ABOUT THE SPEAKER
Todd Kuiken - Biomedical engineer
A 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."

More profile about the speaker
Todd Kuiken | Speaker | TED.com
TEDGlobal 2011

Todd Kuiken: A prosthetic arm that "feels"

陶德 奎肯: 義肢也能“有感覺”

Filmed:
964,029 views

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。
- Biomedical engineer
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今天, I would like to talk with you
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今天我想和你們談談
00:18
about bionics仿生學,
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生物工學
00:20
which哪一個 is the popular流行 term術語
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這個流行的專有名詞
00:22
for the science科學 of replacing更換 part部分 of a living活的 organism生物
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意指藉機電裝置或機器人
00:25
with a mechatronic機電 device設備, or a robot機器人.
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來取代生物體部份機能的學問
00:28
It is essentially實質上
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本質上就是
00:30
the stuff東東 of life meets符合 machine.
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生命和機器結合的東西
00:33
And specifically特別, 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仿生學 is evolving進化
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生物工學對使用義肢的人
00:38
for people with arm amputations截肢.
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如何地進展
00:41
This is our motivation動機.
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這是我們的動力來源
00:44
Arm amputation切斷術 causes原因 a huge巨大 disability失能.
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手臂截肢會造成極度不便
00:47
I mean, the functional實用 impairment減值 is clear明確.
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在功能上的損傷是很明顯的
00:49
Our hands are amazing驚人 instruments儀器.
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我們的雙手是驚人的工具
00:51
And when you lose失去 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更難 to do the things
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在生理上執行事情
00:56
we physically物理 need to do.
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就困難許多了
00:58
There's also a huge巨大 emotional情緒化 impact碰撞.
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在心理方面的影響也非常巨大
01:00
And actually其實, I spend as much of my time in clinic診所
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事實上,我在診所處理
01:02
dealing交易 with the emotional情緒化 adjustment調整 of patients耐心
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病人情緒調節的時間
01:05
as with the physical物理 disability失能.
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和他們身體功能障礙的時間一樣多
01:07
And finally最後, there's a profound深刻 social社會 impact碰撞.
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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迎接 with our hands.
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我們用手打招呼
01:14
And we interact相互作用 with the physical物理 world世界 with our hands.
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我們用手摸索物質世界
01:17
And when they're missing失踪,
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沒有手
01:19
it's a barrier屏障.
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就會產生障礙
01:21
Arm amputation切斷術 is usually平時 caused造成 by trauma外傷,
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手臂截肢通常由創傷所導致
01:24
with things like industrial產業 accidents事故,
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例如工業意外
01:26
motor發動機 vehicle車輛 collisions碰撞
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機車衝撞
01:28
or, very poignantly尖銳, war戰爭.
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或殘酷的戰爭
01:30
There are also some children孩子 who are born天生 without arms武器,
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也有些小孩是生來殘缺的
01:33
called congenital先天性 limb deficiency不足.
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稱做先天性肢體缺失
01:36
Unfortunately不幸, we don't do great
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可惜我們在
01:38
with upper-limb上肢 prosthetics假肢.
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上肢義肢方面沒有做得很好
01:40
There are two general一般 types類型.
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有兩種主要類型
01:42
They're called body-powered體供電 prostheses假肢,
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一種是身體動力型義肢
01:44
which哪一個 were invented發明 just after the Civil國內 War戰爭,
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發明於南北戰爭過後不久
01:46
refined精製 in World世界 War戰爭 I and World世界 War戰爭 IIII.
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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專利
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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不同
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和我病人身上的義肢
01:55
than the one you see on my patient患者.
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沒有太大差別
01:58
They work by harnessing治理 shoulder power功率.
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它們運用肩膀力量來帶動義肢
02:00
So when you squish果醬 your shoulders肩膀, they pull on a bicycle自行車 cable電纜.
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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自行車 cable電纜 can open打開 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彎曲 an elbow彎頭.
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或使手肘彎曲
02:08
And we still use them commonly常用,
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這種義肢仍然相當普遍
02:10
because they're very robust強大的
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因為它們算是非常穩健
02:12
and relatively相對 simple簡單 devices設備.
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相對來說也較為簡便的裝置
02:14
The state of the art藝術
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第二種較為先進的技術
02:16
is what we call myoelectric肌電 prostheses假肢.
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則是我們所謂的肌電義肢
02:18
These are motorized機動的 devices設備
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這些機動裝置
02:20
that are controlled受控
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會偵測
02:22
by little electrical電動 signals信號 from your muscle肌肉.
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你肌肉所產生的微小電子訊號
02:24
Every一切 time you contract合同 a muscle肌肉,
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每當你收縮一條肌肉
02:26
it emits發射 a little electricity電力
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它會釋放一些電信號
02:28
that you can record記錄 with antennae天線 or electrodes電極
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供接收天線或電極記錄
02:30
and use that to operate操作 the motorized機動的 prosthesis假體.
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再用來操作機動義肢
02:33
They work pretty漂亮 well
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對只失去手部的人來說
02:35
for people who have just lost丟失 their hand,
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使用起來很方便
02:37
because your hand muscles肌肉 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肌肉 contract合同.
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你握緊手,這些肌肉就會收縮
02:41
You open打開 it, these muscles肌肉 contract合同.
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你把手打開,這些肌肉也會收縮
02:43
So it's intuitive直觀的, and it works作品 pretty漂亮 well.
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所以它是直覺性的,效果很棒
02:46
Well how about with higher更高 levels水平 of amputation切斷術?
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那假如截肢範圍更大呢?
02:48
Now you've lost丟失 your arm above以上 the elbow彎頭.
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假設手肘以上的部份都被截掉了
02:50
You're missing失踪 not only these muscles肌肉,
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你不但失去了這些肌肉
02:52
but your hand and your elbow彎頭 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耐心 have to use
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我們的患者必須使用
02:58
very code-y代碼-Y systems系統
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非常編碼的系統
03:01
of using運用 just their arm muscles肌肉
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單純使用他們的手臂肌肉
03:03
to operate操作 robotic機器人 limbs四肢.
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來操作機械手臂
03:06
We have robotic機器人 limbs四肢.
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我們有機械手臂
03:08
There are several一些 available可得到 on the market市場, and here you see a few少數.
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市面上都買得到,這裡也看得到一些
03:11
They contain包含 just a hand that will open打開 and close,
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包含一隻會開合的手
03:14
a wrist rotator and an elbow彎頭.
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一個旋腕關節及手肘
03:16
There's no other functions功能.
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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內置 our own擁有 arm at the Rehab康復 Institute研究所 of Chicago芝加哥
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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我們已經 added添加 some wrist flexion屈曲 and shoulder joints關節
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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馬達, or six degrees of freedom自由.
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以達到六個馬達, 或是說六個自由度
03:29
And we've我們已經 had the opportunity機會 to work with some very advanced高級 arms武器
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我們也研究一些很先進的假肢
03:32
that were funded資助 by the U.S. military軍事, using運用 these prototypes原型,
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美國軍方贊助的這些原型
03:35
that had up to 10 different不同 degrees of freedom自由
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有高達10種不同的自由度
03:38
including包含 movable活動 hands.
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包括可移動式手臂
03:40
But at the end結束 of the day,
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但最終難題還是
03:42
how do we tell these robotic機器人 arms武器 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控制 them?
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要如何控制它們呢?
03:46
Well we need a neural神經 interface接口,
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我們需要一個神經介面
03:48
a way to connect to our nervous緊張 system系統
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來連接我們的神經系統
03:50
or our thought processes流程
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或思考過程
03:52
so that it's intuitive直觀的, it's natural自然,
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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身體 works作品 by starting開始 a motor發動機 command命令 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神經 and to your periphery周邊.
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到神經末梢
04:05
And your sensation's轟動的 the exact精確 opposite對面.
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你的感官觸動則完全相反
04:07
You touch觸摸 yourself你自己, there's a stimulus刺激物
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當你觸碰自己,會產生刺激
04:09
that comes up those very same相同 nerves神經 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失去 your arm, that nervous緊張 system系統 still works作品.
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就算你失去手臂,那個神經系統仍運作
04:16
Those nerves神經 can put out command命令 signals信號.
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那些神經可以發出指令信號
04:19
And if I tap龍頭 the nerve神經 ending結尾
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假如我在一位二戰老兵殘肢上
04:21
on a World世界 War戰爭 IIII vet獸醫,
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輕輕拍打神經末梢
04:23
he'll地獄 still feel his missing失踪 hand.
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他還是可以感覺到失去的那隻手
04:25
So you might威力 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記錄 signals信號,
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放個東西來紀錄信號
04:32
or in the end結束 of the peripheral外圍設備 nerve神經 and record記錄 them there.
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或放到末梢神經去紀錄
04:35
And these are very exciting扣人心弦 research研究 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數以百計 of microscopic顯微 wires電線
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成百上千個微纜線
04:44
to record記錄 from little tiny individual個人 neurons神經元 -- ordinary普通 fibers纖維
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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信號
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所發出的微弱信號
04:50
that are microvolts毫伏.
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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耐心 today今天.
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實在是太困難了
04:56
So we developed發達 a different不同 approach途徑.
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因此我們研發出不同的方法
04:59
We're using運用 a biological生物 amplifier放大器
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我們使用生物放大器 - 肌肉
05:02
to amplify放大 these nerve神經 signals信號 -- muscles肌肉.
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來放大這些神經信號
05:05
Muscles肌肉 will amplify放大 the nerve神經 signals信號
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肌肉會放大神經信號
05:07
about a thousand-fold千倍,
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大概一千倍
05:09
so that we can record記錄 them from on top最佳 of the skin皮膚,
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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途徑 is something we call targeted針對 reinnervation神經移植術.
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我們的方法就是所謂的標靶神經移植術
05:17
Imagine想像, with somebody who's誰是 lost丟失 their whole整個 arm,
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想像一個人失去整個手臂
05:20
we still have four major重大的 nerves神經
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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神經 away from your chest胸部 muscle肌肉
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我們將那些胸肌神經拉出
05:27
and let these nerves神經 grow增長 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部分 of your chest胸部 contracts合同.
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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彎曲 elbow彎頭,"
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你想“彎手肘”
05:35
a different不同 section部分 contracts合同.
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胸肌的另一區塊也會收縮
05:37
And we can use electrodes電極 or antennae天線
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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移動.
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接收信號讓手臂動起來
05:42
That's the idea理念.
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大概就是這樣
05:44
So this is the first man that we tried試著 it on.
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這是我們首先測試的對象
05:47
His name名稱 is Jesse傑西 Sullivan沙利文.
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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-歲 lineman前鋒 who touched感動 the wrong錯誤 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武器 burnt so badly
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導致雙臂嚴重灼傷
05:56
they had to be amputated截肢 at the shoulder.
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在雙肩部位截肢
05:58
Jesse傑西 came來了 to us at the RICRIC
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傑西來到芝加哥復健醫院
06:00
to be fit適合 with these state-of-the-art最先進的 devices設備, 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運用 that old technology技術
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我仍用舊技術
06:06
with a bicycle自行車 cable電纜 on his right side.
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在他右肩裝腳踏車纜線
06:08
And he picks精選 which哪一個 joint聯合 he wants to move移動 with those chin下巴 switches開關.
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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現代 motorized機動的 prosthesis假體
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左邊裝的是先進的肌電義肢
06:14
with those three joints關節,
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連接三個關節
06:16
and he operates操作 little pads in his shoulder
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他操作肩膀上的小墊子
06:19
that he touches觸摸 to make the arm go.
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藉由碰觸讓手臂動起來
06:21
And Jesse's傑西的 a good crane起重機 operator操作者,
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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標準.
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依我們標準來說他表現還不錯
06:25
He also required需要 a revision調整 surgery手術 on his chest胸部.
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他在胸肌還需進行再次手術
06:28
And that gave us the opportunity機會
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這給了我們機會
06:30
to do targeted針對 reinnervation神經移植術.
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進行標靶神經移植術
06:32
So my colleague同事, Dr博士. Greg格雷格 DumanianDumanian, did the surgery手術.
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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神經 to his own擁有 muscle肌肉,
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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神經
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接著我們將他的手臂神經
06:40
and just kind of had them shift轉移 down onto his chest胸部
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轉移到胸肌部位
06:42
and closed關閉 him up.
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最後再縫合好
06:44
And after about three months個月,
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大約三個月後
06:46
the nerves神經 grew成長 in a little bit and we could get a twitch抽搐.
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那些神經長出來了一點開始抽動
06:48
And after six months個月, the nerves神經 grew成長 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強大 contractions宮縮.
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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容貌 like.
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看起來大概像這樣
06:55
This is what happens發生 when Jesse傑西 thinks
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當傑西想著
06:57
open打開 and close his hand,
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把手打開和關閉
06:59
or bend彎曲 or straighten弄直 your elbow彎頭.
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或手肘彎曲或伸直
07:02
You can see the movements運動 on his chest胸部,
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你可以看到胸肌上的收縮動作
07:04
and those little hash哈希 marks分數
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而且這些小記號
07:06
are where we put our antennae天線, or electrodes電極.
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就是我們放天線或電極的地方
07:08
And I challenge挑戰 anybody任何人 in the room房間
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我相信這裡沒有人的胸肌
07:10
to make their chest胸部 go like this.
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可以像他一樣這樣動吧!
07:12
His brain is thinking思維 about his arm.
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他的腦袋想著他的手臂
07:14
He has not learned學到了 how to do this with the chest胸部.
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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學習 process處理.
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中間沒有任何學習過程
07:19
That's why it's intuitive直觀的.
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這樣才算是所謂的直覺性
07:21
So here's這裡的 Jesse傑西 in our first little test測試 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左手 side, you see his original原版的 prosthesis假體,
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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運用 those switches開關
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他需要那些開關
07:29
to move移動 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個月, so he's pretty漂亮 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個月 after we fit適合 him with his targeted針對 reinnervation神經移植術 prosthesis假體 --
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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哪一個, by the way, is the same相同 physical物理 arm,
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對了,而且是裝在同一隻手臂上
07:42
just programmed程序 a little different不同 --
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但設計上稍微不同
07:44
you can see that he's much faster更快
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大家可以看到他的速度快了許多
07:46
and much smoother平滑 as he moves移動 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能夠 to use three of the signals信號 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驚喜 in science科學.
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接著出乎意料之外
07:57
So we're all motivated動機 to get motor發動機 commands命令
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當我們都在等待運動指令的出現
07:59
to drive駕駛 robotic機器人 arms武器.
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來操作義肢時
08:01
And after a few少數 months個月,
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幾個月後
08:03
you touch觸摸 Jesse傑西 on his chest胸部,
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當你觸摸傑西的胸肌
08:05
and he felt his missing失踪 hand.
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他竟然感覺到他失去的手
08:08
His hand sensation感覺 grew成長 into his chest胸部 again
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他手的知覺竟長回到他的胸肌裡去
08:10
probably大概 because we had also taken採取 away a lot of fat脂肪,
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可能因為我們也抽掉很多脂肪
08:13
so the skin皮膚 was right down to the muscle肌肉
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所以皮膚下面就是肌肉
08:15
and deinnervateddeinnervated, if you would, his skin皮膚.
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皮膚神經也被抽掉了
08:17
So you touch觸摸 Jesse傑西 here, he feels感覺 his thumb拇指;
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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觸摸 it here, he feels感覺 his pinky小指.
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摸這裡,他會感覺到他的小指
08:21
He feels感覺 light touch觸摸
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輕微的碰觸
08:23
down to one gram公克 of force.
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微小到一克的力道都有感覺
08:25
He feels感覺 hot, cold, sharp尖銳, dull平淡,
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甚至是冷、熱、尖、鈍
08:28
all in his missing失踪 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胸部,
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或在手和胸肌上同時感受到
08:32
but he can attend出席 to either.
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他兩者都能兼顧
08:34
So this is really exciting扣人心弦 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門戶,
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因為我們開創了先機
08:38
a portal門戶, or a way to potentially可能 give back sensation感覺,
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或者說,開發了恢復知覺的潛力
08:42
so that he might威力 feel what he touches觸摸
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他才能用義肢
08:44
with his prosthetic假肢 hand.
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重拾觸覺
08:46
Imagine想像 sensors傳感器 in the hand
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想像手中的傳感器
08:48
coming未來 up and pressing緊迫 on this new hand skin皮膚.
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傳遞到這新的手皮膚部位
08:51
So it was very exciting扣人心弦.
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所以這相當振奮人心
08:53
We've我們已經 also gone走了 on
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我們也繼續
08:55
with what was initially原來 our primary population人口
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向我們的原始實驗對象
08:57
of people with above-the-elbow上述的肘 amputations截肢.
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也就是手肘以上截肢的族群
08:59
And here we deinnervatedeinnervate, or cut the nerve神經 away,
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我們從肌肉的一小塊裡
09:02
just from little segments of muscle肌肉
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將神經移除,或切除
09:04
and leave離開 others其他 alone單獨
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然後把其他的保留
09:06
that give us our up-down上下 signals信號
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這讓我們有上下信號
09:08
and two others其他 that will give us a hand open打開 and close signal信號.
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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耐心, Chris克里斯.
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這是我們第一個病患,克里斯
09:13
You see him with his original原版的 device設備
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你看到他在左邊的是
09:15
on the left there after eight months個月 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個月.
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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快速
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這個小效能指標
09:22
with this simple簡單 little performance性能 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最好 parts部分 of my job工作
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我工作最精彩的部份
09:30
is working加工 with really great patients耐心
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就是能和很棒的病患合作
09:32
who are also our research研究 collaborators合作者.
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他們也是我們的研究夥伴
09:34
And we're fortunate幸運 today今天
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我們今天很幸運
09:36
to have Amanda阿曼達 Kitts基茨 come and join加入 us.
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能邀請艾曼達基茨來加入我們
09:38
Please welcome歡迎 Amanda阿曼達 Kitts基茨.
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請歡迎艾曼達基茨
09:40
(Applause掌聲)
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(掌聲)
09:47
So Amanda阿曼達, would you please tell us how you lost丟失 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阿曼達 Kitts基茨: Sure. In 2006, I had a car汽車 accident事故.
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艾曼達:好的。我在2006年出了車禍
09:53
And I was driving主動 home from work,
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當時下班開車回家路上
09:56
and a truck卡車 was coming未來 the opposite對面 direction方向,
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迎面而來一台卡車
09:58
came來了 over into my lane車道,
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衝到我的車道上
10:00
ran over the top最佳 of my car汽車 and his axle tore撕毀 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托德 Kuiken庫伊肯: Okay, so after your amputation切斷術, you healed癒合 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常規 arms武器.
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關於您使用過傳統的義肢
10:09
Can you tell us how it worked工作?
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能否告訴我們您是如何操作的呢?
10:12
AKAK: 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二頭肌 and a tricep三頭肌.
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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簡單 little things like picking選擇 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彎曲 my elbow彎頭,
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我就要先把我的手肘彎曲
10:22
and then I would have to cocontractcocontract
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再共同收縮
10:24
to get it to change更改 modes模式.
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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二頭肌
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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三頭肌 to get it to open打開,
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然後使用三頭肌來張手
10:35
cocontractcocontract again
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再共同收縮
10:37
to get the elbow彎頭 to work again.
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才能讓手肘恢復運作
10:39
TKTK: So it was a little slow?
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陶:這樣過程有點遲緩吧?
10:41
AKAK: 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集中 a whole整個 lot.
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你必須很專心才行
10:46
TKTK: Okay, so I think about nine months個月 later後來
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陶:好,那大概九個月後
10:49
that you had the targeted針對 reinnervation神經移植術 surgery手術,
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您進行標靶神經移植手術
10:51
took six more months個月 to have all the reinnervation神經移植術.
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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適合 her with a prosthesis假體.
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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
AKAK: It works作品 good.
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艾:很棒
11:02
I was able能夠 to use my elbow彎頭
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我可以同時
11:06
and my hand simultaneously同時.
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使用手肘和手
11:09
I could work them just by my thoughts思念.
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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 cocontractingcocontracting and all that.
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所以完全不需要再共同收縮了
11:14
TKTK: A little faster更快?
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陶:比較快?
11:16
AKAK: A little faster更快. And much more easy簡單, much more natural自然.
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艾:比較快了,而且簡單多,又自然多了
11:20
TKTK: Okay, this was my goal目標.
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陶:好的,那就是我的目的
11:23
For 20 years年份, my goal目標 was to let somebody
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二十年來,我的目標就是
11:26
[be] able能夠 to use their elbow彎頭 and hand in an intuitive直觀的 way
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讓病人能很直覺性的同時使用
11:29
and at the same相同 time.
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手肘和手
11:31
And we now have over 50 patients耐心 around the world世界 who have had this surgery手術,
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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包含 over a dozen of our wounded負傷 warriors勇士
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包括至少十二名
11:36
in the U.S. armed武裝 services服務.
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美國國軍的受傷戰士
11:38
The success成功 rate of the nerve神經 transfers轉讓 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百分.
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高達96%
11:43
Because we're putting a big fat脂肪 nerve神經 onto a little piece of muscle肌肉.
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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提供 intuitive直觀的 control控制.
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這樣就給了病人直覺性的支配權
11:50
Our functional實用 testing測試, those little tests測試,
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我們的功能測試,這些小測試
11:52
all show顯示 that they're a lot quicker更快 and a lot easier更輕鬆.
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全都顯示它的速度和簡易操作
11:54
And the most important重要 thing
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而且最重要的是
11:56
is our patients耐心 have appreciated讚賞 it.
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我們的病患用得很開心
11:58
So that was all very exciting扣人心弦.
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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信息 in those nerve神經 signals信號,
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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移動 each finger手指. You can move移動 your thumb拇指, 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實驗
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因此我們進行了些實驗
12:16
where we saturated飽和的 our poor較差的 patients耐心 with zillions不計其數 of electrodes電極
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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不同 tasks任務 --
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然後請他們完成二十四項任務
12:22
from wiggling擺動 a finger手指 to moving移動 a whole整個 arm
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從擺動手指到動整隻手臂
12:25
to reaching到達 for something --
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再到伸手拿東西
12:27
and recorded記錄 this data數據.
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然後把這資料紀錄下來
12:29
And then we used some algorithms算法
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接著,我們利用一些演算法
12:31
that are a lot like speech言語 recognition承認 algorithms算法,
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很像語音辨識系統
12:33
called pattern模式 recognition承認.
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叫做圖案辨識
12:35
See.
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看吧
12:37
(Laughter笑聲)
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(笑聲)
12:39
And here you can see, on Jesse's傑西的 chest胸部,
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你可以看到,傑西的胸肌上
12:41
when he just tried試著 to do three different不同 things,
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當他試著做三件不同的事
12:43
you can see three different不同 patterns模式.
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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電極
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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合作 with our colleagues同事 in University大學 of New Brunswick不倫瑞克,
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因此我們和新柏倫瑞克大學的同事合作
12:52
came來了 up with this algorithm算法 control控制,
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想出了這個演算控制
12:54
which哪一個 Amanda阿曼達 can now demonstrate演示.
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現在艾曼達可以示範給我們看
12:56
AKAK: So I have the elbow彎頭 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迴轉
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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屈曲 and extension延期.
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我有可以彎曲的手腕
13:10
And I also have the hand closed關閉 and open打開.
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還有可以開關的手
13:13
TKTK: Thank you, Amanda阿曼達.
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陶:謝謝,艾曼達
13:15
Now this is a research研究 arm,
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這是個還在試驗的手臂
13:17
but it's made製作 out of commercial廣告 components組件 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少數 that I've borrowed from around the world世界.
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還有一些從各地借來的
13:23
It's about seven pounds英鎊,
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重量約3.175公斤
13:26
which哪一個 is probably大概 about what my arm would weigh稱重
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大概跟我的手臂一樣重
13:28
if I lost丟失 it right here.
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如果從這裡算的話
13:30
Obviously明顯, that's heavy for Amanda阿曼達.
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很明顯的,對艾曼達來說很重
13:33
And in fact事實, it feels感覺 even heavier較重,
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事實上,她在感覺上會更重
13:35
because it's not glued膠合 on the same相同.
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因為接合方式不同
13:37
She's carrying攜帶 all the weight重量 through通過 harnesses吊帶.
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她是籍以索帶支撐這些重量
13:39
So the exciting扣人心弦 part部分 isn't so much the mechatronics機電一體化,
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所以最精彩的部份並不是機電整合
13:42
but the control控制.
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而是支配能力
13:44
So we've我們已經 developed發達 a small microcomputer微電腦
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因此我們研發了一個微型電腦
13:47
that is blinking閃爍 somewhere某處 behind背後 her back
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在她的背後運作
13:50
and is operating操作 this
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操作這隻手
13:52
all by the way she trains火車 it
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完全由她去訓練的
13:54
to use her individual個人 muscle肌肉 signals信號.
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運用她的個別肌肉信號
13:56
So Amanda阿曼達, when you first started開始 using運用 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
AKAK: It took just about probably大概 three to four hours小時
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艾:大概三到四小時
14:03
to get it to train培養.
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來訓練它
14:05
I had to hook it up to a computer電腦,
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我必須連上電腦
14:07
so I couldn't不能 just train培養 it anywhere隨地.
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所以不能在任何地方訓練
14:09
So if it stopped停止 working加工, 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能夠 to train培養
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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穿 it around.
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我可以到處走
14:18
If it stops停止 working加工 for some reason原因, I can retrain再培訓 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分鐘.
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大概花一分鐘而已吧
14:23
TKTK: So we're really excited興奮,
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陶:所以我們非常興奮
14:25
because now we're getting得到 to a clinically臨床 practical實際的 device設備.
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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目標 is --
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這就是我們的目標
14:30
to have something clinically臨床 pragmatic務實 to wear穿.
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讓它在臨床上可行
14:34
We've我們已經 also had Amanda阿曼達 able能夠 to use
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我們也讓艾曼達能夠使用
14:37
some of our more advanced高級 arms武器 that I showed顯示 you earlier.
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一些剛才提到的先進手臂
14:41
Here's這裡的 Amanda阿曼達 using運用 an arm made製作 by DEKADEKA Research研究 Corporation公司.
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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院長 Kamen假面 presented呈現 it at TEDTED a few少數 years年份 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阿曼達, you can see,
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那麼你可以看出艾曼達
14:50
has really good control控制.
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操作得很棒
14:52
It's all the pattern模式 recognition承認.
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這都是圖案辨識
14:54
And it now has a hand that can do different不同 grasps掌握.
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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患者 go all the way open打開
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我們讓病患腦力激盪
15:00
and think, "What hand grasp把握 pattern模式 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模式,
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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不同 hand grasps掌握 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阿曼達, how many許多 were you able能夠 to do with the DEKADEKA arm?
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艾曼達,你操作DEKA手時,能做幾種?
15:10
AKAK: I was able能夠 to get four.
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艾:我能做四種
15:12
I had the key grip, I had a chuck夾頭 grip,
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我可以握手,彎手指
15:15
I had a power功率 grasp把握
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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喜愛 one was just when the hand was open打開,
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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孩子,
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因為我工作要跟小孩玩
15:23
and so all the time you're clapping拍手 and singing唱歌,
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所以常要拍手唱歌
15:26
so I was able能夠 to do that again, which哪一個 was really good.
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我可以再度拍手了,感覺很棒
15:29
TKTK: That hand's手的 not so good for clapping拍手.
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陶:那隻手就不是很能拍手了
15:31
AKAK: Can't clap with this one.
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艾:這隻不能
15:33
TKTK: All right. So that's exciting扣人心弦
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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可能 go with the better mechatronics機電一體化,
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是非常令人興奮的
15:37
if we make them good enough足夠
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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市場 and use in a field領域 trial審訊.
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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密切.
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我想請大家仔細看
15:44
(Video視頻) Claudia克勞迪婭: Oooooh哇,!
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嗚!
15:46
TKTK: That's Claudia克勞迪婭,
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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感覺 through通過 her prosthetic假肢.
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從義肢上感受到知覺
15:53
She had a little sensor傳感器 at the end結束 of her prosthesis假體
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在義肢尾端有小感應器
15:56
that then she rubbed over different不同 surfaces,
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她在和不同表面摩擦時
15:59
and she could feel different不同 textures紋理
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還能辨別不同的質感
16:01
of sandpaper砂紙, different不同 grits, ribbon色帶 cable電纜,
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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神經支配 hand skin皮膚.
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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橫過 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手指 was rocking搖擺.
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她感覺得到手指在震動
16:12
So that's an exciting扣人心弦 laboratory實驗室 experiment實驗
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那就是非常令人振奮的實驗
16:14
on how to give back, potentially可能, some skin皮膚 sensation感覺.
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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這裡的 another另一個 video視頻 that shows節目 some of our challenges挑戰.
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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傑西, and he's squeezing擠壓 a foam泡沫 toy玩具.
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這是傑西,他在捏一個海綿玩具
16:23
And the harder更難 he squeezes擠壓 -- you see a little black黑色 thing in the middle中間
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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推動 on his skin皮膚 proportional成比例的 to how hard he squeezes擠壓.
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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電極 around it.
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但看周圍所有的電極
16:31
I've got a real真實 estate房地產 problem問題.
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出現了房地產的問題
16:33
You're supposed應該 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電機 making製造 all kinds of noise噪聲
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但我們的小肌電卻在電極旁邊
16:38
right next下一個 to my electrodes電極.
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發出各種噪音
16:40
So we're really challenged挑戰 on what we're doing there.
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這方面是個重大挑戰
16:43
The future未來 is bright.
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未來充滿光明
16:45
We're excited興奮 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擺脫 of my real真實 estate房地產 problem問題
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搞定我的房地產問題
16:53
and get better signals信號.
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得到更好的信號
16:55
We want to develop發展 these little tiny capsules膠囊
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我們想研發一些小膠囊
16:58
about the size尺寸 of a piece of risotto燴飯
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小到像一粒米一樣
17:00
that we can put into the muscles肌肉
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然後放進肌肉裡
17:02
and telemeter遙測 out the EMG肌電圖 signals信號,
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再將肌電信號傳遞出來
17:05
so that it's not worrying令人擔憂 about electrode電極 contact聯繫.
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這樣才沒有電極連接的問題
17:08
And we can have the real真實 estate房地產 open打開
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我們也可以讓房地產保持開放
17:10
to try more sensation感覺 feedback反饋.
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來測試更多知覺反應
17:12
We want to build建立 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製作 for the 50th percentile百分 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哪一個 means手段 they're too big for five-eighths八分之五 of the world世界.
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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強大 or super fast快速 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製造 an arm that is --
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我們要做這種義肢
17:27
we're starting開始 with,
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先由
17:29
the 25th percentile百分 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包裝 around,
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可以做手握動作
17:34
opens打開 all the way,
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又可以完全張開
17:36
two degrees of freedom自由 in the wrist and an elbow彎頭.
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在手腕及手肘有兩個自由度
17:39
So it'll它會 be the smallest最少 and lightest最輕
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這樣就會是最小、最輕
17:41
and the smartest最聰明的 arm ever made製作.
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又最先進的義肢了
17:43
Once一旦 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更輕鬆 making製造 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目標.
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這些是我們的一些目標
17:50
And we really appreciate欣賞 you all being存在 here today今天.
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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黑暗 side,
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有鑑於昨天的主題
17:56
with yesterday's昨天的 theme主題.
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我想分享一個我們這行業之苦
17:58
So Amanda阿曼達 came來了 jet-lagged噴射滯後,
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艾曼達還在調時差
18:00
she's using運用 the arm,
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她想用這隻手臂
18:02
and everything goes wrong錯誤.
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但都被搞亂了
18:04
There was a computer電腦 spook間諜,
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電腦出問題
18:06
a broken破碎 wire,
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有個線斷了
18:08
a converter變流器 that sparked引發.
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有個轉換器壞了
18:10
We took out a whole整個 circuit電路 in the hotel旅館
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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報警.
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差點就觸發了火警警報器
18:14
And none沒有 of those problems問題 could I have dealt處理 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研究 team球隊.
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我根本不可能解決那些問題
18:19
And thankfully感激地 Dr博士. Annie安妮 Simon西蒙 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工作 really hard yesterday昨天 to fix固定 it.
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非常努力幫我們把它修好
18:24
That's science科學.
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這就是科學
18:26
And fortunately幸好, it worked工作 today今天.
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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掌聲)
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(掌聲)
Translated by Ariel Zheng
Reviewed by Johnathan Lau

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ABOUT THE SPEAKER
Todd Kuiken - Biomedical engineer
A 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."

More profile about the speaker
Todd Kuiken | Speaker | TED.com