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Rehabilitation Engineering Part 2 > L19 Upper Limb Prothetics > Flashcards

L19 Upper Limb Prothetics Flashcards

1
Q

Prosthesis

A

an artificial device to replace a missing or impaired
part of the body

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2
Q

Prosthetics

A

the field of study or specialty concerned with the design, construction of fitting of prostheses

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3
Q

Prosthetic

A

Of or relating to a prosthesis or prosthetics
prosthetic limb

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4
Q

Persons with amputations:

A
  • 1.6 million persons with amputation in the United States in 2005.
  • 35% with loss or deficiency of the upper extremity.
  • Approximatively 2.2 million amputees in 2020.
  • 2.4% of all the wounded in the Iraq and Afghanistan (OIF/OEF) conflicts have
    had a traumatic amputation
  • Each year there are 185,000 amputations that have a
    cost of over 8.3 billion dollars
  • Main causes for these amputations are vascular
    diseases that take up 54 percent of the amputee
    population and 45 percent of the causes are due to trauma.
  • # of amputations due to diabetes increased by 24%from 1988 to 2009
  • Traditional lower limb prostheses: $5,000 to $50,000
  • Traditional upper limb prosthesis: $3,000 to $30,000
    dollars.
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5
Q

Leading Causes of Upper Extremity Amputations

A
  • Trauma
  • Congenital deficiency
  • Tumor
  • Disease
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6
Q

Amputation Levels

A
  • Transradial amputation: below the elbow: long,
    medium, short
  • Transhumeral amputation: above the elbow – typical length, 50-90% of humeral length
  • Shoulder, elbow, or wrist disarticulation
  • Finger, partial hand
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7
Q

Successful prosthesis

A
  • Comfortable
  • Easy to don/doff
  • Lightweight
  • Durable
  • Cosmetically pleasing
  • Functions well
  • Reasonable maintenance
  • Motivates individual
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8
Q

Components of an Upper Limb Prosthesis

A
  • Suspension
  • Socket Design
  • Alignment
  • Terminal Devices: hooks, hands, specialties
  • Wrist units, elbow units, shoulder units
  • Control: body-powered, myoelectric, hybrid
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9
Q

Component Selection

A
  • Patient’s Limb: skin, muscle function, tolerance
  • Amputation level
  • Type of trauma or injury: frostbite, land mines, congenital
  • Gender, age
  • Developed or developing countries
  • Occupation
  • Leisure activities
  • Cost/Reimbursement
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10
Q

Basic Types of Upper Limb Prostheses

A
  • Body powered prosthesis
  • Myoelectric prosthesis
  • Hybrid System
  • Activity specific
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11
Q

Terminal Devices - Non prehensile

A

touching feeling, pressing down with fingers, tapping, lifting, pushing

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12
Q

Terminal Devices - Prehensile

A

precision grip – pincher grip, lateral grip, hook power grip

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13
Q

Terminal Devices - Active

A

hooks, functional hands, activity specific

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14
Q

Terminal Devices - Passive

A

cosmetic hands

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15
Q

Body powered

A

Voluntary Opening (VO):
* Practical
* In closed position, by springs
* User pulls the cable to open
* Prehensile force – from spring

Voluntary Closing (VC):
* Physiological
* In open position
* User pulls the cable to close
* Prehensile force – from patient
* Greater proprioceptive inpu

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16
Q

Myoelectric Prosthetic Hands

A

Bebionic Hand:
* Ottobock
* 14 different grip patterns
* Individual motors in each finger
* Three wrist options
* Two Sizes

i-Limb Ultra:
* Ossur
* 18 different grips
* Five motors for each finger
* 4 sizes

TrueLimb:
* Unlimited Tomorrow
* Ultralightweight (1-1.5 lbs)
* 30+ sensors: intuitive control
* 3D scan residual limb
* 3D printed

17
Q

Recent Innovations

A
  • Increased joint movement and power
  • Settings, adjustments controlled via Bluetooth
  • User change modes, grip patterns
  • EMG pattern recognition – may increase the amount of motions user can control
  • Targeted Muscle Reinnervation
  • Proprioception
18
Q

Hand Proprioception and Touch Interfaces (HAPTIX)

A
  • DARPA Project
  • deliver natural sensation to prosthesis users
  • brain and nervous system working together based on intent
19
Q

Pattern recognition

A
  • Solves problem of a lack of muscles controlling a prosthetic movement at
    ounterintuitive joint segments
  • More natural control and movements

Generation of EMG signals -> Preprocessing to remove obvious interferences -> Windowing of EMG signals -> Feature recognition -> Recognition/Classification

20
Q

Challenges

A
  • Loss of joints due to amputation: limited DOFs
  • Body’s kinematics changed drastically
  • Compensatory motion
  • More utilization of intact limb
  • Overuse syndrome will most likely appear
  • High rejection rates of upper limb prostheses
  • Lack of training using the prosthesis
  • Need for an effective prosthetic training tool
21
Q

Outcome Measures

A

Box and Blocks Test
Southampton Assessment Procedure (SHAP)

22
Q

e-Nable

A
  • Online global community
  • Use 3-D printer to make free and low cost prosthetic upper limb devices
  • 40,000 volunteers in over 100
    countries

Rehabilitation Engineering Part 2 (11 decks)

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