SCIENCE ROBOTICS | RESEARCH ARTICLE

PROSTHETICS Copyright © 2020

The Authors, some
The Hannes hand prosthesis replicates the key rights reserved;
exclusive licensee
biological properties of the human hand American Association
for the Advancement
of Science. No claim
M. Laffranchi1*, N. Boccardo1, S. Traverso1, L. Lombardi1, M. Canepa1, A. Lince1, M. Semprini1, to original U.S.
J. A. Saglia1, A. Naceri2, R. Sacchetti3, E. Gruppioni3, L. De Michieli1 Government Works

Replacing the human hand with artificial devices of equal capability and effectiveness is a long-standing challenge.
Even the most advanced hand prostheses, which have several active degrees of freedom controlled by the electrical
signals of the stump’s residual muscles, do not achieve the complexity, dexterity, and adaptability of the human
hand. Thus, prosthesis abandonment rate remains high due to poor embodiment. Here, we report a prosthetic
hand called Hannes that incorporates key biomimetic properties that make this prosthesis uniquely similar to a
human hand. By means of an holistic design approach and through extensive codevelopment work involving re-
searchers, patients, orthopaedists, and industrial designers, our proposed device simultaneously achieves accurate
anthropomorphism, biomimetic performance, and human-like grasping behavior that outperform what is required
in the execution of activities of daily living (ADLs). To evaluate the effectiveness and usability of Hannes, pilot
trials on amputees were performed. Tests and questionnaires were used before and after a period of about 2 weeks,
in which amputees could autonomously use Hannes domestically to perform ADLs. Last, experiments were conducted
to validate Hannes’s high performance and the human likeness of its grasping behavior. Although Hannes’s speed
is still lower than that achieved by the human hand, our experiments showed improved performance compared
with existing research or commercial devices.

INTRODUCTION like joint angular coordination, and, of course, robustness. Extensive

Until recently, upper limb prosthetic systems were meant as tools research has been carried out on the sensorimotor system of the
rather than replacements of a missing arm or hand. The main reasons human hand and, specifically, on the control of the temporal and
for this implementation were due to technological limiting factors spatial coordination of the digit force, muscle, and joint movements
that did not permit the restoration of the full functionalities of a (17, 22). Principal components analysis (PCA) was used for explor-
missing limb. This is the case for traditional body-powered prosthetic ing different hand patterns during grasping of several objects. This

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devices based on split hooks, so-called prehensors, and more ad- technique essentially allows the reduction of a large set of hand motor
vanced myoelectric hands (1–7). As a main consequence, the draw- variables into a smaller set of principal components (PCs) represent-
backs of such solutions lead to a substantial rate of abandonment of ing the majority of these variables. With respect to this method, it
upper limb prostheses, which is one of the main obstacles that re- was discovered that the kinematic synergistic behavior of the human
searchers in the field attempt to overcome (8, 9). hand during grasping is such that only the first two PCs are sufficient
Several studies have been carried out to determine the key factors to classify and reconstruct hand postures at 80% of the variance, with
that characterize the behavior and properties of the human hand as a predominance of the first synergy among other PCs (23, 24).
a guide to achieve a truly bioinspired prosthetic device; these factors Therefore, nature suggests that replicating grasping movements as
are as follows: (i) anthropomorphic-related features, which include combinations of synergistic motion patterns is another crucial factor
kinematics, size, weight, and appearance (4, 10, 11); (ii) performance that determines high levels of biomimicry and may ultimately lead
such as speed, force, and dexterity (10, 12); and (iii) robust and syner- to proficient execution of ADLs. These insights led scientists to develop
gistic grasping (13–18). To effectively replicate the latter two as- systems that could intrinsically implement these synergies through
pects in a prosthesis, biomimetic motion velocity levels should be ad hoc designs based on underactuation and, in some cases, me-
combined with an appropriate grip force: The digits should be able chanical compliance that intrinsically adapts the device’s configuration
to move with a suitable speed and exert a sufficient grasp strength to during the interaction with the environment (14, 25–30).
make the device effective in the execution of activities of daily living Nevertheless, the most advanced anthropomorphic robotic hands
(ADLs) (5). In addition, the digits should be controllable with suit- (25, 31–33) or research prostheses (2, 10, 14, 30, 34, 35) do not meet
able precision and responsiveness to enable proper usage and dex- the weight, size, and/or power demands required for practical use
terity (12), which are also among the most basic requirements for (36). In the last decade, however, a few prosthetic devices have
permitting embodiment (10, 15, 19, 20). These latter characteristics made an attempt to approach the functional and physical properties
are strongly correlated with a variety of biomimetic properties beyond of a human hand, trying to satisfy the increasing need for function
good engineering practice (21), including excellent similarity with and “form” in one device (8). To replicate the form factor accurately,
the kinematic model and behavior of the human hand (15), human-­ unconventional research approaches focus on the use of three-­
dimensional (3D) scanning of the contralateral limb and additive
manufacturing techniques (37). Nevertheless, among several devices, the
1
Rehab Technologies, Istituto Italiano di Tecnologia, Via Morego, 30, 16163 Genova, most successful implementations are represented by the Michelangelo
Italy. 2Advanced Robotics, Istituto Italiano di Tecnologia, Via Morego, 30, 16163 and the BeBionic hands by Ottobock (38, 39), the iLimb from
Genova, Italy. 3Centro Protesi INAIL, Istituto Nazionale per l’Assicurazione contro gli
Infortuni sul Lavoro, Via Rabuina 14, 40054, Vigorso di Budrio (BO) Italy. Ossür (40), and the Vincent hand from Vincent systems (41). Al-
*Corresponding author. Email: [email protected] though these devices resemble a human hand in their appearance

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SCIENCE ROBOTICS | RESEARCH ARTICLE

and provide reasonably functional performances, the devices still do formance, and human-like grasping, which have been demonstrated
not incorporate several of the abovementioned fundamental properties in previous studies to be key aspects that determine the overall
of a human hand. The adaptability of these devices to different “goodness” of a prosthesis (4, 5, 8, 10–12, 15–17, 19, 22, 24). These
shapes and force distributions among the fingers is typically limited characteristics have been implemented using a holistic biomimetic
to static grasping, which results in an ineffective and unnaturally design approach as shown in Fig. 2 and Movie 1.
low grasp robustness (11, 42), particularly when the grasped object
is perturbed and/or moves within the prosthetic hand. The main Hannes’s high anthropomorphism
reason for this limitation is that these devices are designed with tra- Hannes is shown in Fig. 1B. Figure 3A shows the dimensions, kine-
ditional robotic “stiff” approaches, where the adaptability of the matics, and ranges of motion (ROMs) of Hannes in direct comparison
hand during an interaction relies on feedback control that hardly with a 50th percentile human hand used as reference for the design
implements the high interaction ability typical of a human hand. (46); see also table S1 for details. Figure 3A shows the extremely high
Furthermore, the kinematics of these prostheses represent a gross anthropomorphism of Hannes: A maximum discrepancy of 4.8%
simplification of that of a real hand, resulting in low levels of anthro- can be observed in the proximal-intermediate diameter of the middle
pomorphism. For some devices, the approximations include the sup- finger, demonstrating the exceptionally high resemblance with the
pression of some critical degrees of freedom (DOFs). For example, reference hand model. Regarding the kinematics, Fig. 3B shows that
in the Michelangelo hand, only the metacarpophalangeal (MCP) joint all finger DOFs are implemented except the distal interphalangeal
is responsible for flexing or extending each of the fingers, whereas (DIP) joint, which is omitted and set to a fixed angle because of a
other devices do not include finger abduction/adduction. Similarly, design trade-off between functionality and the complexity of imple-
in other poly-articulated hands, such as the BeBionic hand, the joints mentation. The thumb exhibits different kinematics such that the
of each finger are coupled by a linear kinematic relationship that interphalangeal (IP) and MCP joints are locked, whereas abduction
governs the coordination of the fingers’ joints (4). These approxi- is actuated and rotation is passive.
mations in poly-articulated prostheses make the grasp and interac- Last, for a comprehensive comparison, Fig. 3C shows the angular
tion much less effective, adaptable, and robust than the grasp and excursions of Hannes’s DOFs compared with the DOFs of the human
interaction of their biological counterpart: adaptable grasping in- hand and the Michelangelo prosthesis, which has been used as the
creases the contact area and therefore the manipulation stability gold standard due to its advanced anthropomorphism compared
(43). Such design choices have further implications for the capability with that of other existing prosthetic hands (4, 38). Apart from
of implementing human-like movements and an appropriate syner- the locked DIP joints, Hannes’s ROMs are, overall, close to those of
gic coordination between the joints: It follows that the overall bio- the human hand and substantially more biomimetic than those of the
mimicry of such systems remains rather limited. Researchers have Michelangelo prosthesis.
attempted to solve these issues by developing self-adapting mechanism

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concepts such as the KIT hand by Karlsruhe Institute of Technology Passive wrist elasticity for enhanced adaptability
(35) and the SoftHand by University of Pisa and Istituto Italiano di Another main component of Hannes is the passive F/E wrist on the
Tecnologia (25); nevertheless, the performance of these devices is far proximal part of the hand. This module naturally conforms to its
from the levels required to perform ADLs, resulting in limited usability. F/E based on interaction forces, and it has been demonstrated to
In particular, researchers have advocated that the design approach achieve grasp robustness and adaptability to the task being executed,
should involve trade-offs among biomimetic performance, human-­ as shown in Movie 2. At the base of the wrist, a quick release system
like grasping behavior, and anthropomorphism (5, 10, 44, 45); however, replicates the “de facto” standard produced by Ottobock and is
we assert that these properties should all be included and follow an un- manufactured to permit the connection of Hannes to the socket and
compromising holistic design approach that is paramount for achiev- achieve an electrical connection with the controller. This component
ing effective limb replacements with high potential of embodiment (9). additionally allows passive prono-supination of the hand.
We propose a prosthetic hand called Hannes that incorporates
high levels of biomimicry through the concurrence of anthropo- Intuitive interface and direct strategies for
morphism, performance, and functionality, which lead to better seamless grasping
performance compared with other existing research and commercial Regarding control and interfacing, we decided to adopt direct EMG
prosthetic devices. This result was achieved by organically involving control for the sake of reliability, robustness, and practicality, leaving
researchers, patients, orthopaedists, and industrial designers in a code- the implementation of the aforementioned properties to advanced
sign process. Last, we perform a thorough evaluation of the device hardware design. Two sEMG sensors are used to detect the muscular
through laboratory tests and clinical trials on amputated participants. activity of an amputee’s stump, i.e., the muscular contractions of the
forearm flexor and extensor muscles, which permit the closure and
opening of the device, respectively, and its control. The two sEMG
RESULTS sensors were placed inside the socket and interface with the Hannes
System overview hand by means of dedicated conditioning and control electronics
Hannes consists of three main interacting physical components: a modules embedded within the “EMG processing board” shown in
myoelectric poly-articulated prosthetic hand that exploits a differ- Fig. 1A, which was custom designed and returned the control signal
ential underactuated mechanism; a passive flexion-extension (F/E) to be sent to the “motor control board” module. The Hannes system is
wrist module; and a myoelectric interface/controller that includes powered by a battery pack that is also placed inside the socket and is
two surface electromyographic (sEMG) sensors, battery pack, and designed to last up to 1 day. Last, a magnetic plug connector is used to
control electronics, as shown in Fig. 1A. These three components recharge the batteries when the system is not in use. The used con-
have been developed to realize anthropomorphism, biomimetic per- troller is proportional; i.e., it sends velocity references to the hand

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SCIENCE ROBOTICS | RESEARCH ARTICLE

A
Emg processing board

Flexion Extension wrist

Motor control board

DC motor

Magnetic plug
connector

sEMG sensors

Battery pack

Battery Management System (BMS)

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C D E F G

Fig. 1. Hannes system. It is composed of three main components, i.e., a myoelectric poly-articulated prosthetic hand, a passive F/E wrist module, and a myoelectric
interface/controller. (A) Architecture: The DC motor and the motor control board are embedded within the myoelectric hand, whereas the sEMG-based myoelectric interface/
controller is housed within the socket. The F/E wrist is placed between these two modules. (B) Views of the Hannes hand without glove. (C to G) Gloved device performing
ADLs: (C) a precision grasp of a pen, (D) a lateral grasp of a business card, (E) a power grasp of a compliant object, (F) a lateral grasp of a marker, and (G) a power grasp of a tool.

that increase proportionally with the muscular activation. The con- previously, the biomimetic performance and human-like grasping
trol parameters are tuned for each person to achieve fine motion and behavior were assessed experimentally.
force control of the device on each patient.
Biomimetic performance superior to that required by ADLs
Experimental evaluation Force and velocity experiments were carried out to determine
The results from the experimental evaluation presented in this section Hannes’s performances in regulating the grasp through EMG control.
validate that Hannes is able to satisfy the requirements mentioned The force capabilities of Hannes are reported in Fig. 4A. It can be ob-
earlier. Although anthropomorphism is assumed by design, as shown served that the prosthesis starts moving as soon as the EMG closure

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nspired Design A
B io-i pp
ic ro
ist a
l
Ho

ch

rphism Biomimetic per

mo for
po ma
ro n c
th
An

e
TY Movie 1. Summary of Hannes hand.
SI EIG PE

CI
ZE H

LO
W HA

VE
S

the grasping of the objects in Fig. 5 (A and B). The analysis of the
human hand postures revealed correlations (r > 0.8, P < 0.01) be-
tween (i) the MCP flexions of adjacent fingers and (ii) the abduction
CS

of neighboring fingers, with the exception of the little finger. These

I
AT
M

FO

results are consistent with data in the literature (23, 47, 48).
NE

RC
KI

The correlation matrix of Hannes exhibited the same correla-

tions as those observed for the human hand (r > 0.8, P < 0.01): (i)
GR OBU
AP FIG OU IC

TY N
AD ON AVI IST

R
AS ST
LI IO
TA UR R,

MCP flexions and (ii) MCP abductions of the neighboring fingers.

P NE
C EH ERG

BI AT
B N

The finger-adjacency effect observed for the human hand is even

SY

SS

more evident for Hannes, showing large correlations even for the
index-little pair. Furthermore, the PIP and DIP joints exhibit cor-
relations within each finger and with the immediate neighbor

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Hu
man-
li k e g r a s pi n
g (r > 0.80, P < 0.01). The observed correlations among the joints of
Fig. 2. The holistic biomimetic prosthesis design approach. The Hannes system was Hannes suggest that there is possibility of a dimensionality reduction
conceived using a holistic design approach that takes into account all the main of the postures of Hannes. We therefore conducted PCA.
characteristics which express anthropomorphism, human-like grasping, and bio- Figure 5E shows a comparison of the variance for each component
mimetic performance since its early development stage. These key biomimetic fac- (up to the eighth component) for Hannes and the human hand. PCA
tors complementarily converge and have all been incorporated into the Hannes system. revealed that the first synergy of the human postures accounts for
about 39% of the total variance of the system, 23% in PC2 and 14% in
threshold is reached. The digits of Hannes then enter into contact PC3 (Fig. 5E). In cumulative terms, the first two PCs accounted for
with the hand dynamometer, and the force starts increasing. The 62% of the variance of the data, whereas we observed that the ex-
first experiment, shown in Fig. 4A (left), demonstrates that the force plained variances are 76 and 87% for the third and fifth components,
can be modulated to slowly increase and decrease by means of the respectively. These results are consistent with (23, 47).
user through an appropriate regulation of the EMG activity. The In Hannes, the first synergy is much more predominant than in
second experiment, shown in Fig. 4A (right), shows that when rampant the human hand, accounting for about 75% of the variance, whereas
EMG activation is applied, the prosthesis can quickly close and the second synergy decreases markedly to about 12%. In cumulative
reach the peak force of about 150 N in less than 0.25 s. terms, the first two PCs account for about 86% of the variance of the
The angular velocities of Hannes’s joints for a full-speed closure data. Including up to the third and fifth components, the cumulative
are shown in the plot in Fig. 4B. The plot shows that the MCP joints values reach 97 and 99%, respectively.
reach a peak velocity of about 4 rad/s (229°/s), whereas the proximal We briefly describe the postures corresponding to each synergy
IP (PIP) joints can reach a peak velocity of about half this value. in Hannes:
Hannes can perform a full closure in less than 1 s. 1) PC1 corresponds to an opening closure of the hand, mainly
by means of finger MCP flexion combined with a little thumb
Human-like synergistic behavior rotation and abduction.
Kinematic analysis was conducted to determine the extent to which 2) PC2 is responsible for the PIP F/E of the fingers. Thumb ab-
the Hannes hand exhibits human-like synergistic kinematic behavior. duction is also observed.
The other aspect related to human-like grasping, i.e., grasp robustness, 3) PC3 corresponds to thumb rotation and thumb abduction.
was evaluated empirically through observation; the result is demon- The obtained results for the first synergy (PC1) obtained for
strated in Movie 2. Hannes are consistent with previous research on the human hand
Figure 5 (C and D) shows the pairwise Pearson correlations of (23, 47). Although to a lesser extent, the second and third PCs also
the joint angles of Hannes and the human hand, respectively, during appear to contribute to the same DOFs typically involved in human

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A
Palm Fingers
1.2

1
Normalised dimensions

0.8

0.6

0.4 th
50 Percentile
(Proximal-Intermediate) Diameter
0.2 (Intermediate-Distal) Diameter
(From Tip to Crotch) Length
0
Depth Width Length Thumb Index Middle Ring Little

B Joint Description

MPIP MDIP TABD Thumb Abduction

IPIP RPIP TROT
IDIP RDIP Thumb Rotation
TMCP Thumb Metacarpal
IMCP MMCP RMCP LPIP IPIP MPIP TIP Thumb Interphalangeal
RPIP LDIP
LMCP IABD Index Abduction
IABD MABD RABD IMCP Index Metacarpal
LPIP
IMCP MMCP IPIP
LABD RMCP Index Proximal
LMCP IDIP Index Distal
IABD MABD MABD Middle Abduction
RABD
MMCP Middle Metacarpal
LABD
TROT TIP MPIP Middle Proximal
MDIP Middle Distal
TROT
RABD Ring Abduction
TMCP
TABD RMCP Ring Metacarpal
TABD RPIP Ring Proximal
RDIP Ring Distal
LABD Little Abduction

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LMCP Little Metacarpal
LPIP Little Proximal
LDIP Little Distal
C
Fingers
150
Human hand
Hannes
Michelangelo

100
ROM (deg)

50

0
IMCP IPIP IDIP MMCP MPIP MDIP RMCP RPIP RDIP LMCP LPIP LDIP TMCP TIP

Fig. 3. Anthropometry of Hannes. The high fidelity in the reproduction of biomimetic anthropomorphism in Hannes is shown by directly comparing the size, shape, and
kinematic model of Hannes with anthropometric data and kinematics of a typical human hand and the Michelangelo prosthesis that is used as a gold standard. (A) Di-
mensions of Hannes and a comparison with the 50th percentile human hand; in addition, refer to table S1. (B) Kinematic model and nomenclature of Hannes and the
human hand. (C) ROM of the 50th percentile human hand, Hannes, and Michelangelo prosthesis.

synergies for grasping tasks, with the exception of the thumb move- Analyzing PC2 for the human hand, the PIP joints are extended at
ments in PC2 (23); see also Movie 3 and fig. S1. To analyze the first PC2max, while they progressively flex toward PC2min. In Hannes’s
two PCs in detail, Fig. 5 (F and G) presents how these PCs combine second synergy, there is also a predominant effect on the PIP joints,
to form different postures for grasping the nine objects in the trials. although the motion is reversed, i.e., from extension at PC2min to
These postures can be determined by the points that identify each flexion at PC2max. Analyzing the thumb, instead, there is a rotation
single object, displayed in the plane formed by PC1 and PC2. Figure 5 component in the human hand that is not present in Hannes. Although
(F and G) shows that the MCP finger joints are completely extended there are differences between the PCs computed for the human hand
at PC1min, whereas the fingers fully flex at the rightmost point, which and Hannes, the plots in Fig. 5 (F and G) clearly show that the objects
confirms the discussion above for PC1; see also Movie 3 and fig. S1. are mostly distributed on the PC1 axis for Hannes, in contrast to the

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case for the human hand. Last, the motion of the DIP joints in our with the reference prosthesis. Participants #1 and #2 performed bet-
human data for both PC1 and PC2 is very small, which has been ter with Hannes, with decreases in the time needed to perform the
confirmed by previous studies (47, 49) and validates our design task of about 10 and 30%, respectively, whereas participant #3 per-
choice of keeping them locked. formed better with the reference hand: The timings obtained during
T0, T1, and T2 were longer than those obtained during TB, although
Pilot clinical trials show the high potential of Hannes there was a marginal increase of about 15% as shown in Fig. 6 (note
The evaluation was conducted on three participants by executing tests that for the Minnesota test, negative values indicate an improvement
and using questionnaires that are specifically meant to measure pros- and positive values indicate deterioration). This result can be ex-
thesis use ability. Table S2 provides the obtained scores for the three plained by the fact that, with respect to other participants, partic-
participants with the reference hand during the baseline assessment ipant #3 only had experience with a tridigital hand and was not
(TB) and with the Hannes system during the study (T0, T1, and T2); familiar with a poly-articulated hand. In detail, although the tridigital
see Materials and Methods for details. Figure 6 also summarizes hand was already represented into his body schema (50), the ring
the improvement/deterioration in the tests and questionnaires and little fingers of Hannes were not: Two weeks of training are
scores from the baseline to the end of the study by reporting the insufficient to shape neural plasticity so as to incorporate a poly-­
difference between the scores recorded at T2 and the scores re- articulated prosthesis into body representation (51). Participant #1
corded at TB. performed better with Hannes from the beginning of the experi-
The results obtained with the Minnesota Manual Dexterity Test, mental procedure (M ± SD: 132 ± 6 s at T0 versus 137.33 ± 15.31 at
Placing only (MMDT-P), which measures the time required to TB; table S2), possibly because the participant was an expert user of
move a set of objects, were, on average, better with Hannes than a poly-articulated hand and thus did not experience difficulty in adapt-
ing to Hannes’s grasp. However, despite the initial performance, all
participants improved their results on the Minnesota test with
Hannes during the training (from T0 to T2; see table S2). Similar
results were obtained for the Southampton Hand Assessment Pro-
cedure (SHAP) test: The scores obtained at TB and T2 were compa-
rable across the participants, and in many cases, there was an increase
from TB to T2 (see the positive values in Fig. 6). The results from
this test for participant #1 were overall more neutral, probably be-
cause this participant was already an expert user of poly-articulated
hands. Critical results were only obtained for the lateral grasp with
participants #1 and #3 due to a technical issue experienced during

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the whole execution of the trial that did not allow a firm grasp in
this configuration. This was due to suboptimal mechanical fitting
between the pin and the hole of the thumb’s MCP joint that caused
high friction that resulted in poor thumb performance. This prob-
Movie 2. Amputated participant using Hannes. lem was solved in the device after the trials with a minor mechanical

A B TABD I MCP M MCP

150 4
force (N)
Grasp

75 0

0 -4
Angular velocity (rad/s)

R MCP L MCP I PIP

100 4
sensors (%)
EMG

50 0

0 - 4
MPIP R PIP R PIP
100 4
position (%)
Motor

50 0

0 -4
0 10 20 0 10 20 0 1 2 0 1 2 0 1 2

Time (s) Time (s)

Fig. 4. Force and velocity experiments. Direct evaluation of the force and velocity capabilities of Hannes and the controllability of the force regulation. (A) Regulation
of the force (left) and power grasps (right) regulated through direct EMG control. In the EMG plots, the red lines indicate opening EMG sensor activity, and the blue lines
indicate closure EMG sensor activity. The red and blue dotted lines indicate the activation thresholds for opening and closure EMG sensor activities, respectively. In the bottom
plot, the normalized motor position ranges from 0 to 100% and denotes motor positions that correspond to fully open and fully closed hand, respectively. In this test, the
grasp occurs at about half the motor travel, i.e., when the motor position assumes a value of around 50%. (B) Angular velocities of the main articulation of Hannes during a
full-speed closure. The black lines indicate the median values. The shaded areas indicate the SD.

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C TROT TIP I MCP I DIP M MCP M DIP R MCP R DIP L MCP L DIP D TROT TIP I MCP I DIP MMCP MDIP R MCP R DIP L MCP L DIP
TMCP I ABD I PIP MABD M PIP R ABD R PIP L ABD L PIP TMCP I ABD I PIP MABD MPIP R ABD R PIP L ABD L PIP
1
T ABD
T ROT
0.9
T MCP
T IP 0.8
I ABD
I MCP 0.7
I PIP
I DIP 0.6
M ABD
M MCP 0.5
M PIP
M DIP 0.4
R ABD
R MCP 0.3
R PIP
R DIP 0.2
L ABD
L MCP 0.1
Hannes L PIP Human
0

E 100
Explained variance (%)

80
Hannes
60 Human

40

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20

0
PC1 PC2 PC3 PC4 PC5 PC6 PC7 PC8

F PC2 Max 2 G PC2 Max

2

Key
PC1 Min 1 PC1 Max Ball PC1 Min 1 PC1 Max

Screwdriver
Mug
Battery
-1 -2 1 2 -1 -2 1 2
Mouse
Credit card
-1 -1
Marker
Water bottle

-2 -2
PC2 Min PC2 Min

Fig. 5. Kinematic analysis of Hannes and its synergistic behavior. Static and dynamic kinematic behavior of Hannes and its resemblance to that of the human hand
by direct comparison of postures, correlation patterns, and synergies, and their combination while grasping the different objects. (A and B) The static postures of Hannes
and the human hand, respectively, for each grasped object. Patterns of correlation in the joint angles during the grasping of nine objects are shown in (C) for Hannes and
in (D) for the human hand. (E) Comparison of the Pareto plot of the variances for each PC (up to the eighth). (F) Scatter plot of the Hannes postures projected along PC1
and PC2. (G) Scatter plot of the human hand postures projected along PC1 and PC2. The markers indicate the median position of the three participants ((73) credited for
the hand and mesh models of the human). The 3D views of the postures of Hannes and the human hand on the right and left in (F) and (G), aligned with the horizontal
axis, are the postures with minimum and maximum values of PC1. The top and bottom postures, aligned with the vertical axis, correspond to the maximum and minimum
values of PC2, respectively.

fix. The execution of these tests by amputated participants and the Beyond these tests, the questionnaires provide a qualitative evalu-
correct accomplishment of lateral and precision grasps by the ation of the independence of the user in the execution of ADLs.
Hannes hand can be observed in movies S1 and S2, respectively. Specifically, the Orthotics and Prosthetics User Survey Upper Extremity
Please note that the grasps shown in movie S2 are performed by a Functional Status (OPUS-UEFS) questionnaire measures functional
healthy participant. activities executed by amputees with a prosthesis. As reported in

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SCIENCE ROBOTICS | RESEARCH ARTICLE

Fig. 6, for participant #1, the reference hand enabled higher scores (Fig. 6 and table S2). Last, according to the final evaluation question-
and therefore seemed more desirable, according to this questionnaire. naire (table S3), participants #1 and #2 greatly appreciated Hannes.
Participant #2 showed an improvement with the use of Hannes,
whereas participant #3 improved their scores with Hannes with respect
to the scores achieved with the reference hand. DISCUSSION
The Disabilities of the Arm, Shoulder, and Hand (DASH) question- An analysis of the anthropomorphism of Hannes showed that the
naire returns measurements of the level of impairment in functional vast majority of the dimensions are reproduced with high fidelity,
activities of the upper limb with scores ranging from 0 (functional in addition to the kinematics, which replicate most of the DOFs
activity like in a natural hand) to 100% (no function at all). According (Fig. 3, A and B). An exception is the approximation in the design
to this questionnaire (Fig. 6 and table S2), participants #1 and #2 for the fixation of the digits’ distal DOFs. However, when compared
performed better with the reference prosthesis (scored with 0), whereas with other hand joints, the DIP joint contributes minimally to the
for participant #3, the level of functionality was unchanged. The functionality of the hand. By extracting the data in (47), it can be
change in the DASH scores cannot be represented as a percentage; simply demonstrated that this joint, considering the first three syn-
thus, in Fig. 6, we report the difference between the scores at T2 and ergies, among the five fingers, has an average ROM that is about
TB (note that for the DASH, negative values indicate an improve- four times smaller than that of the other DOFs. The smaller signifi-
ment and positive values deterioration). cance of this DOF means that it is appropriate to keep the DIP
The Trinity Amputation and Prosthesis Experience Scales locked and does not undermine biomimicry and effectiveness. In
(TAPES) questionnaire, which considers the degree of satisfaction addition, Hannes exhibits MCP ROMs that are very similar to those
in the utilization of a prosthesis, promotes the Hannes system over of a human hand in most digits; this difference is higher for the PIP
the reference hand in the case of participants #2 and #3, as the scores joints. Provided that grasping tasks are involved, this kinematic dis-
improve by three and five points, respectively (Fig. 6), whereas partici- crepancy does not represent a problem, because the maximum flex-
pant #1 achieves a slightly higher score with the reference prosthesis ions measured for these DOFs in the range of the objects tested are
smaller than the mentioned ROMs: The maximum measured IPIP,
MPIP, RPIP, and LPIP flexions across all the participants and grasped
objects are 51.9°, 47.1°, 39.8°, and 44.2°, respectively, which are
smaller than the available ROMs reported in Fig. 3C. This result
provides evidence that Hannes has exceptionally high levels of anthro-
pomorphism, even when compared with state-of-the-art devices,
such as the Michelangelo prosthesis. Last, the mass of the device is
480 g, which is close to that of its biological counterpart (52). Note

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that a prosthesis weight that matches the weight of a human hand is
generally described by users as being too heavy, and it is well known
that the perceived weight increases due to the fact that the weight is
borne by the stump’s soft tissue and not the skeletal system as in the
case of healthy participants (53). Nevertheless, it is extremely chal-
lenging to replicate weight levels below the weight of a human hand
because of the constraints of current electromechanical systems and
Movie 3. Principal components analysis.

TESTS QUESTIONNAIRES

-50 50 50 -50
Improvement
-40 40 40 -40 Deterioration

-30 30 30 -30
Subject #1
-20 20 20 -20 Subject #2
T2-TB variation (%)

T2-TB variation (#)

Subject #3
-10 10 10 -10
0 0 0 0
10 -10 -10 10
20 -20 -20 20
30 -30 -30 30
40 -40 -40 40
50 -50 -50 50
od

n
rip

ge

e
er

t
F
-P

al

k
ra

or
or

or
io
Io

AD

or
w
ric
DT

ip

sa
PT
te

ns

Sp
Sc
Sc
Po

W
AP

Tr
he

SU
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te
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ES
FS

SH
SH

S
AP

SH
M

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AP

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EF

DA
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P
A

DA

DA
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OP

OP

Fig. 6. Rate of improvement of the scores for the tests and questionnaires. The differences between the scores at T2 and TB are reported for each participant in
histogram format for a direct visualization of the rates of improvement. These rates—for the MMDT-P and SHAP tests (left), and the OPUS-UEFS, TAPES, and DASH questionnaires
(right)—are reported. The difference is indicated as the percentage variation for all the tests and questionnaires except for DASH; the improvement/deterioration is indi-
cated by the T2-TB negative/positive values for the MMDT-P and the DASH and T2-TB positive/negative values in other cases.

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SCIENCE ROBOTICS | RESEARCH ARTICLE

material technologies. Hence, we decided to set the reference weight hand and Hannes are responsible for moving the same set of joint
value to the weight of a human hand. angles, with the exception of the thumb motion in PC2, there are
Hannes is also very biomimetic in terms of performance: Its differences in their respective patterns. However, this is not an issue,
mechatronic design is such that its performance is very close to because previous studies demonstrated that, in a human hand, only
that exhibited by a human hand. The results show that the device the first synergy requires an assumption of repeatable behavior,
outperforms the velocity levels and grasping forces needed for the whereas the trends of higher-order synergies can substantially vary
execution of ADLs. The user can modulate the force when grasping depending on the boundary conditions (56). In this study, these dif-
an object, which is necessary for dexterity and grasp robustness (11, 12). ferences are mainly caused by imperfections in the kinematic model
In addition, the delay between a muscle contraction and a hand actu- of Hannes, which is clearly not identical to that of a human hand,
ation is about 10 ms, which is smaller than the physiological electro- particularly in terms of the thumb and the idiosyncrasies among the
mechanical delay (54) and cannot be perceived by the user. This participants’ hands (57). Furthermore, PC2 and PC3 for Hannes
feature, combined with the high motion speed achieved by Hannes, assume plausible biomimetic behavior. Hence, these results provide
is fundamental for the desired high effectiveness of the prosthesis key evidence for the exceptional biomimicry of the grasping postures
(5, 10) and crucial for achieving embodiment of the device (19). To of Hannes and demonstrate its ability to reproduce synergistic human-­
the best of the authors’ knowledge, the levels of force achieved by like grasping behavior. Attempts to reproduce such a characteristic
Hannes are superior to those of most existing research and commercial in prosthetic hands were made in (25); however, because the kine-
poly-articulated devices, with the exception of the lateral grasp of the matics of that device roughly approximated that of a human hand,
Michelangelo prosthesis (table S4). Few prostheses can achieve high- the resulting behavior could not be compared with that of a human
er speeds—for example, (34, 44)—but only at the expense of force, hand. This issue was overcome in (35); however, the performance
which is often much smaller than the reference ADL level (5). From levels were well below the required biomimetic force and speed values.
the performance perspective, the key property of the presented de- In contrast, Hannes exhibits high levels of biomimicry during
sign, as compared with other existing designs, relies on the concur- grasping, as shown in Fig. 1 (C1 to C5), Movies 1 and 2, and movie
rent achievement of high scores in weight, force, and velocity levels S1. Furthermore, the presented approach based on direct hardware
(table S4), as well as highly anthropomorphic shape, size, and kine- implementation of PCs strongly facilitates the implementation of
matics and highly robust grasping capabilities (Movie 1). To achieve biomimetic control: The high human likeness achieved in this work
the final goal, however, the aforementioned features must be combined is realized using a simple direct proportional control. This means
with highly biomimetic synergistic behavior, as discussed next. that evolutions of this design, which will include the capability of
PCA was conducted on both the human hand and Hannes for reproducing more PCs—through, e.g., the implementation of more
direct comparison. The correlation matrix in Fig. 5C shows that degrees of actuation—will pave the way to strategies that can seam-
Hannes exhibited a similar correlation pattern to the human hand. lessly and optimally exploit the potential offered by the proposed

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Although the correlation coefficients tend to be larger for Hannes, hardware approach. Promising control approaches in this perspective
which is expected from an underactuated system with moderate in- are methods based on postural/abstract control, which combine
tertrial variability, for both the human hand and Hannes, adjacent different PCs during motion in a flexible and biomimetic way and
fingers have a higher correlation than nonadjacent fingers (23, 48). therefore enhance the controllability of the device (58–63).
This effect is even more relevant in Hannes than the human hand Hannes’s results in the pilot clinical trials were, on average, higher
for two main reasons: Due to the one-DOF underactuation of all than those for advanced state-of-the-art devices. Hannes provided
fingers, the kinematics in Hannes are expected to be more correlated high and seamless configuration adaptability during both grasping
than in the human hand, and the ergonomics of daily life objects and manipulation, offering high grasp stability and robustness (11, 43).
leads to postures in which adjacent fingers tend to have a similar The high scores obtained in the tests suggest that Hannes has a
orientations and attitudes. Overall, Fig. 5 (C and D) shows similarity quick learning curve; hence, much better results are expected with a
in the patterns obtained by the human hand and Hannes, particularly refined version of the device and appropriate experience and training
in the correlation between neighboring MCP joints (all with P < 0.01). to allow the amputees to develop suitable grasp strategies. As ex-
These considerations have clear reflections on the resulting coeffi- pected, in most of the tests and questionnaires, the amount of im-
cients of the first human hand PC, which is consistent with the litera- provement from TB to T2 was stronger in participants that normally
ture (23, 55). For Hannes, the related PC1 behavior is very close to use a tridigital hand (i.e., participants #2 and #3), although the im-
that of the human hand, and the first synergy exhibits a marked provements were achieved at the expense of slower learning rates
predominance of the variance over the other synergies, more than than the learning rate of participant #1. Participants #2 and #3 had
that found for the human hand, where the variance is more evenly to learn the different behaviors of the poly-articulated hand; partici-
distributed as observed in (23). We expect that this effect might be pant #2 obtained higher scores than participant #3, which can be
reduced in designs that can independently reproduce more synergies. explained possibly because the participant was younger and by the
This could be obtained by including further degrees of actuation, fact that the participant occasionally used poly-articulated hands.
which would lead to a reduction of PC1 variance with consequent The role of training and practice is described in literature as a criti-
increase in the variance score of higher order PCs. Yet, although cally important factor for establishing the embodiment of a pros-
Hannes was designed to implement the first human synergy with thetic device in terms of its representation into the user’s body schema
high fidelity, other PCs were obtained. These PCs represent a “side after use-related changes in brain plasticity (64). Last, note that the
effect” that results from the mechanical intrinsic ability of Hannes lateral grip test was the only test that demonstrated poor performance
to adapt to the shape of the grasped object, which imposes the final because of a technical problem that was solved after the trials were
configuration of the device and contributes to the human likeness completed, as explained in Results. Movie S2 demonstrates the ca-
of Hannes’s posture. Although PC2 and PC3 observed for the human pability of the fully functional Hannes hand to perform lateral and

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SCIENCE ROBOTICS | RESEARCH ARTICLE

precision grasps. Please note that the grasps shown in this video are which implements simultaneous synergistic kinematic behavior, con-
performed by healthy participants. Participants #1 and #3 had poor figuration adaptability, and robust grasping through a combination
scores with Hannes, whereas participant #2 had marginally better of movement coordination and a uniform force distribution, as in-
scores. spired by (25). The detailed mechanical model of Hannes is reported
The questionnaire scores were, on average, comparable with those in the Supplementary Materials.
obtained with the reference prosthesis. Although such results appear The evaluation of the mentioned static and dynamic biomimetic
to be not as promising as those obtained for the tests, the three partici- properties have been evaluated by means of lab tests that included
pants verbally confirmed that they truly appreciated the high resem- the use of motion capture systems and force sensors for the mea-
blance of Hannes with a human hand in terms of human-like behavior surement of velocity and kinematic behavior and grasp forces, re-
and anthropomorphism, as shown in Movies 1 and 2 and movie S1. spectively. In addition, the obtained kinematic data were also used
In addition, the participants were very satisfied with the usability, for PCA on both the human hand and Hannes.
overall effectiveness, and robustness during the trials. This was con- A pilot clinical trial was performed with the primary goal of de-
firmed by the results of the final evaluation questionnaires, which fining Hannes’s functionality, safety, and reliability and assessing the
had high scores for two out of three participants (tables S2 and S3). potential benefits regarding the quality of life of amputees. Three
The contradiction between the positive direct user feedback and the amputated participants could autonomously use Hannes at home to
average questionnaire scores can be explained by the fact that question- perform ADLs for a period of about 2 weeks. Tests and questionnaires
naires focus on effectiveness in the execution of everyday activities were used before and after this phase.
and assume that the participant has become familiar with the de-
vice by developing appropriate grasping strategies. This familiar- Hannes’s mechatronics
ity requires consistent training and use that can only be achieved Poly-articulated prosthetic hand
with more time than the time allowed in this study: 16 days. Much Hannes’s palm houses the main components of the hand—an
better results are therefore expected with longer training times. In electric actuator, a control board, sensors, and the transmission
contrast, the test results showed that the potential of the device to mechanism—whereas the F/E extension flexible wrist is located at
effectively execute grasping tasks is very high, apart from the afore- the base of the device. The power train consists of a compact, high-
mentioned lateral grip issue; in addition, considering the relatively power-­density DC motor coupled to a custom-made hypocycloid
short training time, the scores are promising and show the very high gearbox. A 3D view of the assembly is shown in Fig. 7A. The pow-
potential of Hannes. er train actuates the leader wire, thus transmitting the force FA and
One of the main limitations of this study is that the Hannes system speed to the cable-based mechanism housed in the palm. The leader
has been tested on a small number of participants. However, the par- wire originates from the motor and ends in the thumb, passing
ticipant sample is representative of the potential end-users because through two differential elements mounted onto linear guides

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it includes young and elderly individuals with different years of myo- that are each made of a custom-made bush bearing and two rails
electric hand experience. Furthermore, the main drawback of the along which the bushing moves. Each bushing houses two idle
extreme exploitation of the underactuation concept used in this pulleys: one pulley supports the leader wire, whereas the second
work is that it lacks versatility when different grasps styles are required pulley is used by the follower wire to actuate two adjacent fin-
by the participant. Again, this might be overcome by incorporating gers. There are two follower wires: The first wire moves the in-
additional actuators to the current design, which can support the dex and middle fingers, while the second follower wire is used to
execution of different PCs. actuate the ring and little fingers. To avoid slack on the leader
We conclude by stating that one of the paramount concepts to wire, springs acting on the linear guides are also included in the
be considered in the design of prosthetics is that prostheses must assembly.
promote true embodiment so that they can actually be perceived as Fingers
part of the body rather than a “simple” tool. We believe this feat can Figure 7B shows a finger and its kinematics. The mechanism relies
only be achieved by means of a firm concurrent incorporation of on dowel pins to guide the wires in the fingers and to maximize the
the discussed key biomimetic properties, particularly grasp force, integration density and robustness, which additionally implements
velocity, robustness, anthropomorphism, and static and dynamic a biomechanically plausible hinge joint-based solution (65). Two wires
biomimicry (5, 30), Movie 1, which may lead to realizing the ultimate are observed in the cross-sectional view: On the lower side of the
and most fundamental goal of upper limb prosthetics: increasing figure, the follower wire comes from the corresponding linear guide
the rate of acceptance. and terminates on the distal phalanx, and the wire located at the top
is used for the extension of the finger and is part of a mechanism
that includes a compression spring of stiffness ​​K​jext​​,​ where j = [1, 2,
MATERIALS AND METHODS 3, 4] identifies the finger such that 1 corresponds to the index and 4
The goal of this research was to develop and evaluate a prosthetic to the little. This component generates tension that increases with
hand that could achieve the three main design goals addressed in the flexion of the finger, and a pretensioning mechanism is located
Fig. 2. Biomimetic levels of force, velocity, and weight are possible on the other end to set the appropriate preload. As the motor
because of appropriate component sizing and a highly integrated applies torque, the follower and return wires both get tensioned,
and efficient centralized design that uses one motor to drive all the which results in a compression of the extension spring. Hence, the
articulations of the hand implemented into a highly anthropomorphic tensioned return wire generates torque on the MCP and PIP joints
shape. Human-like grasping properties—such as robustness, stability that is an antagonist to the torque generated by the follower
(5, 11, 43), and synergistic coordination of the fingers (17, 18, 22)— wire. Thus, the magnitude of the tension force applied to the return
are implemented via an underactuated differential drive mechanism, wire is proportional to ​​F​Aj ​  ​​, with a factor that is easily computed

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SCIENCE ROBOTICS | RESEARCH ARTICLE

A Follower wire 1

DC motor Follower wire 2

Motor control board

Encoder

Linear guide

Quick release Leader wire

B C
Abduction / Adduction axis Preload mechanism Abduction /
Adduction axis Preload mechanism
MCP pin
Guiding pulleys

Return wire Abduction /

Adduction mechanism

PIP pin MCP pin

MCP axis Follower wire

MCP axis
Abduction / Leader wire
PIP axis Adduction pin
Compression spring
Compression spring

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Return wire

D E
Extension wire

Flexion / Extension axis

Flexion wire

Compression springs

Guiding pulleys

Wrist Extension Wrist neutral position Wrist Flexion

[-70°] [0°] [+70°]

Fig. 7. Hannes’s mechatronics. The core mechatronics of the Hannes hand in its components: palm, digits, and wrist. (A) 3D view of the hand (left) and cross section of the
transmission mechanism located in the palm (right). The leader wire, follower wire 1 (index and middle fingers), and follower wire 2 (ring and little fingers) are shown in red,
green, and yellow, respectively. (B) Finger kinematics (left) and mechanical design (right). (C) Thumb kinematics (left) and mechanical design (right). (D) Detailed cross
section of the F/E wrist integrated in Hannes and (E) the F/E wrist in three configurations: (left) maximum extension, (middle) neutral position, and (right) maximum flexion.

by the ratio of the respective levers. When the motor unwinds the form force distribution along the finger to mimic the first human
leader wire, the follower wire slackens, with a consequent exten- kinematic synergy.
sion of the return spring and finger. When the follower wire is Thumb
tensioned with force F​​​ Aj ​  ​​, fig. S4, two resulting lever arms act on The thumb comprises an active abduction/adduction joint that op-
the MCP and PIP joints, making it possible to set appropriate joint erates similarly to the MCP joint of the fingers, whereas the IP and
torques for these articulations. In particular, the MCP torque is DIP joints are locked, as shown in Fig. 7C. In addition, the thumb
designed to be about twice the torque of the PIP joint, which per- rotation is implemented by a custom-made spring-based plunger
mits the regulation of the activation timing of each joint and a uni- mechanism, Fig. 7C, that can lock the finger in three equally spaced

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Fig. 8. Experimental setup of the motion capture analysis of Hannes and a human hand. Healthy participants and Hannes in the designed experimental setup per-
forming grasps of objects of different size and shape. (A to C) Participants #1 to #3 grasping different objects, respectively. (D to F) Hannes grasping different objects.
Hannes is controlled by the healthy participant using EMG control.

stable positions (fig. S2) to perform different grasp styles, as shown HD-BTA by Vernier). The motor position was regulated through
in Fig. 1 (C1 to C5), Movie 1, and movie S1. The closure timing direct EMG control to either regulate the prosthesis to move slowly
of the thumb can be synchronized with the fingers by means of a and regulate the grasp force, as shown in Fig. 4A (left), or to per-
screw-based mechanism that acts on the preload of the corre- form power grasps with maximum speed to evaluate the maximum

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sponding return wire, Fig. 7C. This is crucial to perform precision grasp force, as shown in Fig. 4A (left). The EMG sensors were two
grasps correctly. 13E200 MyoBock sensors made by Ottobock.
Passive F/E wrist module Velocity
The F/E wrist exploits a mechanical compression spring engaged by Hannes was set up with the arrangement described in the follow-
a cable-based system to reproduce elasticity. The wrist flexes and ing section to record the motion of each phalanx via a motion cap-
extends around a pin-based revolute joint (Fig. 7D). When the wrist ture system. Hannes was controlled through an EMG interface to
is flexed, the flexion wire attached to the Hannes base at one end, perform a full-speed closure, and no object was grasped in this ex-
and a compression spring at the other end is tensioned, compress- periment. The angles were recorded using the procedure described
ing the elastic element and introducing slack to the extension wire; in text S2 and then postprocessed to obtain the angular velocities
the opposite occurs when the wrist is extended (Fig. 7E). Both wires of each articulation through numerical differentiation.
are based on Dyneema. The wires are guided by rectified pins along
their paths and by two pulleys to preserve their integrity and guar- Human-like synergistic behavior experiments
antee high robustness for the entire system. Last, the proper preload Participants
of the spring avoids a backlash around the equilibrium position. In Three right-handed healthy participants (three males of 24 to 27 years
addition, a locking mechanism allows the wrist to lock in five equally with self-reported hand dominance) were tested. The same procedure
spaced positions along an ROM similar to that of its biological was also conducted using a right-hand Hannes prosthesis through an
counterpart, about ±70° (46). The exerted torque and stiffness values able-bodied adapter. All participants were unaware of the purpose of
are also set to match those of the human hand (66): The maximum the experiment and had no history of neurological or motor deficits.
exerted torque is 0.75 Nm at the end of the stroke, which leads to an Experimental setup
average stiffness of about 0.614 Nm/rad. A linear relationship exists Six 850-nm VICON Vero V2.2 cameras (VICON Motion Systems,
between the rotation of the wrist and the compression of the spring, Oxford, United Kingdom; sampling frequency of 100 Hz, resolu-
which is made possible by pins located along a profile defined by a tion of 2.2 megapixels, 330 frames per second) were used to record
circle with an axis located at the center of rotation. Thus, the tor- kinematic data from a set of passive reflective markers (MKR-4.0H
sional stiffness is quasi-linear. and PM-9.5, B&L Engineering, California, USA) placed on partic-
ipants’ hands and Hannes, as shown in Fig. 8.
Biomimetic performance experiments Procedure
Force The participants were instructed to sit on a chair with their forearm
The prosthesis grasped a hand dynamometer that can measure the lying on a tripod to fix the initial position. First, a static acquisition
grasping force by means of a force sensor (Hand Dynamometer was performed. Once the participants signaled that they were ready

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SCIENCE ROBOTICS | RESEARCH ARTICLE

to start a trial, they were asked to grasp one of the nine objects as prosthetic hand for a period of 16 days for domestic use and daily
they would consider most appropriate, hold the object for 1 s, and utilization.
place the object back in its original position (Fig. 8, A to C). The The same tests used for baseline assessment were repeated with
procedure was repeated five times for each of the objects. The order the Hannes hand before the training procedure (T0), at the end of
in which the objects were grasped was randomized for each partici- the training period (T1), and at the end of the study (T2). Question-
pant. Each participant was tested on different days at different naires (see the “Clinical evaluation measures” section) were pre-
times. The total duration of the experiment was about 1.5 hour sented at TB and T2.
per participant, with a break of a few minutes at the halfway point. Figure S3 depicts the experimental protocol and its various phases.
The participants could choose to rest at the end of each trial. The training consisted of a 4-hour procedure repeated for 4 days
The same procedure was repeated using a right-hand Hannes pros- and involved accomplishing a set of tasks combining generic ma-
thesis (Fig. 8, D to F). Hannes was placed in a fixed configuration nipulation and the execution of several ADLs. Table S6 reports the
by attaching the prosthesis to a stump locked to a fixed frame. executed tasks.
The participant was asked to place an object within Hannes’s reach Clinical evaluation measures
so that the object could be grasped in a natural manner. Hannes was The clinical evaluation consisted of monitoring parameters collected
commanded to open/close using the EMG interface consisting of from the tests and questionnaires during different phases. We used
two EMG sensors mounted onto the right arm with an elastic band. two tests and four questionnaires. Specifically, the used tests were
The object was held for 1 s and then placed back in its original posi- the MMDT-P and the SHAP. The first test assesses the ability to
tion by the participant. The procedure was designed to focus on the move small objects, and the score is the total number of seconds
postures during grasping; reaching movements were not considered. required to complete the chosen number of test trials (68). The second
Principal components analysis test measures the ability of the amputee in using a prosthetic hand,
Correlation analysis was first conducted on the Hannes and human and the scores range from 0 to 100, where 100 corresponds to the
hand angle data to assess the extent to which the angular posi- typical functionality of a healthy limb (69) and are calculated for the
tions covaried with respect to each other, according to the kine- overall hand function (index of function) or for specific postures
matic model in Fig. 3B. PCA was then performed to obtain two (i.e., spherical, tripod, power, lateral, tip, and extension).
full sets of postural synergies: one set for Hannes and one set for the The questionnaires provide a qualitative evaluation of the inde-
human hand. The data were processed using the procedure ex- pendence of the user in the execution of ADLs. The used question-
plained in the “Angle extraction” section provided in the Supple- naires were as follows:
mentary Materials. 1) the OPUS-UEFS module (70), which evaluates the efficacy in
carrying out daily tasks, such as general self-care and the usage of
Pilot clinical trials domestic tools; the scores indicate how easily participants perform

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The clinical study was performed in collaboration with the Pros- the tasks and if they use the prosthesis for these activities (a higher
thetic Centre of INAIL (Istituto Nazionale per l’Assicurazione contro score indicates greater function);
gli Infortuni sul Lavoro, Italian workers’ compensation system) in 2) the DASH questionnaire (71), which returns measurements
Vigorso di Budrio (Italy). The testing procedures presented here of the functional activities of the upper limb in ADL, work, and
were approved by the Ethics Committee of Bologna and Imola (CE-BI, sport and produces a score indicating the level of disability ranging
protocol number 16051) in accordance with the guidelines of the from 0 (performance of a healthy limb) to 100 (full disability);
Declaration of Helsinki. 3) the TAPES questionnaire (72), which consider the degree of
Participants satisfaction in the utilization of the prosthesis in various tasks with
Three male right-handed participants were enrolled (62, 29, and scores ranging from 0 to 120; and
55 years) with a transradial amputation of the right hand (the level 4) a final evaluation questionnaire (administered only at T2, see
of amputation was medial for participants #S1 and #S2 and distal table S3).
for participant #S3) and no psychological comorbidity related to The tests and questionnaires were used to assess the behavioral
hand loss. All participants had residual muscles that were efficiently performance of the participants using a prosthetic hand and thus
active and were expert in the use of a myoelectrically controlled were performed both when participants used Hannes and the refer-
hand [Ottobock Michelangelo (38) for participant #S1 and Ottobock ence hand.
Variplus (67) for participants #S2 and #S3].
Before their enrollment in the study, the participants signed an
SUPPLEMENTARY MATERIALS
informed consent form. Table S5 summarizes the information robotics.sciencemag.org/cgi/content/full/5/46/eabb0467/DC1
about the recruited participants. Text S1. Mechanical model
Experimental protocol Text S2. Angle extraction
The participants were first tested (see the “Clinical evaluation Fig. S1. First three synergies.
Fig. S2. The three stable rotation positions of the thumb.
measures” section) with their commonly used myoelectric prosthesis
Fig. S3. Outline of the experimental protocol.
to assess their baseline (TB, see fig. S3). A myometric exam was then Fig. S4. Forces acting in the palm mechanism.
performed to evaluate the functional state of the residual muscles Fig. S5. Mechanics of the digits.
and the amount of EMG signals to establish the optimal positions of Table S1. The main dimensions of the digits of the human hand and Hannes.
the Hannes EMG sensors. Table S2. Scores of the tests and questionnaires.
Table S3. Final evaluation questionnaire.
After this phase, a training procedure followed (see table S6) during Table S4. Comparison table of commercial and research prosthetic hands.
which participants became acquainted with the Hannes prosthetic Table S5. Participants’ information.
system. Patients were then dismissed and provided with the Hannes Table S6. ADL tasks executed during the rehabilitative training with Hannes.

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SCIENCE ROBOTICS | RESEARCH ARTICLE

Movie S1. Amputees performing clinical tests with Hannes. 27. K. Xu, H. Liu, Y. Du, X. Zhu, Design of an underactuated anthropomorphic hand
Movie S2. Healthy participants performing precision and lateral grasps with Hannes. with mechanically implemented postural synergies. Adv. Robot. 28, 1459–1474
References (74–76) (2014).
28. J. B. Rosmarin, H. H. Asada, Synergistic design of a humanoid hand with hybrid DC
REFERENCES AND NOTES motor - SMA array actuators embedded in the palm, in 2008 IEEE International Conference
on Robotics and Automation (IEEE, Pasadena, CA, 2008), pp. 773–778.
1. R. Vinet, Y. Lozac’h, N. Beaudry, G. Drouin, Design methodology for a multifunctional
29. M. C. Carrozza, G. Cappiello, S. Micera, B. B. Edin, L. Beccai, C. Cipriani, Design of a cybernetic
hand prosthesis. J. Rehabil. Res. Dev. 32, 316–324 (1995).
hand for perception and action. Biol. Cybern. 95, 629–644 (2006).
2. C. Pylatiuk, A. Kargov, S. Schulz, Design and evaluation of a low-cost force feedback
30. C. Cipriani, M. Controzzi, M. C. Carrozza, The SmartHand transradial prosthesis.
system for myoelectric prosthetic hands. JPO J. Prosthet. Orthot. 18, 57–61 (2006).
J. Neuroeng. Rehabil. 8, 29 (2011).
3. H. Bouwsema, C. K. van der Sluis, R. M. Bongers, Learning to control opening and closing
31. M. Grebenstein, A. Albu-Schäffer, T. Bahls, M. Chalon, O. Eiberger, W. Friedl, R. Gruber,
a myoelectric hand. Arch. Phys. Med. Rehabil. 91, 1442–1446 (2010).
S. Haddadin, U. Hagn, R. Haslinger, H. Höppner, S. Jörg, M. Nickl, A. Nothhelfer, F. Petit,
4. J. T. Belter, J. L. Segil, A. M. Dollar, R. F. Weir, Mechanical design and performance
J. Reill, N. Seitz, T. Wimböck, S. Wolf, T. Wüsthoff, G. Hirzinger, The DLR hand arm system,
specifications of anthropomorphic prosthetic hands: A review. JRRD. 50, 599–618
in 2011 IEEE International Conference on Robotics and Automation (IEEE, Shanghai, China,
(2013).
2011), pp. 3175–3182.
5. R. F. Weir, in Standard Handbook of Biomedical Engineering and Design (McGraw-Hill,
32. Y. Kurita, Y. Ono, A. Ikeda, T. Ogasawara, Human-sized anthropomorphic robot hand
New York, USA, 2004), p. 32.1–32.61.
with detachable mechanism at the wrist. Mech. Mach. Theory 46, 53–66 (2011).
6. G. K. Patel, C. Castellini, J. M. Hahne, D. Farina, S. Dosen, A Classification Method
33. E.-H. Kim, S.-W. Lee, Y.-K. Lee, A dexterous robot hand with a bio-mimetic mechanism.
for Myoelectric Control of Hand Prostheses Inspired by Muscle Coordination. IEEE Trans.
Int. J. Precis. Eng. Manuf. 12, 227–235 (2011).
Neural Syst. Rehabil. Eng. 26, 1745–1755 (2018).
34. P. Slade, A. Akhtar, M. Nguyen, T. Bretl, Tact: Design and performance of an open-source,
7. M. Zecca, S. Micera, M. C. Carrozza, P. Dario, Control of Multifunctional Prosthetic Hands
affordable, myoelectric prosthetic hand, in 2015 IEEE International Conference on Robotics
by Processing the Electromyographic Signal. Crit. Rev. Biomed. Eng. 45, 383–410 (2017).
and Automation (ICRA) (IEEE, Seattle, WA, USA, 2015), pp. 6451–6456.
8. E. A. Biddiss, T. T. Chau, Upper limb prosthesis use and abandonment: A survey of the last
35. P. Weiner, J. Starke, F. Hundhausen, J. Beil, T. Asfour, The KIT Prosthetic Hand: Design and
25 years. Prosthet. Orthot. Int. 31, 236–257 (2007).
Control, in 2018 IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS)
9. C. Castellini, Chapter 19 - Upper limb active prosthetic systems – Overview, in Wearable
(IEEE, Madrid, 2018), pp. 3328–3334.
Robotics (Elsevier, 2020), pp. 365–376.
36. H. Ritter, R. Haschke, in Humanoid Robotics and Neuroscience: Science, Engineering and
10. H. A. Varol, S. A. Dalley, T. E. Wiste, M. Goldfarb, Biomimicry and the Design of Multigrasp
Society, G. Cheng, Ed. (CRC Press/Taylor & Francis, Boca Raton, FL, 2015), Frontiers in
Transradial Prostheses, in The Human Hand as an Inspiration for Robot Hand Development,
Neuroengineering.
R. Balasubramanian, V. J. Santos, Eds. (Springer International Publishing, Cham, 2014),
37. S. J. Day, S. P. Riley, Utilising three-dimensional printing techniques when providing
vol. 95 of Springer Tracts in Advanced Robotics, pp. 431–451.
unique assistive devices: A case report. Prosthet. Orthot. Int. 42, 45–49 (2018).
11. M. Controzzi, C. Cipriani, M. C. Carrozza, Design of Artificial Hands: A Review, in The Human
38. Ottobock, Michelangelo Prosthetic Hand (2020); https://shop.ottobock.us/Prosthetics/
Hand as an Inspiration for Robot Hand Development, R. Balasubramanian, V. J. Santos, Eds.
Upper-Limb-Prosthetics/Michelangelo-Axon-Bus-System/Michelangelo-Hand-
(Springer International Publishing, Cham, 2014), vol. 95 of Springer Tracts in Advanced
AxonHook/Michelangelo-Hand/p/8E500~5L-M.
Robotics, pp. 219–246.
39. Ottobock, BeBionic Hand (2020); www.ottobockus.com/prosthetics/upper-limb-
12. L. Biagiotti, F. Lotti, C. Melchiorri, G. Vassura, How Far Is the Human Hand? A Review on
prosthetics/solution-overview/bebionic-hand/.
Anthropomorphic Robotic End-effectors (2004), pp. 1–21.
40. Ossür, iLimb Ultra (2019); www.ossur.com/prosthetic-solutions/products/touch-
13. A. Bicchi, Hands for dexterous manipulation and robust grasping: A difficult road toward

Downloaded from https://www.science.org on April 24, 2022

solutions/i-limb-ultra.
simplicity. IEEE Trans. Robot. Automat. 16, 652–662 (2000).
41. Vincent Systems, Vincent Hand, https://vincentsystems.de/en/prosthetics/vincent-
14. C. Y. Brown, H. H. Asada, Inter-finger coordination and postural synergies in robot hands evolution-3/.
via mechanical implementation of principal components analysis, in 2007 IEEE/RSJ 42. K. Z. Zhuang, N. Sommer, V. Mendez, S. Aryan, E. Formento, E. D’Anna, F. Artoni, F. Petrini,
International Conference on Intelligent Robots and Systems (IEEE, San Diego, CA, USA, G. Granata, G. Cannaviello, W. Raffoul, A. Billard, S. Micera, Shared human–robot proportional
2007), pp. 2877–2882. control of a dexterous myoelectric prosthesis. Nat. Mach. Intell. 1, 400–411 (2019).
15. C. D. Murray, Embodiment and Prosthetics, in Psychoprosthetics, P. Gallagher, 43. T. Laliberte, L. Birglen, C. M. Gosselin, Underactuation in robotic grasping hands. Mach. Intell.
D. Desmond, M. MacLachlan, Eds. (Springer London, London, 2008), pp. 119–129. Robot. Cont. 4, 1–11 (2002).
16. E. J. Weiss, M. Flanders, Muscular and Postural Synergies of the Human Hand. 44. M. Controzzi, F. Clemente, D. Barone, A. Ghionzoli, C. Cipriani, The SSSA-MyHand:
J. Neurophysiol. 92, 523–535 (2004). A Dexterous Lightweight Myoelectric Hand Prosthesis. IEEE Trans. Neural Syst. Rehabil.
17. A. Bicchi, M. Gabiccini, M. Santello, Modelling natural and artificial hands with synergies. Eng. 25, 459–468 (2017).
Phil. Trans. R. Soc. B. 366, 3153–3161 (2011). 45. L. Resnik, S. L. Klinger, K. Etter, The DEKA Arm: Its features, functionality, and evolution
18. A. Leo, G. Handjaras, M. Bianchi, H. Marino, M. Gabiccini, A. Guidi, E. P. Scilingo, P. Pietrini, during the Veterans Affairs Study to optimize the DEKA Arm. Prosthet. Orthot. Int. 38,
A. Bicchi, M. Santello, E. Ricciardi, A synergy-based hand control is encoded in human 492–504 (2014).
motor cortical areas. eLife 5, e13420 (2016). 46. A. R. Tilley, H. D. Associates, The Measure of Man and Woman: Human Factors in Design,
19. F. de Vignemont, Embodiment, ownership and disownership. Conscious. Cogn. 20, 82–93 Revised Edition, Wiley (Wiley, New York, USA, 2001).
(2011). 47. C. Della Santina, M. Bianchi, G. Averta, S. Ciotti, V. Arapi, S. Fani, E. Battaglia,
20. E. D’Anna, G. Valle, A. Mazzoni, I. Strauss, F. Iberite, J. Patton, F. M. Petrini, S. Raspopovic, M. G. Catalano, M. Santello, A. Bicchi, Postural hand synergies during environmental
G. Granata, R. D. Iorio, M. Controzzi, C. Cipriani, T. Stieglitz, P. M. Rossini, S. Micera, constraint exploitation. Front. Neurorobot. 11, 41 (2017).
A closed-loop hand prosthesis with simultaneous intraneural tactile and position 48. J. Lukos, C. Ansuini, M. Santello, Choice of contact points during multidigit grasping:
feedback. Sci. Robot. 4, eaau8892 (2019). Effect of predictability of object center of mass location. J. Neurosci. 27, 3894–3903
21. A. M. Okamura, N. Smaby, M. R. Cutkosky, in Proceedings 2000 ICRA. Millennium (2007).
Conference. IEEE International Conference on Robotics and Automation. Symposia 49. P. H. Thakur, A. J. Bastian, S. S. Hsiao, Multidigit movement synergies of the human hand
Proceedings (Cat. No.00CH37065) (San Francisco, CA, USA, 2000), vol. 1, pp. 255–262. in an unconstrained haptic exploration task. J. Neurosci. 28, 1271–1281 (2008).
22. M. Santello, M. Bianchi, M. Gabiccini, E. Ricciardi, G. Salvietti, D. Prattichizzo, M. Ernst, 50. M. Pazzaglia, M. Molinari, The embodiment of assistive devices—from wheelchair
A. Moscatelli, H. Jörntell, A. M. L. Kappers, K. Kyriakopoulos, A. Albu-Schäffer, C. Castellini, to exoskeleton. Phys. Life Rev. 16, 163–175 (2016).
A. Bicchi, Hand synergies: Integration of robotics and neuroscience for understanding 51. F. Marini, C. F. Tagliabue, A. V. Sposito, A. Hernandez-Arieta, P. Brugger, N. Estévez,
the control of biological and artificial hands. Phys. Life Rev. 17, 1–23 (2016). A. Maravita, Crossmodal representation of a functional robotic hand arises after extensive
23. M. Santello, M. Flanders, J. F. Soechting, Postural hand synergies for tool use. J. Neurosci. training in healthy participants. Neuropsychologia 53, 178–186 (2014).
18, 10105–10115 (1998). 52. C. E. Clauser, J. T. McConville, J. W. Young, Weight, Volume, and Center of Mass Segments
24. R. Gentner, J. Classen, Modular organization of finger movements by the human central of the Human Body. J. Occup. Environ. Med. 13, 270 (1971).
nervous system. Neuron 52, 731–742 (2006). 53. C. Pylatiuk, S. Schulz, L. Döderlein, Results of an Internet survey of myoelectric prosthetic
25. M. G. Catalano, G. Grioli, E. Farnioli, A. Serio, C. Piazza, A. Bicchi, Adaptive synergies hand users. Prosthet. Orthot. Int. 31, 362–370 (2007).
for the design and control of the Pisa/IIT SoftHand. Int. J. Robot. Res. 33, 768–782 (2014). 54. P. R. Cavanagh, P. V. Komi, Electromechanical delay in human skeletal muscle under
26. S. Li, X. Sheng, H. Liu, X. Zhu, Design of a myoelectric prosthetic hand implementing concentric and eccentric contractions. Eur. J. Appl. Physiol. Occup. Physiol. 42, 159–163
postural synergy mechanically. Industrial Robot. 41, 447–455 (2014). (1979).

Laffranchi et al., Sci. Robot. 5, eabb0467 (2020) 23 September 2020 14 of 15

SCIENCE ROBOTICS | RESEARCH ARTICLE

55. C. R. Mason, J. E. Gomez, T. J. Ebner, Hand synergies during reach-to-grasp. 73. M. Schröder, T. Waltemate, J. Maycock, T. Röhlig, H. Ritter, M. Botsch, Design
J. Neurophysiol. 86, 2896–2910 (2001). and evaluation of reduced marker layouts for hand motion capture. Comput. Animat. Virt. W.
56. E. Todorov, Z. Ghahramani, Analysis of the synergies underlying complex hand 29, e1751 (2017).
manipulation, in The 26th Annual International Conference of the IEEE Engineering in 74. S. B. Godfrey, K. D. Zhao, A. Theuer, M. G. Catalano, M. Bianchi, R. Breighner, D. Bhaskaran,
Medicine and Biology Society (San Francisco, CA, 2004), vol. 2, pp. 4637–4640. R. Lennon, G. Grioli, M. Santello, A. Bicchi, K. Andrews, The SoftHand Pro: Functional evaluation
57. A. Naceri, A. Moscatelli, R. Haschke, H. Ritter, M. Santello, M. O. Ernst, Multidigit force of a novel, flexible, and robust myoelectric prosthesis. PLOS ONE 13, e0205653 (2018).
control during unconstrained grasping in response to object perturbations. 75. Prensilia, Azzurra IH2 user manual; www.prensilia.com/portfolio/ih2-azzurra/.
J. Neurophysiol. 117, 2025–2036 (2017). 76. T. E. Wiste, S. A. Dalley, T. J. Withrow, M. Goldfarb, in 2009 IEEE International Conference on
58. J. L. Segil, R. F. f. Weir, Design and validation of a morphing myoelectric hand posture Rehabilitation Robotics (IEEE, Kyoto, Japan, 2009), pp. 675–681.
controller based on principal component analysis of human grasping. IEEE Trans. Neural
Syst. Rehabil. Eng. 22, 249–257 (2014). Acknowledgments: We thank the volunteers who participated in the study; A. Veronelli for
59. J. L. Segil, R. Kaliki, J. Uellendahl, R. F. f. Weir, A myoelectric postural control algorithm contribution to the mechanical design in the initial phase of the project; A. F. Kleppa,
for persons with transradial amputations: A consideration of clinical readiness. IEEE Robot. A. Marinelli, S. Scarpetta, and A. Cimolato for support in conducting the experiments and the
Automat. Mag. 27, 77–86 (2020). production of the material; V. Squeri, M. L. D’Angelo, and P. Randi for help in the clinical trials;
60. T. Pistohl, C. Cipriani, A. Jackson, K. Nazarpour, Abstract and proportional F. Tessari for support in revising the mechatronics section; M. Chiappalone and G. Barresi for
myoelectric control for multi-fingered hand prostheses. Ann. Biomed. Eng. 41, valuable advice on writing the paper; G. Berretta, S. Stedman, and D. Farina for the support in
2687–2698 (2013). the preparation of the videos. We also thank M. Zambelli for key advice on the development
61. G. C. Matrone, C. Cipriani, E. L. Secco, G. Magenes, M. C. Carrozza, Principal components and revision of the device and L. De Bartolomeis, G. Diamanti, and F. Poli for support in the
analysis based control of a multi-DoF underactuated prosthetic hand. J. Neuroeng. industrial design of the device. Funding: This work was supported by the INAIL under grant
Rehabil. 7, 16 (2010). agreement PPR1A. Author contributions: M.L. conceived and designed the study and
62. M. Dyson, J. Barnes, K. Nazarpour, Myoelectric control with abstract decoders. J. Neural coordinated the scientific and technical aspects of this work. N.B. conducted the mechatronic
Eng. 15, 056003 (2018). integration, tested the device, and performed all the clinical trials. S.T. conducted the
63. J. L. Segil, R. F. Weir, Novel postural control algorithm for control of multifunctional mechanical development of the systems. L.L. developed part of the electronics and conducted
myoelectric prosthetic hands. J. Rehabil. Res. Dev. 52, 449–466 (2015). the PCA. M.C. developed the electronics. A.L. conducted the mechanical development of the
64. L. A. Wheaton, Neurorehabilitation in upper limb amputation: Understanding how systems and coordinated the mechanical engineering team in the final phase of the project.
neurophysiological changes can affect functional rehabilitation. J. Neuroeng. Rehabil. 14, M.S. analyzed the outcome of the clinical trials. A.N. coordinated the “Human-like synergistic
41 (2017). behavior” experiments. J.A.S. conceived and designed the study and co-coordinated the
65. M. Grebenstein, M. Chalon, G. Hirzinger, R. Siegwart, Antagonistically driven finger project with M.L. in its initial phase. R.S. was clinical and technical advisor. E.G. was clinical and
design for the anthropomorphic DLR Hand Arm System, in 2010 10th IEEE-RAS technical advisor and coordinated the clinical trials. L.D.M. conceived and designed the study
International Conference on Humanoid Robots (IEEE, Nashville, TN, USA, 2010), and revised the work. M.L., L.L., A.L., M.S., and A.N. wrote the manuscript. N.B. and S.T.
pp. 609–616. contributed to the writing of the paper. N.B., M.S., A.N., L.L., and S.T. prepared the figures; N.B.,
66. D. Formica, S. K. Charles, L. Zollo, E. Guglielmelli, N. Hogan, H. I. Krebs, The passive A.N., and E.G. prepared the videos. M.L. and L.D.M. revised the manuscript and coordinated the
stiffness of the wrist and forearm. J. Neurophysiol. 108, 1158–1166 (2012). review process. M.L., J.A.S., and L.D.M. supervised the teams involved in the study and
67. Ottobock, MyoHand VariPlus Speed (2020); www.ottobock-export.com/en/prosthetics/ collected the funding to perform the study. All the authors have read and approved the
products-from-a-to-z/arm-prosthetics/myohand-variplus-speed/. manuscript in its final form. Competing interests: M.L., N.B., S.T., A.L., E.G., and L.D.M. are
68. J. Desrosiers, A. Rochette, R. Hébert, G. Bravo, The minnesota manual dexterity listed as inventors in the following patent applications: PCT application no. PCT/

Downloaded from https://www.science.org on April 24, 2022

test: Reliability, validity and reference values studies with healthy elderly people. IB2019/052172 “Artificial Wrist”; PCT application no. PCT/IB2019/053682 “An Underactuated
Can. J. Occup. Ther. 64, 270–276 (1997). Prosthetic Hand”; PCT application no. PCT/IB2019/053683 “Prosthetic Finger”; and PCT
69. C. M. Light, P. H. Chappell, P. J. Kyberd, Establishing a standardized clinical assessment application no. PCT/IB2019/056142 “Prosthetic Wrist” submitted by the Istituto Italiano di
tool of pathologic and prosthetic hand function: Normative data, reliability, and validity. Tecnologia and INAIL, which cover the fundamental principles and design of Hannes. The
Arch. Phys. Med. Rehabil. 83, 776–783 (2002). other authors declare that they have no competing interests. Data and materials availability:
70. A. W. Heinemann, R. K. Bode, C. O’Reilly, Development and measurement properties All data and materials are available in the main text or the Supplementary Materials.
of the Orthotics and Prosthetics Users’ Survey (OPUS): A comprehensive set of clinical
outcome instruments. Prosthet. Orthot. Int. 27, 191–206 (2003). Submitted 25 January 2020
71. P. L. Hudak, P. C. Amadio, C. Bombardier, D. Beaton, D. Cole, A. Davis, G. Hawker, Accepted 18 August 2020
J. N. Katz, M. Makela, R. G. Marx, L. Punnett, J. Wright, Development of an upper extremity Published 23 September 2020
outcome measure: The DASH (disabilities of the arm, shoulder, and head). Am. J. Ind. Med. 10.1126/scirobotics.abb0467
29, 602–608 (1996).
72. P. Gallagher, M. MacLachlan, The Trinity amputation and prosthesis experience scales Citation: M. Laffranchi, N. Boccardo, S. Traverso, L. Lombardi, M. Canepa, A. Lince, M. Semprini,
and quality of life in people with lower-limb amputation. Arch. Phys. Med. Rehabil. 85, J. A. Saglia, A. Naceri, R. Sacchetti, E. Gruppioni, L. De Michieli, The Hannes hand prosthesis
730–736 (2004). replicates the key biological properties of the human hand. Sci. Robot. 5, eabb0467 (2020).

Laffranchi et al., Sci. Robot. 5, eabb0467 (2020) 23 September 2020 15 of 15

 The Hannes hand prosthesis replicates the key biological properties of the human
hand
M. LaffranchiN. BoccardoS. TraversoL. LombardiM. CanepaA. LinceM. SempriniJ. A. SagliaA. NaceriR. SacchettiE.
GruppioniL. De Michieli

Sci. Robot., 5 (46), eabb0467. • DOI: 10.1126/scirobotics.abb0467

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