Font Zoom in Regular Zoom out

Felix finally approved for a myoelectric arm – talking to Dario who built it

Finally approved for a myoelectric arm and talking to Dario who built it

Lily Toengi-Andrews

Dario Ruckli is an Orthopaedic Technician at Ortho Team in Luzern, Switzerland. He is working with Dominik Sager, Divisional Manager Prosthetics to build an arm for our 12-year old son, Felix, who has been approved for a myoelectric arm by the Swiss Invalidenversicherung (Swiss disability insurance). As a family, we know this side of living with a limb difference, the frustration, the fight for approval and the 12 months waiting, but we wanted to know what Dario’s motivations and experiences were in his position. Thanks, Dario, for sharing your story.

Dario knew he wasn’t the type to sit behind a desk and most of the jobs he looked at during school work experience didn’t appeal to him. He went to the careers advisor who suggested he go to Ortho Team in Luzern. “It is the diversity of the job I like, I get to work with my hands, there is the technical element and also the social work with the clients. The client relationship is friendlier than in some jobs, you work closely with them and you are part of a team. I also work with their doctor, physiotherapist, and my work colleagues, and together we are trying to give our clients the best quality of life possible,” he said.

The biggest part of the job is the production of orthoses and protheses and while the work has turned out to be what he expected, there are also a lot of changes as it becomes more digital. “Originally, they were all made by hand from carbon fibre or orthosis polypropylene but now a big part of the device is made with 3D printing. The benefit is that once they have been constructed on the computer, we are always able to reproduce any part if it breaks or there is a problem,” Dario added.

“Sometimes there can be disappointment as everyone has a picture in their mind of what the prothesis should look like and what it can do, so it can be difficult to satisfy everyone’s expectations. Sometimes, the doctor doesn’t know what is or isn’t possible and the myoelectric hand we are creating for Felix is not common,” he explained.

“Unfortunately, I don’t really have a good relationship with the insurance company as it is annoying and frustrating dealing with unanswered phone calls, lack of understanding and lots of to-ing and fro-ing. We are ready to begin, ready to deliver to our clients, but it is always the insurance company who holds up the process. None of us here like it.”

“To be honest, this is not something I expected before I started the job. Switzerland is a rich country and I just thought that this service would be covered by insurance,” he said.

Dario said that the job doesn’t stress him out, but it does make him a little bit sad as he knows what is possible and how it could give some of his clients a better life. “People don’t choose this life as they were either born like this or have had an accident. We do our best to get approval and support our clients. We have the knowledge and the background to explain to the insurance company why they need this and how it can help their life,” he added.

Orthopaedic products have developed a lot since the second world war. The biggest progress was made back then because of all the amputations, but now there are fewer clients so progress isn’t moving at the same speed. I don’t know how fast it will continue to develop, but it would be good if products got cheaper, or if there were new production techniques so more people could benefit from this or even pay for it themselves.

“The biggest costs are development of the materials and safety, as no-one wants to be responsible if something doesn’t function properly. The materials for carbon fibre are really expensive as it is super light and hard and these materials amount to about 70% of the total cost. We have two big brands in Switzerland, Össur from Iceland, and Ottobock which was founded in Germany and is where Felix’s hand is from. They are doing a lot of work with new technology, the hand is always able to do more movements, like rotating and moving the thumb in different directions.

“It is getting closer to being like a real hand but it’s really difficult to reproduce every movement as it is probably the most complex part of our body. It also depends on how well a client can control their muscles. Someone who has never had to use those muscles can find it difficult, so it’s good to start young like Felix who has really good muscle control. Someone who has lost a hand will still have the muscles,” explained Dario.

For Felix’s myoelectric arm there are two sensors that press against the skin, near the elbow. Contracting the muscle on the top of his arm opens the hand and the muscle at the bottom closes the hand. You can see how Felix does this by watching this video.

You can have up to four sensors which provide more movement. Right now, the best products can have up to 24 positions and on the bebionic Hand EQD created by Ottobock, every finger can be controlled electronically. Felix’s hand will open and close, but the fingers will not individually move.

For Dario, what makes it all worthwhile is helping a client live a better life. “We had a client whose legs were nearly numb so without support he wouldn’t be able to walk. We built an expensive orthosis and he can now walk without crutches. That was the best life quality we could give back to a client. I really enjoyed doing that, it was amazing to give him the chance to live his life the way he wanted to, that was really cool – that is why I have chosen this job.

“I am really happy to be helping Felix. It is nice to see the progress, to see someone control the myoelectric hand for the first time – it is super cool. There was a girl younger than Felix and she was able to pick up a glass and that was special and that makes it worth all the difficulties with the insurance. One day I would like to build something for a Paralympic athlete. This really inspires me, that would be my dream,” Dario concluded.

Felix shares Dario’s excitement and says “I’m really happy that they helped me get this arm, it’s really cool.  I am learning to use it and practise opening and closing the hand and holding things.”