Subject Keith Vonderhuevel shares his exerience of participating in prosthetic studies

In 2005, Keith Vonderhuevel lost his right arm below his elbow in a work-related accident. For about eight years, he wore a hook and various prosthetic arms before he heard about prosthetic studies in Human Fusions Institute director Dustin Tyler’s lab at Case Western Reserve University. In Fall 2012, Vonderhuevel and his wife went to CWRU to check the studies out, and he said things “snowballed from there.” 

Keith Vonderhuevel reads a paper with his robotic prostethic

Vonderhuevel was implanted with the first generation of the lab’s technology in January 2013, and nearly eleven years later, he is the first person to go home with a fully implanted system. With this system, he can flex and extend his wrist, open and close his hand, grasp his arm in six different positions, and lift objects. 

“At home, I can feel sensors turning on in my thumb, index finger, and the palm and back of my hand,” he said. “With the implanted EMGs, I can control my hand wherever I put my arm; that wasn’t always possible with prosthetics I had in the past.” 

However, the best part is that Vonderhuevel can now pick up and hold his grandchildren “without worrying about grabbing and squeezing too tight.” In the past, he would often take off his prosthetics when interacting with his grandchildren. 

Vonderhuevel is also happy that he can now shake hands with people and pick up food without smashing it. “Doing little things is just amazing,” he said, pointing out that he can now do things he didn’t give a second thought before his accident, such as peeling potatoes and cutting peppers. 

The path for Vonderhuevel to use his fully implanted system full-time at home has been challenging. He received surgery to implant his system, which included 16 electromyogram (EMG) electrodes, four peripheral nerve stimulation cuffs, and four smart leads in November 2021. He believed the initial surgery “went great,” but a wire needed to be replaced in 2023.  

Since the wire was replaced, the system has been working smoothly. Vonderhuevel has been focusing on motor control and feeling sensations in different locations. 

While at home, Vonderhuevel wears activity trackers to track how much he uses his intact and prosthetic hands to see if he favors either hand. He will do functional measures where he’ll be asked to complete a task, and researchers will score how well he completes each task. 

About once a month, Vonderhuevel comes to Cleveland, where he works with members of Tyler's team. PhD student Sedona Cady will study his sensations and motor control, while Christine Cowen, an occupational therapist at Cleveland’s Veteran Affairs Medical Center, trains Vonderhuevel to use the prosthesis. 

Cowen described Vonderhuevel as a "very confident user” and said it has been “rewarding” to see him use the system functionally. Recently, she did a woodworking project with Vonderhuevel, who has always enjoyed woodwork. 

In addition to doing exercises with Vonderhuevel at the hospital, Cowen conducts functional testing when he and other subjects come to the hospital, and she has been in contact with him while he is at home, where she gives him ideas for motor control exercises. 

A clinical research nurse in the study, Melissa Schmitt, said it is "wonderful to see him become more confident to do different activities and not have to rely on others.” 

Vonderhuevel has had the opportunity to demonstrate the capabilities of his system at two events so far and has bonded with other upper extremity prosthesis users who have received prosthetics from Tyler’s lab. “The further this study goes, the better it gets,” he said of his optimism about the impact the study will have on future participants. 

Schmitt, Cowen, and Cady agreed that they are also excited to see more individuals receive implants in the future and see how Vonderhuevel uses his system full-time at home. "It's been a lot of fun to work on this project," said Cady.