Browsing by Author "Mandacina, Stephen"

Now showing 1 - 5 of 5
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    ELECTIVE AMPUTATION OF CEREBRAL PALSY PATIENT SUCCESSFULLY WEARS ELECTRIC PROSTHESIS
    (2002) Mandacina, Stephen; Farnsworth, Troy
    Cerebral Palsy affects 15-20 new borns in every 10,000. Currently, near a half million people in the U.S. are effected with C.P. Diagnosing the condition is done clinically, with lab test only ruling out other diseases. The tests performed, such as manual muscle testing, ROM, physical and emotional development, are all compared to normal childhood outcomes. Therefore, many infants are not diagnosed with C.P. until the age of two or three. Symptoms are normally weak or tight muscles, poor balance and gait, along with seizures in approximately half of the effected people. Over time, weak muscles can often develop severe joint contractures, classified as spastic Cerebral Palsy
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    ELECTRIC OPTIONS & SOCKET DESIGN FOR PARTIAL HAND PATIENTS
    (2005) Mandacina, Stephen
    Recent improvements in prosthetics has allowed for a marked increase in success and functional rehabilitation of the partial hand patient. Manufacturers are designing much smaller and lighter components such as electrodes, switches, batteries, and programmable microprocessors that allow a much smaller and simple prosthesis. In most partial hand cases, this allows the socket to not extend proximal to the wrist for full wrist ROM, simplified socket design, and lighter weight prostheses, all leading to greater acceptance. Improvements are being made with two separate designs for partial hand patients that use an intact thumb to assist with prehension, or a smaller drive unit decreasing space necessary in the hand. Although both designs are progressing, the components are not readily available for most prosthetists fitting a Transmetacarpal/ Transcarpal level amputation. The focus of the paper and presentation is to educate on options currently available and easily used by a majority of the prosthetic field.
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    MULTIPLE IMPAIRMENTS OVERCOME BY SOCKET DESIGN & APPROPRIATE COMPONENTS
    (2005) Mandacina, Stephen; Lenzini, Gary
    The success of prosthetic rehabilitation involves a number of facets including optimum therapy, appropriate components, interdisciplinary network, patient motivation, and a good fitting socket. All of these facets get multiplied in severity when more than one ailment is presented in the patient. This case study will discuss the socket design principles and components that allow for vocational return for a hip disarticulation-shoulder disarticulation patient who is also blind. The design of the myoelectric shoulder disarticulation prosthesis had to be lightweight and provide as much feedback as possible to control the elbow, terminal device, and wrist rotator—as well as aid in balance while ambulating with a sight cane.
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    RECENT IMPROVEMENTS IN UPPER LIMB PEDIATRICS
    (2005) Mandacina, Stephen
    Not only are children fit with myoelectric arms at a much earlier age than years before, but also they are now much more functional and successful with these devices. Advancements such as microprocessor-based controls, longer lasting batteries, improved socket design, and flexible socket materials have improved the functionality of children, especially those under the age of 5, with their prosthesis. Because the pediatric population is so small in our field, it is infrequent that the practitioner knows these advancements. Understanding these improvements and changes to fitting protocols not only helps the child with the device, but also strengthens the rehab team, including the O&P practitioner and OT, as well as strengthens the relationship with referrals and payors. Yet, most importantly, the entire rehab team becomes aware of these advances and can provide optimum care not seen even just a few years ago. Having a child born without a limb is an emotional trying time for parents. Although many children develop a one-handed independence, parents do not want their child to struggle physically or psychologically. Our organization has found an increasing acceptance of myoelectric control for this young population, primarily from the results received in improved socket design and components. However, the three most important criteria for functionality at this age comes from 1) a team approach, 2) continual follow up, and 3) discussions by the parents, Certified Prosthetists, Occupational Therapists, manufacturers, and other referrals such as Case Managers.
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    THE DIFFERENCE A TERMINAL DEVICE CAN MAKE
    (2005) McGahey, Patrick; Mandacina, Stephen
    The manufacturers of electronic components have answered the requests of patients in recent years. Advancements were made with microprocessor-based controllers that allow for easy computerized adjustments, answering the need for increased control of the terminal device. Additionally, batteries have moved to Li-Ion, NiMH, and soon Li-Polymer, answering the request to provide a longer life to the charge, as well as the ability to top-off the charge. Another patient request was to increase the speed of the terminal device. In actuality, what patient wanted was a quicker response from the terminal device as they provided an input signal. An earlier response by the field was to increase the voltage to the terminal device. The higher voltage wasn’t the perfect answer because it was also difficult to operate at slow speeds. The Sensor Hand Speed answered these requests to have a more responsive hand that operates quickly, but also is able to operate very slowly according to the user’s input.