Child Prosthetics

Question 1

What is a passive prosthetic?

Answer 1

It provides something other than the functionality of picking something up (e.g. make somebody feel more confident)

Question 2

What is an adjustable passive prosthetic?

Answer 2

Same as a passive prosthetic but the user can adjust parts of it (e.g. the thumb)

Question 3

What is a functional prosthetic?

Answer 3

It is functional and body powered (e.g use the wrist to open and close the hand)

Question 4

What is a myoelectroc prosthetic?

Answer 4

It reads the muscle activity from the arm and uses that to control the hand

Question 5

What powers hand prosthetics?

Answer 5

The majority of hand prosthetics are body powered

Question 6

What powers forearm prosthetics?

Answer 6

The majority of them are externally powered, some are body powered

Question 7

What powers upper arm prosthetics?

Answer 7

The majority are externally powered

Question 8

How much control do passive static and passive adjustable devices have ?

Answer 8

No control

Question 9

How much control do body powered devices have?

Answer 9

Majority controlled by the wrist and a small amount are elbow and shoulder harness controlled

Question 10

Which type of control do externally devices have?

Answer 10

Majority have EMG control (sensors on the arm), some have EEG control (from the brain)

Question 11

What force distribution do 3D printed hands have?

Answer 11

Majority is equal force (objects can slip out), then some have independent force (most beneficial to model hand more accurately) , minimal have distributed force

Question 12

What are the findings about 3D printed hands?

Answer 12

• good for individualisation, e.g. for children being able to change the colour, shape and size
• data on user acceptance, functionality and durability is lacking (there is a huge amount of data on what devices exist, there’s a certain degree of data on what tests have been done, but there is not much info on what happens after the devices go)
• 3D-printing is not necessarily the cheapest option, injection moulding is cheaper

Question 13

What are the Pro’s and Con’s of 3D printing in terms of costs?

Answer 13

Cost (+ print new parts as child grows, - assumes access to printer)

Question 14

What are the Pro’s and Con’s of 3D printing in terms of social?

Answer 14

+ promote confidence

Question 15

What are the Pro’s and Con’s of 3D printing in terms of design?

Answer 15

+ colourful and appealing

Question 16

What are the Pro’s and Con’s of 3D printing in terms of models?

Answer 16

+ can be customised to recipient

- often very task specific

Question 17

What are the Pro’s and Con’s of 3D printing in terms of open source?

Answer 17

+ free and often updated (anyone can get involved)

- not regulated/ tested

Question 18

What are the Pro’s and Con’s of 3D printing in terms of impact?

Answer 18

+ lightweight and child friendly

- Lomb functional and quality of life not necessarily improved)

Question 19

3D printed summary

Answer 19

In the absence of evidence no conclusions can be drawn

Rapidly growing area

Question 20

Info on congenital limb loss

Answer 20

• Effect 1 in every 2500 births
• The majority is unilateral trans-radial (somewhere between wrist and elbow)
• Likely causes are mutation or vascular compromise
• Make up about 94% of paediatric referrals

Question 21

Describe the process of prosthesis fitting

Answer 21

First fit with passive, the passive adjustable, then functional

Question 22

What does a passive do?

Answer 22

Trains the child to use both hands and supports brain development

• must be regarded as an extension of the residual tissue (encourages motor learning)
• should swing naturally and be placed spontaneously (integration of the prosthetic into the body schema)

Question 23

What does a passive adjustable do?

Answer 23

Used to encourage functional use of the prosthetic

Question 24

What does functional do?

Answer 24

Reduce overuse and facilitate independence

• maintains muscle mass in residual limb
• prevents compensatory movements

Question 25

Prosthesis management summary

Answer 25

Limited evidence of any benefit to fitting a prosthesis before age 1

General consensus is that prosthesis should be fitted between the ages of 1-3

Question 26

What are the device rejection rates?

Answer 26

45% body powered
38% passive
35% for myoelectric

Actual numbers likely to be higher because most studies conducted through rehab centres

Children prefer myoelectroc devices

Question 27

What are the reasons for rejection?

Answer 27

Children with congenital deficiencies do not have sense of limb loss
Naturally develop complementary skills for humanism activities

If the prosthesis provides no functionality gain they are generally rejected