Browsing by Subject "Upper Limb Prostheses"

Now showing 1 - 8 of 8
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    A BUS PROTOCOL FOR INTERCOMPONENT COMMUNICATION IN ADVANCED UPPER-LIMB PROSTHESES
    (2005) Stavdahl, Oyvind; Mathisen, Geir
    Microcontrollers are ubiquitous in modern electronic products, powered prosthetic components being no exception. Likewise, digital communication buses are the key technology for interconnecting such smart devices for reasons such as reduced wiring requirements, high information throughput, robustness in the presence of noise and flexibility. This flexibility contains the potential of interoperability, which means that similar components from different manufacturers may communicate in the same way so that one can easily be replaced by another or components from different manufacturers can be combined in one and the same system. However desirable this situation is, it requires an open, sandardised communication protocol that is adhered to by the majority of the manufacturers and research organisations. Presently no such standard exists in the prosthetics industry, while it has existed in related fields such as wheelchairs and environmental controllers for a number of years. In this paper we propose such a bus standard, and outline the potential benefits for end users, prosthetists and technicians, healthcare providers, manufacturers and researchers. We then list several important aspects of a prosthesis bus that must be carefully considered, and invite interested parties to engage in the completion of a draft specification.
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    A COMPARISON OF UPPER LIMB AMPUTEES AND PATIENTS WITH UPPER LIMB INJURIES USING THE DISABILITY OF THE ARM, SHOULDER AND HAND (DASH).
    (2005) Davidson, Judith
    Amputation of a limb represents a catastrophe for the adult amputee and their family. However data regarding the prosthetic, functional and psychological outcomes achieved by these patients is limited. There is no well recognised outcome measure used throughout Australia, UK or America especially for aquired adult amputations of the upper limb. Most scales currently in use fail to identify the psychological adjustment problems which many of these amputees demonstrate. Many adult amputees continue to report significant behavioural limitations and discomfort, associated with low self-esteem, anxiety and depression when compared with an able-bodied control sample.(1) Phantom limb phenomena is also a well recognised problem for many upper limb amputees . Scales used to measure prosthetic use rarely investigate the impact pain has on the amputee and his or her well being. The Disability of the Arm Shoulder and Hand Scale (DASH) is an evaluative outcome measure for patients with upper extremity musculoskeletal conditions designed in the mid 1990s by the American Academy of Orthopaedic Surgeons and Toronto Institute for Work and Health. (2,3,4) It is a region specific questionnaire as opposed to diagnosis specific questionnaire. It measures function & symptoms of musculo-skeletal disorders in upper limb. The DASH was able to demonstrate change in all situations in which change was presumed to have occurred. The DASH was found to have comparable responsiveness to the joint specific measures. It demonstrated suitable levels of sensitivity and specificity.
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    A TRAINING PROGRESSION FOR THE UPPER LIMB PROSTHETIC USER
    (2005) Gulick, Kristin
    As we all know, each patient that we see in our practices is an individual and should be approached with a client-centered philosophy. During the early phases of rehabilitation, my role as an occupational therapist on the amputee rehabilitation team is to work with the patient to determine his or her view of their interaction with their environment and their occupation. This is an all encompassing view of their life. A person’s environment includes physical, social, cultural and institutional elements. A person’s occupation is any aspect of self-care, productivity, and leisure that is part of their life. Once we have a sense of the areas of importance to this person, an occupational therapist will analyze the key components and skills required for the patient to perform in these occupations. This analysis will lead to the development of an individualized rehabilitation program.
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    ADVANCEMENT OF UPPER EXTREMITY PROSTHETIC INTERFACE AND FRAME DESIGN
    (2002) Alley, Randall D.
    Although traditional upper extremity prosthetic interface and frame (collectively referred to here as “interface”) designs have enabled many individuals to integrate prostheses into their rehabilitation plan, the biomechanical attributes and other parameters of these designs have not been significantly reviewed and improved upon until recently. In the last decade, a multitude of design innovations have been incorporated, which have resulted in wearers reporting superior comfort, suspension, stability, and range of motion, among other advantages. In most cases, when paired with a variety of control systems, the new designs appear to be inherently more efficient in terms of force transmission and motion capture, and more functionally consistent than traditional types of “sockets”. It is the intention of this paper to highlight these novel design elements, as well as to discuss the biomechanical principles involved, to enable prosthetic users and other individuals to better understand these advanced interfaces.
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    FUNCTIONAL OUTCOME OF ADOLESCENTS AND YOUNG ADULTS WITH CONGENITAL UPPER LIMB REDUCTION DEFICIENCY
    (2005) Lambregts, S.A.M.; Doornbosch, F.; Roebroeck, M.E; Rol, M.; Arendzen, J.H.
    In the Netherlands approximately seventy children with a congenital upper limb reduction deficiency will be born each year. One third of these children will be eligible for a prosthesis. Little is known about the functional outcome of adolescents and young adults with congenital upper limb deficiency. This study is the second part of a project to investigate the functional outcome of adolescents and young adults with an unilateral congenital upper limb deficiency in the south-west region of the Netherlands. The first part consisted of a description of functional status and level of participation of this group by using postal questionnaires. In this part the adolescents and young adults have undergone a functional assessment.
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    MULTI-FUNCTION SWITCHING OPTION FOR THE HIGHER LEVEL UPPER LIMB AMPUTEE
    (2005) Mikosz, Matthew J.
    The purpose of this article is to describe an alternative switching option for the higher-level upper limb amputee. Currently available body powered switches allow for only one function which can become quite cumbersome when multiple control methods are used. A multi-functional switch that can activate many different controls either independently or simultaneously could greatly reduce the amount of hardware required to operate all of these devices. When working with bilateral shoulder or interscapulothoracic amputees one of the main goals is to provide as much function as possible while maintaining simplicity in the design. The first patient that was fit with the actuator was currently wearing bilateral shoulder prostheses with seven switches. The result was a reduction in the amount of switches necessary to operate the different controls from seven to two. The switch can also be configured to operate Force Sensing Resistors (FSR’s) or linear transducers to provide proportional control.
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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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    USING GROSS MOTOR ACTIVITIES TO ASSESS UPPER LIMB PROSTHETIC FUNCTION
    (2005) Biden, E.; Ross, M.; Chester, V.; Bush, G.; Hill, W.; Tingley, M.; MacPhee, B.; Brown, L.
    For children with unilateral below elbow limb loss, many of the activities for which a prosthesis is of value involve gross motor function during play. To assess function in these activities we studied normally limbed children and children using below elbow powered prostheses while they performed various tasks. This paper is focused on two tasks, swinging on a swing, and zipping up a vest. The study had three primary objectives: 1. To collect data for normally limbed children to provide baseline data, 2. To collect data for children who use either a single degree of freedom friction wrist or an “omniwrist”, and 3. To compare the results for users of the two types of wrist to their normally limbed peers. The two tasks chosen represent two different types of activity. The swing has a cycle time or rhythm which is determined principally by the length of the ropes. As a result the child who is swinging must react to the activity on a time scale which is out of their control. By comparison the zipper task is one where the child can simply slow down, to whatever extent needed, in order to be able to perform it. The strategy of taking more time is a common one if activities are difficult to accomplish.