Page 232 - Control Theory in Biomedical Engineering

Wearable mechatronic devices for upper-limb amputees 213

imprisoned in chains, cut off his foot to escape and subsequently made him-
self a wooden foot to replace it. The first pictured arm prosthesis dates to ca.
1400AC. The Alt-Ruppin hand had artificial digits and small holes to allow
the air to cool the residual limb. A picture of another prosthesis, Ballif’s arm
(1812), shows the fixing belts and the system for moving the artificial limb.
This prosthesis introduced for the first time the principle of hand operation
by the shoulder and arm movement, which is currently the standard for
body-powered prostheses. This allows for grasping tasks using cable-based
mechanisms that amplify the movement of other body parts, commonly
the shoulder and arm ( Jacobsen et al., 1999). Currently, the cost of a com-
mercial body-powered prosthetic hand ranges from $4000 to $10,000
(Resnik et al., 2012). However, due to the revolution of advanced
manufacturing and 3D printing, many systems have been developed as
body-powered prostheses (e.g., Zero Point Frontiers prosthetic device
(2013), Talon Flextensor 1.0 by profbink (2014), Hollies Hand Version 4
by Anthromod (2015), and Victoria Hand (2019)), thus reducing the fabri-
cation time and cost to about $500 (Ten Kate et al., 2017). An important
technical point is that although body-powered prostheses allowed a greater
range of elbow flexion, shoulder flexion is also required for completing a
continuous grasp, which nowadays is addressed using externally powered
prostheses.

4.3 Externally powered prosthesis
Historically, a crucial turning point in changing from body-powered to
externally powered prostheses was World War II due to the increase in
the number of amputees. Since then, the technology has changed from
body-powered prostheses that use external energy (externally powered
prostheses), such as pneumatic or electrical. The first externally powered
prosthesis was patented in Germany in 1915 (Dahlheim, 1915). It used a
pneumatic-powered hand to deliver grasp movements. Four years later, also
in Germany, the first publication related to an electrical-powered prosthesis
was released (Schlesinger, 1919). Since then, many studies have compared
user adherence of body-powered vs. electrical-powered prostheses. For
instance, the work of Muilenburg and LeBlanc (1989) provides a significant
discussion about the inherent proprioceptive feedback using body-powered
prostheses relating to low cost, reliability, and functionality apropos of exter-
nally powered prostheses. In contrast, Heger et al. (1985) provide statistics of
prosthesis fitting in a residual limb, resulting in 80% of patients having