Todd Kuiken: A prosthetic arm that "feels"

176,083 views ・ 2011-10-20

TED


請雙擊下方英文字幕播放視頻。

譯者: Ariel Zheng 審譯者: Johnathan Lau
00:15
So today, I would like to talk with you
0
15260
3000
今天我想和你們談談
00:18
about bionics,
1
18260
2000
生物工學
00:20
which is the popular term
2
20260
2000
這個流行的專有名詞
00:22
for the science of replacing part of a living organism
3
22260
3000
意指藉機電裝置或機器人
00:25
with a mechatronic device, or a robot.
4
25260
3000
來取代生物體部份機能的學問
00:28
It is essentially
5
28260
2000
本質上就是
00:30
the stuff of life meets machine.
6
30260
3000
生命和機器結合的東西
00:33
And specifically, I'd like to talk with you
7
33260
2000
我要特別跟你們談談
00:35
about how bionics is evolving
8
35260
3000
生物工學對使用義肢的人
00:38
for people with arm amputations.
9
38260
3000
如何地進展
00:41
This is our motivation.
10
41260
3000
這是我們的動力來源
00:44
Arm amputation causes a huge disability.
11
44260
3000
手臂截肢會造成極度不便
00:47
I mean, the functional impairment is clear.
12
47260
2000
在功能上的損傷是很明顯的
00:49
Our hands are amazing instruments.
13
49260
2000
我們的雙手是驚人的工具
00:51
And when you lose one, far less both,
14
51260
3000
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
15
54260
2000
在生理上執行事情
00:56
we physically need to do.
16
56260
2000
就困難許多了
00:58
There's also a huge emotional impact.
17
58260
2000
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
18
60260
2000
事實上,我在診所處理
01:02
dealing with the emotional adjustment of patients
19
62260
3000
病人情緒調節的時間
01:05
as with the physical disability.
20
65260
2000
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.
21
67260
3000
最後,還有廣大的社會衝擊
01:10
We talk with our hands.
22
70260
2000
我們說話時以手為輔
01:12
We greet with our hands.
23
72260
2000
我們用手打招呼
01:14
And we interact with the physical world with our hands.
24
74260
3000
我們用手摸索物質世界
01:17
And when they're missing,
25
77260
2000
沒有手
01:19
it's a barrier.
26
79260
2000
就會產生障礙
01:21
Arm amputation is usually caused by trauma,
27
81260
3000
手臂截肢通常由創傷所導致
01:24
with things like industrial accidents,
28
84260
2000
例如工業意外
01:26
motor vehicle collisions
29
86260
2000
機車衝撞
01:28
or, very poignantly, war.
30
88260
2000
或殘酷的戰爭
01:30
There are also some children who are born without arms,
31
90260
3000
也有些小孩是生來殘缺的
01:33
called congenital limb deficiency.
32
93260
3000
稱做先天性肢體缺失
01:36
Unfortunately, we don't do great
33
96260
2000
可惜我們在
01:38
with upper-limb prosthetics.
34
98260
2000
上肢義肢方面沒有做得很好
01:40
There are two general types.
35
100260
2000
有兩種主要類型
01:42
They're called body-powered prostheses,
36
102260
2000
一種是身體動力型義肢
01:44
which were invented just after the Civil War,
37
104260
2000
發明於南北戰爭過後不久
01:46
refined in World War I and World War II.
38
106260
3000
又在第一次和二次世界大戰時經改良
01:49
Here you see a patent
39
109260
2000
你現在看到的是
01:51
for an arm in 1912.
40
111260
2000
1912年的一項義肢專利
01:53
It's not a lot different
41
113260
2000
和我病人身上的義肢
01:55
than the one you see on my patient.
42
115260
3000
沒有太大差別
01:58
They work by harnessing shoulder power.
43
118260
2000
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.
44
120260
3000
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
45
123260
3000
而鋼索就會將手鉤打開、關上
02:06
or bend an elbow.
46
126260
2000
或使手肘彎曲
02:08
And we still use them commonly,
47
128260
2000
這種義肢仍然相當普遍
02:10
because they're very robust
48
130260
2000
因為它們算是非常穩健
02:12
and relatively simple devices.
49
132260
2000
相對來說也較為簡便的裝置
02:14
The state of the art
50
134260
2000
第二種較為先進的技術
02:16
is what we call myoelectric prostheses.
51
136260
2000
則是我們所謂的肌電義肢
02:18
These are motorized devices
52
138260
2000
這些機動裝置
02:20
that are controlled
53
140260
2000
會偵測
02:22
by little electrical signals from your muscle.
54
142260
2000
你肌肉所產生的微小電子訊號
02:24
Every time you contract a muscle,
55
144260
2000
每當你收縮一條肌肉
02:26
it emits a little electricity
56
146260
2000
它會釋放一些電信號
02:28
that you can record with antennae or electrodes
57
148260
2000
供接收天線或電極記錄
02:30
and use that to operate the motorized prosthesis.
58
150260
3000
再用來操作機動義肢
02:33
They work pretty well
59
153260
2000
對只失去手部的人來說
02:35
for people who have just lost their hand,
60
155260
2000
使用起來很方便
02:37
because your hand muscles are still there.
61
157260
2000
因為你的手部肌肉還在
02:39
You squeeze your hand, these muscles contract.
62
159260
2000
你握緊手,這些肌肉就會收縮
02:41
You open it, these muscles contract.
63
161260
2000
你把手打開,這些肌肉也會收縮
02:43
So it's intuitive, and it works pretty well.
64
163260
3000
所以它是直覺性的,效果很棒
02:46
Well how about with higher levels of amputation?
65
166260
2000
那假如截肢範圍更大呢?
02:48
Now you've lost your arm above the elbow.
66
168260
2000
假設手肘以上的部份都被截掉了
02:50
You're missing not only these muscles,
67
170260
2000
你不但失去了這些肌肉
02:52
but your hand and your elbow too.
68
172260
2000
連你的手和手肘都沒了
02:54
What do you do?
69
174260
2000
該怎麼辦?
02:56
Well our patients have to use
70
176260
2000
我們的患者必須使用
02:58
very code-y systems
71
178260
3000
非常編碼的系統
03:01
of using just their arm muscles
72
181260
2000
單純使用他們的手臂肌肉
03:03
to operate robotic limbs.
73
183260
3000
來操作機械手臂
03:06
We have robotic limbs.
74
186260
2000
我們有機械手臂
03:08
There are several available on the market, and here you see a few.
75
188260
3000
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,
76
191260
3000
包含一隻會開合的手
03:14
a wrist rotator and an elbow.
77
194260
2000
一個旋腕關節及手肘
03:16
There's no other functions.
78
196260
2000
沒有其他功能
03:18
If they did, how would we tell them what to do?
79
198260
2000
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
80
200260
3000
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
81
203260
3000
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.
82
206260
3000
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
83
209260
3000
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,
84
212260
3000
美國軍方贊助的這些原型
03:35
that had up to 10 different degrees of freedom
85
215260
3000
有高達10種不同的自由度
03:38
including movable hands.
86
218260
2000
包括可移動式手臂
03:40
But at the end of the day,
87
220260
2000
但最終難題還是
03:42
how do we tell these robotic arms what to do?
88
222260
2000
要如何操作這些機械手臂呢?
03:44
How do we control them?
89
224260
2000
要如何控制它們呢?
03:46
Well we need a neural interface,
90
226260
2000
我們需要一個神經介面
03:48
a way to connect to our nervous system
91
228260
2000
來連接我們的神經系統
03:50
or our thought processes
92
230260
2000
或思考過程
03:52
so that it's intuitive, it's natural,
93
232260
2000
讓它很直覺、很自然
03:54
like for you and I.
94
234260
4000
像你、我一樣
03:58
Well the body works by starting a motor command in your brain,
95
238260
3000
我們身體先由腦部下行動作指令
04:01
going down your spinal cord,
96
241260
2000
經由你的脊隨傳遞訊息
04:03
out the nerves and to your periphery.
97
243260
2000
到神經末梢
04:05
And your sensation's the exact opposite.
98
245260
2000
你的感官觸動則完全相反
04:07
You touch yourself, there's a stimulus
99
247260
2000
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.
100
249260
3000
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.
101
253260
3000
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.
102
256260
3000
那些神經可以發出指令信號
04:19
And if I tap the nerve ending
103
259260
2000
假如我在一位二戰老兵殘肢上
04:21
on a World War II vet,
104
261260
2000
輕輕拍打神經末梢
04:23
he'll still feel his missing hand.
105
263260
2000
他還是可以感覺到失去的那隻手
04:25
So you might say,
106
265260
2000
這時候你可能會說
04:27
let's go to the brain
107
267260
2000
我們何不在大腦裡
04:29
and put something in the brain to record signals,
108
269260
3000
放個東西來紀錄信號
04:32
or in the end of the peripheral nerve and record them there.
109
272260
3000
或放到末梢神經去紀錄
04:35
And these are very exciting research areas,
110
275260
3000
這些研究領域是非常令人興奮的
04:38
but it's really, really hard.
111
278260
2000
但也相當相當艱鉅
04:40
You have to put in
112
280260
2000
你必須置入
04:42
hundreds of microscopic wires
113
282260
2000
成百上千個微纜線
04:44
to record from little tiny individual neurons -- ordinary fibers
114
284260
4000
來記錄微小單一神經元 - 普通纖維
04:48
that put out tiny signals
115
288260
2000
所發出的微弱信號
04:50
that are microvolts.
116
290260
2000
也就是微伏特
04:52
And it's just too hard
117
292260
2000
這對我的患者和使用上
04:54
to use now and for my patients today.
118
294260
2000
實在是太困難了
04:56
So we developed a different approach.
119
296260
3000
因此我們研發出不同的方法
04:59
We're using a biological amplifier
120
299260
3000
我們使用生物放大器 - 肌肉
05:02
to amplify these nerve signals -- muscles.
121
302260
3000
來放大這些神經信號
05:05
Muscles will amplify the nerve signals
122
305260
2000
肌肉會放大神經信號
05:07
about a thousand-fold,
123
307260
2000
大概一千倍
05:09
so that we can record them from on top of the skin,
124
309260
3000
我們在皮膚表面上能讀取得到
05:12
like you saw earlier.
125
312260
2000
就像你剛才看到的
05:14
So our approach is something we call targeted reinnervation.
126
314260
3000
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,
127
317260
3000
想像一個人失去整個手臂
05:20
we still have four major nerves
128
320260
2000
但還有四條主要神經
05:22
that go down your arm.
129
322260
2000
連接手臂
05:24
And we take the nerve away from your chest muscle
130
324260
3000
我們將那些胸肌神經拉出
05:27
and let these nerves grow into it.
131
327260
3000
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.
132
330260
3000
所以你在腦袋裡想“握拳”,胸肌就會收縮
05:33
You think, "Bend elbow,"
133
333260
2000
你想“彎手肘”
05:35
a different section contracts.
134
335260
2000
胸肌的另一區塊也會收縮
05:37
And we can use electrodes or antennae
135
337260
2000
我們可以利用電極或天線
05:39
to pick that up and tell the arm to move.
136
339260
3000
接收信號讓手臂動起來
05:42
That's the idea.
137
342260
2000
大概就是這樣
05:44
So this is the first man that we tried it on.
138
344260
3000
這是我們首先測試的對象
05:47
His name is Jesse Sullivan.
139
347260
2000
他叫傑西 沙利文
05:49
He's just a saint of a man --
140
349260
2000
是個非常好的人
05:51
54-year-old lineman who touched the wrong wire
141
351260
2000
這位54歲的架線工因誤觸電線
05:53
and had both of his arms burnt so badly
142
353260
3000
導致雙臂嚴重灼傷
05:56
they had to be amputated at the shoulder.
143
356260
2000
在雙肩部位截肢
05:58
Jesse came to us at the RIC
144
358260
2000
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.
145
360260
3000
裝上這些圖上看到的先進裝置
06:03
I'm still using that old technology
146
363260
3000
我仍用舊技術
06:06
with a bicycle cable on his right side.
147
366260
2000
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.
148
368260
3000
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
149
371260
3000
左邊裝的是先進的肌電義肢
06:14
with those three joints,
150
374260
2000
連接三個關節
06:16
and he operates little pads in his shoulder
151
376260
3000
他操作肩膀上的小墊子
06:19
that he touches to make the arm go.
152
379260
2000
藉由碰觸讓手臂動起來
06:21
And Jesse's a good crane operator,
153
381260
2000
傑西是個不錯的起重機操作員
06:23
and he did okay by our standards.
154
383260
2000
依我們標準來說他表現還不錯
06:25
He also required a revision surgery on his chest.
155
385260
3000
他在胸肌還需進行再次手術
06:28
And that gave us the opportunity
156
388260
2000
這給了我們機會
06:30
to do targeted reinnervation.
157
390260
2000
進行標靶神經移植術
06:32
So my colleague, Dr. Greg Dumanian, did the surgery.
158
392260
3000
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,
159
395260
3000
首先,我們將連接肌肉的神經切掉
06:38
then we took the arm nerves
160
398260
2000
接著我們將他的手臂神經
06:40
and just kind of had them shift down onto his chest
161
400260
2000
轉移到胸肌部位
06:42
and closed him up.
162
402260
2000
最後再縫合好
06:44
And after about three months,
163
404260
2000
大約三個月後
06:46
the nerves grew in a little bit and we could get a twitch.
164
406260
2000
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,
165
408260
3000
再六個月後,神經再生狀況良好
06:51
and you could see strong contractions.
166
411260
2000
你可以看出很明顯的肌肉收縮反應
06:53
And this is what it looks like.
167
413260
2000
看起來大概像這樣
06:55
This is what happens when Jesse thinks
168
415260
2000
當傑西想著
06:57
open and close his hand,
169
417260
2000
把手打開和關閉
06:59
or bend or straighten your elbow.
170
419260
3000
或手肘彎曲或伸直
07:02
You can see the movements on his chest,
171
422260
2000
你可以看到胸肌上的收縮動作
07:04
and those little hash marks
172
424260
2000
而且這些小記號
07:06
are where we put our antennae, or electrodes.
173
426260
2000
就是我們放天線或電極的地方
07:08
And I challenge anybody in the room
174
428260
2000
我相信這裡沒有人的胸肌
07:10
to make their chest go like this.
175
430260
2000
可以像他一樣這樣動吧!
07:12
His brain is thinking about his arm.
176
432260
2000
他的腦袋想著他的手臂
07:14
He has not learned how to do this with the chest.
177
434260
3000
他並沒有刻意去學要怎麼動胸肌
07:17
There is not a learning process.
178
437260
2000
中間沒有任何學習過程
07:19
That's why it's intuitive.
179
439260
2000
這樣才算是所謂的直覺性
07:21
So here's Jesse in our first little test with him.
180
441260
3000
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,
181
444260
3000
在左手邊,你可以看到他原本的義肢
07:27
and he's using those switches
182
447260
2000
他需要那些開關
07:29
to move little blocks from one box to the other.
183
449260
2000
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.
184
451260
3000
他在操作那義肢已有20年的經驗,相當熟練
07:34
On the right side,
185
454260
2000
在右邊呢
07:36
two months after we fit him with his targeted reinnervation prosthesis --
186
456260
3000
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,
187
459260
3000
對了,而且是裝在同一隻手臂上
07:42
just programmed a little different --
188
462260
2000
但設計上稍微不同
07:44
you can see that he's much faster
189
464260
2000
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.
190
466260
3000
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.
191
469260
3000
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.
192
472260
5000
接著出乎意料之外
07:57
So we're all motivated to get motor commands
193
477260
2000
當我們都在等待運動指令的出現
07:59
to drive robotic arms.
194
479260
2000
來操作義肢時
08:01
And after a few months,
195
481260
2000
幾個月後
08:03
you touch Jesse on his chest,
196
483260
2000
當你觸摸傑西的胸肌
08:05
and he felt his missing hand.
197
485260
3000
他竟然感覺到他失去的手
08:08
His hand sensation grew into his chest again
198
488260
2000
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,
199
490260
3000
可能因為我們也抽掉很多脂肪
08:13
so the skin was right down to the muscle
200
493260
2000
所以皮膚下面就是肌肉
08:15
and deinnervated, if you would, his skin.
201
495260
2000
皮膚神經也被抽掉了
08:17
So you touch Jesse here, he feels his thumb;
202
497260
2000
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.
203
499260
2000
摸這裡,他會感覺到他的小指
08:21
He feels light touch
204
501260
2000
輕微的碰觸
08:23
down to one gram of force.
205
503260
2000
微小到一克的力道都有感覺
08:25
He feels hot, cold, sharp, dull,
206
505260
3000
甚至是冷、熱、尖、鈍
08:28
all in his missing hand,
207
508260
2000
通通在他失去的手上感受到了
08:30
or both his hand and his chest,
208
510260
2000
或在手和胸肌上同時感受到
08:32
but he can attend to either.
209
512260
2000
他兩者都能兼顧
08:34
So this is really exciting for us,
210
514260
2000
這實在是令我們精神為之一振
08:36
because now we have a portal,
211
516260
2000
因為我們開創了先機
08:38
a portal, or a way to potentially give back sensation,
212
518260
4000
或者說,開發了恢復知覺的潛力
08:42
so that he might feel what he touches
213
522260
2000
他才能用義肢
08:44
with his prosthetic hand.
214
524260
2000
重拾觸覺
08:46
Imagine sensors in the hand
215
526260
2000
想像手中的傳感器
08:48
coming up and pressing on this new hand skin.
216
528260
3000
傳遞到這新的手皮膚部位
08:51
So it was very exciting.
217
531260
2000
所以這相當振奮人心
08:53
We've also gone on
218
533260
2000
我們也繼續
08:55
with what was initially our primary population
219
535260
2000
向我們的原始實驗對象
08:57
of people with above-the-elbow amputations.
220
537260
2000
也就是手肘以上截肢的族群
08:59
And here we deinnervate, or cut the nerve away,
221
539260
3000
我們從肌肉的一小塊裡
09:02
just from little segments of muscle
222
542260
2000
將神經移除,或切除
09:04
and leave others alone
223
544260
2000
然後把其他的保留
09:06
that give us our up-down signals
224
546260
2000
這讓我們有上下信號
09:08
and two others that will give us a hand open and close signal.
225
548260
3000
和其他兩個讓手開關的信號
09:11
This was one of our first patients, Chris.
226
551260
2000
這是我們第一個病患,克里斯
09:13
You see him with his original device
227
553260
2000
你看到他在左邊的是
09:15
on the left there after eight months of use,
228
555260
2000
使用了八個月的原本裝置
09:17
and on the right, it is two months.
229
557260
2000
右邊的新裝置,則使用了兩個月
09:19
He's about four or five times as fast
230
559260
3000
這個小效能指標
09:22
with this simple little performance metric.
231
562260
3000
讓他速度快了約四、五倍
09:25
All right.
232
565260
2000
很好
09:27
So one of the best parts of my job
233
567260
3000
我工作最精彩的部份
09:30
is working with really great patients
234
570260
2000
就是能和很棒的病患合作
09:32
who are also our research collaborators.
235
572260
2000
他們也是我們的研究夥伴
09:34
And we're fortunate today
236
574260
2000
我們今天很幸運
09:36
to have Amanda Kitts come and join us.
237
576260
2000
能邀請艾曼達基茨來加入我們
09:38
Please welcome Amanda Kitts.
238
578260
2000
請歡迎艾曼達基茨
09:40
(Applause)
239
580260
7000
(掌聲)
09:47
So Amanda, would you please tell us how you lost your arm?
240
587260
3000
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.
241
590260
3000
艾曼達:好的。我在2006年出了車禍
09:53
And I was driving home from work,
242
593260
3000
當時下班開車回家路上
09:56
and a truck was coming the opposite direction,
243
596260
2000
迎面而來一台卡車
09:58
came over into my lane,
244
598260
2000
衝到我的車道上
10:00
ran over the top of my car and his axle tore my arm off.
245
600260
4000
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.
246
604260
3000
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.
247
607260
2000
關於您使用過傳統的義肢
10:09
Can you tell us how it worked?
248
609260
3000
能否告訴我們您是如何操作的呢?
10:12
AK: Well, it was a little difficult,
249
612260
2000
艾:恩,過程有點困難
10:14
because all I had to work with was a bicep and a tricep.
250
614260
2000
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,
251
616260
3000
所以光是撿東西的這些簡單小動作
10:19
I would have to bend my elbow,
252
619260
3000
我就要先把我的手肘彎曲
10:22
and then I would have to cocontract
253
622260
2000
再共同收縮
10:24
to get it to change modes.
254
624260
2000
以切換模式
10:26
When I did that,
255
626260
2000
當時
10:28
I had to use my bicep
256
628260
3000
我必須使用二頭肌
10:31
to get the hand to close,
257
631260
2000
來讓手收合
10:33
use my tricep to get it to open,
258
633260
2000
然後使用三頭肌來張手
10:35
cocontract again
259
635260
2000
再共同收縮
10:37
to get the elbow to work again.
260
637260
2000
才能讓手肘恢復運作
10:39
TK: So it was a little slow?
261
639260
2000
陶:這樣過程有點遲緩吧?
10:41
AK: A little slow, and it was just hard to work.
262
641260
3000
艾:滿遲緩的,而且操作困難
10:44
You had to concentrate a whole lot.
263
644260
2000
你必須很專心才行
10:46
TK: Okay, so I think about nine months later
264
646260
3000
陶:好,那大概九個月後
10:49
that you had the targeted reinnervation surgery,
265
649260
2000
您進行標靶神經移植手術
10:51
took six more months to have all the reinnervation.
266
651260
3000
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.
267
654260
3000
然後我們幫他配上義肢
10:57
And how did that work for you?
268
657260
2000
配完以後感覺如何?
10:59
AK: It works good.
269
659260
3000
艾:很棒
11:02
I was able to use my elbow
270
662260
4000
我可以同時
11:06
and my hand simultaneously.
271
666260
3000
使用手肘和手
11:09
I could work them just by my thoughts.
272
669260
2000
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.
273
671260
3000
所以完全不需要再共同收縮了
11:14
TK: A little faster?
274
674260
2000
陶:比較快?
11:16
AK: A little faster. And much more easy, much more natural.
275
676260
4000
艾:比較快了,而且簡單多,又自然多了
11:20
TK: Okay, this was my goal.
276
680260
3000
陶:好的,那就是我的目的
11:23
For 20 years, my goal was to let somebody
277
683260
3000
二十年來,我的目標就是
11:26
[be] able to use their elbow and hand in an intuitive way
278
686260
3000
讓病人能很直覺性的同時使用
11:29
and at the same time.
279
689260
2000
手肘和手
11:31
And we now have over 50 patients around the world who have had this surgery,
280
691260
3000
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
281
694260
2000
包括至少十二名
11:36
in the U.S. armed services.
282
696260
2000
美國國軍的受傷戰士
11:38
The success rate of the nerve transfers is very high.
283
698260
3000
神經移植的成功機率相當高
11:41
It's like 96 percent.
284
701260
2000
高達96%
11:43
Because we're putting a big fat nerve onto a little piece of muscle.
285
703260
3000
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.
286
706260
4000
這樣就給了病人直覺性的支配權
11:50
Our functional testing, those little tests,
287
710260
2000
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.
288
712260
2000
全都顯示它的速度和簡易操作
11:54
And the most important thing
289
714260
2000
而且最重要的是
11:56
is our patients have appreciated it.
290
716260
2000
我們的病患用得很開心
11:58
So that was all very exciting.
291
718260
2000
這一切都非常振奮人心
12:00
But we want to do better.
292
720260
3000
但我們還不滿足
12:03
There's a lot of information in those nerve signals,
293
723260
4000
那些神經信號還有很多資訊
12:07
and we wanted to get more.
294
727260
2000
我們想要取得更多
12:09
You can move each finger. You can move your thumb, your wrist.
295
729260
3000
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?
296
732260
2000
我們可以再更進一步嗎?
12:14
So we did some experiments
297
734260
2000
因此我們進行了些實驗
12:16
where we saturated our poor patients with zillions of electrodes
298
736260
3000
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 --
299
739260
3000
然後請他們完成二十四項任務
12:22
from wiggling a finger to moving a whole arm
300
742260
3000
從擺動手指到動整隻手臂
12:25
to reaching for something --
301
745260
2000
再到伸手拿東西
12:27
and recorded this data.
302
747260
2000
然後把這資料紀錄下來
12:29
And then we used some algorithms
303
749260
2000
接著,我們利用一些演算法
12:31
that are a lot like speech recognition algorithms,
304
751260
2000
很像語音辨識系統
12:33
called pattern recognition.
305
753260
2000
叫做圖案辨識
12:35
See.
306
755260
2000
看吧
12:37
(Laughter)
307
757260
2000
(笑聲)
12:39
And here you can see, on Jesse's chest,
308
759260
2000
你可以看到,傑西的胸肌上
12:41
when he just tried to do three different things,
309
761260
2000
當他試著做三件不同的事
12:43
you can see three different patterns.
310
763260
2000
你可以看到三種不同圖案
12:45
But I can't put in an electrode
311
765260
2000
但我無法將一個電極放上去
12:47
and say, "Go there."
312
767260
2000
然後叫它“去那裡”
12:49
So we collaborated with our colleagues in University of New Brunswick,
313
769260
3000
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,
314
772260
2000
想出了這個演算控制
12:54
which Amanda can now demonstrate.
315
774260
2000
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.
316
776260
5000
艾:我有可以舉起和放下的手肘
13:01
I have the wrist rotation
317
781260
2000
我有可以轉動的手腕
13:03
that goes -- and it can go all the way around.
318
783260
3000
可以轉一圈
13:06
And I have the wrist flexion and extension.
319
786260
4000
我有可以彎曲的手腕
13:10
And I also have the hand closed and open.
320
790260
3000
還有可以開關的手
13:13
TK: Thank you, Amanda.
321
793260
2000
陶:謝謝,艾曼達
13:15
Now this is a research arm,
322
795260
2000
這是個還在試驗的手臂
13:17
but it's made out of commercial components from here down
323
797260
3000
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.
324
800260
3000
還有一些從各地借來的
13:23
It's about seven pounds,
325
803260
3000
重量約3.175公斤
13:26
which is probably about what my arm would weigh
326
806260
2000
大概跟我的手臂一樣重
13:28
if I lost it right here.
327
808260
2000
如果從這裡算的話
13:30
Obviously, that's heavy for Amanda.
328
810260
3000
很明顯的,對艾曼達來說很重
13:33
And in fact, it feels even heavier,
329
813260
2000
事實上,她在感覺上會更重
13:35
because it's not glued on the same.
330
815260
2000
因為接合方式不同
13:37
She's carrying all the weight through harnesses.
331
817260
2000
她是籍以索帶支撐這些重量
13:39
So the exciting part isn't so much the mechatronics,
332
819260
3000
所以最精彩的部份並不是機電整合
13:42
but the control.
333
822260
2000
而是支配能力
13:44
So we've developed a small microcomputer
334
824260
3000
因此我們研發了一個微型電腦
13:47
that is blinking somewhere behind her back
335
827260
3000
在她的背後運作
13:50
and is operating this
336
830260
2000
操作這隻手
13:52
all by the way she trains it
337
832260
2000
完全由她去訓練的
13:54
to use her individual muscle signals.
338
834260
2000
運用她的個別肌肉信號
13:56
So Amanda, when you first started using this arm,
339
836260
2000
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?
340
838260
3000
花多久時間學會?
14:01
AK: It took just about probably three to four hours
341
841260
2000
艾:大概三到四小時
14:03
to get it to train.
342
843260
2000
來訓練它
14:05
I had to hook it up to a computer,
343
845260
2000
我必須連上電腦
14:07
so I couldn't just train it anywhere.
344
847260
2000
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.
345
849260
3000
所以假如它壞了,我就必須取下來
14:12
So now it's able to train
346
852260
2000
現在只要用背上的小東西
14:14
with just this little piece on the back.
347
854260
2000
就可以訓練
14:16
I can wear it around.
348
856260
2000
我可以到處走
14:18
If it stops working for some reason, I can retrain it.
349
858260
3000
就算壞了,我還是可以重新訓練它
14:21
Takes about a minute.
350
861260
2000
大概花一分鐘而已吧
14:23
TK: So we're really excited,
351
863260
2000
陶:所以我們非常興奮
14:25
because now we're getting to a clinically practical device.
352
865260
3000
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 --
353
868260
2000
這就是我們的目標
14:30
to have something clinically pragmatic to wear.
354
870260
4000
讓它在臨床上可行
14:34
We've also had Amanda able to use
355
874260
3000
我們也讓艾曼達能夠使用
14:37
some of our more advanced arms that I showed you earlier.
356
877260
3000
一些剛才提到的先進手臂
14:41
Here's Amanda using an arm made by DEKA Research Corporation.
357
881260
3000
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.
358
884260
4000
相信迪恩卡門幾年前在TED介紹過給大家
14:48
So Amanda, you can see,
359
888260
2000
那麼你可以看出艾曼達
14:50
has really good control.
360
890260
2000
操作得很棒
14:52
It's all the pattern recognition.
361
892260
2000
這都是圖案辨識
14:54
And it now has a hand that can do different grasps.
362
894260
3000
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
363
897260
3000
我們讓病患腦力激盪
15:00
and think, "What hand grasp pattern do I want?"
364
900260
3000
想“我要什麼樣的緊握模式?”
15:03
It goes into that mode,
365
903260
2000
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.
366
905260
2000
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?
367
907260
3000
艾曼達,你操作DEKA手時,能做幾種?
15:10
AK: I was able to get four.
368
910260
2000
艾:我能做四種
15:12
I had the key grip, I had a chuck grip,
369
912260
3000
我可以握手,彎手指
15:15
I had a power grasp
370
915260
2000
可以緊握
15:17
and I had a fine pinch.
371
917260
2000
還可以用手指捏東西
15:19
But my favorite one was just when the hand was open,
372
919260
2000
但我最喜歡的部份是手可以打開
15:21
because I work with kids,
373
921260
2000
因為我工作要跟小孩玩
15:23
and so all the time you're clapping and singing,
374
923260
3000
所以常要拍手唱歌
15:26
so I was able to do that again, which was really good.
375
926260
3000
我可以再度拍手了,感覺很棒
15:29
TK: That hand's not so good for clapping.
376
929260
2000
陶:那隻手就不是很能拍手了
15:31
AK: Can't clap with this one.
377
931260
2000
艾:這隻不能
15:33
TK: All right. So that's exciting
378
933260
2000
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,
379
935260
2000
是非常令人興奮的
15:37
if we make them good enough
380
937260
2000
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.
381
939260
3000
開放到市場上賣,並拿去做研究試驗
15:42
I want you to watch closely.
382
942260
2000
我想請大家仔細看
15:44
(Video) Claudia: Oooooh!
383
944260
2000
嗚!
15:46
TK: That's Claudia,
384
946260
2000
那是克拉蒂雅
15:48
and that was the first time
385
948260
2000
那是她第一次
15:50
she got to feel sensation through her prosthetic.
386
950260
3000
從義肢上感受到知覺
15:53
She had a little sensor at the end of her prosthesis
387
953260
3000
在義肢尾端有小感應器
15:56
that then she rubbed over different surfaces,
388
956260
3000
她在和不同表面摩擦時
15:59
and she could feel different textures
389
959260
2000
還能辨別不同的質感
16:01
of sandpaper, different grits, ribbon cable,
390
961260
3000
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.
391
964260
3000
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,
392
967260
3000
她說用義肢在桌子上摸過去
16:10
it felt like her finger was rocking.
393
970260
2000
她感覺得到手指在震動
16:12
So that's an exciting laboratory experiment
394
972260
2000
那就是非常令人振奮的實驗
16:14
on how to give back, potentially, some skin sensation.
395
974260
3000
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.
396
977260
3000
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.
397
980260
3000
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
398
983260
3000
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.
399
986260
3000
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.
400
989260
2000
但看周圍所有的電極
16:31
I've got a real estate problem.
401
991260
2000
出現了房地產的問題
16:33
You're supposed to put a bunch of these things on there,
402
993260
2000
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
403
995260
3000
但我們的小肌電卻在電極旁邊
16:38
right next to my electrodes.
404
998260
2000
發出各種噪音
16:40
So we're really challenged on what we're doing there.
405
1000260
3000
這方面是個重大挑戰
16:43
The future is bright.
406
1003260
2000
未來充滿光明
16:45
We're excited about where we are and a lot of things we want to do.
407
1005260
3000
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,
408
1008260
2000
例如
16:50
one is to get rid of my real estate problem
409
1010260
3000
搞定我的房地產問題
16:53
and get better signals.
410
1013260
2000
得到更好的信號
16:55
We want to develop these little tiny capsules
411
1015260
3000
我們想研發一些小膠囊
16:58
about the size of a piece of risotto
412
1018260
2000
小到像一粒米一樣
17:00
that we can put into the muscles
413
1020260
2000
然後放進肌肉裡
17:02
and telemeter out the EMG signals,
414
1022260
3000
再將肌電信號傳遞出來
17:05
so that it's not worrying about electrode contact.
415
1025260
3000
這樣才沒有電極連接的問題
17:08
And we can have the real estate open
416
1028260
2000
我們也可以讓房地產保持開放
17:10
to try more sensation feedback.
417
1030260
2000
來測試更多知覺反應
17:12
We want to build a better arm.
418
1032260
2000
我們想建造更好的義肢
17:14
This arm -- they're always made for the 50th percentile male --
419
1034260
4000
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.
420
1038260
4000
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,
421
1042260
3000
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 --
422
1045260
2000
我們要做這種義肢
17:27
we're starting with,
423
1047260
2000
先由
17:29
the 25th percentile female --
424
1049260
3000
第25百分位數的女性開始
17:32
that will have a hand that wraps around,
425
1052260
2000
可以做手握動作
17:34
opens all the way,
426
1054260
2000
又可以完全張開
17:36
two degrees of freedom in the wrist and an elbow.
427
1056260
3000
在手腕及手肘有兩個自由度
17:39
So it'll be the smallest and lightest
428
1059260
2000
這樣就會是最小、最輕
17:41
and the smartest arm ever made.
429
1061260
2000
又最先進的義肢了
17:43
Once we can do it that small,
430
1063260
2000
只要可以在這麼小的義肢上達成
17:45
it's a lot easier making them bigger.
431
1065260
2000
做大一點的就簡單多了
17:47
So those are just some of our goals.
432
1067260
3000
這些是我們的一些目標
17:50
And we really appreciate you all being here today.
433
1070260
4000
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,
434
1074260
2000
有鑑於昨天的主題
17:56
with yesterday's theme.
435
1076260
2000
我想分享一個我們這行業之苦
17:58
So Amanda came jet-lagged,
436
1078260
2000
艾曼達還在調時差
18:00
she's using the arm,
437
1080260
2000
她想用這隻手臂
18:02
and everything goes wrong.
438
1082260
2000
但都被搞亂了
18:04
There was a computer spook,
439
1084260
2000
電腦出問題
18:06
a broken wire,
440
1086260
2000
有個線斷了
18:08
a converter that sparked.
441
1088260
2000
有個轉換器壞了
18:10
We took out a whole circuit in the hotel
442
1090260
2000
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.
443
1092260
2000
差點就觸發了火警警報器
18:14
And none of those problems could I have dealt with,
444
1094260
3000
要是沒有一個很聰明的研究團隊
18:17
but I have a really bright research team.
445
1097260
2000
我根本不可能解決那些問題
18:19
And thankfully Dr. Annie Simon was with us
446
1099260
3000
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.
447
1102260
2000
非常努力幫我們把它修好
18:24
That's science.
448
1104260
2000
這就是科學
18:26
And fortunately, it worked today.
449
1106260
2000
還好義肢今天沒有出問題
18:28
So thank you very much.
450
1108260
2000
所以我要非常感謝大家
18:30
(Applause)
451
1110260
14000
(掌聲)
關於本網站

本網站將向您介紹對學習英語有用的 YouTube 視頻。 您將看到來自世界各地的一流教師教授的英語課程。 雙擊每個視頻頁面上顯示的英文字幕,從那裡播放視頻。 字幕與視頻播放同步滾動。 如果您有任何意見或要求,請使用此聯繫表與我們聯繫。

https://forms.gle/WvT1wiN1qDtmnspy7


This website was created in October 2020 and last updated on June 12, 2025.

It is now archived and preserved as an English learning resource.

Some information may be out of date.

隱私政策

eng.lish.video

Developer's Blog