Glass, Welcome to tech stuff. I'm care Price. Yes it's Friday, but instead of the Week in Tech, we wanted to share a conversation I had with Jim Ashworth Beaumont some years ago. Jim was clipped by a truck when biking and sustained a traumatic injury.
I was sitting at traffic lights and Lorry basically turned as it was leaving the traffic lights, and they caught me on the side of the vehicle and dragged me underneath. So I was essentially going to get crushed by the bat wheels, and I reflexively reached up to the bottom of the Lorry and grabbed hold of the underneath of it. So I got dragged up the road undre meters and my arm got caught under the bat wheels and taken off.
On top of losing his arm, Jim's lungs were punctured and his liver was split in two. He told me that the next six weeks were a blur an coma, but also in a conscious state.
I assume that I died and I was I was sort of going through between dimensions of experiencing various lives, and although in six weeks it seemed like a lot longer to me. I was experiencing things physically, by which I mean the doctors trying to save my life. I was basically having heart attacks like two three times a day, so they're kind of jumpstarted me, like continually.
Amazingly, Jim was able to pull through, and soon he was troubleshooting how to live a one armed life. For most people, living with a prosthetic or even thinking about prosthetics would require a huge mindset shift, But this wasn't Jim's first encounter with these devices. After leaving the Royal Marines, Jim got a degree in prosthetics and orthotics and has worked in a clinical capacity helping patients through pain, function
and mobility issues for decades. So when Jim needed a prosthetic arm of his own, his peers made him their guinea pig of sorts for the bionic future of prosthetic First, he was fitted with a titanium implant that was surgically
inserted into the surviving bone of his arm. This is called ossio integration, and Jim's prosthetics can now attached to this socket instead of molding over a residual limb or stump on top of Ossio integration, Jim is living with a high tech electronic arm that looks like it's straight out of a Sci Fi props department. The Black Mental Arm costs upwards of one hundred thousand dollars, is controlled via Bluetooth app and provides increased mobility, grip and control.
And in the interview you'll hear what it sounds like. Jim is truly inspiring and the future of prosthetics is extremely exciting to witness. So let's dive into my conversation with Jim Ashworth Beaumont. How would you say that your technical knowledge and experience helped you in your rehabilitation.
Well, it's not straightforward to me because my history is quite varied. Into the armed forces as a professional athlete for a few years, I completed a PhD in human rehabilitation and the master's in rehabilitation. I qualified as a personal trainer, and I'm also a running coach as well, so all those different kind of aspects of my knowledge sort of focused on myself. I was kind of my own perfect subject, I suppose guinea pig, if that's the
right phrase. So fortunately for me, it just turns out all the interests I've had, or the majority of them, have actually been related to getting somebody through an injury, optimizing their performance, getting them as good as they can
be for sport. But those principles apply equally to patients, and I applied that to myself very quickly and very naturally, And I would say that gave me a massive advantage not only in addressing my own problem directly, but also communicating with other health cares and giving them a strategy to solved my problem. So it's extremely lucky in that respect.
Yeah, can you talk about what limitation traditional prosthetics have, So.
I saw a break prostheses down into three main categories. So is the let's say, very specific or task dependent device. So that might be something that's designed for a particular purpose, like, for example, I'm quite a keen runner, and what you need for good balance running is two arms as well as two legs. And once I've lost the arm, I spent four years running in a very weird way and
getting lots of sort of injuries as a result. So this very simple kilogram and a half of steel attached to my body very very securely enables me to run and exercise very efficiently. So the next sort of category would be a body powered device. So the technology is probably about one hundred and fifty years old, and early examples are seen in the Civil War kind of American Civil War type of thing. When you have a war,
innovation happens in prosthetics. So in like eighteen fifty odd when the American Civil War happened, people spend a lot of time thinking about, oh, how do we make a functioning device that people can actually pick things up or do a job once they get out of the services.
So body powered devices they have. I usually have a hand and an elbow if we're talking about somebody's lost an arm above the elbow like I have, and then you can use cables which you're attached to other parts of the body and use accessory movements like shrugging the shoulders or stretching the chest out in order to power those components. I have a body powered arm that I use at work. And the advantage of those devices is they're very simple. You know exactly what they're going to do.
The power comes from you're an input, not from a battery. And also they're very durable, so you can drop it in a bucket of water or we're using a dusty environment, it's still going to work. And then we come onto these powered devices like I'm wearing at the moment. So at the moment, I'm wearing a a prothesis with a powered elbow and I've got power grist, so it has an internal battery which you can take out in charge
every day. These lithium iron botteries are quite heavy, but they do store a massive amount of charge and that battery will last me two days and allow me to power the hand and the wrist and the elbow of
this arm. So it is a fully functioning arm. And the only thing that's missing is the level of control that I have with it, and that's something that is quite important and prosthetics, and that's where the latest research is going right now, is figuring out how to give people that the number of channels of the richness of information to control a synthetic arm, which, on the face of it, given the mechanical technology that's available now, in principle,
you can control the hand individual fung pingu wise, but there are so many degrees of movement involved in that that you need the in some way to reinstatement and That's the way the challenge lies for me because leasing the arm at the level I have, I've got two channels of information. I've got biceps and triceps and that's it.
So you're trying to solve for more control essentially.
Yeah, so there's a number of variables you're juggling. Is the simple ability of the arm to move throughout all its degrees of freedom, and then there's the practicality, is the safety, the durability. So these are all qualities of a natural arm that you don't even think about. But once these problems start arising, and then you have to think of ways either to solve them all at once or prioritize particular properties to suit the environment, to suit
the task. And that's where the skill of my job lies actually, is really talking with patients to figure out what the lives are like, what their priorities, and how to solve them.
How would you describe O CEO integration to someone who knows nothing about prosthetics? I e.
Me, Most of us or many of us will know about prosthetic teeth. You know where they're implanted into your skull, your jaw. Many of us will know people who were pre profoundly deaf and have a cochlear implant, so that's something that's implanted into the skull. And very many of us know about hip and knee replacements and things like that. So for the last thirty years we've had Ossi integration, where you have this bit of titanium that sticks into
the bone. But if you have regard to the potential for infection, which you're going to get if something sticken out for your skin, as long as you take care of that, you've basically got something which is anchored directs your skeleton.
And that was what the situation you were in.
Yeah you got it. Yeah, absolutely. So the issue with me as a prostatic patient is that my residual limb, my stump is which very very short, and so that limits the amount of force you can apply to a prosthetic device and also the amount of pressure on your body that results from you try to put pressure through it. So you've got this tissue viability issues. Not all of us knowbmd's lost an arm or a leg, but wear a badly fitting pair of shoes for any time I'd
have to walk for a long distance. You know about it pretty soon, right, And if that's your only pair of shoes. If that's all you got. What that does it limits your ability to use the device or it certainly puts you off. So what you have in upper and Prospects is a situation where many people need limbs in places like Gaza and all that. So many people have lost limbs, and even if you can provide somebody with the limb, the comfort factor and the tissue viability
factor really limit the use. In Europe, we've got the situation in Ukraine and actually that is an experimental hotbed for ussy integration right now.
To your point, war zones unfortunately become a breeding ground for innovation, you got it.
Yeah, absolutely, So those specialists in OSCI integration are spending a lot of time in Ukraine and it is pushing forward the field most definitely.
What are some of the things that they're experimenting with.
Well, if I can talk about the effect of an explosion or a high velocity bullet, if you catch you around in your upper arm, it's going to take your entire arm off. If you catch your through your forum, it's going to take your arm up below the elbow or potentially above it. And having an elbow having a joint is great under voluntary control, and having all those muscles and nerves undervolved controls great because then you can
use them to directly drive a prosthesis. If you lose the entire arm, of the majority of arm, then you know get limited kind of options. So that's where OSI integration comes in as a way to securely anchor a prosthesis, and that enables you to push so much more load through your body. Before I got milesome integration, I could just about take loads through the end of it without a prosthesis on. But now I can support my entire body weight through my stump.
Really yeah.
I can do press ups, I can do pull ups. And when I'm a work as well as working with patients, I'm in the workshop building things as well, and I can apply a huge amount of force through the prosthesis and it's absolutely fantastic.
That's incredible, And that's because of OCO integration absolutely yeah.
Yeah. The other side of it is because the prosthesis so securely fixed to my body, it makes it so much easier to control because although I'm still using the electrical signals from my stump to control a prosthesis in quite a limited way. The fact that the electrodes stay in the same place all the time means that my control is so much better.
Can you talk a little bit about the procedure and the risks of the procedure and what made you decide to try it?
Well, there was the practical side of things that I've discussed. I wouldn't say it necessarily limited me at work, but I was. My use of a prosthesis was very limited to work through necessity, and then when I was outside work, I wouldn't wear anything. When you're wearing a prosthesis, you kind of have to think about what your priorities are.
I weighed up the benefit of using a prosthesis against the comfort side of things and decided, well, it's not worth me wearing a prosthesis for most of the time, right, So, knowing about the science already, I didn't need to be convinced that having the surgery to implant the titanium implant into my stuff was a good idea. It was more
the emotional side of it. You know, it continues actually to play on the back of your mind and you're always thinking, I've got this artificial things sticking out through my body, This is kind of weird, being right, I would imagine, Yeah, but when as soon as I put an arm on, that problem solves because I'm getting the benefit.
So what I tend to do now is as soon as getting out of bed in the morning, I'll put a prosthetic arm on, and then I feel complete and all those concerns about having that bit of mel sticking out through my body go away. Don't even think about it.
So it's really when it's not there.
Yeah. Now, But before the US integration, wearing an arm we felt foreign and weird because it wouldn't do etaally what I wanted to do. It to do it moved relative to my body. So because you've got the bone in my arm, then you've got the soft tissue, and then you've got the prosthesis on the outside of that, all these things move relative to each other, and so it never does exactly what we wanted it to do, whereas now I'm in control of it again.
After the break, how Jim's one hundred thousand dollars arm works with him stay with us. How did you end up with the high tech prosthetic that you have now? Like, what was the process of developing it? After your accident.
So essentially that was the based on our relationship that I've so reinforced in my time in ospital. So I spent four months in a critical care unit, so very limited in terms of my mobility, and so I got busy kind of exploring all sorts of avenues either using the cod bless the Internet, but also linking up with
my kind of connections within the industry. So one of the guys that I spoke to was Alantdougal at Proactive Prosthetics, which is a private company based out into the west of London, and I basically got chatted to him and started talking about what as possible. This fantastic arm that I have, which is worth an excess of one hundred thousand pounds, is a nice stuff black and in myoelectrics, which is the field of externally powered prosthetic devices, most
of these aren't covered for waterproof or dusty environments. So what I tend to do is revert to using a body powered prosthesis for things that require that sort of level of durability. Now, in terms of the arm itself, I've got two channels of information available. I've got the biceps and the triceps which are the two surviving muscles that I have in my arm. So if I was using a traditional powered prosthesis, I would be able to
open and close one component and that's it. So what we're then doing is you were using software in order to improve the flexibility of my use of the device. Right, So I've got an elbow which has got two degrees of freedom flex and extent. I've got a wrist which is wroteation only, so that's another two degrees of freedom, and then I've got the hand itself. And here what I'm doing is I'm using mechatronic algorithms in order to
change the grip of the hand. So once again we have the old traditional hands which just have one grip pattern which is like a pinch grip, and then we have these multi grip hands which are oution about now. This particular hand I'm using, which is an elimb made by a company called Dosser. By the way, this has up to thirty two different grip patterns and they're programmable.
So I've programmed this with the grip patterns I need, and when I want to switch it, I essentially use a pattern of muscle twitches in order to change the grass pattern. So all those degrees of movement in their hand, which I think the number about twenty seven and all, I've actually devolved to a mechanical algorithm, but it's under my control. You can give the patient like a smartphone with the software for the hand, so to a limited extent, they can actually program their.
Hand themselves, and that hopening currently.
Yeah, yeah, absolutely, This hands been around about fifteen years, I think, so that technology is there, and me, being a qualified procethestist, I've also got the software for the wrist and the elbow, which has given me complete cote blanche to program the arm, which the average patient doesn't have at the moment. But suffice to say, prostetists spend an awful lot of time trying to get it right.
That's incredible.
The next stage in this is software which will essentially configure itself when you put the arm.
On on the basis of your muscles.
Well, there's a software package called coapt and that is a pattern recognition software. So instead of just having electrodes on specific muscle groups within your remaining part of your arm, you have a sleeve which you roll onto the arm and that picks up patterns of activation rather than individual signals, and then you assign each pattern of activation to a particular action. So it means that the patient doesn't actually
have to train to use the device. The device trains itself to work with the patient, which is pretty awesome. That's incredible, and that's machine learning. It's not quite AI. AI is a different thing entirely, but it is using machine learning to get the device to work with the patient.
And can you just elaborate on that a little bit for a lay person.
Sure. So what you do is you start saying to the patient, okay, i'll put this device on you. Now if you think about closing your hand, and then you show them on the screen hand closing, and then what they'll do is just imagine the hand closing and using their nerves that they had, and then using the patterns of electrical signal that you pick up off the surfaces of the skin, you basically generate a pattern of activation which you can then assign to the hand closing.
So it's code. What you're doing.
Essentially allowing the machine to code that signal and match it to an output. So it means that the machine and the individual can learn together, which is pretty.
So essentially like the software update is coming from the person.
Yeah, yeah, definitely, that's it. Wow, you're uploading that information every time you put on It's incredible. That's pretty well.
Has it changed the way that you work with patients.
I don't think it's changing the way I deal with patients. It's definitely changed the way they see me. I was always very kind of go focused and interested in educating patients and giving them their heads up on what the light the outcome would be of their kind of treatment. And there's that kind of paradigm gap between a clinician and the patient where I'm thinking one thing and they're thinking,
what the hell do they know? Because they are all fit, healthy and stuff, and they've got a point and I suppose. And then when they see me with artificial limb because of where the armor work, I just walk into the waiting room and greet the patient and say hi, I'm Jim, and they'll look at my arm straight off the bat.
Then I can see the wheels turning. We're over the huddle already because they can see I've been through something and I've got some sort of insight into what it takes to come back from an injury or a pathology of some sort. So that's huge. Actually, it really is.
What is the biggest change in your daily life since you got an ascio integrated prosthesis.
I would say the level of confidence I've got in just living life and feeling on a par with other people. The way I approach my life. I don't regard as myself as disabled, let's put that way. And that's not because I refute the word. It's just that I'm enable in so many parts of my life that actually the
stuff I can't do is kind of infintestimally small. But since the also integration, because I can wear an arm all the time and operate and in a lot of things exceed what other people do with sport and things like that, I just feel like a different person, but somebody that's equal to other people.
You talk about how ZEO integration is something that you get through private insurance and fund it yourself. I know it's very important to you probably to have these things more widely available. What is that going to take.
I think it's evidence, that's what it's going to take. So if you imagine that I'm one of maybe ten or fifteen people in the UK, that have had oscient integration in the last ten years, right, it is quite hard to develop that kind of evidence. Now there are some recipients of OSC integration in the UK that have received it on the National Health Service their lower limb
and their ex servicemen. But as the cost comes down, as we produce more evidence to show that it's not a technology that's going to cause harm through infection for example, because that's one of the only real downsides with oscient integration, apart from the bone fracturing or whatever, and make it more economical for people to get that technology, the better and more people will get it, and as at some point we'll reach the point where our authorities allow people
to get more of it. Now America is slightly different how so well because insurance kind of driven economy, right, so if you have the money, you can have the technology.
Right.
You can in the UK as well, but it's much more explicit in the US.
I guess what does the future of this technology look like? As someone who's on the front lines of it, both personally and professionally.
Well, the also integration technology moves alongside other technologies as well, So I talked about the anchoring of the prothesis to the body, which is really important and that's how I've benefited. There are also other techniques which can try and compensate for the lack of information that is transmitted from the
individual through to the prosthesis. At the end of the day, we're talking about translating thought into action, but there are so many steps along the way there, and one of the big ones is actually transmitting those impulses from the surviving nerves through to the prosthesis and then to the actual components, and then delivering back sensory information back to the person, which is where I control loopsclosed and you actually get effective control.
Right, What do you think that the next evolution will be, Like, what is what comes after zo integration?
Well, I think what we see more of in rehabilitation is probably exoskeletons.
I've spent time with someone with a pair of exo legs, all right, Okay, yeah, it's pretty incredible to see.
Yeah, So there's been quite a lot of interest in the delivery of exoskeletons to reinstate walking function and it's quite so of illustrative that you can put a pair of exoskeleton legs on an individual and then what do you do with it? Because you can press the button to get the anista straight in and the hips straight in to get the present standing and then move them in a straight line, and then what's the next step.
So every time an individual moves through the environment, and this is the issue is prosthetics as well, is that you come hard up against the practical challenges of using devices that really aren't under very higher levels of control.
Is there technology that you wish was available for amputees right now that is not that in your wildest dreams you wish existed.
So one of the things I would like to try next, which is already out there, is targeted muscle reinnovation. So that's where you take that nerve that you've got still in there but it's been obviously cut by the accident, and then plug that into a little bit of muscle, and then that little bit of muscle will give you a signal when the nerve contracts, when the nerve is stimulated right by your brain effectively. So that's a really
neat way of giving information back to the prosthesis. So it's a really great way of reinstating movement that doesn't give you the full control loop, because you still need to sense what's going on in the limb end. And one thing with prosthetics is that lack of sensory information that you've got in a natural limb and it's not in the prosthesis. So that's it. Yet their innovation that's coming on Actually you can literally wire yourself into a prosthesis now.
So Jim, what are some of the things that have to happen in order for this tech to become more widely available.
So at the moment, an awful lot of the development they're academic efforts, but they're going to feed down to the commercial side of things, which is really down to the relationships between research groups and working surgeons. You know, these are clinical teams as well working very closely together, and those groups based around the world are working together
to take the technology forward very quickly. So if we're talking about providing maximum benefit to the maximum amount of people, it's really about making the procedures as commercially viable as possible. I suppose. Unfortunately you talk about hugely complex engineering and
surgical challenges. It takes money to do that, to develop that, So I see my role now as actually trying to bridge the gap between the commercial side of things, insurance based medicine and NHS based kind of high value, low cost care.
Well, thank you so much, Jim for taking all this time to talk very personally and scientifically about what you've been working on and what your experience has been.
I really appreciate it.
Good problem.
That's it for this week for Tech Stuff. I'm Kara Price. My co host is oz Vaalashan. This episode was produced by Eliza Dennis and Tyler Hill. It was executive produced by me oz Vaalashan, Julian Nutter and Kate Osborne forro Kaleidoscope, and Katrina Norvall for iHeart Podcasts. Jack Insley mixed this episode and Kyle Murdoch wrote our theme song. Please rate, review and reach out to us at tech Stuff podcast at gmail dot com. We want to hear from you.