MANAGEMENT OF HIGH LEVEL BILATERAL ARM AMPUTEES WHO USE WHEELCHAIRS FOR MOBILITY

Management of the high-level bilateral arm amputee poses many challenges to the prosthetist and rehabilitation team. When the amputee is also in a wheelchair, use of arm prostheses becomes more difficult. Positioning of the prosthesis without the use of the lower extremities is remarkably difficult. The work envelop is further reduced when trunk motion and stability is compromised by paralysis. Heckathorne and Uellendahl have recommended a framework for component and control strategy selection when designing prostheses for high level bilateral arm amputees.1-3 This strategy calls for use of dissimilar components on each side to enhance prosthesis usefulness and control schemes that provide dedicated control of as many components as possible allowing simultaneous control when functionally desired. Uellendahl has used this approach for over 15 years for clinical fittings. The long-term success of this fitting philosophy demonstrates the clinical efficacy of this approach. In fact, one of the amputees (MM) reported on in this paper has used prostheses of the same original design for more than a dozen years