Isabella Nicola, who turns 11 on May 6, tentatively pulled the bow across the strings of her violin. The sound was as strong as her smile, and applause filled the room at George Mason University’s Long and Kimmy Nguyen Engineering Building.
It was the first time Isabella, born without a left hand and with only partial bone from her left elbow to her wrist, had played using the prosthetic prototype created by a senior design team of five George Mason bioengineering majors who witnessed the impromptu concert.
The prosthetic is hot pink, one of Isabella’s favorite colors, and fashioned in three sections connected by straps to allow freedom of movement, with the bow attached at the end. Made of acrylonitrile butadiene styrene, a common thermoplastic polymer, it is light, about 12 ounces, and was produced by a 3-D printer.
It took Isabella a few tries to get the hang of placing the bow on the strings, but once comfortable, she played simple scales and then wowed with a version of Beethoven’s “Ode To Joy.”
“I’m just very happy to see it,” said Racha Salha, a member of the design team in Mason’s Volgenau School of Engineering. “I would never believe we would get such a result.”
“Extremely overwhelming,” Isabella’s mother, Andrea Cabrera, said. “I want to cry because of how lucky I am that they took over this project.”
It is a project the design team members said will continue even after they graduate in May.
Isabella, a fifth grader at Island Creek Elementary School in Alexandria, Va., has been learning to play the violin for a year. But she rests the instrument on her right shoulder (instead of the usual left) so her right hand can finger the strings, which, thanks to a local music shop, were restrung for left-handed bowing.
The simple gold-painted prosthetic she has been using was constructed from PVC pipe by Matthew Baldwin, the string director at Island Creek and a Mason alumnus.
“It wasn’t great. It wasn’t perfect,” said Baldwin, who studied music education at Mason. “I didn’t have the knowledge to take it to the next level, but I knew I could reach out to George Mason University.”
Her mother said Isabella’s disability was caused by amniotic band syndrome, a situation in which a fetus becomes entangled in the fibrous string-like bands in the womb. In Isabella’s case, blood flow was cut off to her left arm, causing it to develop improperly.
“But she’s proud,” she said. “She looks people straight in the eyes and says, ‘I was born like this.’ She’s a very determined little child. I think the violin came across because she wanted to be like most of her peers.”
“I can ride a bike. I can tie my shoes,” Isabella said proudly. “I personally believe that if you put your mind to it you can do it. I don’t think having one hand affects me from doing anything. If I try really hard, I can achieve what I want.”
That determination inspired the design team when they first met Isabella, the day before Thanksgiving in 2016. Creating the prosthetic became their senior capstone project, but it also became a duty.
“Seeing her smile, our feeling was we really want to help her,” said team member Yasser Alhindi. “Immediately, we said, ‘This is our Thanksgiving miracle.’ ”
In addition to Alhindi and Salha, the design team consists of Mona Elkholy, Abdelrahman Gouda, and Ella Novoselsky. The instructor for the team is Laurence Bray, associate chair of the Bioengineering Department. Faculty mentors are Wilsaan Joiner and Vasiliki Ikonomidou.
In creating the prosthetic, the students studied those already used by violinists and examined five different plastics with varied strengths and rigidities. They used PVC pipe for a crude first prototype just to get design ideas.
Because the team miscalculated the thickness of the design, the first plastic prototype crumbled after coming out of the 3-D printer.
Isabella’s feedback also was crucial. She told them the notches anchoring the binding straps between the upper arm and forearm sections of the prototype rubbed against each other. That inhibited Isabella’s ability to bend her elbow and control her bowing motion. The easy fix extended the gap between the sections.
From the second to third prototype, the section above the elbow was reduced in size to reduce the weight, which took stress off Isabella’s shoulder.
The section that holds the bow also changed dramatically from using a metal rod as an anchor (too heavy) to two bolts that hold the bow firmly, but, depending on how much they are tightened, allow flexibility of motion.
“There are three dimensions to think about,” Mason music violin instructor Elizabeth Adams said. “There’s the bow moving perpendicular across the string, there’s the tilt of the bow and the changing strings aspect. Your arm and your shoulder control all those factors. Which angles were best? That’s what I helped them with.”
The result of Adams’ input is a joint near the prosthetic’s bow holder that mimics wrist movement but is stiff enough to allow Isabella to control bow position with the pronation of her forearm.
“So cool,” Adams said. “Everybody involved is willing to try stuff, and that’s what this project is. It’s a combination of trial and error.”
When Baldwin, the string teacher from Island Creek Elementary, contacted Mason about Isabella, Bray was cautious.
“Having an end user is great,” she said of Isabella. “But she’s still a child. We wanted to help her, but we didn’t want to give her false hope.”
Those concerns seemed so long ago, as design team members surprised Isabella at her last fitting with an attachment that will allow her to grip a bicycle handle. There is talk of designing another attachment that will allow her to apply nail polish, and of producing a lighter and stronger prosthetic made of nylon fiber.
“It’s really exciting,” Novoselsky said. “This really shows me how applying your knowledge will affect people directly.”
“That’s important,” Joiner said. “One of the draws of bioengineering is helping people. As a department, our projects are evolving toward that. It’s definitely something we are trying to achieve.”