Todd Kuiken: A prosthetic arm that "feels"

174,094 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