Browsing by Subject "Amputees"

Now showing 1 - 5 of 5

Open Access
ADAPTING THE BOSTON DIGITAL ARM TO ACCEPT FIVE INDEPENDENT INPUTS FROM TMR AMPUTEES
(2008) Williams, T. Walley, III
In conventional myoelectric control, muscles are assigned to control functions differing from those controlled in the intact limb. In 1984 a bilateral amputee was fitted with four myoelectric inputs around the shoulder. These were to be used in pairs to independently control operation of the gripper and elbow flexion-extension. Since none of the muscles were doing their original assignment, a program was set up to train the user on the system. After many sessions, the amputee and trainer agreed that simultaneous control was never going to work. The control system was reconfigured, and the user mastered controlling one device at a time sequentially with the two best control sites. Twenty years later people are again trying to control several devices simultaneously, but with a difference. Now, with targeted muscle reinnervation (TMR) each muscle is being used to control the same function as in the intact limb.
Open Access
Cable Driven Multi-Articulating Fingers, Providing Compliant Grasp For The Partial Hand Amputee.
(2008) Mikosz, Matthew J.
This article will describe a new concept in fitting the partial hand amputee to offer them enhanced grasp and improve their overall functional ability with the prosthesis. The concept is to activate the mechanical fingers through existing wrist motion to provide active grasp that is compliant to any object.
Open Access
Clinical Experience of Fitting Amputee Soldiers at the Center for the Intrepid at Brooke Army Medical Center (BAMC): Part 2 – Prosthetic Services
(2008) Farnsworth, Troy; Lipe, Del; Ebner, Christopher; Fergason, John; Menetrez, Jennifer
This lecture will discuss the experiences at the Center for Intrepid located at Brooke Army Medical Center (BAMC) providing rehabilitation of amputee soldiers. This is part two of a series illustrating the prosthetic services, rehabilitation and research currently underway at BAMC. Case presentations will be utilized to illustrate the team approach to provide clinically appropriate amputee rehabilitation. This cohesive effort includes surgical considerations, early prosthetic fittings, long-term prosthetic care, rehabilitation services, case management, physiological and social support services. Prosthetic considerations will be presented, including combining the use of technology and basic prosthetic principles. Special attention will focus on unique requirements of traumatic amputations resulting from blast, gunshot, burn injuries, and high demands of the young active users. All advanced systems have been fit at various levels of amputation including fittings with patients who have undergone targeted muscle reinnervation surgery. In addition to being one of the three primary prosthetic amputee care centers, BAMC serves as the primary burn center for the Army worldwide.
Open Access
Differential expression of systemic inflammatory mediators in amputees with chronic residual limb pain.
(Pain, 2017-01) Chamessian, Alexander; Van de Ven, Thomas; Buchheit, Thomas; Hsia, Hung-Lun; McDuffie, Mary; Gamazon, Eric R; Walsh, Colin; Bruehl, Stephen; Buckenmaier, Chester 'Trip'; Shaw, Andrew
Chronic postsurgical pain impacts most amputees, with more than half experiencing neuralgic residual limb pain. The transition from normal acute postamputation pain to chronic residual limb pain likely involves both peripheral and central inflammatory mechanisms. As part of the Veterans Integrated Pain Evaluation Research study, we investigated links between systemic inflammatory mediator levels and chronic residual limb pain. Subjects included 36 recent active duty military traumatic amputees with chronic residual limb pain and 40 without clinically significant pain. Blood samples were obtained and plasma concentrations of an array of inflammatory mediators were analyzed. Residual limb pain intensity and pain catastrophizing were assessed to examine associations with inflammatory mediators. Pro-inflammatory mediators including tumor necrosis factor (TNF)-α, TNF-β, interleukin (IL)-8, ICAM-1, Tie2, CRP, and SAA were elevated in patients with chronic residual limb pain. Across all patients, residual limb pain intensity was associated positively with levels of several proinflammatory mediators (IL-8, TNF-α, IL-12, TNF-β, PIGF, Tie2, SAA, and ICAM-1), and inversely with concentrations of the anti-inflammatory mediator IL-13, as well as IL-2 and Eotaxin-3. Pain catastrophizing correlated positively with IL-8, IL-12, TNF-β, PIGF, and ICAM-1, and inversely with IL-13. Significant associations between catastrophizing and residual limb pain intensity were partially mediated by TNF-α, TNF- β, SAA, and ICAM-1 levels. Results suggest that chronic postamputation residual limb pain is associated with excessive inflammatory response to injury or to inadequate resolution of the postinjury inflammatory state. Impact of pain catastrophizing on residual limb pain may be because of part to common underlying inflammatory mechanisms.
Open Access
NINETEEN YEAR FOLLOW-UP OF A BILATERAL SHOULDER DISARTICULATION (BSD) AMPUTEE
(2008) Uellendahl, J.E.; Heckathorne, C.W.
Management of high-level bilateral amputees poses a significant challenge for the treating parties. Selection of the most appropriate prosthetic components and controls requires knowledge of the many options available and the ability to predict which systems will most benefit the user. Long-term follow-up of these individuals is rarely reported. Through retrospective study it may be possible to identify attributes of prosthetic systems that have been successful and incorporate those attributes in future systems. This paper outlines the prosthetic management of an individual, KF, with traumatic bilateral shoulder disarticulation amputations over a nineteen-year period. In 1986, the Prosthetic/Orthotic Clinical Service Department of the Rehabilitation Institute of Chicago (RIC) and the Rehabilitation Engineering Research Center (RERC) in Prosthetics and Orthotics of Northwestern University began a collaboration to improve the prosthetic fitting of persons with higher-level bilateral amputations. By the time of KF’s admission to the RIC, a hybrid fitting concept had been developed using body-powered and electric-powered components in a complementary manner to enhance the function of the total prosthetic system [1,2]. Cable-actuated body-powered components were used on the dominant side to take advantage of the physiological proprioceptive feedback intrinsic to cable control. This prosthesis was used primarily for fine positioning and dexterous object handling and manipulation. Electric-powered components were used on the non-dominant, or assistive, side to provide higher gripping forces and greater lifting torque.