Upper Extremity Prosthetics

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.

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

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.

Powered Upper Limb Prostheses deals with the concept, implementation and clinical application of utilizing inherent electrical signals within normally innervated residual muscles under voluntary control of an upper limb amputee. This amplifies these signals by battery-powered electrical means to make a terminal device, the prosthetic hand, move to perform intended function. The reader is introduced to various facets of upper limb amputations and their clinical management in both children and adults. The authors from Canada, USA and Great Britain are well known practicioners, academics and researchers in the field. The book has over 130 illustrations and contains an extensive bibliography.

Making Hands: The Design and Use of Upper Extremity Prosthetics provides a historical account of the development of upper extremity prostheses. It describes different aspects surrounding the development of key elements of mechanisms and control, for prosthetic hands and arms, and includes biographical sketches of some key contributors. The field is broad and uses knowledge from a wide range of disciplines. Sections cover the background to give researchers and professionals what they need to learn about adjacent fields. The author's expertise on the control of prostheses makes this a very comprehensive resource on the topic. Covers research and technological innovation in the development of upper limb prostheses Introduces upper limb prosthetics from the different perspectives of biology, engineering, clinical practice and industry Discusses innovations of the recent decades, rapid manufacture, the 'citizen engineer', and how these things may shape prosthetics in the future

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 technological level of upper limb prostheses has always been fairly poor so far if compared with that of other analogous systems (e.g. lower limb prostheses, assistive robots). However, there is no doubt that in the recent years the upper limb researc"

This resource addresses all aspects of combat amputee care ranging from surgical techniques to long-term care, polytrauma and comorbidities such as traumatic brain injury and burns, pain management, psychological issues, physical and occupational therapy, VA benefits, prosthetics and adaptive technologies, sports and recreational opportunities, and return to duty and vocational rehabilitation.