Design and evaluation of a distally actuated powered finger prosthesis with self-contained transmission for individuals with partial hand loss

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Collaborative and Controllable Robotics for Biomedical and Industrial Applications - Research Article Design and evaluation of a distally actuated powered finger prosthesis with self-contained transmission for individuals with partial hand loss Advances in Mechanical Engineering 2019, Vol. 11(4) 1 16 Ó The Author(s) 2019 DOI: 10.1177/1687814019834114 journals.sagepub.com/home/ade Barathwaj Murali 1, Stephen Huddle 2 and Richard F ff Weir 2 Abstract Partial hand loss accounts for the overwhelming majority of upper limb deficiencies. Despite this, individuals with partial hand loss have a limited number of prosthetic options at their disposal. Existing externally powered devices typically house both motor and gear transmission in the proximal phalanx, which provides function at the expense of anthropomorphism. We present a novel design for an externally powered finger prosthesis with a custom gear transmission that is capable of higher intermittent torques compared to commercial gearheads of equivalent volume. We manufacture a fully functional transmission using a high-strength maraging steel alloy and direct laser metal sintering. The transmission consists of multiple planetary and spur gear stages arranged in a stackable (or laminar) configuration and accommodates joint movement at the proximal interphalangeal joint. The powered finger is equivalent in size to a 50th percentile female index finger and is capable of generating pinch forces comparable to those of commercial powered fingers at flexion speeds that exceed those of existing devices. While there are several practical and functional improvements for future iterations, our design represents a viable option for a powered finger capable of accommodating a wide range of individuals with partial hand loss. Keywords Powered finger, partial hand loss, amputation, prosthesis, transmissions, prosthetic hand, assistive device Date received: 31 August 2018; accepted: 22 January 2019 Handling Editor: Jinguo Liu Introduction The human hand plays a major role in dexterous manipulation and expressive communication, which makes serious injury or amputation especially devastating. 1 There are approximately 500,000 people living with minor upper limb loss in the United States, 2,3 and while the field refers to these types of amputation as minor, it can cause severe disability, especially when the amputation involves the loss of the thumb and/or multiple digits. For example, loss of both the index and middle fingers results in 40%, 36%, and 22% impairments of the hand, upper extremity, and whole body, respectively. 4 Partial hand deficiencies also account for approximately 46.4% of total congenital upper limb deficiencies. 5 Amputation can cause physical, psychosocial, and economic damage to an individual and can 1 Department of Mechanical Engineering, Rice University, Houston, TX, USA 2 Bioengineering Department, University of Colorado at Denver, Aurora, CO, USA Corresponding author: Barathwaj Murali, Department of Mechanical Engineering, Rice University, P.O. Box 1892, MS-321, Houston, TX 77005, USA. Email: barath.murali@rice.edu Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/ open-access-at-sage).

2 Advances in Mechanical Engineering lead to depression, anxiety, loss of self-esteem, and social isolation. 6,7 Over half of individuals with partial hand loss are unable to return to their prior occupations 8 and experience greater rates of post-traumatic stress and an increased negative perception of body image. 9 While the number of individuals with partial hand amputation is 10 times greater than that of all other categories of upper limb amputation combined, the prosthetic options for this patient population are relatively poor. 4,5 Prosthetic solutions for partial hand amputations are generally considered only after reconstructive surgical procedures have failed. 10 Individuals with partial hand loss can be fit with either passive silicone cosmeses, passive mechanical devices, body-powered devices, or externally powered devices. 11 Silicone cosmeses simply restore the appearance of a missing hand or fingers and can provide a good facsimile of the missing hand for social situations (Figure 1). Cosmetic silicone finger extensions can also provide functional benefits by improving finger spread and reach, which can enable the possibility of performing simple typing tasks, playing instruments, grasping kitchenware, and using cutlery. There are a number of cosmetic silicone finger restoration providers such as Artech Laboratories, Livingskin of Touch Bionics, and American Hand Prosthetics, to name a few. The cosmetic result associated with a silicone restoration has positive effects on self-image. 8,12 These same studies showed, however, that a silicone restoration was not durable enough for individuals hoping to return to jobs involving manual labor. Body-powered devices for partial finger amputations can provide more functionality, but usually at the expense of esthetics and comfort. 11 While these devices can articulate, they require power from either a residual digit (Figure 2), an adjacent intact digit, or a cabling system. 13 In addition, the grip strength of bodypowered devices is limited by the strength of the driving body part and the motion provided by these devices is always coupled, which limits the number of achievable grasps. 14,15 There are a number of passive articulating full and partial finger systems available, 14,15 such as the TITAN and M-Fingers (Partial Hand Solutions), the VINCENTpartial passive (Vincent Systems), the MCPDriver and PIPDriver (Naked Prosthetics), and the X-Finger (Didrick Medical). Positioning a passive partial finger prosthesis is important for seamlessly performing activities of daily living (ADL). The TITAN series partial M-Finger offers a passive ratcheting mechanism for positioning, but must be dislocated using the opposite hand to extend the finger from a Figure 1. Silicone cosmetic restoration of middle and ring finger with skin tone match to subject. Figure 2. Partial M-Fingers from Partial Hand Solutions. flexed position. Point Designs 16 offer a novel, durable, and robust 3D-printed passive mechanical finger manufactured from steel that users can position by pressing against their body or some other object in the environment. Externally powered finger prostheses, also referred to as powered fingers, are a relatively recent development, with the earliest design dating back to 1989. 17 There are three main options for active (i.e. powered) prosthetic fingers for individuals with transcarpal (all digits) amputations. The Transcarpal Hand (Ottobock) is a single-degree-of-freedom (DOF) prehensor that uses two-site myoelectric control for actuation. The hand provides high strength but requires transcarpal amputation and mounting of additional electronics onto the residual limb. The ProDigits (Touch Bionics) is a system of actuated prosthetic fingers for

Murali et al. 3 amputations at the metacarpophalangeal (MCP) joint level. Each digit is a single-dof system with an underactuated proximal interphalangeal (PIP) joint. Similarly, the VINCENTpartial (Vincent Systems) is a system of single-dof digits for amputations at the MCP level that uses a kinematic linkage system consisting of a crossed 4-bar linkage to actuate the PIP joint. Despite their sophisticated design and control electronics, none of these systems are suitable for heavy-duty use. Powered finger prostheses are capable of greater force generation than silicone and body-powered devices 18 and generally use a DC motor gearhead combination along with a controller typically and electromyography (EMG) signals recorded from the muscles of the residual limb. 11 Externally actuated systems require battery power in order to drive the electric motors housed within the prosthesis. The electronics and batteries for actuated systems are usually placed on the forearm as in Figure 3 and result in wires and hinges crossing the wrist that can potentially impede wrist motion. More innovative fittings mount the fingers, electrodes, electronics, and power source onto a residual hand socket that captures the styloids of the wrist, which suspends the prosthesis while preserving wrist motion. Phillips et al. 19 discuss the issues associated with fitting electric powered fingers, a major issue being that their overall length effectively limits such systems to those individuals with long metacarpal amputations. Locating the prosthesis center of rotation about its own MCP joint means that individuals with finger amputations at the MCP can find these devices too long, as there is insufficient room to accommodate their residual limb. For an amputee with a finger amputation located at the MCP, the prosthetist will place the prosthesis past the anatomic MCP joint. This extends the finger beyond the anatomical position of its user. This issue affects a large proportion of partial hand amputees and is a shortcoming of all the current partial hand replacements (with the exception of the Point Digit 16 ) including the electric powered devices from Touch Bionics and Vincent Systems. We are proposing to design a powered finger, which is capable of being fit with its center of rotation at or near the anatomical MCP joint. A major constraint in the design of powered finger prostheses is the limited volume available for housing the various actuation, power, and control components. 20 The DC motor and gearhead occupy a large portion of this available space and require an elongated proximal phalanx when fully contained within an anatomical finger. Several existing partial and full hand prostheses are 2-DOF mechanisms with a feature on the distal finger segment that provide the appearance of the distal interphalangeal (DIP) joint. 21 Although Figure 3. Fitting of Vincent finger onto patient. Note location of battery and electrodes on forearm. this enables the development of powered fingers with self-contained actuation (i.e. a full power transmission housed within the volume of one or more finger phalanges), it substantially reduces anthropomorphism. Esthetic considerations are important since it is thought that an anatomically similar artificial limb leads to greater ownership and acceptance of the device, as well as reduced phantom limb pains. 22 Filatov et al. 20 explored the possibility of separating the motor and gearhead across an interphalangeal (IP) joint to potentially improve both anthropometry and minimum overall size. The IP transmissions from Filatov et al. 20 showed promise for further miniaturization and integration into a powered finger. In addition, recent advances in additive manufacturing (AM) processes for plastic and metal are enabling the development of robust production-grade parts for a variety of industries. 23 Such processes provide substantial design freedom, especially for complex miniature components that are outside the capabilities of traditional machining. AM is becoming increasingly widespread in the development of customized medical devices for a variety of body-powered devices, 24 and more recently externally powered prosthetic hands for research. 25 Here, we present a novel design for a fully articulated powered finger prosthesis with self-contained actuation. We utilize direct laser metal sintering (DMLS) to fabricate a functional gear transmission and directly integrate it into the medial phalanx of our finger. The transmission connects to a DC motor in the proximal phalanx using elements from Filatov et al. 20 These elements also allow for torque transmission across the PIP joint. Our design allows for a powered finger equivalent in size to a 50th percentile female index finger with potential for further size reductions that will improve its accessibility for amputee populations and enable the placement of its MCP joint closer to the anatomical MCP of the user. The powered finger is capable of flexion speeds and fingertip forces comparable to those of existing partial and full-hand devices from Belter et al. 21 and our design shows potential in becoming a durable yet highly anthropomorphic device for partial

4 Advances in Mechanical Engineering and full-hand amputees that can accommodate a wide range of sizes. Design Design objectives The main design objective for the powered finger was to develop a device with its transmission housed fully within the volume of its phalanges. The powered finger was to be fully articulated with a maximum flexion angle for the MCP greater than 70, and maximum PIP and DIP flexion angles of at least 90 and 60, respectively consistent with normal hand function. 26 The size of the finger was chosen to be analogous to a 25th 50th percentile female index finger to improve its accessibility to amputee populations, 27 as a device designed for 25th percentile female anthropometry would make it accessible to 87% of the population, compared to a device designed for a 50th percentile male, which is suitable for only 30% of the population. 28 Due to the perception of the prosthesis as an external load worn on the residual limb of an individual, it is necessary that the weight of the powered finger be no more than that of the biological fingers. 29 To be useful in ADL, the powered finger should produce a force of approximately 15 18 N from recommendations in Weir and Sensinger. 29 The minimum fingertip force goal was set as approximately 10 N, which is the average force across the existing commercial and research devices from Belter et al. 21 The maximum flexion speed of the finger was chosen to be 3 4 rad/s, from recommendations in Krausz et al. 25 and Weir and Sensinger. 29 Finger design The IP transmission from Filatov et al. 20 significantly reduces the length of the proximal phalanx, as it only houses a DC motor. Using a DMLS printer configured to use a high-strength steel alloy enabled the development of a miniature gear transmission small enough for integration within the volume of a single finger phalange because we were able to print gears with custom pressure angles and modules. As a result, it is possible to design a fully articulated finger containing both a PIP and DIP joint. As commonly performed on several commercial and research hands, the powered finger is underactuated through a set of kinematic linkages that transfer torque to the MCP joint. The finger phalanges and underactuation mechanism form a 6-bar linkage and is essentially a superposition of two 4-bar linkages commonly used to underactuate two-phalanx commercial and research devices. 21 The linkage system couples the motion of each IP joint to provide a flexion trajectory suitable for a variety of grasps used in ADL. Some devices, such as the ilimb, use a flexible cable and extension spring for a compliant joint coupling mechanism, 21 but the rigid 6-bar linkage structure provides advantages in durability, longer service life, and design simplicity. From a kinematic perspective, a set of loop closure equations can provide for an accurate description of the motion and mechanical advantage of the 6-bar mechanism. The parameters of the linkage system were determined using the overall length of the phalanges using anthropometric data of the hand from Tilley et al. 28 The length of the motor resulted in its placement in the proximal phalanx. The dimensions of the motor and the bevel gear stage at the PIP determined the minimum length of the phalanx. The length of the medial phalanx is dependent on the layout of the gear transmission, while its maximum thickness was set to 12 mm so the addition of a plastic cosmetic shell around the finger would comply with the anthropomorphic dimensions given by Tilley et al. 28 Esthetics determined the length of the distal phalanx, which used a combination of the golden ratio 26 and anthropometric data from Tilley et al. 28 The location of the linkage pin connections used to couple joint motions was determined by the flexion trajectory of the powered finger. The placement of the connections depended on the ratio of the maximum angles of the joints being coupled, which provided a circular locus of points around each joint. This allowed each IP joint in the powered finger to reach its maximum angle, assuming no mechanical interferences. The angle between the pin joint and the horizontal centerline of the accompanying phalanx is fixed to determine the relative angular positions and velocities of the phalanges during joint motion. The final placement of the linkages also depended on potential mechanical interferences with the remainder of the mechanism, which resulted in their curved shapes in Figure 4. Power transmission Each phalanx of the finger has a functional role within the power transmission. The proximal phalanx of the finger contains an 8 W Maxon EC10 Brushless DC motor. 30 Using a brushless motor requires more complex control electronics, but provides performance advantages when compared to coreless brushed DC motors commonly used in powered finger prostheses. 11,29 The output of the motor is directed toward the medial phalanx, which contains a six-stage, 340:1 custom gear transmission that outputs to the DIP. Rotation of the distal phalanx transfers rotational motion to the PIP and MCP joints through the 6-bar linkage mechanism. Some powered devices are able to use smaller gearheads or direct-drive actuation using a much stronger

Murali et al. 5 Figure 4. Rendering of the steel components of the powered finger with kinematic link bar system outlined. Dashed lines indicate that the bracket containing the links has been raised to show orientation. Bracket is grounded to proximal phalanx with two set screws at locations indicated by arrows. The hollowed plastic shells that enclose the entire finger mechanism are not shown for clarity. motor housed separate from the fingers, generally making it unsuitable for partial hand prostheses. An example of this is the Michelangelo hand, which uses a custom 45 mm brushless motor housed in the palm. 21 Due to the low continuous and stall torque ratings of the 8 10 mm diameter motors used in existing powered fingers, 11,21 a substantial gear reduction is necessary to obtain the desired fingertip forces. The device presented in Imbinto et al. 31 uses a five-stage planetary gearhead of 1024:1 reduction from Maxon motors, while the ilimb uses a five-stage transmission of 1600:1 reduction consisting of a 64:1 planetary gearhead, a bevel gear stage, and a worm gear stage. Commercially available gearboxes small enough to be housed within a finger phalange, such as those from Maxon or Faulhaber, generally require further gearing to reach the desired power specifications due to limitations in their intermittent torque ratings. 32,23 This additional gearing can also serve to reorient the rotation axis of the transmission output along an IP joint axis, generally at the MCP. As shown in Figure 5, the ProDigits use a custom 25:1 worm drive at the MCP, while the Vincent fingers use a bevel stage. 21 Both of these devices house the entire power transmission in the proximal phalanx, which limits their minimum lengths and the degree of anthropometry, despite the Vincent finger and ilimb Digits having reasonable overall lengths. 34,35 The transmission, summarized in Table 1, begins with a bevel stage adapted from Filatov et al. 20 at the PIP joint. The bevel stage reorients the rotation axes for the remainder of the transmission to be parallel to the IP joints. A spur gear printed directly onto the top face of the output of the bevel stage connects to the remainder of the transmission. Figure 6 shows the layout of the gear transmission, which consists of several planetary and spur gear stages housed in flat sections referred to as lamina. These sections stack together to form the overall transmission and medial phalanx. The output of the first spur gear stage connects to the sun gear of a planetary stage through a spline key. To obtain the maximum reduction from the planetary stages, the sun and planet gears were used as the respective input and output, while the annulus was grounded to the phalanx. The output of each planetary stage consists of a carrier piece, or carrier, visible in Figure 7. Each carrier serves as either a pinion gear for a spur gear stage or as a central shaft that connects two adjacent planetary stages. The carrier pieces also direct the output of each planetary stage toward the interior of the transmission, which allows for the containment of the spur stages within the central volume of the medial phalanx. The carrier for the final planetary stage serves as the output of the transmission and connects to the remainder of the distal phalanx. Figure 5. Comparison of the power transmissions of the finger prototype, Vincent fingers, and ilimb Digits, showing types of gears used and location of the transmission output. Adapted from Belter et al. 21

6 Advances in Mechanical Engineering Table 1. Breakdown of the gear transmission in the medial phalanx. Stage Module (mm/teeth) Face width (mm) Ratio Pressure angle ( ) Bevel 0.3 1 1.5:1 20 Spur 0.333 1 3:1 20 Planetary 0.375 2 4:1 35 Planetary 0.375 2 4:1 35 Spur 0.375 1 1.3 1.182:1 20 Planetary 0.375 2.9 4:1 35 Total reduction 340.363:1 Figure 6. Exploded view of medial phalanx gear transmission. Parts outlined in rectangles are the different lamina. Left and right inner laminae contain planetary stages and enclose spur/bevel gear stages housed in the central lamina. Outer laminae connect to proximal phalanx and enclose carrier pieces. Output of gear transmission connects to distal phalanx. Figure 7. Connections between adjacent spur and planetary stages. Parts outlined in rectangles form gear cages around planetary stages which improve axial alignment. Carrier pieces direct torque toward interior of transmission. Radial ball bearings of 1 mm inner diameter are placed on both sides of the bevel and idler spur gear stages. An EOSINT M270 DMLS printer capable of part accuracies up to 20 mm 36 was used to manufacture the transmission components out of a high-strength maraging steel alloy. Figure 8 highlights the achievable sizes and resolution of the printed gears. Using AM allows for gears with nonstandard pressure angles, modules as small as 0.25 mm/teeth, and face widths as small as 0.7 mm along with a herringbone-shaped profiles. All gears in the transmission had a pitch circle diameter under 10 mm in order to remain fully enclosed within the medial phalanx. We also have the ability to print preassembled planetary gear sets. Each planetary stage had a 4:1 reduction ratio, and a module of 0.375 mm/ teeth. The herringbone-shaped teeth shown in Figure 9 Figure 8. Functional custom gears manufactured using an increased the gear tooth strength 37 and allowed for the EOSINT M270 DMLS printer, next to a United States penny for planetary stages to be printed as fully assembled components. In order to avoid undercut tooth profiles, the comparison. pressure angle for each gear stage was determined using equation (1) modified from Norton 37 sin 2 u = 2 ð1þ N min

Murali et al. 7 and dimensional optimization in order to achieve the low friction of commercially available ball bearings. The transmission uses miniature radial ball bearings of 1 mm inner diameter from NSK Micro Precision (Tokyo, Japan) on the planetary and spur gear stages, arranged within the transmission according to Figure 7. The relatively low torques and corresponding thrust loads experienced in the bevel gear stage permitted the use of flanged radial ball bearings of 1 mm inner diameter. The outer diameter of each bearing is 3 mm. Figure 9. Rendering of section view of lamina containing an integrated planetary gear stage. Cross-section of herringboneshaped gears resembles an hourglass shape and enables planetary stages to be printed as fully assembled pieces. The minimum number of teeth N min corresponds to the number of teeth on the smallest gear in each stage. Applying equation (1) on each stage gave a required pressure angle of at least 30.0 for the planetary stages, 28.2 and 22.2 for the first and second spur gear stages, respectively, and 24.1 for the bevel stage. The planetary gears, as printed, had a 35 pressure angle, while the remainder of the gears in the transmission had 20 pressure angles. Each spur gear stage has one idler gear to avoid interferences between the neighboring stages. The maximum gear ratio for each spur stage depended on the sizes of the pinion and output gears that sufficiently avoided interferences between neighboring stages, resulting in the gear reductions in Table 1. A modified form of the Lewis equation given in Norton 37 provided approximate face widths for each gear F = 25:4N stm s b Yr ð2þ The minimum face width is dependent on determined material yield strength s b, defined as 1000 MPa, 36 the torque T at each stage, gear module m, and pitch radius r. The Lewis form factor (Y) is a function of tooth number and pressure angle. 37 The form factor for each gear assumed a 20 pressure angle. A factor of safety (N s ) of 1.2 was also used in determining face widths. For ease of assembly, the minimum face width used for each gear was 1 mm. While it is likely possible to use AM to print selfcontained roller bearings within the outer lamina, the components would require significant post-processing Finger assembly Gearing occurs within the two innermost laminae of the medial phalanx. The two outermost laminae enclose the carriers from Figure 7 and connect to the proximal phalanx at the PIP. The proximal phalanx consists of the motor housing and connects to the MCP and PIP, as well as to a bracket that serves as a pin joint for the distal link bar, as shown in Figure 4. The linkages responsible for PIP-DIP joint coupling connect the distal and proximal phalanges on both sides of the finger, while the linkages responsible for MCP-PIP joint coupling connect the medial phalanx and the MCP mount. Plastic shells adapted from a scanned hand model and printed using an Object 360 SLA printer provide cosmetic enclosures for each phalanx. The plastic shells for the proximal and medial phalanges are hollowed using the motion of the 6-bar linkage system in order to fully contain the finger phalanges and kinematic linkages without any mechanical interferences. For ease of assembly and minimal removal of support structure, the bottom surfaces of the steel components at the proximal and distal phalanges are flat. This is also true for the laminae and individual gears found in the medial phalanx. These surfaces were ground to tolerance using a set of hand files. Due to the rough surface finish of parts produced by DMLS, polishing is necessary to avoid considerable frictional losses within the transmission. To polish the miniature components without damaging features that are either inaccessible or contribute to efficiency, such as the herringbone-shaped planetary gears or the involute-shaped gear teeth, an 800-grit lapping compound was applied to the transmission while connected to a motor. Running the motor caused the lapping compound to polish the meshing surfaces of the gears. This lapping compound was then washed out. Projected finger performance The gear reductions from Table 1 provide an estimate of the expected force at the fingertip, before

8 Advances in Mechanical Engineering considering any possible torque multiplication from the finger mechanism itself. The torque from the gear transmission is given as T = T motor N Gear h Gear ð3þ From Table 1, N Gear = 340:36 and T motor = 6 mn m, approximately half of the motor stall torque from the datasheet. If a 10% efficiency loss is assumed for each stage (which is consistent with our experience for a good planetary gear set), the overall efficiency of the six-stage gearbox is then h Gear = 0:9 6. Using these values in equation (3) give a projected torque applied at the DIP of 1085.3 mn m. The torque at the MCP joint governs the amount of fingertip force produced, as it is grounded to a socket at the residual limb. The remainder of the finger can be treated as a rigid moment arm extending from the MCP. Assuming that the finger mechanism does not provide a mechanical advantage (i.e. T MCP = T DIP ), a conservative estimate of the fingertip force is given F = T r fingertip ð4þ If r fingertip 69 mm for a 50th percentile female-sized finger, 28 equation (4) predicts a projected fingertip force of 15.7 N. The approximate motor speed necessary to reach the desired flexion speed is given by v motor = N gear v output ð5þ Substituting the desired output flexion speed of 4 rad/s and the overall gear ratio into equation (5) gives the minimum motor no-load speed requirement of 1361 rad/s. Finger kinematics Joint motion at the MCP, PIP, and DIP is coupled by the link bar system in Figure 4. This makes it possible to apply an input torque to any joint and obtain motion about the MCP. Since the output of the gear transmission occurs at the DIP, the torque generated by the transmission is transferred to the MCP across the entire link bar system. Therefore, in order to justify the placement of the gear transmission output at the DIP, it necessary to consider the contributions of the link bars to the overall fingertip force. The kinematic model of the finger in Figure 10 shows that it is essentially a six-bar linkage with two ternary links CDO and CBE representing the proximal and medial phalanges, respectively, and one binary link EF at the distal phalanx. Two binary links AB and DF are responsible for underactuating the mechanism. Link AB connects to the fixed binary link OA and the Figure 10. Kinematic model of the finger. Proximal and medial phalanges are at links CDO and CBE. Distal phalanx is at link EF. Fixed link OA is at the base of the finger containing the MCP and beginning of proximal link bar AB. Distal link bar DF connects to proximal and distal phalanges. medial phalanx, while link EF connects to the proximal and distal phalanges. Position The angular positions of each joint can be determined by splitting the mechanism into two four-bar linkages OABC and CDFE and performing a loop closure equation (33) on each. For loop OABC r 1 e ju 1 + l 1 e ju 3 d 1 e ju 2 r 3 e ju 4 = 0 ð6þ Equation (6) provides a set of equations that can be used to solve for angles u 3 and u 4. u 4 is related to the PIP flexion angle and is determined using the following equation from Norton 37 p B 6 ffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi A u 4 = 2 arctan 2 + B 2 C 2 1, 2 ð7þ C A To solve for coefficients A, B, and C, equation (6) can be rearranged to express the link bar l 1 e ju 3 = d 1 e ju 2 + r 3 e ju 4 r 1 e ju 1 ð8þ Separating equation (8) into its real and imaginary components and following the procedure outlined in Stanisˇić 38 give the following expressions for coefficients A, B, and C A = 2d 1 r 3 cos u 2 2r 1 r 3 cos u 1 B = 2d 1 r 3 sin u 2 2r 1 r 3 sin u 1 ð9þ ð10þ C = d1 2 + r2 1 + r2 3 l2 1 2d 1r 1 ðcos u 1 cos u 2 +sinu 1 sin u 2 Þ ð11þ Substituting the value of u 4 determined by equation (7) gives an expression for u 3 u 3 = arctan d 1 sin u 2 + r 3 sin u 4 r 1 sin u 1 d 1 cos u 2 + r 3 cos u 4 r 1 cos u 1 ð12þ

Murali et al. 9 To solve for angles u 7 and u 8, the loop closure equation for loop CDFE is used v 4 = v 1r 1 sinðu 1 u 3 Þ+ v 2 d 1 sinðu 3 u 2 Þ r 3 sinðu 3 u 4 Þ ð19þ r 2 e ju 6 + l 2 e ju 7 d 2 e ju 5 r 4 e ju 8 = 0 ð13þ For loop CDFE Repeating the procedure to determine equations (9) (11) gives the coefficients A = 2d 2 r 4 cos u 5 2r 2 r 4 cos u 6 B = 2d 2 r 4 sin u 5 2r 2 r 4 sin u 6 ð14þ ð15þ C=d2 2 +r2 2 +r2 4 l2 2 2d 2r 2 ðcos u 5 cos u 6 + sin u 5 sin u 6 Þ ð16þ Equation (7) can be reused to solve for u 8 using the coefficients given by equations (14) (16). Solving for u 7 will provide the angular position of the entire mechanism v 6 r 2 e ju 6 + v 7 l 2 e ju 7 v 5 d 2 e ju 5 v 8 r 4 e ju 8 ð20þ Repeating the process used to determine equation (19) gives the angular velocity of the DIP (v 8 ) in terms of PIP joint velocity (v 5 ). Additionally, v 5 = v 4 and v 6 = v 2, as they are both defined at the PIP. Using the above relations when simultaneously solving the component equations from equation (20) gives v 8 = v 2r 2 sinðu 7 u 6 Þ v 4 d 2 sin (u 7 u 5 ) ð21þ r 4 sinðu 7 u 8 Þ Substituting equation (19) for v 4 gives the angular velocity of the DIP (v 8 ) in terms of that of the MCP (v 2 ) v 8 = v 2r 2 r 3 sin (u 3 u 4 ) sinðu 7 u 6 Þ+ v 2 d 1 d 2 sinðu 3 u 2 Þsin (u 7 u 5 ) r 3 r 4 sinðu 3 u 4 Þsinðu 7 u 8 Þ ð22þ u 7 = arctan d 2 sin u 5 + r 4 sin u 8 r 2 sin u 6 ð17þ d 2 cos u 5 + r 4 cos u 8 r 2 cos u 6 The joint angles for the MCP, PIP, and DIP as measured from the horizontal axis are given by u 2, u 5, and u 8, respectively. The angles were plotted as a function of MCP flexion angle u 2 in Figure 11(a) and were verified by measuring the joint angles given by the CAD model of the powered finger. Velocity The angular velocity of loops OABC and CDFE can be found using the time derivative of equations (6) and (13). For loop OABC v 1 r 1 e ju 1 + v 3 l 1 e ju 3 v 2 d 1 e ju 2 v 3 r 3 e ju 4 = 0 ð18þ Mechanical advantage The mechanical advantage of the finger mechanism can be defined using the angular positions and velocities determined above. Assuming the mechanism has negligible frictional losses P out = P in ð23þ If the input torque is applied to the MCP joint, again assuming negligible frictional losses, equation (23) becomes T 8 v 8 = T 2 v 2 ð24þ where T 8 and v 8 are the respective torque and angular velocity of the DIP, respectively, and T 2 is the torque at the MCP. The MCP flexion angle is defined as v 2,as measured from the horizontal axis in Figure 10. Solving for the mechanical advantage gives T 8 T 2 = v 2 v 8 = r 3 r 4 sinðu 3 u 4 Þsinðu 7 u 8 Þ ð Þsin (u 7 u 5 ) r 2 r 3 sin (u 3 u 4 ) sinðu 7 u 6 Þ+ d 1 d 2 sin u 3 u 2 ð25þ Separating the real and imaginary components of equation (18) and solving simultaneously give the angular velocity of the PIP (v 4 ) in terms of that of the MCP (v 2 ) The inverse of equation (25) gives the mechanical advantage of the finger across its MCP flexion range. Figure 11(b) gives the mechanical advantages for the 4- bar linkage CDFE and for the entire mechanism, both as a function of MCP flexion angle. The mechanical advantages predicted analytically by equations (19) and (25) are verified by numerically differentiating the

10 Advances in Mechanical Engineering (a) (b) Figure 11. (a) Left: MCP, PIP, and DIP joint angles as a function of MCP flexion angle. (b) Right: plot of mechanical advantages versus MCP flexion angle, as predicted by equations (19) and (25). Actuating the finger from the DIP amplifies torque at the MCP throughout flexion range. angular positions given in Figure 11(a) and applying equation (24). This indicates that actuating the finger mechanism from either of its distal joints likely results in an increase of torque at the MCP. Testing The testing setup in Figure 12 was built to measure fingertip force and flexion speed. An Escon 24/2 controller from Maxon Motors powered at 12 V was configured as an open-loop speed controller to apply a voltage to the motor proportional to its maximum nominal speed. The controller also provided motor current draw and voltage readings. A Futek LSB200 load cell powered at 24 V was positioned on an acrylic base to contact the fingertip at different PIP joint flexion angles, while a Quanser Q8-USB data acquisition board using MATLAB/Simulink simultaneously collected load cell force, motor current draw, and voltage. Flexion speed and fingertip force trials had the MCP and proximal phalanx of the finger grounded to the acrylic base while the motor actuated the PIP and DIP joints. To measure fingertip force, the load cell was positioned to contact the fingertip at a 0 PIP flexion angle. The controller provided full power to the motor and the finger was driven into the load cell. The motor was powered for 0.5 seconds after the detection of the impulse load from contacting the load cell and the holding force was recorded. To measure flexion speed, the load cell was moved to contact the fingertip at an 85 PIP joint flexion angle. The flexion speed was then determined by dividing the time the finger took to contact the load cell from its fully extended position by the angular displacement of the finger. The force and speed Figure 12. Testing setup used configured for flexion speed trials. Maxon Escon 24/2 motor controller collected motor voltage and current draw. Futek LSB200 Load Cell collected forces. MATLAB/Simulink and Quanser Q8-USB used for data acquisition. trials were repeated 15 times in order to verify repeatable behavior of the transmission, as in Imbinto et al. 31 Results and discussion Finger Performance The average flexion speed at the PIP joint was determined to be 10.37 6 0.021 rad/s and the fingertip force was 6.05 6 0.396 N. The consistency of the force trials is evident in Figure 13(a), which shows the fingertip force averaged across all trials. In order to accurately

Murali et al. 11 (a) (b) Figure 13. (a) Left: Plot of fingertip force time profile averaged across all force trials. (b) Right: Plot of load cell force time profile for a single flexion speed trial. The x immediately after the spike in force denotes the time of contact between the fingertip and load cell, determined by detecting the time at which the motor current began to increase and the motor speed began to decrease. Table 2. Summary of the maximum, minimum, and average fingertip force and flexion speed recorded. Test Max Min Average Force (N) 6.63 5.47 6.05 6 0.396 Speed (rad/s) 10.75 9.89 10.37 6 0.021 determine flexion speed, the time of contact between the fingertip and load cell was determined by detecting the time at which the motor began to experience a concurrent increase in current draw and decrease in motor speed. This provided the load cell contact times used to calculate flexion speed, similar to the one indicated in Figure 13(b). The flexion speed values were also averaged across all trials to obtain the values given in Table 2. Although the fingertip force reached approximately one-third of the force target, it was able to produce a force comparable to that of the existing devices in Table 3. Due to an intermittent current limit of 6 A on the motor controller, the motor was unable to reach its full stall torque of 12 mn m. 30 It should be noted a prosthesis generally requires intermittent force generation, which makes it acceptable for the motors to operate shortly outside their continuous power rating to provide additional torque. 29 In addition, due to the high no-load speed of the motor and the relatively low reduction ratio used by the transmission, the maximum flexion speed and the approximate mechanical power were considerably higher than that of both the existing Table 3. Comparison of performance and physical characteristics for several commercial powered fingers from Belter et al. 21 and the prototype tested in Section IV. Finger Force (N) Average speed (rad/s) Power (W) Weight (g) Vincent Large (index, middle, ring) 4.82 1.80 0.7201 35 37 ilimb Med (index/ring) 5.39 1.66 0.6745 52 Bebionic (index) 12.47 0.80 0.7183 a Bebionic v2 Large (index, middle, ring) 14.5 1.68 1.7539 a S-Finger from Imbinto et al. 31 4.3 1.57 0.5401 70 Powered finger prototype 6.05 10.37 2.4468 43.5 PIP: proximal interphalangeal; MCP: metacarpophalangeal. Note that the flexion speed of the powered finger prototype was recorded at the PIP joint, rather than the MCP. Mechanical power was determined by estimating the moment arm of the devices from images, converting the force columns into torque, and finding the product of torque and angular speed. a Measured using data from Bebionic Information for Technicians. 39

12 Advances in Mechanical Engineering Figure 14. Speed torque curve for motor input (left) and transmission output (right). devices from Belter et al. 21 and recommendations from Weir and Sensinger. 29 Comparing the speed-torque curve of the motor, estimated using its current draw and no load speed, with that of the motor and the gear transmission, estimated using the average finger flexion speed and torque produced at the PIP, provided an approximate measure of efficiency. Comparing the power generated by the two curves from Figure 14 provides an approximate efficiency of 8.5% for the gear transmission and distal linkage system combined. The standalone efficiency of the transmission would be slightly higher at approximately 9.4% 10.6%, assuming a conservative linkage efficiency of 80% 90% based on the surface finish of the mating components. This is a clear indicator that improvements in gear surface finish and alignment are necessary in future iterations. Transmission improvements The layered structure and layout of the gear transmission facilitated the alignment of the individual components, as each piece essentially stacked onto the subsequent ones. The accuracy of the DMLS printer also allowed for the printing of alignment pins directly onto certain pieces of the transmission, although misalignments that likely reduced the efficiency of the transmission were present due to hole tolerances. In a more recent iteration of the powered finger, we have found that a tolerance of 0.15 mm is ideal for components used for alignment. Axial and radial misalignments within the planetary gears from relaxed tolerances are another likely source of efficiency loss. Tighter tolerances that ensure that the planetary gears move after support structure removal with minimal axial and radial deviation should be addressed moving forward. The bevel gears were shown to be especially sensitive to misalignments, likely because of their low modules and the presence of thrust loads that moved the gears away from their nominal pitch circles during operation. The gears also experienced misalignments from loose tolerances between their bearings and their housings in the respective lamina. Several of the disadvantages noticed with bevel gears can likely be avoided using a face gear pair similar to in Imbinto et al. 31 Face gears are less sensitive to misalignments than bevel gears and are capable of efficiencies up to 96%. 31 They can allow for a higher gear reduction in a smaller profile than a bevel gear pair of equivalent size, which is highly desirable since the overall width of the power transmission is dependent on the width of the bevel gear stage in order to maintain symmetry. A face gear pair also uses a standard spur gear as the pinion, which would eliminate any thrust loads on the motor. The design flexibility provided using DMLS allowed for nonstandard pressure angles on the planetary gears. While this prevents undercutting and improves tooth strength, it also results in an increased bearing load and a diminished bearing service life. Alternative gearings that do not use involute gears can help mitigate this and one of particular interest is a cycloidal transmission. The integration of a cycloidal gear stage would likely require additional assembly, in contrast to the direct printing of fully functional planetary gears, but would enable for a dramatic increase in gear reduction and efficiency, along with a decrease in backlash and overall transmission size. Given its tradeoffs, the advantages and disadvantages of using alternative gearings should be evaluated further. Comparison with existing devices The power transmissions of existing powered fingers feature a rigid coupling between motor and gearbox, which connects to an additional bevel or worm gear

Murali et al. 13 Table 4. Comparison of the torque density of commercial gearheads from the transmission of the powered finger prototype in the medial phalanx. 32,33 Gearbox Intermittent torque (Nm) Volume (mm 3 ) Torque density (Nm/m 3 ) Maxon 10 mm 0.20 1845.69 108,360 Faulhaber 10 mm 0.2 1735.72 115,225 Maxon 12 mm 0.3 2646.48 113,360 Faulhaber 12 mm 0.45 2228.02 201,970 Powered finger prototype 0.361 2086.16 173,050 stage that aligns the axis of the transmission output with that of the MCP. This places restrictions on not only anthropometry and minimum finger lengths, but also on force capability. The single-tooth contact between the bevel gears used by the Vincent fingers handle the entire transmission load, while the worm gears used by the ilimb can handle higher torques at the expense of efficiency. The novel coupling of the motor and gear transmission using a bevel gear at the PIP not only allows for torque transmission across a moving joint but also reorients the output axis at the low-torque region of the transmission. The planetary gears at output are able to handle higher loads, as the output torques are distributed among the planet gears. As predicted by Figure 11(b), applying the output torque from the gear transmission to either of the distal joints amplifies the MCP joint torque throughout its range of motion. It is possible that this also contributed to the sizable amount of force produced by the finger despite the efficiency of the gear transmission, although the exact amount is yet to be determined. To our knowledge, there are no other powered finger prostheses that place their transmission output at the DIP, nor are there any devices that use a power transmission developed almost entirely by AM processes. The degree of miniaturization of the gear transmission can be described using its torque density. Torque density is defined as the ratio of the maximum intermittent torque capacity of the transmission and its volume. The values given in Table 4 are determined by the mathematically defined intermittent torque of the gear transmission and the volume of the CAD model and may vary upon physical use of the transmission. The densities of the commercial gearheads of equivalent size are determined from their datasheet values. 32,33 The intermittent torque of the gear transmission is limited by the load rating of the bearing connected to the idler gear of the second spur gear stage. Despite this, the expected torque density of the gear transmission used in the powered finger is higher than or comparable to those of commercially available planetary gearheads of similar volume. Further miniaturization of the Figure 15. Powered finger compared to (a) 50th percentile male index finger and (b) standard idigits finger. Approximate joint axes marked by dashed red line. transmission and higher strength can increase the torque density of the transmission. The weight of the finger as shown in Figure 15 (excluding the base attachment at the MCP) and the motor was 43.5 g, well below the weight of 48 g of the small ilimb finger model. 21 Further reductions in weight are necessary to match that of the Vincent fingers at 29 37 g. 21 The overall length, as defined in Tilley et al., 28 was approximately 71 mm. Minor modifications to the plastic shell of the distal phalanx would allow for a length analogous to a 50th female index finger. It is possible to reach anthropometry in the 25th percentile with further dimensional refinement of the gear transmission, namely the removal of the idler gears within the spur gear stages, and changes to the distal phalanx. This level of anthropomorphism currently applies to powered fingers that contain a hinge joint at the MCP, which would be useful for transmetacarpal amputations (i.e. partial hand amputations proximal to the MCP). Recent work on the powered finger includes a sliding mechanism at the knuckle that can accommodate amputees with an intact MCP.

14 Advances in Mechanical Engineering refinement in order to provide a more anatomical finger flexion trajectory. It is also necessary to consider performance characteristics other than active force generation, such as resistance to unexpected impulse loads or static external loads. Fatigue testing is also necessary to determine the service life of the gear transmission. Imbinto et al. 31 state that the ability for force opposition is an important aspect in the design of a finger prosthesis and utilized a clutch in order to protect the gear transmission from sudden external loads. Future work will involve the design of compliant elements into the finger mechanism, similar to the elements in the Vincent fingers, and a closer evaluation of other methods of protecting the powered finger from extreme or unexpected loads. Figure 16. Recent prototype of powered finger with 1197:1 gear transmission and MCP mounting for more distal amputations. Future directions The design of the powered finger informed the recent development of iteration with a higher transmission reduction and a replacement of components that likely contributed to efficiency losses. The prototype in Figure 16 replaces the bevel gears with a 5:1 face gear stage at the PIP and updates the planetary gears with thinner, higher reduction stages to achieve a reduction ratio of 1197:1. The updated transmission does not use any idler gears, which allow for higher efficiencies and length reductions that were leveraged to include a mount for individuals with a residual MCP. The length of the powered finger is equivalent to 50th percentile female anthropometry, as before. Steel pieces on both sides of the medial and distal phalanges replace the fully plastic cosmetic shells previously used. These pieces contain shafts that connect to the rest of the phalanges and provide a double-shear connection for the kinematic linkages. The plastic shell for the proximal phalanx press fits onto the steel motor housing. A closer evaluation of the efficiency of each individual gear stage is necessary to determine the specific contributions of the face gear pair to the overall transmission efficiency. The higher reduction planetary gear stages are not fully enclosed by the gear cage structure in Figure 7 and require further evaluation for justification. The mechanical advantage of the finger predicted by Figure 11(b) requires experimental validation and the dimensioning of the linkage system requires further Conclusion The proof-of-concept successfully validates the design of externally powered finger prosthesis capable of producing forces and flexion speeds equivalent to existing devices yet in a size and weight below current devices. By distributing the power transmission across each phalanx and employing DMLS to manufacture components from a high-strength maraging steel alloy, it is possible to obtain a highly customizable and durable powered finger capable of accommodating a wide range of sizes. The simplest and most anthropomorphic configuration for the powered finger was to house the motor in the proximal phalanx and gear transmission in the medial phalanx. It is also predicted that actuating the finger from one of the distal joints amplifies the torque produced at the MCP due to the kinematic linkage mechanism that underactuates the finger. To fully realize and quantify the benefits in force production from distally actuating the finger, improvements in gear transmission and linkage efficiencies are necessary. Ongoing work on the powered finger has resulted in a more compact and higher reduction power transmission and future work will include a closer evaluation of the transmission efficiencies to determine the benefit of using face gears and the changes made to the structure of planetary gear stages. Alternative gearings that increase the overall reduction of the transmission while decreasing the number of gear stages necessary is of interest, in addition to a more thorough examination of the gear polishing process. Work will also include refinements to the residual limb attachment that better accommodates individuals with amputations distal to the MCP, as well as improvements to the robustness and anatomical motion of the kinematic link bar system. Upcoming iterations of the finger will also include improvements