ORIGINAL RESEARCH ARTICLE

A Cost-Effective Myoelectric Prosthetic Hand

MD Moin Atique, MS, Siddique-e Rabbani, PhD

ABSTRACT
Introduction: A cost-effective myoelectric prosthetic hand for persons with wrist amputations is a need for developing countries.
Instead of trying to develop manipulation of all the fingers, which would be complex, expensive, and demanding on battery
power, we took an approach to make the design simple but moderately usable.
Methods and Materials: Because a sizable number of tasks can be done by controlling the thumb only, we anticipate that it would
be an efficient design where the user will control only the thumb using electromyographic (EMG) signals. The shape of the hand
is such that it will let the user hold small objects, such as a pen. A mannequin's hand was used as the structure, and after specific
modification, the necessary circuitry was set up. Surface electrodes were used to acquire the EMG signals, which were then
amplified using a bioelectric amplifier specifically designed and developed for this purpose. A microcontroller-based interface
Downloaded from http://journals.lww.com/jpojournal by BhDMf5ePHKbH4TTImqenVMtmbmyf2CDPSnT6nSDo8QuehBfuihTXEvuUlWOJoMr7tEpCxgKiZhU= on 11/03/2018

detects EMG and controls the DC gear motor that moves the thumb.
Results: The thumb of the developed unit responded to contraction of the arm muscles as desired. The user can control the
thumb using his or her EMG signal and write holding a pen. A box-and-blocks test was conducted in which, on average, the user
was able to move 6.6 blocks per minute.
Conclusions: The design is moderately usable but needs some minor improvements before practical use.
(J Prosthet Orthot. 2018;30:231–235)
KEY INDEXING TERMS: prosthetics, prosthetic design, upper-limb prosthetics, EMG

P
rosthetic facilities for the disabled are pushing the bound-
aries of technological prowess with advances such as
three-dimensional printed hands, advanced upper-limb
prostheses such as those provided by Touch Bionics, and robot-
ics. However, the majority of the disabled population lives in de-
veloping countries where these advanced technologies are often
unattainable due to the cost and the lack of medical and engi-
neering facilities. To address this situation, we intended to de-
sign an affordable prosthetic hand for the disabled population
in developing countries such as Bangladesh. One important fea-
ture of this design is the choice of materials that are available in
the local markets. At the end of this article, we estimated the
cost based on our design for both individual and mass-scale im-
plementation. Our estimation assures the main objective of this
article: anyone with basic technical knowledge and having ac-
cess to the local market can implement this design to the fullest.
To begin with, our inspiration for this design stems from the
recent studies of myoelectric hand prostheses controlled by
electromyographic (EMG) signals from the hand or other neigh-
boring parts of the human body.1 The EMG signal is produced
MD MOIN ATIQUE, MS; and SIDDIQUE-E RABBANI, PhD, are affiliated
with the Department of Biomedical Physics and Technology, Univer-
sity of Dhaka, Dhaka, Bangladesh.
The authors declare no conflict of interest.
Funding received from the Ministry of ICT, Government of the People’s
Republic of Bangladesh, and Beximco Pharmacuticals Ltd.
Copyright © 2018 American Academy of Orthotists and Prosthetists.
Correspondence to: MD Moin Atique, MS, Department of Biomedical Phys-
ics and Technology, University of Dhaka, Dhaka 1000, Bangladesh; email:
moin@bmpt.du.ac.bd
by a muscle when an electrical command signal originates from
the brain and is transmitted through nerve cells to contract the
muscle.2 It has been possible to detect such signals from the
appropriate muscles using skin-surface electrodes. Because
the brain signals originate from the thought process of a person,
therefore, essentially a myoelectric hand is controlled by the
thoughts of that person. Recently, many researchers and also
commercial companies, mainly in developed countries, have de-
signed and marketed such prostheses.3–4 As for an example, a re-
search team has developed an EMG-controlled hand with a
vibrotactile feedback system that has been successfully tested
on subjects.5 Such a feedback system for the user should facili-
tate an increase in the usefulness of the prosthetic hand. In an-
other case, the introduction of more degrees of freedom and
efficient mechanisms has seen light due to the recent interest
from researchers.6 In an attempt to achieve near-perfect control
of the prosthetic forearm, a detailed analysis of EMG signals has
been reported.7 One successful work has been reported by a re-
search team led by N. Dechev who designed a passive adaptive
grasp prosthetic hand for the 7 to 11 years of age group.8 Finally,
one of the latest reports states that using a proportional-
integral-derivative or fuzzy-based system can improve the per-
formance of the prosthetic hand.7,9 These detailed and robust
advancements are bringing EMG-based prostheses closer to nat-
ural hand function.
As stated earlier, some of the commercially available designs
are cutting edge in terms of technology, but almost all of these
are cost prohibitive for the general populace and more so for
the people of low-income countries. One such case is Touch Bionics,
which offers different designs of hand prostheses of various sizes
and capabilities such as rotating thumb with lateral and opposi-
tional grip patterns and as many as 36 different available grips.10

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Copyright © 2018 by the American Academy of Orthotists and Prosthetists. Unauthorized reproduction of this article is prohibited.
Atique et al.
Another well-known system is the Bebionic, which was devel-
oped as a dynamic hand prosthesis and possesses a precise grip-
ping ability11 with all fingers controlled individually. Lastly, the
Open Hand Project is an open-source hand prosthesis project
that provides a three-dimensional printed design giving anyone
the freedom to create or modify their design.12
In brief, the aim of the work presented in this article is to de-
sign a cost-effective prosthetic hand for persons with wrist am-
putations, which could be controlled using EMG signals from
the forearm of the user. This work is a legacy design inspired
by the mechanical hand prosthesis built by a group from the
University of Dhaka.13–14 In this original work, the thumb is
spring loaded to rotate in a gripping action, being normally
closed. However, the design requires the assistance of another
hand to slip a pen or other items in the prosthetic hand. In
our work, we envisaged a user-controlled design operated by
EMG signals instead of a mechanical system. We showed that
the EMG signal from the forearm is appropriate for this case,
and there are different features having a high rate of motion
classification for artificial hand controlling.7 The work follows
a basic concept where a majority of functionality is achieved by
simply rotating the thumb at the will of the user. The user showed
her ability to hold objects like a pen, soldering iron, and so on, and
to put these objects to effective use. Moreover, a set of box-and-
blocks tests were performed to represent the performance of the
designed hand.15
MATERIALS AND METHODS
THE DESIGN
The design of the prosthetic hand was adapted from a manne-
quin as it would have the advantage of being low cost and more
importantly, it would give the look of an almost real hand. This
would give confidence to the wearer, which would, in turn, sig-
nificantly motivate the person to use it effectively. To keep the
design economical, we chose mannequin hands made using
thermoplastic materials, which also offer effortless reshaping
by hot-air treatment. Thus, the design ensures availability and
functionality while keeping it affordable for all walks of society.
In some conventional designs, the thumb and the fingers are
normally open, and the motor is activated to hold onto an object
continually through a feedback mechanism. The motor is also
used to open the grip. This scheme consumes power from the
battery throughout the period that the subject holds onto an ob-
ject. As for an example, if the subject wants to hold a pen and
write, the battery power will be consumed throughout the pe-
riod of writing and may be used at a lesser rate just to maintain
the pressure, but the total energy consumed over a long period
might be large. So, we envisaged an idea where the main grip-
ping action will be performed by a spring as in the design that
preceded our work; however, a motor will operate under the
control of a transient EMG signal to open the thumb. This signal
will be produced voluntarily by the wearer through muscle con-
traction. The motor will help to open and hold the open position
by applying torque against the spring. To close the hand, the
232
Copyright © 2018 by the American Academy of Orthotists and Prosthetists. Unauthorized reproduction of this article is prohibited.
Journal of Prosthetics and Orthotics
motor will stop forcing against spring mechanism and the
spring mechanism will close the thumb, which will again be ini-
tiated by another transient voluntary EMG signal. So, two tran-
sient EMG signals are required to grab an object; first, one will
open the hand and the system will keep it open until the second
EMG signal is received. After the second EMG signal, the hand
will close to grab the object. In this way, the battery has to pro-
vide power only during the opening and holding the thumb
open, but the gripping action is being performed by the spring
power. This has the potential to make the prosthesis cost-
effective in terms of battery consumption as well. One may argue
that the motor has to provide a higher power compared with
conventional designs to work against the spring, but the motor
action occurs over a very small period, a few seconds at most,
which ensures that the overall total consumption will be smaller
than traditional designs. Also, because thumb movement con-
trols most of the gripping and holding functions of our hand
in day-to-day activities, this design requires less battery power
by sacrificing a few functionalities that require five fingers to
move. In our design, the thumb is cut open and reattached
using a spring and a gear motor. The spring keeps the thumb
in a closed position (with the help of the forefinger and the mid-
dle finger for holding an object) and thus requires no electrical
power from the battery. Now, the thumb only opens by the ac-
tion of the motor, which is controlled by the voluntary EMG sig-
nal generated by the thought of the wearer. After the EMG signal
subsides and the action initiated by the motor is stopped, the
spring brings the thumb back to the closed position (Figure 1).
As explained previously, the wearer is able to open or close
the thumb using the EMG signal from her muscles. One feature
of our design is that the EMG signal only changes the state of the
thumb, which means to keep the thumb open, a continuous
EMG signal is not required. Thus, the hand remains at closed
state due to the spring force unless the user contracts her re-
quired muscles for a certain period to initiate the thumb open-
ing mechanism. If the user wants to close the thumb, she
again contracts the muscles similarly to change its state from
open to close. This is important for another reason: we experi-
enced that it is a little difficult for a person with a wrist amputa-
tion to generate a continuous EMG signal because her targeted
muscles could be less active compared with any regularly used
muscle. So generating EMG only to change the state of the hand
is more convenient for her.
Next, floating electrodes fixed on the skin are used to acquire
the desired EMG signals from the designated muscle, typically in
the forearm region of the user. After proper amplification and
filtering, the signal is fed to the ADC input of a microcontroller.
The microcontroller checks for the availability of the EMG sig-
nal through a suitable algorithm developed for this purpose.
Based on this input, the microcontroller sends appropriate sig-
nals to control the DC gear motor.
To achieve fluency and efficiency in this system, the wearer
needs training and subsequent practice for operation. The pen
is usually kept on a stand such that it allows the wearer to grab
it at an appropriate position. When the pen comes in between
the thumb and the forefinger, the wearer contracts the muscle
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Journal of Prosthetics and Orthotics
Figure 1. The EMG detection and microcontroller interfacing.
so that the EMG signal is available for a short period, which
switches the motor off and the spring rotates the thumb back
to the default closing position and holds the pen. The similar oper-
ation is practiced for different objects varying in shapes and sizes.
ELECTRONIC INSTRUMENTATION DESIGN
The EMG signals usually have amplitudes of 0.5 mV to 5 mV
with a frequency range of 10 Hz to 5 kHz, mostly under 1 kHz.
The difficulty in detection and amplification of EMG signals is
due to the external noise picked up by the human body known
as common mode noise. The amplifier should have a minimum
CMRR (common mode rejection ratio) of 60 dB at 0 to 500 Hz to
be able to minimize this noise effectively. For this experiment,
the circuit has a filtering range of 0.16 Hz to 5 kHz, and the total
gain of the complete circuit is about 900.
ALGORITHM FOR DETECTING EMG
The software on the microcontroller uses the EMG signal to
drive the motor to rotate the thumb of the prosthetic hand out-
wards (open position) or inwards (closed position). The noise
has smaller amplitude compared with that of the EMG signal
(Figure 2). So, if the differences of voltages at short time inter-
vals (order of tens of microseconds) are calculated, it is most
probable that the difference values in the presence of an EMG
Figure 2. The EMG output of the amplifier using digital oscilloscope (Instek). Here, each square from X axis is 250 ms and Y axis is 1V. Left half is for
a relaxed muscles (virtually no signal) and the right half is during voluntary contraction of the muscles.
Volume 30 • Number 4 • 2018
Copyright © 2018 by the American Academy of Orthotists and Prosthetists. Unauthorized reproduction of this article is prohibited.
A Cost-Effective Myoelectric Prosthetic Hand
will be higher than that from the noise. To ensure a reliable de-
cision, such measurements will be carried out many times con-
secutively and averaged.
This design works online, and 100 consequent values of EMG
amplitude are collected with a time gap of 100 microseconds be-
tween them. The average of such values is compared with a pre-
viously defined threshold values, and if it is higher than the
threshold, the software will consider that as a probable EMG sig-
nal. Because a movement artifact or unwanted spike due to
noise can give a false EMG confirmation, five subsequent detec-
tions of average above the threshold will be considered as actual
EMG detection. If the detection happens less than five times, the
software will reset counting the number of EMG detections.
This ensures a higher probability of avoiding noise.
TRIAL WITH INDIVIDUAL WITH AMPUTATION
First, the total system was tested by healthy subjects without
amputation. After a successful trial on an individual without
amputation, a prototype of the developed prosthetic hand
was then fitted on a target human subject, a female with wrist
amputation, aged 23 years. The subject was trained to contract
and relax the muscles in her forearm to control the thumb rota-
tion to hold a pen. It was then tested whether she could write
using this prosthesis.
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Atique et al.
Figure 3. Displacement vs. weight graph.
THE BOX-AND-BLOCKS TRIAL
The box-and-blocks trial is a standard procedure to test the
performance of any prosthetic hand. For this experiment, we have
used a box with the dimension of 17.5 cm  28 cm, and the height
of the box boundary is 2.5 cm. The barrier has a height of 12 cm
and thickness of 2 mm. The blocks are cubical in shape and have
a dimension of 1 cm.
RESULTS AND DISCUSSION
MECHANICAL OUTPUT
To represent the strength of the spring mechanism attached
to the thumb, the displacement of the thumb was recorded
while the tip of the thumb was forced to move outside by hang-
ing objects with different mass (Figure 3). It can be seen that to
open the thumb by about 35 mm (at the tips) against the spring,
a force of about 9.81 N (1000 g mass) is required.
AMPLIFIER PERFORMANCE
The measured CMRR of the amplifier was more than
100 dB for frequencies below 500 Hz and greater than 60 dB
at 5 kHz, which is adequate to minimize common mode noise,
occurring mostly at 50 Hz from main power line. Because for
this application, EMG components under 1 kHz are used, this
value of CMRR was adequate.
Figure 4. A person with amputation is writing using the designed prosthetic hand.
234
Copyright © 2018 by the American Academy of Orthotists and Prosthetists. Unauthorized reproduction of this article is prohibited.
Journal of Prosthetics and Orthotics
Figure 2 shows an amplified EMG signal (at a designed gain
of about 1500) in both relaxed position of the muscle (left half
of the trace) and on contraction (right half ). This signal was taken
from the flexor muscles of the forearm. The difference is large
enough to detect using subsequent circuitry and signal process-
ing using the microcontroller.
TRIAL ON PARTICIPANT WITH WRIST AMPUTATION
A prototype of the developed prosthetic hand was fitted on a
human subject, a female with wrist amputation (age, 23 years).
She was trained to contract and relax the muscles in her forearm
to control the thumb rotation as designed and described previ-
ously. She was able to hold a pen and write using the prosthetic
hand. Of course, the letters are slightly larger than usual as she
does not have the dexterity of the fingers; however, overcoming
the disability by being able to write is a big achievement for that
person. It is shown in the figure that the participant is writing in
her native language using the prosthetic hand (Figure 4).
THE BOX-AND-BLOCKS TRIAL
The box-and-blocks trial was performed by the participant
(Figure 5). After five trials, the user was able to move 6.6 blocks
per minute on average. A prosthetic hand for able-bodied subjects
can move 20 blocks on average.16 Another user with shoulder
amputation and after a targeted reinnervation surgery can move
4 only.17 Our case is different in the sense that no surgical pro-
cedure was required and the user has wrist-level amputation
and can use the hand just after some practice.
DISCUSSION AND CONCLUSIONS
This is a cost-effective design targeting low-income people;
therefore, the initial cost and battery consumption are both kept
to a minimum. In this design, an individual with wrist amputa-
tion can perform a majority of common tasks by simply rotating
the thumb against fixed fingers. Because the muscles of the up-
per arm and forearm are intact in such cases, the user can per-
form day-to-day tasks using this prosthesis. As stated earlier, the
previous mechanical version of the prosthetic hand developed at
Dhaka University needed help from the other hand to hold
things.14 Our present design uses EMG signals from the forearm
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Journal of Prosthetics and Orthotics
Figure 5. Subject performing the box-and-blocks trial.
to open the thumb to eliminate this limitation. In addition, the
thumb only opens at the user's will when it is necessary. This
simple but robust system facilitates the design to be used by a
person with amputations of both hands. Also, it ensures longev-
ity in terms of battery power and motor life because the power
dissipates only when the thumb opens. One caveat of such a de-
sign is that the spring mechanism is limited to producing only
enough force to hold only a pen or similar objects; holding
larger objects like a drinking glass is not possible in this design.
However, the gripping action could be improved by pasting thin
rubber sheets at the fingertips and later optimized by playing
with the shape and size of the fingers. In our case, the box-
and-blocks test shows that the user is able to control the hand
and to write using the hand. Hence, we believe that the hand
is functional and usable to the extent it designed for.
Although disposable electrocardiogram floating electrodes
worked satisfactorily in this experiment, it is expected that the
electrodes will lose efficacy when used on a daily basis. Thus,
for prolonged periods, an alternative will be needed. A possible
solution is to use of dry carbon electrodes (without any gel). Last
but not least, we believe there is plenty of room to make the de-
sign compact. As an example, the current EMG amplifier circuit
was designed and fabricated on a single-sided printed circuit
board (PCB) using surface-mount technology (SMD) compo-
nents to reduce the size. However, the circuit that controls the
hand used conventional integrated circuit and was not designed
for SMD yet. By using a double-sided PCB for SMD circuit de-
sign, we can reduce the size of all the circuits appropriately so
that the whole circuit could be placed inside the hand mount.
To conclude, we report a prosthetic hand design that requires
an overall cost of US $100 to $120 without prior advanced
knowledge of prosthetic engineering. The cost of an individ-
ual unit should be significantly reduced if the design is devel-
oped and distributed by a commercial manufacturer. Thus,
our design satisfies its criteria of being efficient, robust, and
cost-effective, and with the potential to benefit the underpriv-
ileged population of the globe.
ACKNOWLEDGMENT
The authors acknowledge the Ministry of ICT, Government of the People’s
Republic of Bangladesh, for the financial support in the form of a
fellowship. The authors also acknowledge the part played in financial
support from Beximco Pharmacuticals Ltd., under their Corporate
Volume 30 • Number 4 • 2018
Copyright © 2018 by the American Academy of Orthotists and Prosthetists. Unauthorized reproduction of this article is prohibited.
A Cost-Effective Myoelectric Prosthetic Hand
Social Responsibility. Authors are thankful to Mr. Kamrul Hussain,
Mr. A.K.M. Bodiuzzaman, Mr. Abdullah-Al Amin, and Mr. Mehedi H.
Pretom of the Department of Biomedical Physics and Technology of
Dhaka University for suggestions, help, and support at different phases
of the work. Authors are also thankful to Mr. Shah M. Bahauddin from
Physics and Astronomy Department, Rice University, for his sugges-
tions on editing the manuscript.
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