Guest writer, Andy Lin, MS, ATP, Rehabilitation Engineer and Director of Emerging Tech Lab at Rancho Los Amigos National Rehabilitation Center, also Adjunct Professor at ArtCenter College of Design, brings us some insights on how 3D printing is bringing big, positive changes to the fields of assistive technology and rehabilitation engineering. Andy has over 25 years of experience designing, creating, and customizing technology for individuals with disabilities.

Since the mid-1990’s, I’ve had the privilege of working within the fields of rehabilitation engineering and assistive technology at Rancho Los Amigos National Rehabilitation Center (Rancho) in Downey, California. Rancho is one of the largest comprehensive medical rehabilitation centers in the US, providing services to a wide range of individuals with catastrophic illnesses and injuries. With a staff of over 2000, Rancho focuses on a holistic approach to restoring and rebuilding lives, including intensive physical and occupational therapy, medical/surgical services, peer mentoring, and health/wellness programs.

alt="Andy Lin with Mr. R, who is using a custom adapted gaming setup using both 3D printed and commercially available components." title="Andy Lin with Mr. R, who is using a custom adapted gaming setup using both 3D printed and commercially available components."
Andy Lin with Mr. R, who is using a custom adapted gaming setup using both 3D printed and commercially available components.

My role has evolved over the years, shifting from various departments as opportunities arose. I started volunteering a few hours a week after college while working different jobs to get by. Soon my volunteer role at Rancho became a part-time paid research position, and later a full-time technical position. It was at the Rehabilitation Engineering department I honed my engineering, machine shop, and prototyping skills, with traditional tools and materials found in shops those days, including mills and lathes. Our projects focused on the research and development of orthotic and prosthetic devices for young children with disabilities, several of which later were incorporated into commercial lines of products.

Fast forward to the early 2000s, I transitioned to a new role as a rehabilitation engineer at one of Rancho’s specialty services, the Center for Applied Rehabilitation Technology (CART). CART provides assistive technology evaluation services for individuals with disabilities ranging from powered mobility, alternative computer access, augmentative & alternative communication, and adaptive gaming.  The clients we serve have a wide range of technology needs, and each member of our interdisciplinary team works together to create a cohesive system for each individual.

alt="3D printers within the Emerging Tech Lab. 3 Ultimaker 3
3D printers within the Emerging Tech Lab. 3 Ultimaker 3's and 2 Monoprice machines.

In 2014, the Emerging Tech Lab (ETL) was established at Rancho to explore the design and application of new emerging technologies for patient use. With such impactful technologies as virtual/mixed reality and wearable tech, the ETL became an incubator and working testbed for such devices. One such technology that became a centerpiece for work within the ETL is 3D printing. Since the early days of setting up our first small yet beautifully designed 3D printer (a Deezmaker Bukito), the potential was obvious in relation to this technology and its varying use case scenarios for the people we serve. From the first splints and disability aids that were printed, the impact was immediate. Over time, as both clinical and technical staff became more experienced with 3D printing and how to best utilize its potential to the fullest extent, more innovative and out-of-the-box ideas came to life.

Now with over 30 FFM printers (including Ultimaker 3’s, Monoprice Delta Pro’s & MP10’s, and Creality CR10s machines) as well as access to an HP Multi Jet Fusion 580, the ETL has become a vital hub of activity within Rancho singularly focused on innovating for the individuals with a disability that we serve. When traditional and/or commercial assistive technology options are not adequate or functional, the design and creation of customized and individualized solutions with 3D printing and other fabrication techniques are considered.

alt="3D printed devices, including a feeding wrist orthosis with swivel spork, adapted retro gaming console, stand for a portafilter, adapted chopsticks, stylus palm brace, and door knob lever." title="3D printed devices, including a feeding wrist orthosis with swivel spork, adapted retro gaming console, stand for a portafilter, adapted chopsticks, stylus palm brace, and door knob lever."
3D printed devices, including a feeding wrist orthosis with swivel spork, adapted retro gaming console, stand for a portafilter, adapted chopsticks, stylus palm brace, and door knob lever.

As a rehabilitation engineer and director of the ETL, I have the privilege of working with clinical staff including occupational and physical therapists, speech-language pathologists, and directly with individuals with disabilities in the co-design of new adaptive solutions. 3D printing allows for the rapid development, testing, and refinement of tools to aid the clients we serve. From feeding orthotics for those without much hand dexterity due to a stroke or spinal cord injury to customized power wheelchair controllers to adapted cup holders and key turners – the possibilities are endless.

Each week brings new projects to the ETL. This is the result of the varied and individualized aspect of living with a disability. Designs often need to be adapted for the individual user, based on their skills, wants, and needs. For example, the geometry of the functional grasp and the proprioception of the user may influence the attachment points on a splint that is used to allow for the use of a stylus with a mobile phone or tablet. In addition, as the user experiences physical and/or other changes related to his or her disability, designs may need to be modified/tweaked, or completely reworked to accommodate these changes.

alt="Andy Lin, Ms. E, and OT Hanalynn Hunt standing together. Ms. E. using two trekking poles utilizing custom 3D printed braces." title="Andy Lin, Ms. E, and OT Hanalynn Hunt standing together. Ms. E. using two trekking poles utilizing custom 3D printed braces."
Andy Lin, Ms. E, and OT Hanalynn Hunt standing together. Ms. E. using two trekking poles utilizing custom 3D printed braces.
alt="Custom 3D printed braces for Ms. E. Red " title="Custom 3D printed braces for Ms. E. Red "
Custom 3D printed braces for Ms. E. Red

One of the more recent projects related to 3D printing involves my work with Ms. E and her occupational therapist Hanalynn Hunt. Ms. E. has a dynamic and creative personality, who has a disability-related to her extremities. She is missing her left hand, and also parts of her digits on the right hand. Since I first met her several years ago, we’ve collaborated together in designing and creating tools to enable her to perform certain activities. Often Ms. E. already has an idea of how a device needs to be designed. The first concept was a cuff to help her to regain the ability to prepare and cook food, using attached utensils including a fork, spoon, and spatula. Since then, we’ve developed customized devices that worked with scissors, long-stem chopsticks, and most recently trekking poles.

One activity that Ms. E. was determined to regain the ability to do was going on weekly hikes around Los Angeles with her family. After a month of brainstorming different solutions, we produced several prototypes of braces that would function with both her residual left limb and also her right hand. This involved 3D scanning using an Occipital Structure Sensor and importing this data into Onshape, a collaborative solid modeling platform. Based on the shape of her extremities, customized cuffs were designed that conformed to the trekking poles and securely and safely attached to her so she felt comfortable and safe while hiking.

In addition to my work at Rancho, I am currently an adjunct assistant professor of product design at ArtCenter College of Design. One of my core passions is equipping and mentoring the next generation of designers, engineers, and makers. It is imperative that these innovators recognize the importance of inclusive design as it relates to disability. In the past, I’ve been privileged to teach courses at Caltech, and lecture at other universities to provoke more discourse into these often overlooked topics.

alt="Caltech students receiving feedback on their adapted wheelchair bag design from two Rancho staff members who are wheelchair users." title="Caltech students receiving feedback on their adapted wheelchair bag design from two Rancho staff members who are wheelchair users."
Caltech students receiving feedback on their adapted wheelchair bag design from two Rancho staff members who are wheelchair users.

I absolutely love what I do, and feel blessed to be in a profession that helps to change lives. 3D printing has dramatically changed how I can quickly prototype and create new technologies for people with disabilities. My hope is that as more people discover the fields of rehabilitation engineering and assistive technology, there will be more understanding of the need to co-design with individuals with disabilities and actively listen. With this in mind, more impactful change will definitely occur.

Special thanks to Mara Hitner and Matterhackers for their interest and support of our work at the ETL, and for the donation of filament for projects. Also, we want to recognize both Monoprice and Ultimaker for their generous donation of 3D printers and accessories which greatly helped to equip the ETL. Finally, to the AbleGamers Charity for helping to advance our adaptive gaming program through hardware resources and funding for customized 3D printed solutions.

Relevant links:

Emerging Tech Lab at Rancho Los Amigos National Rehabilitation Center
www.retl.org

Center for Applied Rehabilitation Technology
www.cartla.org

Monoprice:
www.monoprice.com

Ultimaker:
www.ultimaker.com

AbleGamers Charity
https://www.ablegamers.org/

Shieldmaker - a joint project with ArtCenter College of Design to create face shields for Rancho and other underserved community facilities
www.shieldmaker.org