Q: What is e-NABLE and how does it work?

e-NABLE is a global network of volunteers who are using their 3D printers, design skills, and personal time to create free 3D printed prosthetic hands for those in need  – with the goal of providing them to underserved populations around the world.

We are not a company and we do not sell these devices.  We describe e-NABLE  as a “movement” because there is no single legal entity or organization that represents it.

In 5 years, e-NABLE has evolved from a small group of pioneers into a loose unofficial confederation of over 80 chapters around the world.  (The e-NABLE.org website is maintained by one such chapter, Rochester Enable Limited,  and by Jon Schull, who named “e-NABLE”, started the e-NABLE GooglePlus community, and co-founded  Rochester Enable Limited.)

Overviews of  e-NABLE can be found at e-NABLE.org and at EnablingTheFuture.org  

Q: How did e-NABLE get started?

The e-NABLE origin story has been told in words and pictures in  “EnablingTheFuture’s “About Us” page, and in several wonderful short videos including these

Q: Where are you based?

e-NABLE is a web-based community that doesn’t have a central location.  As you can see from this map, e-NABLE is a truly global volunteer organization, perhaps 2/3 of us are (currently) based in the United States.

Q: How many volunteers do you have?

The Google-Plus community has over 10 thousand members and continues to grow.  In the last year, almost 2000 people have registered in EnableWebCentral, the new site that matches volunteers with recipients.  Many other volunteers  work independently or with local chapters.

Approximately half of our volunteers operate 3D printers.  Volunteers include hobbyists, students, and amateurs as well as professional engineers,  prosthetists,  occupational therapists, and researchers.

Q: How many people have you helped and are in the process of helping?

Thousands of children in North America and Europe have received “superhero hands.”   But we are increasingly developing and delivering more natural-looking devices for more traditional cultures around the world.

Q: Where are your volunteers and recipients mainly based?

North America, Europe, and Latin America boast many chapters and recipients but there are numerous active chapters in over Asia, Africa, India, and the Middle East as well.

Q: Who can get an e-NABLE device?

People who are missing fingers or arms below the elbow can benefit from these 3D printed devices. They are especially helpful for children who do not normally have the option of traditional prosthetic device either due to cost, time, or due to the uniqueness of their limb difference.

We currently have upper arm solutions for people with  a functional wrist or elbow.   

Q: How old do you  have to be to get an e-NABLE device?

We recommend that children be at least 3 years old before wearing a device due to the choking hazards that small parts pose and so that children can have the chance to learn to do every day things without a helper hand.

Q: What can these 3D printed hands be used for?

These devices should be seen as tools and not a fully functional prosthetic device. Children use them for simple tasks like holding water bottles while being able to hold a snack in their other hand at the same time, helping to give them balance by allowing them to use two hands to ride a bike or swing on the swings, holding sports equipment like baseball or cricket bats, catching soccer or footballs etc. and other simple tasks that having two hands is helpful for. Some children have found that swimming with them has been helpful as well.

These devices can not hold more than a few pounds of weight  and the grip strength is not that strong on most of the designs and can not be used for playing on monkey bars, doing hand-stands, working the brakes on bicycles or anything else that may lead to harm if the device fails or breaks.  Additionally, fingers do not move individually – they have a simple basic grasping function.

Q: How much does a prosthesis from e-NABLE cost?

e-NABLE does not charge for the prosthetic devices it provides. We are a volunteer community and offer these devices completely free of charge.

The cost of materials of the Raptor Hand is approximately $35. However, that does not factor in the time involved in building one, which can include assembly, fitting, testing, and more. Since this can be done by a volunteer or the recipient and his/her family, this is difficult to put a dollar figure on.

Q: What would an equivalent, partial hand prosthesis made by a professional cost?

A professionally made, muscle-actuated hand can cost thousands or tens of dollars.  With good insurance coverage, you may want to consider one of these because it would be custom made, the care would be supervised by a doctor, and it would likely be made out of strong materials like carbon fiber.

 

Q: How durable is an e-NABLE hand?

A: The hands hold up quite well to the activities of a typical child. Many of our recipients have sent in videos of children using the hands to ride bikes, throw a ball with the dog, swim, and perform other activities.

The Gripper Hand endures 60 pounds of pressure.  While more rigorous mechanical testing in ongoing, a group of students has conducted initial impact testing by dropping the hands from a height of several stories.  The hands sustained minor damage, but survived.

When e-NABLE hands do break, simple repairs can be made using a 3D printing pen (i.e. the 3Doodler) or by reprinting the broken part.

The hands can also be printed in a variety of materials, including very durable nylon. 

Q: Are any health care professionals involved in e-NABLE?

Dr. Albert Chi Oregon Health Sciences University works closely with the e-NABLE community. He is a trauma surgeon with a background in biomedical engineering, clinical research, and has been featured on 60 minutes (twice!) for his work on high-tech brain-controlled robotic arms.

Approximately 30 other Certified Prosthetist-Orthotists and Occupational Therapists are members of our Google Plus community. These volunteers work with engineers and 3D designers in e-NABLE, to provide input on comfort factors, usability, and design. 

Q: What kinds of prostheses does e-NABLE offer?

EnablingTheFuture.org maintains a  list of current and recommended designs.

Q: If someone wanted to become an e-NABLE volunteer, but did not own a 3D printer, what would one cost?

The price and quality of desktop 3D printers has improved considerably in recent years. Our volunteers routinely make hands on machines ranging from $200 to $3000.

Q: Is this organization only in need of fabricators and designers?

There are many e-NABLE members/volunteers who do not own a 3D printer and who do not fabricate hands.  There are other ways to participate – please join us!

Q: Does this mean the end of professionally made prostheses?

No. e-NABLE typically focuses on underserved communities (including children missing hands) for whom traditional prostheses are too expensive (because they can cost thousands of dollars per year) or impractical (because children outgrow them).

Professional prostheses serve different needs and provide things that a volunteer community cannot. For example:

Issue Professionally Made Partial Hand Prosthesis e-NABLE Device
Provisioning Provided by Certified Prosthetist with formal education, under a prescription of a Doctor.  A Prosthetist must provide care in an accredited local facility. Developed by volunteers in an innovative online community
Population There are many kinds of medically approved prostheses and procedures for a  variety of amputation types. Extra special care must be taken for people with fragile skin from traumatic amputation or people with dysvascular concerns. A recipients whose residual limb is pressure tolerant, and does not require a highly customized device may well appreciate an e-NABLE device.  It is always recommended  to consult a doctor before considering an e-NABLE device.  These are experimental devices.  (And we are always looking for test pilots!)
Fabrication Generally custom fabricated around a specific mold of the users anatomy.  This produces an intimate fit. The is involved, difficult, and often expensive. Custom fit standardized parts based on measurements of the user’s residual limb.  Most of e-NABLE parts are made from 3D printed plastics
Health Insurance Health Insurance may pay for all or some of the cost of a conventional prosthesis because it is  provided by certified prosthetist per prescription from a Doctor and meets FDA regulation as a class 1 device. (More on device classes: http://www.oandp.org/jpo/library/2010_02_121.asp) Has not been reviewed by FDA.  Comes with disclaimer of liability.
Cost Prostheses can be expensive, however most prostheses prices are not set by prosthetists  They are based on govt. regulated billing codes called Lcodes. These code take into account the device itself, the time for evaluation, fabrication, delivery and 3 months of follow up care. Private insurances negotiate the prices of prostheses based on these codes. By harnessing the good will,  expertise, and resources of volunteers, e-NABLE aims to put radically inexpensive (often free) devices to those for whom they are suitable.  Material costs are approximately $35.