Upper Extremity Amputation and Prosthetics Care Across the Active Duty Military and Veteran Populations (original) (raw)
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Current Concepts in Upper-Extremity Amputation
The Journal of Hand Surgery, 2018
Advances in motor vehicle safety, trauma care, combat body armor, and cancer treatment have enhanced the life expectancy and functional expectations of patients with upper-extremity amputations. Upper-extremity surgeons have multiple surgical options to optimize the potential of emerging prosthetic technologies for this diverse patient group. Targeted muscle reinnervation is an evolving technique that improves control of myoelectric prostheses and can prevent or treat symptomatic neuromas. This review addresses current strategies for the care of patients with amputations proximal to the wrist with an emphasis on recent advancements in surgical techniques and prostheses.
Upper extremity prosthetics: Current status, challenges and uture directions
2012
There is a drastic increment of the demand for prosthetic devices over the last few decades. This is caused by the increased amputees because of casualties due to civil wars, injuries due to accidents, etc. Therefore, the robotic prostheses are one of the highly interested research areas in recent robotic research. The target is to make sure the amputee gets a better chance to interact with the real world, in spite of the amputation he has. The paper presents the results of a comprehensive literature analysis towards a development of an upper-limb prosthetic arm. This study identifies the methods of prosthetic classification as the segment of application, number of degrees of freedom (DoF), types of applied actuators, types of power transmission methods and control methods. In this study, the upper extremity prosthetic devices are classified based on the segment of application. Thus, they can be mainly classified into shoulder prosthetics, transhumeral and elbow prosthetics, transradial and hand prosthetics. This study considers all the above categories of recent upper extremity prosthetics, and reviews their key technologies by taking state-of-the-art robots as examples.
Prosthesis use in persons with lower- and upper-limb amputation
The Journal of Rehabilitation Research and Development, 2008
This study identified clinical (e.g., etiology) and demographic factors related to prosthesis use in persons with upper-and lower-limb amputation (ULA and LLA, respectively) and the effect of phantom limb pain (PLP) and residual limb pain (RLP) on prosthesis use. A total of 752 respondents with LLA and 107 respondents with ULA completed surveys. Factors related to greater use (hours per day) for persons with LLA included younger age, full-or part-time employment, marriage, a distal amputation, an amputation of traumatic etiology, and an absence of PLP. Less use was associated with reports that prosthesis use worsened RLP, and greater prosthesis use was associated with reports that prosthesis use did not affect PLP. Having a proximal amputation and reporting lower average PLP were related to greater use in hours per day for persons with an ULA, while having a distal amputation and being married were associated with greater use in days per month. Finally, participants with LLA were significantly more likely to wear a prosthesis than those with ULA. These results underscore the importance of examining factors related to prosthesis use and the differential effect that these variables may have when the etiology and location of amputation are considered.
Disability and Rehabilitation: Assistive Technology, 2012
Purpose: To describe patterns of prosthesis wear and perceived prosthetic usefulness in adult acquired upper-limb amputees (ULAs). To describe prosthetic skills in activities of daily life (ADL) and the actual use of prostheses in the performance of ADL tasks. To estimate the influence of prosthetic skills on actual prosthesis use and the influence of background factors on prosthetic skills and actual prosthesis use. Method: Crosssectional study analysing population-based questionnaire data (n = 224) and data from interviews and clinical testing in a referred/convenience sample of prosthesis-wearing ULAs (n = 50). Effects were analysed using linear regression. Results: 80.8% wore prostheses. 90.3% reported their most worn prosthesis as useful. Prosthetic usefulness profiles varied with prosthetic type. Despite demonstrating good prosthetic skills, the amputees reported actual prosthesis use in only about half of the ADL tasks performed in everyday life. In unilateral amputees, increased actual use was associated with sufficient prosthetic training and with the use of myoelectric vs cosmetic prostheses, regardless of amputation level. Prosthetic skills did not affect actual prosthesis use. No background factors showed significant effect on prosthetic skills. Conclusions: Most major ULAs wear prostheses. Individualised prosthetic training and fitting of myoelectric rather than passive prostheses may increase actual prosthesis use in ADL.
Advances in Upper Extremity Prosthetic Technology: Rehabilitation and the Interprofessional Team
Current Physical Medicine and Rehabilitation Reports, 2022
Purpose of Review The aim of this paper is to explore current trends and advancements that lead to improved practitioner knowledge and patient care resulting in better outcomes. It is common for the physiatrist to lead the team of interprofessional practitioners in the care of individuals with upper limb absence. The focus of the care is to understand and access prosthetic options, but there are often other health factors and relevant issues to consider. Recent Findings Some of the latest updates offer solutions to pain management, prosthetic control, access to relevant evidence, and outcomes-related data. An interesting finding was the influence of telehealth service delivery on multiple issues faced by this population. These issues include lack of information, pain management, monitoring skin breakdown and peripheral vascular disease, prosthetic training, and access to peers and specialized practitioners. Summary The diverse technology advancements in surgical techniques, materials, outcome measures, and data management, as well as telehealth, work together to assist the collaborative interprofessional team to provide contemporary and comprehensive care to this unique population.