:22
by little electrical signals from your muscle.
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你肌肉所產生的微小電子訊號
02:24
Every time you contract a muscle,
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每當你收縮一條肌肉
02:26
it emits a little electricity
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它會釋放一些電信號
02:28
that you can record with antennae or electrodes
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供接收天線或電極記錄
02:30
and use that to operate the motorized prosthesis.
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再用來操作機動義肢
02:33
They work pretty well
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對只失去手部的人來說
02:35
for people who have just lost their hand,
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使用起來很方便
02:37
because your hand muscles are still there.
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因為你的手部肌肉還在
02:39
You squeeze your hand, these muscles contract.
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你握緊手，這些肌肉就會收縮
02:41
You open it, these muscles contract.
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你把手打開，這些肌肉也會收縮
02:43
So it's intuitive, and it works pretty well.
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所以它是直覺性的，效果很棒
02:46
Well how about with higher levels of amputation?
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那假如截肢範圍更大呢？
02:48
Now you've lost your arm above the elbow.
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假設手肘以上的部份都被截掉了
02:50
You're missing not only these muscles,
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你不但失去了這些肌肉
02:52
but your hand and your elbow too.
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連你的手和手肘都沒了
02:54
What do you do?
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該怎麼辦？
02:56
Well our patients have to use
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我們的患者必須使用
02:58
very code-y systems
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非常編碼的系統
03:01
of using just their arm muscles
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單純使用他們的手臂肌肉
03:03
to operate robotic limbs.
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來操作機械手臂
03:06
We have robotic limbs.
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我們有機械手臂
03:08
There are several available on the market, and here you see a few.
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市面上都買得到，這裡也看得到一些
03:11
They contain just a hand that will open and close,
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包含一隻會開合的手
03:14
a wrist rotator and an elbow.
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一個旋腕關節及手肘
03:16
There's no other functions.
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沒有其他功能
03:18
If they did, how would we tell them what to do?
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要是有的話，我們要如何操作呢？
03:20
We built our own arm at the Rehab Institute of Chicago
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我們在芝加哥復健機構裡建造自己的假肢
03:23
where we've added some wrist flexion and shoulder joints
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並增加一些橈側屈腕肌和肩膀關節
03:26
to get up to six motors, or six degrees of freedom.
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以達到六個馬達, 或是說六個自由度
03:29
And we've had the opportunity to work with some very advanced arms
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我們也研究一些很先進的假肢
03:32
that were funded by the U.S. military, using these prototypes,
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美國軍方贊助的這些原型
03:35
that had up to 10 different degrees of freedom
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有高達10種不同的自由度
03:38
including movable hands.
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包括可移動式手臂
03:40
But at the end of the day,
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但最終難題還是
03:42
how do we tell these robotic arms what to do?
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要如何操作這些機械手臂呢？
03:44
How do we control them?
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要如何控制它們呢？
03:46
Well we need a neural interface,
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我們需要一個神經介面
03:48
a way to connect to our nervous system
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來連接我們的神經系統
03:50
or our thought processes
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或思考過程
03:52
so that it's intuitive, it's natural,
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讓它很直覺、很自然
03:54
like for you and I.
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像你、我一樣
03:58
Well the body works by starting a motor command in your brain,
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我們身體先由腦部下行動作指令
04:01
going down your spinal cord,
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經由你的脊隨傳遞訊息
04:03
out the nerves and to your periphery.
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到神經末梢
04:05
And your sensation's the exact opposite.
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你的感官觸動則完全相反
04:07
You touch yourself, there's a stimulus
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當你觸碰自己，會產生刺激
04:09
that comes up those very same nerves back up to your brain.
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透過相同的神經傳送訊息回腦部
04:13
When you lose your arm, that nervous system still works.
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就算你失去手臂，那個神經系統仍運作
04:16
Those nerves can put out command signals.
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那些神經可以發出指令信號
04:19
And if I tap the nerve ending
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假如我在一位二戰老兵殘肢上
04:21
on a World War II vet,
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輕輕拍打神經末梢
04:23
he'll still feel his missing hand.
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他還是可以感覺到失去的那隻手
04:25
So you might say,
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這時候你可能會說
04:27
let's go to the brain
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我們何不在大腦裡
04:29
and put something in the brain to record signals,
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放個東西來紀錄信號
04:32
or in the end of the peripheral nerve and record them there.
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或放到末梢神經去紀錄
04:35
And these are very exciting research areas,
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這些研究領域是非常令人興奮的
04:38
but it's really, really hard.
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但也相當相當艱鉅
04:40
You have to put in
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你必須置入
04:42
hundreds of microscopic wires
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成百上千個微纜線
04:44
to record from little tiny individual neurons -- ordinary fibers
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來記錄微小單一神經元 - 普通纖維
04:48
that put out tiny signals
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所發出的微弱信號
04:50
that are microvolts.
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也就是微伏特
04:52
And it's just too hard
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這對我的患者和使用上
04:54
to use now and for my patients today.
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實在是太困難了
04:56
So we developed a different approach.
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因此我們研發出不同的方法
04:59
We're using a biological amplifier
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我們使用生物放大器 - 肌肉
05:02
to amplify these nerve signals -- muscles.
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來放大這些神經信號
05:05
Muscles will amplify the nerve signals
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肌肉會放大神經信號
05:07
about a thousand-fold,
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大概一千倍
05:09
so that we can record them from on top of the skin,
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我們在皮膚表面上能讀取得到
05:12
like you saw earlier.
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就像你剛才看到的
05:14
So our approach is something we call targeted reinnervation.
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我們的方法就是所謂的標靶神經移植術
05:17
Imagine, with somebody who's lost their whole arm,
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想像一個人失去整個手臂
05:20
we still have four major nerves
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但還有四條主要神經
05:22
that go down your arm.
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連接手臂
05:24
And we take the nerve away from your chest muscle
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我們將那些胸肌神經拉出
05:27
and let these nerves grow into it.
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然後把手臂神經轉移到病患的胸肌
05:30
Now you think, "Close hand," and a little section of your chest contracts.
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所以你在腦袋裡想“握拳”，胸肌就會收縮
05:33
You think, "Bend elbow,"
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你想“彎手肘”
05:35
a different section contracts.
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胸肌的另一區塊也會收縮
05:37
And we can use electrodes or antennae
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我們可以利用電極或天線
05:39
to pick that up and tell the arm to move.
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接收信號讓手臂動起來
05:42
That's the idea.
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大概就是這樣
05:44
So this is the first man that we tried it on.
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這是我們首先測試的對象
05:47
His name is Jesse Sullivan.
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他叫傑西 沙利文
05:49
He's just a saint of a man --
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是個非常好的人
05:51
54-year-old lineman who touched the wrong wire
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這位54歲的架線工因誤觸電線
05:53
and had both of his arms burnt so badly
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導致雙臂嚴重灼傷
05:56
they had to be amputated at the shoulder.
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在雙肩部位截肢
05:58
Jesse came to us at the RIC
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傑西來到芝加哥復健醫院
06:00
to be fit with these state-of-the-art devices, and here you see them.
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裝上這些圖上看到的先進裝置
06:03
I'm still using that old technology
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我仍用舊技術
06:06
with a bicycle cable on his right side.
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在他右肩裝腳踏車纜線
06:08
And he picks which joint he wants to move with those chin switches.
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讓他決定下巴開關要動哪個關節
06:11
On the left side he's got a modern motorized prosthesis
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左邊裝的是先進的肌電義肢
06:14
with those three joints,
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連接三個關節
06:16
and he operates little pads in his shoulder
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他操作肩膀上的小墊子
06:19
that he touches to make the arm go.
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藉由碰觸讓手臂動起來
06:21
And Jesse's a good crane operator,
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傑西是個不錯的起重機操作員
06:23
and he did okay by our standards.
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依我們標準來說他表現還不錯
06:25
He also required a revision surgery on his chest.
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他在胸肌還需進行再次手術
06:28
And that gave us the opportunity
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這給了我們機會
06:30
to do targeted reinnervation.
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進行標靶神經移植術
06:32
So my colleague, Dr. Greg Dumanian, did the surgery.
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於是我的同事葛瑞格杜曼年執行了這項手術
06:35
First, we cut away the nerve to his own muscle,
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首先，我們將連接肌肉的神經切掉
06:38
then we took the arm nerves
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接著我們將他的手臂神經
06:40
and just kind of had them shift down onto his chest
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轉移到胸肌部位
06:42
and closed him up.
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最後再縫合好
06:44
And after about three months,
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大約三個月後
06:46
the nerves grew in a little bit and we could get a twitch.
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那些神經長出來了一點開始抽動
06:48
And after six months, the nerves grew in well,
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再六個月後，神經再生狀況良好
06:51
and you could see strong contractions.
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你可以看出很明顯的肌肉收縮反應
06:53
And this is what it looks like.
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看起來大概像這樣
06:55
This is what happens when Jesse thinks
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當傑西想著
06:57
open and close his hand,
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把手打開和關閉
06:59
or bend or straighten your elbow.
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或手肘彎曲或伸直
07:02
You can see the movements on his chest,
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你可以看到胸肌上的收縮動作
07:04
and those little hash marks
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而且這些小記號
07:06
are where we put our antennae, or electrodes.
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就是我們放天線或電極的地方
07:08
And I challenge anybody in the room
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我相信這裡沒有人的胸肌
07:10
to make their chest go like this.
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可以像他一樣這樣動吧！
07:12
His brain is thinking about his arm.
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他的腦袋想著他的手臂
07:14
He has not learned how to do this with the chest.
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他並沒有刻意去學要怎麼動胸肌
07:17
There is not a learning process.
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中間沒有任何學習過程
07:19
That's why it's intuitive.
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這樣才算是所謂的直覺性
07:21
So here's Jesse in our first little test with him.
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這個是我們和傑西作的第一個小實驗
07:24
On the left-hand side, you see his original prosthesis,
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在左手邊，你可以看到他原本的義肢
07:27
and he's using those switches
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他需要那些開關
07:29
to move little blocks from one box to the other.
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將小積木從一個盒子裡搬到另一個盒子
07:31
He's had that arm for about 20 months, so he's pretty good with it.
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他在操作那義肢已有20年的經驗，相當熟練
07:34
On the right side,
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在右邊呢
07:36
two months after we fit him with his targeted reinnervation prosthesis --
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是幫他裝上標靶神經移植術義肢的兩個月後
07:39
which, by the way, is the same physical arm,
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對了，而且是裝在同一隻手臂上
07:42
just programmed a little different --
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但設計上稍微不同
07:44
you can see that he's much faster
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大家可以看到他的速度快了許多
07:46
and much smoother as he moves these little blocks.
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移動這些小積木手感也更順
07:49
And we're only able to use three of the signals at this time.
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而且我們同時只能用到三個信號
07:52
Then we had one of those little surprises in science.
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接著出乎意料之外
07:57
So we're all motivated to get motor commands
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當我們都在等待運動指令的出現
07:59
to drive robotic arms.
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來操作義肢時
08:01
And after a few months,
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幾個月後
08:03
you touch Jesse on his chest,
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當你觸摸傑西的胸肌
08:05
and he felt his missing hand.
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他竟然感覺到他失去的手
08:08
His hand sensation grew into his chest again
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他手的知覺竟長回到他的胸肌裡去
08:10
probably because we had also taken away a lot of fat,
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可能因為我們也抽掉很多脂肪
08:13
so the skin was right down to the muscle
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所以皮膚下面就是肌肉
08:15
and deinnervated, if you would, his skin.
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皮膚神經也被抽掉了
08:17
So you touch Jesse here, he feels his thumb;
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所以當你摸傑西這裡，他會感覺到他的拇指
08:19
you touch it here, he feels his pinky.
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摸這裡，他會感覺到他的小指
08:21
He feels light touch
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輕微的碰觸
08:23
down to one gram of force.
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微小到一克的力道都有感覺
08:25
He feels hot, cold, sharp, dull,
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甚至是冷、熱、尖、鈍
08:28
all in his missing hand,
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通通在他失去的手上感受到了
08:30
or both his hand and his chest,
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或在手和胸肌上同時感受到
08:32
but he can attend to either.
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他兩者都能兼顧
08:34
So this is really exciting for us,
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這實在是令我們精神為之一振
08:36
because now we have a portal,
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因為我們開創了先機
08:38
a portal, or a way to potentially give back sensation,
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或者說，開發了恢復知覺的潛力
08:42
so that he might feel what he touches
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他才能用義肢
08:44
with his prosthetic hand.
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重拾觸覺
08:46
Imagine sensors in the hand
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想像手中的傳感器
08:48
coming up and pressing on this new hand skin.
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傳遞到這新的手皮膚部位
08:51
So it was very exciting.
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所以這相當振奮人心
08:53
We've also gone on
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我們也繼續
08:55
with what was initially our primary population
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向我們的原始實驗對象
08:57
of people with above-the-elbow amputations.
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也就是手肘以上截肢的族群
08:59
And here we deinnervate, or cut the nerve away,
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我們從肌肉的一小塊裡
09:02
just from little segments of muscle
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將神經移除，或切除
09:04
and leave others alone
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然後把其他的保留
09:06
that give us our up-down signals
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這讓我們有上下信號
09:08
and two others that will give us a hand open and close signal.
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和其他兩個讓手開關的信號
09:11
This was one of our first patients, Chris.
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這是我們第一個病患，克里斯
09:13
You see him with his original device
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你看到他在左邊的是
09:15
on the left there after eight months of use,
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使用了八個月的原本裝置
09:17
and on the right, it is two months.
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右邊的新裝置，則使用了兩個月
09:19
He's about four or five times as fast
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這個小效能指標
09:22
with this simple little performance metric.
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讓他速度快了約四、五倍
09:25
All right.
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很好
09:27
So one of the best parts of my job
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我工作最精彩的部份
09:30
is working with really great patients
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就是能和很棒的病患合作
09:32
who are also our research collaborators.
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他們也是我們的研究夥伴
09:34
And we're fortunate today
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我們今天很幸運
09:36
to have Amanda Kitts come and join us.
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能邀請艾曼達基茨來加入我們
09:38
Please welcome Amanda Kitts.
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請歡迎艾曼達基茨
09:40
(Applause)
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（掌聲）
09:47
So Amanda, would you please tell us how you lost your arm?
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艾曼達，能否請您分享您如何失去手臂的？
09:50
Amanda Kitts: Sure. In 2006, I had a car accident.
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艾曼達：好的。我在2006年出了車禍
09:53
And I was driving home from work,
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當時下班開車回家路上
09:56
and a truck was coming the opposite direction,
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迎面而來一台卡車
09:58
came over into my lane,
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衝到我的車道上
10:00
ran over the top of my car and his axle tore my arm off.
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我的車就被輾過去，手臂被他的車輪扯斷
10:04
Todd Kuiken: Okay, so after your amputation, you healed up.
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陶德 奎肯：好，那您截肢後就復原了
10:07
And you've got one of these conventional arms.
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關於您使用過傳統的義肢
10:09
Can you tell us how it worked?
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能否告訴我們您是如何操作的呢？
10:12
AK: Well, it was a little difficult,
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艾：恩，過程有點困難
10:14
because all I had to work with was a bicep and a tricep.
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因為我只能用二頭肌和三頭肌去控制義肢
10:16
So for the simple little things like picking something up,
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所以光是撿東西的這些簡單小動作
10:19
I would have to bend my elbow,
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我就要先把我的手肘彎曲
10:22
and then I would have to cocontract
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再共同收縮
10:24
to get it to change modes.
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以切換模式
10:26
When I did that,
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當時
10:28
I had to use my bicep
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我必須使用二頭肌
10:31
to get the hand to close,
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來讓手收合
10:33
use my tricep to get it to open,
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然後使用三頭肌來張手
10:35
cocontract again
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再共同收縮
10:37
to get the elbow to work again.
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才能讓手肘恢復運作
10:39
TK: So it was a little slow?
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陶：這樣過程有點遲緩吧？
10:41
AK: A little slow, and it was just hard to work.
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艾：滿遲緩的，而且操作困難
10:44
You had to concentrate a whole lot.
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你必須很專心才行
10:46
TK: Okay, so I think about nine months later
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陶：好，那大概九個月後
10:49
that you had the targeted reinnervation surgery,
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您進行標靶神經移植手術
10:51
took six more months to have all the reinnervation.
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花了六個月時間完成所有神經移植術
10:54
Then we fit her with a prosthesis.
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然後我們幫他配上義肢
10:57
And how did that work for you?
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配完以後感覺如何？
10:59
AK: It works good.
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艾：很棒
11:02
I was able to use my elbow
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我可以同時
11:06
and my hand simultaneously.
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使用手肘和手
11:09
I could work them just by my thoughts.
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而且可以用想的去使喚它們
11:11
So I didn't have to do any of the cocontracting and all that.
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所以完全不需要再共同收縮了
11:14
TK: A little faster?
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陶：比較快？
11:16
AK: A little faster. And much more easy, much more natural.
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艾：比較快了，而且簡單多，又自然多了
11:20
TK: Okay, this was my goal.
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陶：好的，那就是我的目的
11:23
For 20 years, my goal was to let somebody
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二十年來，我的目標就是
11:26
[be] able to use their elbow and hand in an intuitive way
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讓病人能很直覺性的同時使用
11:29
and at the same time.
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手肘和手
11:31
And we now have over 50 patients around the world who have had this surgery,
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我們現在有超過五十位遍及全球的病患接受這手術
11:34
including over a dozen of our wounded warriors
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包括至少十二名
11:36
in the U.S. armed services.
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美國國軍的受傷戰士
11:38
The success rate of the nerve transfers is very high.
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神經移植的成功機率相當高
11:41
It's like 96 percent.
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高達96%
11:43
Because we're putting a big fat nerve onto a little piece of muscle.
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因為我們要把很大塊的神經放在一小塊肌肉上
11:46
And it provides intuitive control.
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這樣就給了病人直覺性的支配權
11:50
Our functional testing, those little tests,
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我們的功能測試，這些小測試
11:52
all show that they're a lot quicker and a lot easier.
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全都顯示它的速度和簡易操作
11:54
And the most important thing
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而且最重要的是
11:56
is our patients have appreciated it.
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我們的病患用得很開心
11:58
So that was all very exciting.
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這一切都非常振奮人心
12:00
But we want to do better.
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但我們還不滿足
12:03
There's a lot of information in those nerve signals,
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那些神經信號還有很多資訊
12:07
and we wanted to get more.
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我們想要取得更多
12:09
You can move each finger. You can move your thumb, your wrist.
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你可以移動每個手指，可以動拇指、手腕
12:12
Can we get more out of it?
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我們可以再更進一步嗎？
12:14
So we did some experiments
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因此我們進行了些實驗
12:16
where we saturated our poor patients with zillions of electrodes
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我們將上萬個電極裝在我們倒楣的病患上
12:19
and then had them try to do two dozen different tasks --
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然後請他們完成二十四項任務
12:22
from wiggling a finger to moving a whole arm
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從擺動手指到動整隻手臂
12:25
to reaching for something --
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再到伸手拿東西
12:27
and recorded this data.
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然後把這資料紀錄下來
12:29
And then we used some algorithms
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接著，我們利用一些演算法
12:31
that are a lot like speech recognition algorithms,
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很像語音辨識系統
12:33
called pattern recognition.
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叫做圖案辨識
12:35
See.
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看吧
12:37
(Laughter)
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(笑聲)
12:39
And here you can see, on Jesse's chest,
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你可以看到，傑西的胸肌上
12:41
when he just tried to do three different things,
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當他試著做三件不同的事
12:43
you can see three different patterns.
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你可以看到三種不同圖案
12:45
But I can't put in an electrode
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但我無法將一個電極放上去
12:47
and say, "Go there."
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然後叫它“去那裡”
12:49
So we collaborated with our colleagues in University of New Brunswick,
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因此我們和新柏倫瑞克大學的同事合作
12:52
came up with this algorithm control,
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想出了這個演算控制
12:54
which Amanda can now demonstrate.
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現在艾曼達可以示範給我們看
12:56
AK: So I have the elbow that goes up and down.
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艾：我有可以舉起和放下的手肘
13:01
I have the wrist rotation
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我有可以轉動的手腕
13:03
that goes -- and it can go all the way around.
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可以轉一圈
13:06
And I have the wrist flexion and extension.
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我有可以彎曲的手腕
13:10
And I also have the hand closed and open.
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還有可以開關的手
13:13
TK: Thank you, Amanda.
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陶：謝謝，艾曼達
13:15
Now this is a research arm,
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這是個還在試驗的手臂
13:17
but it's made out of commercial components from here down
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但從這裡以下是由商業組件作成的
13:20
and a few that I've borrowed from around the world.
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還有一些從各地借來的
13:23
It's about seven pounds,
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重量約3.175公斤
13:26
which is probably about what my arm would weigh
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大概跟我的手臂一樣重
13:28
if I lost it right here.
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如果從這裡算的話
13:30
Obviously, that's heavy for Amanda.
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很明顯的，對艾曼達來說很重
13:33
And in fact, it feels even heavier,
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事實上，她在感覺上會更重
13:35
because it's not glued on the same.
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因為接合方式不同
13:37
She's carrying all the weight through harnesses.
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她是籍以索帶支撐這些重量
13:39
So the exciting part isn't so much the mechatronics,
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所以最精彩的部份並不是機電整合
13:42
but the control.
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而是支配能力
13:44
So we've developed a small microcomputer
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因此我們研發了一個微型電腦
13:47
that is blinking somewhere behind her back
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在她的背後運作
13:50
and is operating this
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操作這隻手
13:52
all by the way she trains it
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完全由她去訓練的
13:54
to use her individual muscle signals.
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運用她的個別肌肉信號
13:56
So Amanda, when you first started using this arm,
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那麼艾曼達，當妳第一次使用這隻手臂
13:58
how long did it take to use it?
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花多久時間學會？
14:01
AK: It took just about probably three to four hours
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艾：大概三到四小時
14:03
to get it to train.
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來訓練它
14:05
I had to hook it up to a computer,
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我必須連上電腦
14:07
so I couldn't just train it anywhere.
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所以不能在任何地方訓練
14:09
So if it stopped working, I just had to take it off.
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所以假如它壞了，我就必須取下來
14:12
So now it's able to train
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現在只要用背上的小東西
14:14
with just this little piece on the back.
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就可以訓練
14:16
I can wear it around.
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我可以到處走
14:18
If it stops working for some reason, I can retrain it.
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就算壞了，我還是可以重新訓練它
14:21
Takes about a minute.
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大概花一分鐘而已吧
14:23
TK: So we're really excited,
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陶：所以我們非常興奮
14:25
because now we're getting to a clinically practical device.
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因為我們現在做到一個臨床上可行的裝置
14:28
And that's where our goal is --
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這就是我們的目標
14:30
to have something clinically pragmatic to wear.
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讓它在臨床上可行
14:34
We've also had Amanda able to use
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我們也讓艾曼達能夠使用
14:37
some of our more advanced arms that I showed you earlier.
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一些剛才提到的先進手臂
14:41
Here's Amanda using an arm made by DEKA Research Corporation.
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這是艾曼達在操作DEKA研發公司的手臂
14:44
And I believe Dean Kamen presented it at TED a few years ago.
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相信迪恩卡門幾年前在TED介紹過給大家
14:48
So Amanda, you can see,
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那麼你可以看出艾曼達
14:50
has really good control.
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操作得很棒
14:52
It's all the pattern recognition.
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這都是圖案辨識
14:54
And it now has a hand that can do different grasps.
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現在還有可以做不同緊握動作的手
14:57
What we do is have the patient go all the way open
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我們讓病患腦力激盪
15:00
and think, "What hand grasp pattern do I want?"
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想“我要什麼樣的緊握模式？”
15:03
It goes into that mode,
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它就會進入那模式
15:05
and then you can do up to five or six different hand grasps with this hand.
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就可以用這隻手做高達五、六種手握動作
15:07
Amanda, how many were you able to do with the DEKA arm?
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艾曼達，你操作DEKA手時，能做幾種？
15:10
AK: I was able to get four.
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艾：我能做四種
15:12
I had the key grip, I had a chuck grip,
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我可以握手，彎手指
15:15
I had a power grasp
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可以緊握
15:17
and I had a fine pinch.
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還可以用手指捏東西
15:19
But my favorite one was just when the hand was open,
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但我最喜歡的部份是手可以打開
15:21
because I work with kids,
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因為我工作要跟小孩玩
15:23
and so all the time you're clapping and singing,
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所以常要拍手唱歌
15:26
so I was able to do that again, which was really good.
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我可以再度拍手了，感覺很棒
15:29
TK: That hand's not so good for clapping.
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陶：那隻手就不是很能拍手了
15:31
AK: Can't clap with this one.
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艾：這隻不能
15:33
TK: All right. So that's exciting
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陶：太好了，這對朝向更好的機電來說
15:35
on where we may go with the better mechatronics,
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是非常令人興奮的
15:37
if we make them good enough
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我們只需要把手建造得好到可以
15:39
to put out on the market and use in a field trial.
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開放到市場上賣，並拿去做研究試驗
15:42
I want you to watch closely.
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我想請大家仔細看
15:44
(Video) Claudia: Oooooh!
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嗚！
15:46
TK: That's Claudia,
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那是克拉蒂雅
15:48
and that was the first time
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那是她第一次
15:50
she got to feel sensation through her prosthetic.
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從義肢上感受到知覺
15:53
She had a little sensor at the end of her prosthesis
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在義肢尾端有小感應器
15:56
that then she rubbed over different surfaces,
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她在和不同表面摩擦時
15:59
and she could feel different textures
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還能辨別不同的質感
16:01
of sandpaper, different grits, ribbon cable,
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在她重新植入神經後的手部肌膚上
16:04
as it pushed on her reinnervated hand skin.
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感受到沙紙、不同砂石和彩虹排線
16:07
She said that when she just ran it across the table,
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她說用義肢在桌子上摸過去
16:10
it felt like her finger was rocking.
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她感覺得到手指在震動
16:12
So that's an exciting laboratory experiment
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那就是非常令人振奮的實驗
16:14
on how to give back, potentially, some skin sensation.
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幫助我們研究如何讓病人的義肢有知覺
16:17
But here's another video that shows some of our challenges.
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不過這是另一段影片，顯示過程的一些挑戰
16:20
This is Jesse, and he's squeezing a foam toy.
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這是傑西，他在捏一個海綿玩具
16:23
And the harder he squeezes -- you see a little black thing in the middle
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捏越緊的時候，在中間會看到一個黑色小東西
16:26
that's pushing on his skin proportional to how hard he squeezes.
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以同等他施壓的力量推向他的皮膚
16:29
But look at all the electrodes around it.
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但看周圍所有的電極
16:31
I've got a real estate problem.
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出現了房地產的問題
16:33
You're supposed to put a bunch of these things on there,
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我們應該要把一堆東西放在上面
16:35
but our little motor's making all kinds of noise
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但我們的小肌電卻在電極旁邊
16:38
right next to my electrodes.
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發出各種噪音
16:40
So we're really challenged on what we're doing there.
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這方面是個重大挑戰
16:43
The future is bright.
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未來充滿光明
16:45
We're excited about where we are and a lot of things we want to do.
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我們對於現在的進展很興奮，要做的事情還很多
16:48
So for example,
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例如
16:50
one is to get rid of my real estate problem
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搞定我的房地產問題
16:53
and get better signals.
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得到更好的信號
16:55
We want to develop these little tiny capsules
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我們想研發一些小膠囊
16:58
about the size of a piece of risotto
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小到像一粒米一樣
17:00
that we can put into the muscles
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然後放進肌肉裡
17:02
and telemeter out the EMG signals,
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再將肌電信號傳遞出來
17:05
so that it's not worrying about electrode contact.
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這樣才沒有電極連接的問題
17:08
And we can have the real estate open
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我們也可以讓房地產保持開放
17:10
to try more sensation feedback.
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來測試更多知覺反應
17:12
We want to build a better arm.
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我們想建造更好的義肢
17:14
This arm -- they're always made for the 50th percentile male --
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這個義肢，都是為第50百分位數的男性而打造的
17:18
which means they're too big for five-eighths of the world.
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這樣表示它們對其他5/8的人都太大了
17:22
So rather than a super strong or super fast arm,
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因此，與其作一個超級堅固或快速的義肢
17:25
we're making an arm that is --
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我們要做這種義肢
17:27
we're starting with,
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先由
17:29
the 25th percentile female --
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第25百分位數的女性開始
17:32
that will have a hand that wraps around,
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可以做手握動作
17:34
opens all the way,
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又可以完全張開
17:36
two degrees of freedom in the wrist and an elbow.
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在手腕及手肘有兩個自由度
17:39
So it'll be the smallest and lightest
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這樣就會是最小、最輕
17:41
and the smartest arm ever made.
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又最先進的義肢了
17:43
Once we can do it that small,
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只要可以在這麼小的義肢上達成
17:45
it's a lot easier making them bigger.
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做大一點的就簡單多了
17:47
So those are just some of our goals.
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這些是我們的一些目標
17:50
And we really appreciate you all being here today.
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我們真的很感謝大家的聆聽
17:54
I'd like to tell you a little bit about the dark side,
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有鑑於昨天的主題
17:56
with yesterday's theme.
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我想分享一個我們這行業之苦
17:58
So Amanda came jet-lagged,
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艾曼達還在調時差
18:00
she's using the arm,
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她想用這隻手臂
18:02
and everything goes wrong.
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但都被搞亂了
18:04
There was a computer spook,
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電腦出問題
18:06
a broken wire,
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有個線斷了
18:08
a converter that sparked.
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有個轉換器壞了
18:10
We took out a whole circuit in the hotel
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我們把飯店裡的電力線路都弄壞了
18:12
and just about put on the fire alarm.
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差點就觸發了火警警報器
18:14
And none of those problems could I have dealt with,
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要是沒有一個很聰明的研究團隊
18:17
but I have a really bright research team.
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我根本不可能解決那些問題
18:19
And thankfully Dr. Annie Simon was with us
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還好安妮賽門博士昨天在我們身邊
18:22
and worked really hard yesterday to fix it.
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非常努力幫我們把它修好
18:24
That's science.
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這就是科學
18:26
And fortunately, it worked today.
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還好義肢今天沒有出問題
18:28
So thank you very much.
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所以我要非常感謝大家
18:30
(Applause)
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（掌聲）
ABOUT THE SPEAKER
Todd Kuiken - Biomedical engineerA doctor and engineer, Todd Kuiken builds new prosthetics that connect with the human nervous system. Yes: bionics.
Why you should listen
As Dean Kamen said at TED2007, the design of the prosthetic arm hadn't really been updated since the Civil War -- basically "a stick and a hook." But at the Rehabilitation Institute of Chicago, physiatrist Todd Kuiken is building new arms and hands that are wired into the nervous system and can be controlled by the same impulses from the brain that once controlled flesh and blood.
Kuiken's training -- as both a physician and an engineer -- helps him see both sides of this complex problem. A technology called targeted muscle reinnervation uses nerves remaining after an amputation to control an artificial limb, linking brain impulses to a computer in the prosthesis that directs motors to move the limb. An unexpected effect in some patients: not only can they move their new limb, they can feel with it.
He said: "From an engineering standpoint, this is the greatest challenge one can imagine: trying to restore the most incredible machine in the universe."
Todd Kuiken | Speaker | TED.com