Today the market of prostheses is similar to the sphere of smartphones in the 90s - there are few users, and prices are high, says Vasily Khlebnikov, co-founder of Motorika, a cyber prosthetics company. In an interview, he told how much bionic prostheses cost, how to get them for free and why the word “cyborg” can be considered a compliment - in the material of “Gazeta.Ru” - What kind of prostheses are there?

- There are several types of prostheses. The so-called functional - these are prostheses that can move, with their help you can take something. And then there are non-functional, cosmetic prostheses that are designed to hide the absence of a hand. We deal only with functional ones, we do not see much interest in the production of cosmetic prostheses - there are a lot of them on the market.

Active prostheses, in turn, are divided into two options. Active, or traction, Body-part, they work due to the movement of the hand. That is, if a person has a wrist joint, but does not have fingers, then he can use the movement of the wrist joint to make a grip on the hand prosthesis itself. And forearm prostheses, for example, move due to the movement of the elbow joint. We call them "kibi".

There are also prostheses with electronics, batteries and other robotic things. They are already called bionic, which work by reading an electromyographic signal. It is removed by sensors from the muscle surface. We install the prosthesis on the stump, and the person works with the prosthesis with the rest of the muscles.

Sometimes the absence of a hand is an innate history, then a person lives without it until a certain age.

The youngest wearers of the prosthesis are now seven years old, and they still use the traction arm to get used to the cyberhand, learn how to use it and keep their muscles in good shape.

- How many people get used to the prosthesis?

- Very differently, everything is individual here. So, for example, children very quickly get used to it, but they just get used to it just as quickly if they do not wear it for a long time. There are a lot of different parameters that affect the time to get used to the prosthesis.

In general, you can somehow start using the prosthesis immediately after installation. We have a special program in which we teach a person to use the hand in different positions and situations, adjust it, and so on.

It is worth noting that early prosthetics are very important so that a person begins to get used to it. That is, if a child develops without an arm and without a prosthesis, then it is commonplace for him to outweigh one side, which already leads to problems with the spine.

People who do not wear prostheses and live without an arm since childhood have health problems by the age of 30. These are statistics.

Plus, there is also an overuse syndrome, when the entire load falls on the other hand. Then there the joints begin to malfunction earlier, and so on. In general, from a medical point of view, it is important that a child grows up with two hands.

Plus there is a psychological component. When a child comes to school or kindergarten as a cyber hero, this has a positive effect on his self-esteem.

- Do I need to change the prosthesis during operation?

- Of course of course. In general, a prosthetic hand is like any gadget. So it needs to be changed as it wears out, and the wear depends on the usage patterns. First of all, it all depends on the user. Someone actively uses it, for example, in the village, then we put serious protection. And someone goes to the office and does not bear any risks.

Our main task is to make the cyber hand a gadget. As we use the phone now, so we will be a cyber-hand.

With a child, a slightly different story, he can grow up in six months. That is why we have a subscription model of work, that is, we make a subscription for a year. That is, if the child has grown up within a year, then we change small details for him before the second prosthetics. We have a full service there, in addition to training, we actively keep in touch with users. We call to find out if everything is in order, how he uses it, if there are any difficulties. If we identify them, then we try to quickly correct them so that the person has a pattern of daily use of the prosthesis.

That is why we provide an annual subscription. For example, we have a guy who we changed his prosthesis four times a year, because he just used to wear it. Therefore, already in the latest version, we made him the strongest fingers.

In general, Russia has a fairly good model of state support for people with disabilities.

And a child with Russian citizenship, according to the law, can get a hand once a year at the expense of the state. We, among other things, help to completely go through the path of registration, we understand what is happening, we have a bunch of both training courses and information that allows you to get acquainted with the procedure.

We make everything as clear as possible for each potential user.

- Does state support apply only to children or to adults too?- For adults, too, there are a little more terms. If a child can receive a hand annually, then an adult - depending on the type of product. Well, there are now additional commissions.

- Is this a free practice, or maybe there are some restrictions?

- There are only medical restrictions, for example, the topology of the injury. Unfortunately, we cannot install a prosthesis for some cases.

Further, the state also has its own commission models, which determine what kind of prosthesis a person can receive. Here they form the so-called individual program of rehabilitation and habilitation. She is the rationale for the social insurance fund to give a person some kind of equipment.

Well, then the social insurance fund will hold a competition, and there are already several options for getting a cyber hand. There is also an opportunity to receive a product against compensation, that is, to buy first and then receive money.

- If I do not fit into this program, then how much should I pay approximately for the manufacture and installation of a prosthesis?

- Depends on the type of product. The cost starts from 140 thousand rubles. up to 450 thousand rubles in year. In general, there are different types of prostheses, for example, from foreign manufacturers. A prosthesis from Össur can cost 7 million, that is, the prices are very different.

In general, price is one of these barriers in the market. A very good example is the mobile phone market. If you compare us with this business, then we are now somewhere in the late nineties. When we already had some more or less devices there, but there were few of them, there were also users, and the price was very high. Then the number of users increased and the price decreased.

The story is exactly the same with prostheses.

Of the millions of people in the world who live without hands, only about 20% use prostheses.

Moreover, active prostheses are used by 3-5%, the rest use cosmetics. And this is, in fact, a scarce market.

By gradually reducing this percentage of those who do not use cyber hands, we will increase the number of users and thereby reduce the cost.

- Most of the media people use foreign prostheses. Many people think that they are better, is that so?

- It's a delusion. We have different competitors, in general we surpass someone in some parameters, someone surpasses us. We were the first in the world to do many things, and now people are actively using it.

Our approaches are perceived not only in Russia. We have users in 12 countries of the world, and we are actively entering India now - there are already 10 of our users there.

- Do the weather conditions, the lifestyle of a person somehow affect the prostheses?

- Weather conditions affect one way or another, overheating may occur if it is very hot. Now in India we are successfully solving these issues, but we had to tinker a little. With cooling, the opposite topic is the freezing of the battery. For example, we advise wearing mittens on the prosthesis.

There are different dentures with different indices of dust and moisture protection. There are those that it is advisable not to wet, but there are those in which you can swim. Operating conditions are also strongly influenced. As I said, we have super-active users who live in the village, work with their hands. So we work with users in a relatively individualized format that allows us to tailor the product to their needs.

- It happens, probably, that the prosthesis was discharged in some unforeseen circumstances, on the same street, or at work. Are there any replaceable power supplies?

- Can be charged from a power bank, there is a USB-C connector.

- How long does the charge last?

- On average for a day, two. Depends on the activity of use. Someone “zhamka” more, someone less. It's like a cell phone. Our guys basically put on a prosthesis every two days to exercise at night.

- Are cyber hands connected to other devices, can they generally be attributed to the Internet of Things?

- Of course, we were the first to start connecting most of the produced cyberrucks to the cloud. This allows you to build a new format for user interaction.

First, the user has additional options. Second, we can build a predictive maintenance model.

For example, we understand that the user has hit something, some piece of hardware is bent, or an additional load has gone on the engine and it will burn out in three days. We receive a notification about this and promptly solve the problem.

“If the prosthesis can connect to the cloud, then hackers can break it. Are they somehow protected from this?

- Yes, we are working on this story. Overall, there are few risks. At the moment, we are testing our modules for security with Kaspersky Lab.

- How do you know when it's time to buy a new prosthesis?

- Everyone has their own time. It's like a car in a garage and a car that plows behave differently. It's the same here.

Of course I have. obsolescence aspect. We release a new version once a year, and they have more features than the previous one. This is also one of the reasons for the replacement.- Recently, there was news in the media that Zuckerberg is developing a skin for prostheses that can "feel" the touch. Do you have such developments?

- Yes, at the beginning of December we conducted our clinical studies. We connected to the human nervous system with an electrode and transmitted the signal to the tips of the bionic fingers. Now research is proving that we can transmit a signal from the bionic hand to the user's nervous system and thus give him the opportunity, in addition to visual feedback, when he takes something, to receive tactile feedback.

- Let's look a little into the distant future. Will we ever be able to become real cyborgs, or can we already count people with prostheses as them?

- Well, how can they be called differently? Cyborg is, in fact, just a term that is much more interesting than a disabled person or a person with a disability. Our guys, for example, do not want to be called disabled. It's just a new way for users to identify themselves.

People often have bad associative rows: a cripple, no money. We have a client, a girl. She went to work not by car, but by public transport, and her grandmother gave her money. It's just that society perceives a person without a hand as a person without labor. But in fact, he is the same as everyone else.

When the capitalization of mental labor exceeded the capitalization of manual labor, a person without an arm ceased to be limited. Now he needs not pity, but just a good, affordable, high-quality product. We adhere to this paradigm.

Glasses are a good example. At the beginning of the century, a person with poor eyesight had a considerable number of limitations, could not work and do many things. Now, when you meet a person with poor eyesight, you have no desire to help him, to feel sorry for him.

It will be great when children born without an arm grow up and will not know what it is like to live without a prosthesis. It should go from being a utilitarian product to being a cool accessory.

- Will people without medical indications install prostheses for themselves just like that, because it's cool?

- They will definitely be. Moreover, they are already there. But you don't have to cut off your hand to become a cyborg. Anything that is now used for rehabilitation can ultimately be used to improve the body.

- Are the hand and foot prostheses different?

- There is an important nuance. The legs have simpler mechanics; of course, they have their own difficulties, the correct load, kinematics, but they do not have fine motor skills. In our hands, we strive for it. A person has a bionic hand, and he must control each finger, feel it. It's easier with legs.

If a person has an injury at the level of the lower leg, he was correctly done and placed a prosthesis, then it will be impossible to distinguish him from a person on foot. Hands are a more difficult engineering challenge. We are busy with our hands, because it is more interesting, and we are seeing a specific deficit in this area.

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