Open-Source 3D Printing in the Prosthetic Field—The Case of Upper Limb Prostheses: A Review
Abstract
:1. Introduction
2. Materials and Methods
- The design and its printing files must be accessible through an open-source license or freely.
- The availability of a clear and reliable support for printing and assembling (manual or video of instructions) must be provided. As both English or French are mastered by the authors, we included devices with information delivered in those two languages.
- The design and its related printing files should have been made accessible after 2018. If the design is anterior to this date but a proof of continuing support (i.e., answers to questions) until at least 2018 is verified, then the device would be included.
- A design and its related printing files are not accessible through an open-source license or freely.
- A design is available but there is a lack of clear and reliable instructions (i.e., manual, video, etc.) to print or to assemble a device.
- A design is indicated as accessible, but no related printing file is available or the printing files accessible are corrupted.
- A design is indicated by its creator as unsuitable for a daily use or for a purpose different than research.
- Any designs comprising an uncomplete, abandoned or aborted projects. We define an “uncomplete” project as a project, proposed as an accomplished concept or as a “ready-to-use” device, in which there are missing elements (i.e., partial or absence of instructions, code for electronic components, projects steps, etc.). Abandoned or aborted projects are defined as projects not considered accomplished either by its author or by the absence of sign of pursued development on a specific device.
2.1. Ten Kate et al. Review
2.2. Literature Review
2.3. Online Databases Search
e-NABLE Platform
3. Results
3.1. Review of Ten Kate et al.
3.2. Review of Literature
3.2.1. Population
3.2.2. Design
3.2.3. Mechanical Specifications
3.2.4. Kinematic Specifications
3.2.5. 3D Printing Processes and Materials
3.2.6. Production Cost
3.2.7. Functionality Assessment
3.3. Review of Online Databases
3.3.1. General Repositories
3.3.2. Design
3.3.3. Mechanical Specifications
3.3.4. Kinematic Specifications
3.3.5. Production Cost
3.4. e-NABLE Platform
3.4.1. Design
3.4.2. Mechanical Specifications
3.4.3. Kinematic Specifications
3.4.4. Production Cost
4. Discussion
4.1. Designs
4.1.1. Creation
4.1.2. Accessibility
4.1.3. Customization
4.1.4. Mechanical and Kinematic Specifications
4.2. Assembly
4.3. Validation
4.4. Systematic Review
4.5. Online Databases
4.6. Technical Support
4.7. Open-Source Era
4.8. Limitations
4.9. Future Perspectives
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Examples of Applications of the 3D-Printed Prosthesis Report Checklist
Example n°1. 3D-Printed Prosthesis Report Checklist | Zuniga et al. [36] | |
Information | Reported | Data |
Identification | ||
• Creator | Zuniga et al. | |
• Year of Creation | 2017 | |
• Number of versions | 2 | |
• Availability (open-source, URL) | Open-source | |
3D printing | ||
• Design customization required | Yes (colors, fictional characters) | |
• Material (type) | ABS, PLA | |
• 3D printer | Ultimaker 2, Ultimaker B.V., Geldermalsen, The Netherlands; Uprint SE Plus by Stratasys, MN | |
• Orientation | Hexagon pattern (desktop printer), crosshatch (industrial printer) | |
• Infill (percentage, pattern) | 40% | |
• Layer height | 0.15–0.25 mm | |
• Printing recommendations | Rafts and supports for delicate parts | |
• Printing duration | 4–7 h (assembly time included) | |
• Post-printing process | ||
Mechanical specifications | ||
• Level of prosthesis | Hand | |
• Type of prosthesis (passive, active) | Active | |
• Actuation (body-powered, externally powered, etc.) | Body-powered | |
• Type of control (wrist, elbow, shoulder harness, EMG, EEG, etc.) | Wrist | |
• Weight of device (if applicable) | ||
• Maximal Load (tests performed) (if applicable) | ||
• Durability (if applicable) | ||
Kinematic specifications | ||
• Grasping (according to GRASP taxonomy) | Cylindrical and Tip grasps | |
• Range of motion (in degrees) (if applicable) | 20°–30° wrist flexion for hand closure | |
• Degree of freedom (if applicable) | ||
• Force distribution (if applicable) | ||
Assembly | ||
• Material (hardware required, cost) | Nylon cord, elastic cord, Velcro, medical-grade firm padded foam, protective skin sock, BOA dial tensioner | |
• Assembly recommendations | ||
• Assembly duration (if applicable) | 4–7 h (printing time included) | |
Application (if applicable) | ||
• Population (age, impairment, usage, activities) | 11 children (3–15 years old). Congenital defect or amputation. | |
• Intervention (test, procedures, etc.) | Function testing (Box and Block Test) Strength measurements (strength testing with dynamometer) | |
• Presence of control group | Non | |
• Main results | Improvement of manual gross dexterity (function); no significant impact on strength of residual wrist. 3DP prosthesis can be used as a transitional device to improve function. | |
Remarks : Reported and absent data are represented by green and red marks, respectively. | ||
Example n°2. 3D-Printed Prosthesis Report Checklist | Omar et al. [31] | |
Information | Reported | Data |
Identification | ||
• Creator | Omar et al. | |
• Year of Creation | 2019 | |
• Number of versions | ||
• Availability (open-source, URL) | Open-source | |
3D printing | ||
• Design customization required | ||
• Material (type) | PLA | |
• 3D printer | ||
• Orientation | ||
• Infill (percentage, pattern) | ||
• Layer height | ||
• Printing recommendations | ||
• Printing duration | ||
• Post-printing process | ||
• Cost | PLA filament: £37 Hardware parts: £300 3D printer: £310 | |
Mechanical specifications | ||
• Level of prosthesis | Hand | |
• Type of prosthesis (passive, active) | Active | |
• Actuation (body-powered, externally powered, etc.) | Externally powered | |
• Type of control (wrist, elbow, shoulder harness, EMG, EEG, etc.) | Infra-red sensor | |
• Actuators | Servo motors | |
• Weight of device (if applicable) | ||
• Maximal Load (tests performed) (if applicable) | 2 kg | |
• Durability (if applicable) | ||
Kinematic specifications | ||
• Grasping (according to GRASP taxonomy) | Power, Tip, Lateral and Spherical | |
• Range of motion (in degrees) (if applicable) | ||
• Degree of freedom (if applicable) | ||
• Force distribution (if applicable) | ||
Assembly | ||
• Material (hardware required, cost) | PCB board, infra-red sensors, servo motors | |
• Assembly recommendations | ||
• Assembly duration (if applicable) | ||
Application (if applicable) | ||
• Population (age, impairment, usage, activities) | ||
• Intervention (test, procedures, etc.) | Testing (achievement of ADL tasks) | |
• Presence of control group | ||
• Main results | Limited hand functionality (limited grasps options) | |
Remarks: Reported and absent data are represented by green and red marks, respectively. | ||
Example n°3. 3D-Printed Prosthesis Report Checklist | Kinetic Hand | |
Information | Reported | Data |
Identification | ||
• Creator | Mat Bowtell (Free 3D Hands, Ltd.) | |
• Year of Creation | 2020 | |
• Number of versions | 1 | |
• Availability (open-source, URL) | Open-source (https://www.thingiverse.com/thing:4618922, accessed on 3 May 2022) | |
3D printing | ||
• Design customization required | ||
• Material (type) | PLA, PLA+, Ninjaflex | |
• 3D printer | Flashforge Finder Lite, Flashforge Creator Pro | |
• Orientation | ||
• Infill (percentage, pattern) | 40%(PLA)/100% (Ninjaflex) | |
• Layer height | 0.18 mm | |
• Printing recommendations | No support, no raft See complete instruction manual for full printing recommendations | |
• Printing duration | ||
• Post-printing process | See complete instruction manual for full post-printing recommendations. | |
• Cost | ||
Mechanical specifications | ||
• Level of prosthesis | Hand | |
• Type of prosthesis (passive, active) | Active | |
• Actuation (body-powered, externally powered, etc.) | Body-powered | |
• Type of control (wrist, elbow, shoulder harness, EMG, EEG, etc.) | Wrist | |
• Actuators | ||
• Weight of device (if applicable) | ||
• Maximal Load (tests performed) (if applicable) | ||
• Durability (if applicable) | ||
Kinematic specifications | ||
• Grasping (according to GRASP taxonomy) | ||
• Range of motion (in degrees) (if applicable) | 18° wrist flexion for full closure | |
• Degree of freedom (if applicable) | ||
• Force distribution (if applicable) | ||
Assembly | ||
• Material (hardware required, cost) | See complete instruction manual for full hardware lists. | |
• Assembly recommendations | See complete instruction manual for full assembly procedure. | |
• Assembly duration (if applicable) | ||
Application (if applicable) | ||
• Population (age, impairment, usage, activities) | ||
• Intervention (test, procedures, etc.) | ||
• Presence of control group | ||
• Main results | ||
Remarks: Reported and absent data are represented by green and red marks, respectively. |
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Arm Designs |
“El Medallo” Bionic Arm |
Adjustowrap Gripper Arm |
Flexy Arm |
Kwawu Arm |
Phoenix Reborn Arm |
Po Arm |
Self-suspending below-elbow sockets methodology |
Unlimbited Arm v2.1 |
Versatile Elbow Operated Gripper—VEOG |
Hand Designs |
Cyborg Beast |
e-NABLE Phoenix Hand v3 |
Flexy-Hand 2 |
K1 Hand |
Kinetic Hand |
MotoGripper Terminal Device |
Ody Hand |
Osprey Hand |
Phoenix v2 Hand |
Raptor Reloaded |
Talon Hand |
The Paraglider |
Unlimbited Phoenix Hand |
Excluded Devices | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Hosting website not reachable (not functioning URL)/No information about the actual device on the hosting website. | |||||||||||
Zero point Frontiers | One-hinged Cyborg Beast | Cyborg Beast with Increased Wrist Movement | JD-1 | NuHand | IVINA 2.0 | Handiii Coyote | Handiii | One-hinged Cyborg Beast | Adjustable Thumb | The Cyborg arm | |
Not Open-source/Printing files not accessible/In press only. | |||||||||||
Youbionic | Victory Hand | Tenim Hand | Protesis Cosmetica | Not Impossible | Manu Print (Re Hand | Hero arm (Bionic arm) | 3D-printed prosthesis Ecuador | Bionico | |||
Absence of reliable instructions (manual, video…) for specific customization, 3D printing or assembling †. | |||||||||||
Robot Hand | Robohand | InMoov 2 hand | Hollies Hand Version | Flexy arm | |||||||
Posted before 2018 and lack or no more support/No sign of further development ‡. | |||||||||||
The Lucky Paw Prosthetic Hand | Talon Flextensor 1.0 | Hackberry | Flexy hand | e-NABLE RIT Arm | Muscle Robot Hand | GalileoHand | Limbitless Arm | Dextrus EMG | DIY Prosthetic Hand and forearm | Falcon Hand V2 | Flexy-Hand—Filaflex Remix |
Lack of data or information for producing functioning devices (e.g., Printing files, Arduino code, etc.). | |||||||||||
Tact: Low-cost, advanced prosthetic hand | Scand hand | Roboarm | Mind controled Robot Hand | ||||||||
Aborted projects. | |||||||||||
Biohand | |||||||||||
Devices referred by creators as suited research purpose only or not suited for patients or extended use. | |||||||||||
Snap-Together Robohand | e-NABLE Raptor Reloaded | e-NABLE Raptor Hand | Falcon Hand V1 | ||||||||
Included devices | |||||||||||
K-1 | The Cyborg *Beast | Flexy hand 2 |
Author | Year | Number of Prostheses Studied | Name of Device | Level of Prosthetic | New vs. Existing Open-Source Prosthesis | Motion | Study Aim | Study Setting | Number Participants | Main Results | Availability of Designs |
---|---|---|---|---|---|---|---|---|---|---|---|
Alturkistani et al. | 2020 | 1 | Raptor Reloaded Hand | Hand prosthetic | Existing prosthesis | Passive | Developing affordable partial hand prosthesis with flexible material | Design process with patient’s active participation Qualitative assessment (questionnaire) Quantitative assessment (grasping test, lift test) | 1 (transmetacarpal amputation, missing three fingers) | Grips by using contralateral hand Low grip strength (700 g) but function considered as sufficient by participant (stable grasp) Bimanual activities achievable. | Online repository † |
Anderson et al. | 2021 | 1 | Talon hand | Hand prosthetic | Existing prosthesis | Active (wrist) | Developing a 3DP hand prosthesis allowing a child participation in gymnastic class | Impact assessment through testing specific gymnastic skills and questionnaire | 1 (left hand with congenital deficiency) | Improvement in performing specific gymnastic classes; Increased satisfaction, confidence, participation in gymnastic classes. | Online repository † |
Neethan at el. | 2019 | 4 | Flexy hand, Shira, Limbforge, “bionic hand” | Hand prosthetic | Existing prostheses | Active (wrist) | Comparison of strength, comfort and production cost | Analysis for Flexy and Shira hands: Functionality testing (grip strength, grasping); comfort analysis; production cost estimation | 0 | Flexy hand most suitable/appropriate device as lesser cost, reduced effort requirements for users. | Online repository |
Omar et al. | 2019 | 1 | HACKberry | Hand prosthetic | Existing prosthesis | Active (myoelectric) | Developing 3DP prosthetic bionic hand with appropriate sensory and control tuning to perform basic activities of daily living (ADL) | Calibration, Grasping and ADL test. | 5 (not amputees) | Limited Hand functionality (limited grasps options, slippery surface). | Online repository |
Tong et al. | 2019 | 1 | Raptor Hand | Hand prosthetic | Existing prosthesis with additional integrated 3DP electrodes with pressure sensors | Active (wrist) | Approach to create a personalized 3DP hand prosthesis with integrated 3DP electrode for measuring pressure distribution | 3D scanning, reverse engineering, design process, 3DP of integrated electrodes, analysis of pressure distribution on upper limb | 1 (amniotic band syndrome, right hand) | Association of 3D scanning and 3D printing enables creation of form-fitting 3DP personalized low-cost hand prostheses with integrated electronic components. | Online repository † |
Zuniga et al. | 2017 | 1 | Cyborg Beast 2 | Hand prosthetic | Existing prosthesis | Active (wrist) | Analysis of functional and strength changes after usage of a 3DP transitional prosthesis in children with upper limb difference | Function testing (Box and Block Test) Strength measurements (strength testing with dynamometer) | 11 (Congenital defects, amputation) | Improvement of manual gross dexterity (function); no significant impact on strength of residual wrist. 3DP prosthesis can be used as a transitional device to improve function. | Online repository † |
Lifting a 600 mL water bottle up to the mouth. |
Opening a door. |
Picking up a pen and writing. |
Picking up and holding a jacket from a point A to a point B. |
Picking up and holding a shirt from a point A to a point B. |
Turning a page of a book. |
Tying shoelaces. |
Hand Prostheses | ||||||||
---|---|---|---|---|---|---|---|---|
Source: Thingiverse | ||||||||
Name | Creator | Year | Actuation | Versions | Instructions | Support | Progress | Comments |
Cathy’s Lucky Fin V3—Prosthetic Hand—Bowden/Push-Pull Variant | Rhadamanthys76 | 2021 | BP ‡ | 3 | Yes | Yes | / | Support provided up to 2020; instructions more complete in versions 1 et 2. |
Flexibone Prosthetic Hand 2019 | TeamGrenable | 2019 | EP ‡ | 1 | Yes | N/A † | / | / |
Flexy-Hand | Gyrobot | 2014 | BP | 2 | Yes | Yes | Updated in 2015 | Support provided up to 2021. |
Flexy-Hand 2 | Gyrobot | 2014 | BP | 2 | yes | Yes | / | Support provided up to 2018. |
Flexy-Hand 2—Filaflex Remix | Gyrobot | 2015 | BP | 1 | Yes | Yes | / | Support provided up to 2018. |
Gold Dexterity Hand | Nickhs | 2018 | BP | 1 | Yes | Yes | Updated in late 2018 | / |
Modular Flexy Hand 2 (Interchangeable fingers) | HHP_UNCC | 2019 | BP | 1 | Yes | Yes | Updated in late 2019 | / |
Ody Hand 2.1 | Profbink | 2014 | BP | 2 | Yes | Yes | Updated in 2018 | Support provided until this day. |
Phoenix Talons | HHP_UNCC | 2019 | BP | 1 | Yes | N/A | Updated in late 2019 | / |
Robotic prosthesis | Bfessler | 2019 | EP | 1 | Yes | N/A | / | / |
Talon Hand 3.0 | Profbink | 2014 | BP | 3 | Yes | Yes | Updated in 2017 | Support provided until this day. |
The Osprey Hand by Alderhand and e-Nable | Profbink | 2015 | BP | 1 | Yes | Yes | Updated in 2018 | Support provided until this day. |
Source: Instructables | ||||||||
Servo-Controlled Prosthetic Hand | Duncanlaird | 2018 | BP | 1 | Yes | N/A | / | / |
Forearm prostheses | ||||||||
Source: Thingiverse | ||||||||
Name | Creator | Year | Actuation | Versions | Instructions | Support | Progress | Comments |
Arm v2 | Masnart39 | 2015 | BP | 2 | Yes | Yes | Updated in 2016 | Support provided until this day. Printing files available in different formats. |
Bionic Flexy Arm II | Materializacion3DColombia | 2016 | BP | 1 | Yes | Yes | Updated in 2019 | Instructions in video. |
Cosmetic lower arm prosthetic | Hatsyflatsy | 2019 | /¥ | 1 | Yes | N/A | Updated in 2020 | Limited instructions. |
E-Talon | 1d1 | 2019 | EP | 1 | Yes | N/A | / | / |
Kwawu Arm 2.0—Prosthetic | JacquinBuchan | 2018 | BP | 3 | Yes | Yes | Updated in 2019 | / |
Kwawu + Rojava Remix Arm Prosthetic | Mimi_3d | 2021 | BP | 2 | Yes | N/A | / | / |
My Customized The UnLimbited Arm v2.1—Alfie Edition | Edoubleb | 2017 | BP | 1 | Yes | Yes | / | Answers up to 2018, referring to UnLimbited Arm assembly instructions. |
NIOP Kwawu remix | NateMunro | 2019 | BP | 1 | YES | Yes | / | / |
Prótesis personalizada Cinderella (cenicienta) | Materializacion3DColombia | 2016 | BP | 1 | Yes | N/A | Updated in 2019 | Instructions in video. |
Robotic Prosthetic Hand | Grossrc | 2016 | EP | 1 | Yes | Yes | Updated in 2019 | Support provided up to 2019. |
Unlimbited FP3D | FundacionProtesis3D | 2017 | BP | 1 | yes | N/A | Updated in 2021 | Instructions in video. |
Arm prostheses | ||||||||
Source: Thingiverse | ||||||||
Robo arm | Cloudyconnex | 2021 | UD ‡ | 1 | Yes | N/A | / | / |
3D-Printed Forearm Prostheses | ||||||||
---|---|---|---|---|---|---|---|---|
Name | Creator | Original Hosting Platform | Year | Maturity | Instructions | Support | Progress | Comments |
“El Medallo” Bionic Arm | eNABLE Medellin (Mark Walbran et al.) | Github | 2018 | High | Yes | Yes | / | Original platform |
Kwawu arm | Jacquin Buchanan | Github | 2018 | Medium | Yes | Yes | Update in 2019 | Original platform |
Unlimbited Arm v2.1 | Team UnLimbited | Thingiverse | 2017 | High | Yes | Yes | / | Original platform |
3D-printed Hand prostheses | ||||||||
e-NABLE Phoenix Hand v3 | Jason Bryant et coll. | Thingiverse | 2019 | High | Yes | Yes | / | Original platform |
Flexy hand 2 | Gyrobot team | Thingiverse | 2014 | High | Yes | Yes | / | e-NABLE |
Kinetic Hand | Mat Bowtell | Thingiverse | 2020 | High | Yes | Yes | / | Original platform |
Ody Hand | Peter Binkley | Thingiverse | 2014 | High | Yes | Yes | Update in 2018 | Original platform |
Osprey Hand | Peter Binkley | Thingiverse | 2015 | High | Yes | Yes | Update in 2018 | Original platform |
Phoenix v2 Hand | Jason Bryant et coll. | Thingiverse | 2016 | High | Yes | Yes | / | e-NABLE |
Talon Hand 3.0 | Peter Binkley et coll. | Thingiverse | 2014 | High | Yes | Yes | Update in 2017 | Original platform |
The Cyborg Beast | Zuniga et al. | Thingiverse | 2014 | High | Yes | Yes | / | e-NABLE |
Unlimbited Phoenix Hand | Team Unlimbited | Thingiverse | 2017 | High | Yes | Yes | / | e-NABLE |
Information | Reported |
---|---|
Identification | |
• Creator | |
• Year of Creation | |
• Number of versions | |
3D printing | |
• Design customization required | |
• Material (type) | |
• 3D printer | |
• Orientation | |
• Infill (percentage, pattern) | |
• Printing recommendations | |
• Printing duration | |
• Post-printing process | |
• Cost | |
Mechanical specifications | |
• Level of prosthesis | |
• Type of prosthesis (passive, active) | |
• Actuation (body-powered, externally powered, etc.) | |
• Type of control (wrist, elbow, shoulder harness, EMG, EEG, etc.) | |
• Weight of device (if applicable) | |
• Maximal Load (tests performed) (if applicable) | |
• Durability (if applicable) | |
Kinematic specifications | |
• Grasping (according to GRASP taxonomy) | |
• Range of motion (in degrees) (if applicable) | |
• Degree of freedom (if applicable) | |
• Force distribution (if applicable) | |
Assembly | |
• Material (hardware required, cost) | |
• Assembly recommendations | |
• Assembly duration (if applicable) | |
Application (if applicable) | |
• Population (age, impairment, usage, activities) | |
• Intervention (test, procedures, etc.) | |
• Presence of control group | |
• Main results |
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Share and Cite
Wendo, K.; Barbier, O.; Bollen, X.; Schubert, T.; Lejeune, T.; Raucent, B.; Olszewski, R. Open-Source 3D Printing in the Prosthetic Field—The Case of Upper Limb Prostheses: A Review. Machines 2022, 10, 413. https://doi.org/10.3390/machines10060413
Wendo K, Barbier O, Bollen X, Schubert T, Lejeune T, Raucent B, Olszewski R. Open-Source 3D Printing in the Prosthetic Field—The Case of Upper Limb Prostheses: A Review. Machines. 2022; 10(6):413. https://doi.org/10.3390/machines10060413
Chicago/Turabian StyleWendo, Kevin, Olivier Barbier, Xavier Bollen, Thomas Schubert, Thierry Lejeune, Benoit Raucent, and Raphael Olszewski. 2022. "Open-Source 3D Printing in the Prosthetic Field—The Case of Upper Limb Prostheses: A Review" Machines 10, no. 6: 413. https://doi.org/10.3390/machines10060413
APA StyleWendo, K., Barbier, O., Bollen, X., Schubert, T., Lejeune, T., Raucent, B., & Olszewski, R. (2022). Open-Source 3D Printing in the Prosthetic Field—The Case of Upper Limb Prostheses: A Review. Machines, 10(6), 413. https://doi.org/10.3390/machines10060413