So he’s helping them create the coolest prosthetics we’ve ever seen.
When Carlos Arturo Torres set out to create his award-winning IKO Creative Prosthetic System, his main objective was to design prosthetics that would “let kids be kids.” But as he set out to create the system, he discovered, and has since helped bring awareness to, the deficiencies in pediatric prosthetics.
“One thing I found is that there are basically no prosthetics for kids,” the Colombian industrial designer said in a phone interview from his current office in Chicago, Illinois, where he is working for the global design firm IDEO. “That’s recently changed. With this project in the public for over a year now, I think it’s created awareness to focus on kids’ needs. When I was doing my research, all I found were basically smaller adult prosthetics and kids need more than that.”
“Children have anatomical and psychological differences, so prosthetists must treat them differently than adult patients,” Ed Moran, a certified prosthetist orthotist, said in inMotion, a bimonthly magazine published by the Amputee Coalition. The whole process is different for pediatric amputees, Moran said, from the fitting, where Moran recommends putting on headphones to cover up the noise of the cast saw, to conversations about the prosthetics that will involve parents, and into physical therapy and regular follow-up visits, which need to account for growth.
Accounting for growth is one thing Torres sees lacking in the way current pediatric prosthetics work. “The regular prosthetic is modular, but once it is built you cannot reassemble it, and every time you have to replace the whole thing as the kid grows up,” Torres said. “So the idea was to have separate modules of the prosthetic and make it easy to assemble for kids.”
The IKO (pronounced ee-co) Creative Prosthetic System, which draws its name from the word “ik,” which young kids use to say “me” in the Netherlands, works by breaking down the prosthetic into three turn-and-lock interlocking modules: the interface that serves as the socket and battery, the functional muscle part with a motor inside and the hand, which allows for precision grasp and wrist movement and is Lego compatible, as is the muscle unit. The idea, he said, was to create a new way to use prosthetics made especially for kids that would function the way kids need and want them to and would integrate play, which is so important for kids, into their functionality.
“I was interning in a different project at Lego when I came up with the idea, and I went to my boss to see if it was possible to get a sponsorship and use their resources, and he basically said yes right away,” Torres said. “Lego is a social toy. It involves everyone. You can sit down and build something with your mom, dad, brother. You can [build] by yourself too, but it has a social feature, which I found interesting to work with prosthetics.”
The prosthetics give kids the control, Torres said, and kids know what they need and want. It also gives kids a way to interact with others as they build toys that snap onto the prosthesis and can even take advantage of the motor within the prosthesis to make moving Lego contraptions. Studies show that while children with limb deficiencies recover and gain function rather well and better than adults, they are at risk for psychological and social adjustment issues. This is why a multidisciplinary approach that involves a surgeon, prosthetist, and counselor or psychologist is recommended, especially since these issues vary depending on the child and the child’s personality, family and environment and whether the limb loss was from a birth defect or happened later in life with an amputation as a result of trauma or a disease, such as bone cancer. But one thing that has shown to help children cope across the board is perceived social support. A study published in the Journal of Behavioral Medicine in 1992 found “perceived classmate social support the only significant predictor” to affect children’s levels of depression, anxiety and general self-esteem.
“It was the goal psychologically to make the kids be creative and confident in their skills and believe in themselves and make it all tangible,” Torres said.
He also partnered with Cirec, a nonprofit based in Colombia that focuses on transforming and improving the quality of life of people with physical, neurological, degenerative and intellectual disabilities. He collaborated with the nonprofit, he said, to find families he could work with and to help him understand the medical aspects, connecting him with a psychologist, therapist and prosthetist.
“It was the goal psychologically to make the kids be creative and confident in their skills and believe in themselves and make it all tangible.”
–Carlos Arturo Torres
“I was granted access to some families and would go visit kids and follow them and see their abilities throughout the day and make sketches to get inspiration,” Torres said. “And I learned that in dealing with prosthetics, it’s not just about the prosthetic and how it works. You have to understand it’s the whole person, and it was a focus on the psychological.”
There were several other factors to consider when it came to figuring out what prosthetic to design, he said, including the 20-week time constraint for his graduate work to do all of the project’s research, development, prototyping and testing.
“From the very start you have to lower expectations and remind everyone this could just be a student project and maybe nothing could come out of it, which is hard to do,” he said. “Because you’re working with a kid looking at you and you can’t promise anything and you shouldn’t promise anything.”
It was also important to look at what would show that his idea would work, Torres said, which meant focusing on the arm and compromising on the functionality a bit while still making it useful enough to validate the idea of play and social dynamics. He tested the prototype on a nine-year-old child with a congenital below-the-elbow limb deficiency.
“Something I realized in making a project like this is you have to think about how many kids can use this, because the more kids that can use this, the more influence it will have,” he said. “And this [below the elbow] is a common case. It is common to see kids without fingers; that’s why you see a lot of low-cost prosthetics for hands.”
The largest study to look at traumatic pediatric amputations in the United States published in 2005 in the journal Pediatrics found that an estimated 111,600 children younger than 18 years old had amputation injuries treated in U.S. emergency departments from 1990 to 2002, with an average age of six years old. Car accidents, riding lawn mower accidents and fingers shut in doors were the most common reasons for the injuries. Current estimates from the Centers for Disease Control and Prevention (CDC) and the National Birth Defects Prevention Study (NBDPS) show limb deficiencies occur in four out of every 10,000 live births, and upper extremity abnormalities are more common. The United States does not have a formal, complete registry of birth defects, so the precise number is unknown. And this doesn’t take into account other countries’ rates of traumatic and congenital limb deficiencies.
The response to Torres’ project has been positive. It’s won six awards, and Torres said he plans to continue with the project as long as he can. The second phase involves further testing of the prototype, he said, getting more kids and families involved through Cirec in Colombia to validate the prosthetic on a larger scale and create a more functional prosthetic. He said he hopes to attract investors so that the IKO Creative Prosthetic System can eventually expand and reach more kids.