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9-year-old Lincoln cellist plays with help of prosthetic arm

March 16, 2019

LINCOLN, Neb. (AP) — Peyton Tiernan told his parents last year that he wanted to play the cello.

Technically, the bass was his first choice. The cello was a compromise, reached after James and Jamie Tiernan told their son that he’d have to schlep the heavy bass several blocks to and from his elementary school.

Peyton, 9, faced one other challenge. He was born without a left hand. Playing a stringed instrument usually is a two-handed endeavor. Most cellists hold the bow with their right hand and work the strings with the left.

Peyton, however, doesn’t let little things like that hold him back. While his favorite sport is soccer, he also plays basketball, football and baseball.

“We always tell Peyton, ‘You can do whatever you want, we’ll find a way,’” Jamie Tiernan said.

Last summer, their quest intersected with that of others who’ve been trying to find ways to assist kids missing a hand or part of an arm, known as an upper limb deficiency.

Jorge Zuniga, a University of Nebraska at Omaha researcher, and his team had begun expanding on past work on inexpensive, 3D-printed hands for children with the goal of producing new devices capable of more specific tasks, such as holding a bow and swimming. Zuniga had been inspired by a California boy whose family was struggling with the cost of a traditional prosthesis that could hold a violin bow.

At the same time, Zuniga also had begun studying how the brains of children with upper limb deficiencies work. Up to 58 percent of kids who get prostheses — and many do not — don’t use them, he said. Maybe it’s the weight, maybe it’s the feel or the look; no one really knows. But researchers have seen that kids aren’t likely to use the devices if their brains aren’t engaged and able to see their prostheses as effective extensions of their bodies.

By studying kids’ brains when they’re learning new skills, Zuniga said, researchers may be able to figure out how to help kids make those connections. While such kids generally don’t have motor skill deficits initially, they can show up later on, when they’re adults, if they don’t do all of the things — including playing sports and instruments — that usually help foster them.

In the nine children they’ve studied so far, he told the Omaha World-Herald , the researchers have found that one side of the brain is more involved in controlling the body than the other. In most people, the left side of the brain controls the right side of the body, and the right side of the brain drives the body’s left side.

“How can we wake that up?” Zuniga said. “How can we (make) the connections happen again so their motor skills are not affected in the future?”

Meantime, Brett Noser, chairman of Lincoln High School’s music department, had been trying to find someone to create a device that would allow upper limb-deficient students to hold a bow. He and Zuniga connected last summer. They met the Tiernans through Peyton’s elementary school orchestra teacher.

Zuniga’s team then began work on the device. James Pierce, a doctoral student in UNO’s biomechanics program, said they scrapped the grasping hand featured in Zuniga’s original design, known as the Cyborg Beast. Zuniga, who started the work at Creighton University, estimated that his team has made about 2,000 of them. He put instructions for making the 3D hand online — free for anyone to use — several years ago. The device can be built with 3D printing technology for about $50 in materials.

Instead, the team created an arm with a clamp on the end to lock onto the bow. Springs create the correct wrist angle and allow the bow to stay in contact with the strings as Peyton draws it across them.

After some modifications, the team printed a final version and gave it to Peyton after the start of the school year. UNeMed, the tech transfer and commercialization office representing UNO and the University of Nebraska Medical Center, has filed a provisional patent on the device and is working on the full application.

Zuniga said materials for the new device cost between $100 and $150. The team, he said, plans to license the activity-specific devices to prosthetic companies. They’d use the profit to support their nonprofit work with the basic design, enabling them to continue providing devices to children around the world.

Jamie Tiernan said Peyton has had a prosthesis in the past but, like many other children in his situation, opted not to use it. “As he got older, he just made the decision he can do everything else that everyone else does,” she said.

Usually, she said, he just figures out another way. When Peyton plays baseball, for instance, he catches the ball with his right hand, quickly takes off his glove and then throws it. He played catcher and pitched last summer.

The family sometimes watches videos featuring people with similar conditions. A current favorite is Shaquem Griffin, a rookie with the Seattle Seahawks who, according to ESPN, is the first player with one hand to be drafted in the NFL’s modern era. Griffin was a linebacker at the University of Central Florida under former head coach Scott Frost.

But James Tiernan said he and his wife weren’t sure how Peyton would manage the cello without some help. They were excited when they found out about the research project.

Peyton, being Peyton, started without the new prosthetic, working the strings with his left wrist and holding the bow in his right hand.

“When I see something, I will always try it,” he said, as he ran through a standard list of beginner songs, including “Twinkle, Twinkle, Little Star” and “Jingle Bells,” from memory.

But James Tiernan said his son will need to use the prosthesis as he progresses and begins to play more chords. Peyton also participated in testing at UNO to see how his brain was processing his experiences, first without the prosthesis and then with it. He went back for another round after practicing with it for a month or two.

Tiernan said Peyton and the rest of the family have been honored to participate, knowing that the research stands to help other children.

Noser, who wants everyone to be able to participate in music in some way, said he’s excited about the possibilities the task-specific prosthesis could offer students.

“If we can make something work for the bow, there’s a really good chance we can make it work for percussion instruments and the trombone,” he said.

Although it’s still relatively early days for the task-specific devices, Pierce plans to revisit a bike-riding prosthesis the team previously had made. The team also is working on another for swimming, with the goal of making it comply with rules for competition.

In addition, they’ve begun developing a hybrid prosthesis that combines the more precise control of a traditional electronic prosthesis with the manual control of the lighter, body-powered models they’ve focused on so far. Using a manual or body-powered prosthesis allows children to develop healthy muscles on the affected side of the body. Those who don’t use an affected limb can develop long-term muscle weakness and postural problems over time.

Pierce said that once Peyton is happy with the design of his prosthesis, the team will look at getting it to other kids who need it. “Honestly, that’s the best part of the job,” he said.

Peyton’s mom said he has done so well that he’s been invited to move up to play with the fifth-grade orchestra. He’s already anticipating the school concert later this spring.

“You want your kids to have every opportunity,” Jamie Tiernan said, “and succeed at whatever they do.”


Information from: Omaha World-Herald, http://www.omaha.com

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