For Limbitless Solutions president and co-founder Albert Manero, his journey with prosthetics began in perhaps the most mundane way possible: stalled in traffic on the roadways near the University of Central Florida.
“There was a radio interview with the gentleman who made the first 3D-printed mechanical hands,” he recalls. “And they were emailing files around the world trying to figure out how to make this thing work. I heard the interview while I was late coming to campus, and I cold emailed them and said, how can I be a part of this? I want to help.”
Within just eight weeks, the mechanical engineering Ph.D. and his colleagues were delivering a prototype prosthetic arm to a young boy in need of some truly costly assistive hardware. “Watching the impact for that first child was so incredible,” Manero says as he thinks about the encounter. “We all kind of decided this was just something we couldn’t walk away from. And that’s when we formed the nonprofit and we partnered with the University of Central Florida.”
In the eight years following that life-altering moment, Limbitless has honed its additive manufacturing process, refined its mission, started a clinical trial in partnership with some of the nation’s best hospitals, and donated 40 highly sophisticated and customizable 3D-printed arms to “bionic kids” in need. This year, the charity continued its established partnership with Xbox’s 343 Industries to create two new prosthetic designs based on popular characters from the Halo video game franchise.
We spoke to Manero and Limbitless Head of Game Development and Training, Peter Smith to learn more about the organization’s noble cause and to better understand the mental and physical struggles of a young population learning to overcome limb difference. Through our chat, we gleaned some helpful tips that could be of great use to individuals or caretakers of those facing similar situations.
Prosthetic Arms That Cost Less
First and foremost, the goal of Limbitless Solutions is to offer children and families affordable access to pricey, 3D-printed prosthetics. “Nobody has ever paid for an arm,” Smith assures us of the outfit’s donation model. “And they also raise enough money to pay for their trips to the hospital, doctors’ times, and appointments.”
In many cases, artificial limbs like the ones Limbitless provides can cost families upwards of $50,000, with only a small portion of that fee being covered by medical insurance. In this regard, the company’s 3D-printing technology is a huge help.
The Bonding Game: How Limbitless' Prosthetic Arms Work
But aside from relieving the burden of financial difficulty, Limbitless leverages unique methods to overcome one of the most common problems facing people trying bionic limbs: getting wearers to learn and master their hardware.
“I kind of compare it to learning how to play an instrument,” Manero describes. “You’re going to make noise for the first year on an instrument, but it may not be the sound you want right away. The real challenge, whether it’s learning an instrument or learning your prosthetics, is being able to continue forward when it’s challenging. And then, as you start to see progress, being able to reward that progress so that you can continue to build on that momentum…
“Just going to the shoe store and trying to find the right fit of a shoe isn’t a trivial level of challenge, especially if your child’s foot’s growing really fast. A prosthetic is a lot more complicated. And it does take the time to learn how to use it in everyday tasks.”
But Smith plays a key role in making that difficult endeavor a bit more digestible for a less-patient, youthful clientele. Using his learned knowledge as a creator of training modules for the U.S. government, his team has boiled the process of bonding with prosthetics down to playing simple video games.
Through the Limbitless design, users flex once to open an arm and then a second time to close. By flexing with varied levels of strength, the user can perform a wide variety of gestures.
“The video games teach them how to flex in a more finessed way,” Smith says of his team’s software. “So the game will do a different power if they flex at 5% of their strength, 50% of their strength, or as strong and as hard as they can. And then, as they level up in the games, they also level up in their arm, and we unlock multi-gestural support.”
Ask the child to repeat the flex for the lightning power, and it results in the arm performing a basic finger point. Replicate the rock power, and you’ll hopefully see an OK sign. This acclimation process can often be a multi-year journey for those participating in a Limbitless trial, but success rests on the fundamental belief that kids have a higher tolerance for hinderance when video games are involved.
“Nobody ever quits Mario the first time they die,” says Smith with a laugh, “they lose a life and try again.” At least five essential gestures are taught through the software, but Smith believes there’s promise for advancement in future research.
While this training process is underway, participants in the trial have access to Limbitless staff through a specialized feedback app. Should anything need to be replaced through daily use, that support can happen quickly on mobile devices.
That said, Manero was honest about the possible deteriorative impact any separation time can have on the bonding procedure. “There’s a lot of reporting that shows that downtime from your prosthetic limb can make it very difficult to turn it back on when you get it back and go through that process again,” Manero admits.
“It’s another place where the games can play a role,” Smith adds, “During that downtime, they can still flex into the video game and keep the muscles strengthened.” So, Limbitless Solutions’ unique focus on gaming not only helps facilitate the bonding process when prosthetics are available, it encourages kids to stick to the established routine in the unfortunate event they are not.
Prosthetic Designs That Look Cool
Outside its emphasis on training games, Limbitless has also made a name for itself thanks to its focus on personalized designs and freedom of expression. Because, as Smith and company learned early on, kids demanded prosthetics that were not only functional but also looked attractive to their peers.
“The first prosthetic was just the white, 3D printer material,” Smith recalls. “We sent it home with the kid, and when he showed back up, he had painted it. I think his grandfather did the hydro dipping, so he came back with it bright orange, and it had designs on it. And the specialists were like, ‘What happened?’ He’s like, ‘I’m a kid! I wanted to look cool!’ That was kind of the impetus to be like, yeah let’s make them look awesome.”
To that end, Limbitless recently partnered with Microsoft’s Halo Infinite development studio at 343 Industries on two brand-new arm designs meant to replicate series icon Master Chief and fan-favorite, Kat.
That design phase, which takes several months to accomplish, is a collaboration between Manero and folks like Ron Brown, the studio quality-of-life project manager at 343 Industries. The developer provides Limbitless with in-game assets to ensure the designs are as accurate as possible. Brown says getting the sleeves just right requires adherence to two key values.
“They, one, have to make sure it’s something that can be functional. As much as we love the Halo universe, not everything you see in it would be functional in the real world,” Brown explains. “So it is vital that they make some bits and tweaks and moves here and there to make sure these limbs can actually do what they want them to do and can house all the different things they need to house.”
The other part of the creative process requires attention to visual detail, a quality that Limbitless is so devoted to that it even tested Brown’s patience from time to time. “I remember working with Albert, and they were obsessing over the right color green for that specific Chief arm.
“And every arm is kind of its own bespoke creation. And so, if you color one arm one way, and then the paint dries or sets a certain way, or you use a different brand of paint, any number of things can go wrong with the process. I’m just like, it’s just supposed to be green! Paint it green! Take it into the lab, and just paint the mold! And no, instead he’s like, ‘can we get another picture of Chief? We’re really trying to compare with the green.’ So their attention to detail can sometimes be even greater than my own,” Brown says with a chuckle.
But of course, as authentic as these branded prosthetic device designs may be, Smith reminds us that any base design can be customized to a kid’s liking, even if that means replacing Chief’s iconic hue with something else. “They get to pick all the different colors and things. They can pick things that match their favorite outfits or something that’s important to them, a team they’re on, if they like a sports team or something, they can pick their colors,” he says.
As for Kat, Brown sees her design as a way to highlight the broader inclusivity of the humanity-focused Halo franchise. “There was such a good reception to the initial sleeves, that we wanted to make sure we were really calling out the continuation of everything. And the fact that we had a Spartan sleeve that was taken directly from an in-game character who had a prosthetic, that was a really big thing,” he says. “We also just really wanted to celebrate the moment, celebrate the messaging.”
Anyone who receives a custom sleeve from Limbitless can apply any number of designs to a single arm prosthetic via a sliding magnetic rail system as well, so wearers can easily swap to any look they like based on their outfit or demands of the day.
“I love the idea that there’s going to be playgrounds with kids running around with [Master Chief] armor from the video game,” Manero says of Limbitless’ latest creations. “What that means in terms of changing the stigma around prosthetics, it completely changes the conversation for these kids. And I think it’s just a really amazing thing to think about that becoming more normal in our world.”
Stay Motivated At All Costs
The minds behind Limbitless know they’re exploring a challenging sector, both in terms of managing regulatory costs with the FDA as trials continue, and in terms of managing the expectations of the families they serve.
“Getting prosthetics for a child in your family is more complicated, in my opinion, than people might give it credit for,” Manero admits. “Having that patience and being able to work through the tough days, and then celebrate on the more successful days up front can help minimize those challenges in terms of progression with the device. But it does take time to bond with your prosthetic and make it part of your routine.”
Ultimately, Manero feels serving children with limb differences can sometimes be more complex than other disabled populations. “Especially when you’re designing for kids, you have to think differently than designing for, let’s say, for example, the veteran population. There’s just a number of differences that we’re trying to be mindful of. And as we continue to do that, that means getting better at the training, getting better at communicating how the arm works, how you’re going to develop it and then the daily progression. There’s a lot left to do, but we’re really excited to be able to work on it.”
And, perhaps on those tough days, Brown believes people of all kinds can find solace in gaming communities like the one he interacts with on Xbox.
“Do what it is that you want to do,” he says with confidence. “Don’t worry about whether or not the world around you is going to be OK with it. Don’t worry about whether or not this is the place you’re supposed to be. If you are there, you are supposed to be there. And I think gaming is one of those spaces that should be that way all the time. If you want to be in gaming, as a gamer, I want you there…
Gaming does not exist without women, it doesn’t exist without people of color, it doesn’t exist without LGBTQIA folks, because gaming is about humanity. It’s about who we are. Come on in, get in here! Be a part of it in whatever ways you find, and then tell us how you want to be a part of it, so we can lean that way.”