For patients with ALS and other conditions causing hand strength and dexterity impairment such as MS, psoriatic arthritis, and injury, daily tasks can become huge challenges. Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease. Patients often begin to have symptoms such as numbness or tingles in the hands and legs, and they slowly lose function of their extremities and eventually almost all muscle control. While the disease is fatal, there are many treatments and devices available to patients to help improve their quality of life as the disease runs its course. 

Grip aids are one type of device currently available to patients. They often take the form of rubber or silicon bands that can be attached to frequently used items such as toothbrushes or doorknobs. These devices can be greatly helpful to patients by providing an extra loop or handle to the item, or by providing texture to certain surfaces like doorknobs. While these devices are very useful, the main shortcoming is that they must be installed by a fully dexterous person ahead of time. This puts extra burden on caregivers and loved ones, and from the patients' perspective they may struggle to use various items until they can get a caregiver to add a silicon grip to it. 

The main goal of this project was to develop a design for a grip aid device that could be used by patients completely independently of caregivers. 

When generating design inputs, I chose to have conversations with the patient population to best understand the need of the end users. This took the form of utilizing connections and contacting various patient groups and organizations specializing in ALS. Along the way I was also able to have conversations with patients with psoriatic arthritis and hand injuries as well. I also spoke with caregivers to patients with ALS to get their expertise from an external perspective. 

Part of this effort also involved gaining IRB exemption from the university to make sure that these patient interviews were ethical and humane. This involved completing ethics training and answering detailed questions about the plans for my project prior to execution. 

In parallel to the interview effort, I was also creating various design concept sketches. These sketches were early ideas to solve the problems patients are facing, and some would become final designs. 

The patient interviews yielded very interesting results, and it was determined that there were three major areas for improvement in the patient experience: rotary motion, pinch strength, and squeeze strength. Based on these results I started making proof of concept builds of a few designs that seemed to solve these problems for patients. To solve rotary motion tasks (such as turning doorknobs and opening jars), I developed an attachable handle design depicted in the above image carousel. The magnet glove design was also developed at this stage to help with pinch grip. Finally, for squeeze strength a claw-type design was explored. However, the early proof of concept identified some challenges with this design idea, and it was abandoned in favor of focusing efforts on the magnet glove and attachable handle. 

Completing the proof of concept builds gave me a clear direction on where to take the designs going forward. Using SolidWorks and the 3D print lab on campus, I created several versions of the attachable handle. When my parts had printed I would assemble the prototype and test it on my own. This process would often identify some improvements, which would start this process over again. While I was waiting for parts to print, I was also iterating and assembling the glove prototype. In a similar way this work would yeild improvements to be made, allowing me to make minor tweaks throughout the process. 

At the end of the semester I ended up with two versions of a functional prototype for the magnet glove. Unfortunately, due to time constraints as well as a shipping error, I was unable to make the attachable handle prototype functional by the end of the semester. I was invited to present at the Northeastern event RISE 2023, which is an undergraduate research poster session. This was was a great opportunity to showcase all that I had learned and worked on throughout the semester, and my prototypes were well received by the audience, which included a physical therapist. 

Future work efforts on this project would of course be to achieve functionality with the attachable handle prototype. This would simply require a longer timeline and more 3D printing. Following this, more conversations with patients to receive feedback on the designs would be necessary. Greater feedback on the design will allow more robust design iterations to be developed. 

While I will not be able to work on this project to the degree I have been able to during the semester, I plan to continue to develop my designs in my spare time. Additionally, I have made some great connections within the field of ALS, and I am recommending the department of Bioengineering to continue to sponsor and provide opportunities for students to work in this field. 

During this research effort I learned many lessons and wore many hats as I worked through the design process independently. One thing I was able to learn first hand is that finding user needs is vitally important and takes a lot of time and resources. In the future I will continue to put emphasis on this kind of work and be more effective in carrying out these types of projects.