Academy Meeting in Orlando
Myoelectric Hand with Built-In Wrist Flexion & Extension
The folks at Motion Control announced that their electronic hand is now available with a built-in wrist unit that locks in 30 degrees of extension, 30 degrees of flexion, and in neutral. This feature adds no additional length over a standard hand, so it should be suitable for many upper limb amputees.
On rare occasions, I have adapted an existing flexion wrist for use with myo hands, but the added length and service/reliability hassles made me doubt the overall wisdom of the "doing it yourself" approach. At the same time, decades of experience with flexion wrists for mechanical terminal devices and the excellent acceptance of the friction-flexion feature of the Griefer have confirmed the clinical usefulness of this capability. Congratulations are due to Motion Control for implementing this long-overdue feature so cleverly.
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Motion Control's externally powered hand is now available with a locking wrist flexion-extension unit built in.
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Motion Control has always been a leader in gathering information about use patterns of upper limb powered components, and their wrist flexion-extension feature follows this pattern. According to the data gathered during field trials, amputees generally found this new capability useful - for such everyday tasks as pulling on socks, pushing a grocery cart, or using the telephone. One subject also noted that it was helpful in "putting IV tubes in cows"!
Clinical comments from the Beta test sites I have spoken with has been quite favorable, with good durability and patient acceptance. Amputees who were accustomed to a fixed wrist reportedly quickly learned to use the added wrist mobility, although ideally we will start new patients out with this feature, so they learn to incorporate it into their activities of daily living as part of their initial rehabilitation.
It will take some time to develop sufficient clinical experience to identify the indications and contraindications for a flexion-extension myo hand. My hunch is that the increase in the work envelope, particularly for midline activities, will make this a desirable capability for most amputees. Of course, it is likely to be especially valuable to people with bilateral upper limb loss, but I wouldn't restrict it to this population.
Click here to download a PDF file with more information, or go to www.utaharm.com
Socket Preform/Adapter
Composite Inventions, Inc. is a micro-company founded by Douglas Taylor CP to develop commercial applications for composites and other advanced materials. His first prosthetic product is a hemispherical titanium socket adapter with lamination cap that includes an integral carbon fiber braid pre-shaped for a typical socket lamination.
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Doug Taylor CP showed this clever Socket Preform/Adapter designed to make lamination of a thin, strong carbon fiber socket easier and faster.
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One of the benefits of this "all-in-one" solution is that the fiber orientation has been pre-planned to provide maximum strength. The lamination cap has channels that correspond to ports drilled into the socket adapter. This funnels resin into the assembly to help insure thorough wetting of the fibers.
You can email Doug for more information at: info@compositeinventions.com. By the way, he is also an avid guitarist and had a sharp-looking carbon fiber Stratocaster discreetly hidden under his display table at the Academy meeting!
Hydraulic Socket Volume Management System
One of the most interesting innovations debuting at the Academy meeting was the "Active Contact System" from SIMBEX, a company co-founded by Robert C. Dean, Jr. Dr. Dean is an engineer, entrepreneur, and a transfemoral amputee who has been involved in a number of efforts to enhance prosthetic technology in recent decades.
At first glance, this seems quite similar to the familiar "air bag" systems that have been around for several years: a series of flexible pouches, connected by clear tubing, that can be inflated or deflated to modify the internal volume of the socket. But, on closer examination, this product is breaking new ground.
The "Active Contact System" is not filled with air [which is compressible] but with a liquid called "bio-static fluid". This should make the volume changes more stable, even under load. In addition, there is a clever pump/pressure system that uses forces generated during ambulation to pressurize the system to the value set by the prosthetist. This should automatically accommodate for fluctuations in the residual limb.
When the patient is seated, the system gradually depressurizes to increase sitting comfort. There is also a manual "Night Valve" that the user can press to drain all the fluid from the bladders so the socket is as loose as possible for easier donning. According the their brochure, the desired pressure is automatically restored "within a few paces" by normal walking.
This is certainly a well thought out approach to managing residual limb volume fluctuations, and it may represent a significant advance in this area. SIMBEX is currently recruiting Certified Prosthetists willing to purchase and fit two "Active Contact Systems", and to conduct a controlled follow-up for 90 days. Additional information is available by contacting Aaron Buck at abuck@simbex.com.
I should also clarify that the system is NOT battery powered, so there are no power sources to recharge or replace. All in all this seems to be a very promising approach that is worth trying, to determine its clinical value.
PRS Mobile Classroom
Ronney Graves of Prosthetics Research Specialists, Inc. in Florida undoubtedly drove one of the largest vehicles to this Academy meeting. The sleeper-tractor was large enough for a family of four, and the trailer in tow is a fully functional fabrication/teaching classroom.
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PRS has a new mobile classroom that will let them bring hands-on education to their customers around the country.
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PRS is not the first company to have a mobile teaching center. PDI in Ohio has had a ProLAB mobile CADCAM rig for quite some time. [To learn more, go to pdwins.com .] But, to the best of my knowledge, PRS is the first to have a classroom on wheels that includes fabrication equipment for laminations, spray coatings, and the like.
For more information on the PRS product line, or to inquire about their course schedule, www.prostheticsresearch.com
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Question from the 4/2000 posting
Does anyone know where I can get the Canadian Arthritis and Rheumatology Society Knee brace shown there? I have a Dr at the local VA that used to use them, and ordered one yesterday. That posting is the only place I could find even a pict... read more
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Re: Question from the 4/2000 posting
I used a number of these and obtained them from USMC, but to the best of my knowledge, they dropped this product years ago. I believe it is no longer commercially available. You might be able to build one yourself, but the time required w... read more
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Re: Re: Question from the 4/2000 posting
Ciudad de México 8 de Junio, 2002.
Estimado John Michael, C. P. O.
le enviamos un afectuoso saludo desde la ciudad de México y le informamos que la Sociedad Mexicana de Ortesistas y Protesistas, realizará un "Taller de Patología Espinal... read more
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Re: Re: Re: Question from the 4/2000 posting
This should be an excellent course on Spinal Orthoses with such distinguished faculty. Best professional regards. --John Michael CPO
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