Functional Restoration Of Adults And Children With Upper Extremity Amputation

This is the only comprehensive guide to the surgery, prosthetic fitting, and rehabilitation of individuals sustaining an arm amputation. It incorporates the major advances in prosthetics and rehabilitation that have occurred in recent years, and will improve the quality of service and the outcomes for those who sustain an arm amputation. Sections deal with the surgical aspects of arm amputation, the comprehensive management of the arm amputee, prosthetic restoration following arm amputation, the special concerns of upper extremity amputation in children, and clinical outcomes. The incidence, demographics, and functional outcomes are quite different from those of lower limb amputees. The arm amputee is most commonly a young man who sustains a traumatic injury, most often to his right, dominant arm. Because the incidence of arm amputation is low compared to that of the lower extremity, relatively few health professionals have much experience in providing surgery, therapy, rehabilitation, prosthetic care, or counseling for a significant number of arm amputees. This book is the definitive text for these individuals. The prosthetic field, including its allied healthcare team, takes on a formidable task in restoring physical capabilities to the upper extremity amputee. This feat cannot be accomplished solely using modern technology, and technology is not always the central issue. Optimal rehabilitation requires an underlying commitment in many essential areas of care: for one, sensitivity to the desires, anxieties and fears of the individual with amputation. Although the prosthetic practitioner has at his or her disposal more technology than ever before, restoring integral function for the amputee involves still more than mechanical application. Interdisciplinary, cooperative efforts in research, development, and treatment between prosthetic practitioners and other constituents of the allied healthcare team is paramount. The rehabilitation process must focus not only on the provision and use of a prosthesis, but also on issues related to surgical procedures, self-determination and pain management. To this end, Functional Restoration of Adults and Children with Upper Extremity Amputation provides the definitive guide for all surgeons, prosthetists, and rehabilitation professionals who work with upper limb amputees.

Prosthetic Restoration and Rehabilitation of the Upper and Lower Extremity is a well-illustrated, state-of-the-art reference on the science and practice of post-amputation care, prosthetic restoration, and functional rehabilitation, designed to maximize patient independence and quality of life. Chapters are written by physiatrists, prosthetists, surgeons, and therapists at the University of Michigan, clinicians and teachers who work with amputees on a daily basis. Clinically oriented, it covers both lower and upper extremity restoration and rehabilitation and serves as a handy reference for busy practitioners to support sound clinical decision-making. Beginning with basic anatomy, kinesiology, and a recap of surgical decisions principles and post-operative care for amputees, the book discusses biomechanics, clinical assessment, prosthetic options, how to write a complete and detailed prescription for the prosthesis, restoration and management of specific problems by region, and rehabilitation programs and strategies. Common medical issues such as phantom limb sensation and pain, skin problems, and sexual and psychological considerations are discussed as well. In-depth coverage of prosthetic restoration is provided for special populations such as infants, children, the elderly, athletes multi-extremity amputees, and those who have lost limbs to cancer. Chapters are written in expanded outline format for ease of use and feature numerous full-color diagrams, photos, and other illustrations. This text will guide physicians, trainees, and other members of the care team through the fundamentals of restoring function to individuals who have lost limbs or body parts. Key Features: Provides a state-of-the-art, accessible, clinical approach to post-amputation care, prosthetic restoration, and functional rehabilitation Covers both upper and lower extremities Addresses prostheses for special populations and sports and recreation Includes boxed clinical pearls at the start of each chapter, illustrated quick reference tables, and full-color photos throughout Supports clinical decision making and addresses practical questions and problems Advises on new requirements for Medicare and Medicaid patients, and includes patient education materials and sample prescription forms that can be customized for use in any clinic Outlines important information for returning to the community after amputation

Each year in the United States, an estimated 40,000 persons lose a limb. Of these amputees, approximately 30% lose a hand or an arm. This loss is most frequently related to trauma occurring in the healthy young adult male and is often work related. Approximately 3% of all amputees are born with congenital limb absence. In children, the ratio of congenital to acquired amputation is 2: 1, and the ratio of upper-limb to lower-limb amputees is 1. 2: 1. Therefore, since relatively few amputations result in upper-limb loss, only a small number of health practitioners, even those specializing in amputee rehabilitation, have the opportunity to provide services for a significant number of arm amputees. As a result, clinicians need to share their experiences so that the full range of options for optimum care and rehabilitation of the patient population may be considered. To meet this challenge for wider communication of clinical experience, a group of upper-limb amputee specialists met in Houston, Texas, in 1981 to serve as the core faculty for a course entitled "Contemporary Issues in Upper Extremity Amputation and Prosthetic Function. " This program provided the opportunity for surgeons, physiatrists, engineers, prosthetists, social workers, psychologists, occupational therapists, and physical therapists from the United States and Canada to discuss their extensive experience in working with upper extremity amputees. A second conference continuing the discussion of upper limb amputee rehabilitation was held one year later.

The U.S. Census Bureau has reported that 56.7 million Americans had some type of disability in 2010, which represents 18.7 percent of the civilian noninstitutionalized population included in the 2010 Survey of Income and Program Participation. The U.S. Social Security Administration (SSA) provides disability benefits through the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. As of December 2015, approximately 11 million individuals were SSDI beneficiaries, and about 8 million were SSI beneficiaries. SSA currently considers assistive devices in the nonmedical and medical areas of its program guidelines. During determinations of substantial gainful activity and income eligibility for SSI benefits, the reasonable cost of items, devices, or services applicants need to enable them to work with their impairment is subtracted from eligible earnings, even if those items or services are used for activities of daily living in addition to work. In addition, SSA considers assistive devices in its medical disability determination process and assessment of work capacity. The Promise of Assistive Technology to Enhance Activity and Work Participation provides an analysis of selected assistive products and technologies, including wheeled and seated mobility devices, upper-extremity prostheses, and products and technologies selected by the committee that pertain to hearing and to communication and speech in adults.

Implement TMR with Your Patients and Improve Their Quality of Life Developed by Dr. Todd A. Kuiken and Dr. Gregory A. Dumanian, targeted muscle reinnervation (TMR) is a new approach to accessing motor control signals from peripheral nerves after amputation and providing sensory feedback to prosthesis users. This practical approach has many advantages over other neural-machine interfaces for the improved control of artificial limbs. Targeted Muscle Reinnervation: A Neural Interface for Artificial Limbs provides a template for the clinical implementation of TMR and a resource for further research in this new area of science. After describing the basic scientific concepts and key principles underlying TMR, the book presents surgical approaches to transhumeral and shoulder disarticulation amputations. It explores the possible role of TMR in the prevention and treatment of end-neuromas and details the principles of rehabilitation, prosthetic fitting, and occupational therapy for TMR patients. The book also describes transfer sensation and discusses the surgical and functional outcomes of the first several TMR patients. It concludes with emerging research on using TMR to further improve the function and quality of life for people with limb loss. With contributions from renowned leaders in the field, including Drs. Kuiken and Dumanian, this book is a useful guide to implementing TMR in patients with high-level upper limb amputations. It also supplies the foundation to enable improvements in TMR techniques and advances in prosthetic technology.

Long recognized as an essential reference for therapists and surgeons treating the hand and the upper extremity, Rehabilitation of the Hand and Upper Extremity helps you return your patients to optimal function of the hand, wrist, elbow, arm, and shoulder. Leading hand surgeons and hand therapists detail the pathophysiology, diagnosis, and management of virtually any disorder you’re likely to see, with a focus on evidence-based and efficient patient care. Extensively referenced and abundantly illustrated, the 7th Edition of this reference is a "must read" for surgeons interested in the upper extremity, hand therapists from physical therapy or occupational therapy backgrounds, anyone preparing for the CHT examination, and all hand therapy clinics. Offers comprehensive coverage of all aspects of hand and upper extremity disorders, forming a complete picture for all members of the hand team—surgeons and therapists alike. Provides multidisciplinary, global guidance from a Who’s Who list of hand surgery and hand therapy editors and contributors. Includes many features new to this edition: considerations for pediatric therapy; a surgical management focus on the most commonly used techniques; new timing of therapeutic interventions relative to healing characteristics; and in-print references wherever possible. Features more than a dozen new chapters covering Platelet-Rich Protein Injections, Restoration of Function After Adult Brachial Plexus Injury, Acute Management of Upper Extremity Amputation, Medical Management for Pain, Proprioception in Hand Rehabilitation, Graded Motor Imagery, and more. Provides access to an extensive video library that covers common nerve injuries, hand and upper extremity transplantation, surgical and therapy management, and much more. Helps you keep up with the latest advances in arthroscopy, imaging, vascular disorders, tendon transfers, fingertip injuries, mobilization techniques, traumatic brachial plexus injuries, and pain management—all clearly depicted with full-color illustrations and photographs.

The most recent high-profile advocate for Americans with disabilities, actor Christopher Reeve, has highlighted for the public the economic and social costs of disability and the importance of rehabilitation. Enabling America is a major analysis of the field of rehabilitation science and engineering. The book explains how to achieve recognition for this evolving field of study, how to set priorities, and how to improve the organization and administration of the numerous federal research programs in this area. The committee introduces the "enabling-disability process" model, which enhances the concepts of disability and rehabilitation, and reviews what is known and what research priorities are emerging in the areas of: Pathology and impairment, including differences between children and adults. Functional limitationsâ€"in a person's ability to eat or walk, for example. Disability as the interaction between a person's pathologies, impairments, and functional limitations and the surrounding physical and social environments. This landmark volume will be of special interest to anyone involved in rehabilitation science and engineering: federal policymakers, rehabilitation practitioners and administrators, researchers, and advocates for persons with disabilities.