Dressed for the occasion in a red dress and a headband with a white, glittery flower, 10-year-old Isabella Nicola picked up her violin.
Now, thanks to five George Mason University bioengineering seniors — Yasser Alhindi, Mona Elkholy, Abdelrahman Gouda, Ella Novoselsky and Racha Salha — who used 3-D printing technology to create a prosthetic bow arm for her, she’s begun training on an instrument that challenges even the most adroit musicians.
They call it the VioArm.
On Thursday, Isabella donned her fancy clothes for the presentation and subsequent fitting of the latest — and, its creators hope, final — version of the custom-designed, under-12-ounce prosthetic limb made of plastic. The arm holds her bow, and she uses muscles in her shortened forearm and shoulder to manipulate it.
A smile spread across her face and her eyes widened as the team began fitting her with the hot pink, glitter-covered VioArm with her name etched in script on the side. “Oh my gosh,” she gasped, then took charge, asking the team to tighten a screw, loosen a bolt.
Time wasn’t wasted as Elizabeth Adams, a violin/viola professor in the GMU School of Music, began her lesson.
During the next 45 minutes, Isabella played scales, “Mississippi Hot Dog,” “Ode to Joy” and, begrudgingly, “Twinkle Twinkle Little Star,” while Cabrera sat in the corner, eyes and cheeks wet with emotion.
It was the culmination of a journey merely to begin learning an instrument, a journey most don’t have to take.
The project started last year when Isabella, then a fourth grader, decided she wanted to play a string instrument. After all, she did everything else with one hand, even learning to tie her shoes alone at a younger age than her three brothers. Admiring her grandmother’s mastery of the guitar, she originally chose bass. The violin proved a better fit with her small frame.
Her mom was supportive but scared.
“I’ve never had to tell her you can’t do something,” Cabrera told The Washington Post, but she thought that time had finally come. Still, she heeded her own advice of adding “yet” to the phrase “I can’t.” A Catholic, she believed God would help them find a way.
“Everything just seemed to fall into place,” she said. “I do believe in miracles.”
Suddenly, a string of well-wishers came out of the woodwork. Technicians at Potter Violins, a violin shop in Maryland, reversed the strings on her instrument, so she could finger with her right hand. Her first music teacher, Amber Hicks, plucked the strings while Isabella practiced fingering.
“She learned to play all the notes fourth graders are required to learn without ever making a sound on her own,” Matthew Baldwin, strings director for Island Creek Elementary — Isabella’s school — told The Post.
Baldwin then changed everything.
Motivated by his Christian faith and Isabella’s dedication, the GMU alum purchased supplies at the hardware store and began tinkering in hopes of creating a bow arm for his young student. Combining PVC pipes, O-rings and eye screws, he made a usable prosthetic, Baldwin said, using “things you find under your sink.”
“As soon as I got it on her, and we were able to put the bow on the strings, she played a D major scale,” Baldwin said. “She was able to hear it for the first time playing herself, and her face just lit up.”
Exciting as the prosthetic was, it wasn’t ideal. It was heavy and didn’t allow the full range of motion necessarily to truly bow the violin, so Baldwin contacted his alma mater in October. As luck would have it, a group of engineering students needed a senior project.
“I’m so blessed to have them,” Isabella said.
They decided to create her prosthetic using a 3-D printer, which is exactly what it sounds like: a printer that can take a digital 3-D model of an object and “print” it using various materials, such as plastic, metal and even chocolate. It can be, and has been, used for everything from printing spacecraft parts to a carbon fiber plastic working car to knockoff Lego bricks to complexly designed cookies and fondant wedding cake toppers, to name a few.
The technology also created the potential for affordable, easily customization prosthetics for the about 2 million people living in the United States with limb loss.
When asked if five college students could have created a usable prosthetic that cost less than $500 in raw materials before 3-D printing, all five students shouted an emphatic, “No!” And yet they did.
It’s important to note 3-D printing is still young and has limitations. Many advanced prosthetics are made from a mixture of plastics and electronics and fit into a socket inside the body. Making them requires equipment and technical expertise that isn’t readily available to the layperson.
“The idea is — you’re trying to securely attach a hand or a foot or whatever to somebody’s skeleton — which is inside their body — through the soft tissue that’s still around it without damaging that soft tissue or it being uncomfortable,” Jon Kuniholm, who lost his right arm to an explosion as a Marine in Iraq and founded the Open Prosthetic Project, told the Atlantic. “Most of the time, a surface scan of somebody’s body isn’t going to create something that is going to be useful, because it has to interact with the bony part that’s inside.”
In particular, prosthetics made for professional musicians, Alhindi said, tend to be much more advanced. But, the students soon learned that a beginner to the violin, such as Isabella required something far simpler as she learned to hold the weight of a prosthetic while manipulating her muscles in new ways.
“We have to consider our user’s age, and the simplicity of the design was one of our goals,” Alhindi said.
The team went through a few different models before Thursday’s fitting, working with Isabella along the way to make adjustments. The very first one, for example, uncomfortably rubbed the end of her forearm, which is extremely sensitive, so the team designed the VioArm to attach higher on her upper arm. They also worked to shorten it, which would reduce the arm’s weight.
Perhaps the most important change to Isabella, though, was the color. The last version was a chalky white. That just wouldn’t do. So she chose a pink glitter.
“I really, really like the color,” she said, beaming at the new arm.
The students will soon graduate, but their work will remain. Since the VioArm’s design is a 3-D digital model, it can easily be replicated. As Salha explained, the only necessity for immediately duplicating the prosthetic to fit a new client is having the person’s individual measurements.
They could then pop those measurements into the computer and hit print.
In theory, many more children who never imagined being able to play a string instrument could soon be working their way through “Mississippi Hot Dog,” while their teachers remind them to practice daily and their proud moms beam at their fortitude.
Because for Cabrera, secondary to the skill with which Isabella can now handle a violin bow was the sheer courage her young daughter displayed when she climbed on stage for the winter performance well before she could hold a bow at all and played in front of her peers while Hicks plucked the strings.
“I lost it at that moment,” she said.
“To have the courage to stand in front of your peers in fourth grade and have your teacher pluck for you and have a smile and a confidence throughout the whole thing,” Cabrera said. “To not be embarrassed, to not be afraid of what they would think, but to do it with pride, that’s when I won. I thought whether she plays the violin or not, we won already.”
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