UE Prosthetics Flashcards
Factors that influence prosthetic recommendations
Distal amputations
Dominant hand amputation
Family/social support
cognition and age
Goals for prosthetic training
Safety
Improve function and independence
Smooth, efficient movements
strength
Acceptance
Shoulder suspension
Amputation above elbow
Harness- straps bit over both shoulders
Silicone liners and sleeves @ end of RL
Where should the O-ring be placed for a shoulder suspension
near the opposite scapula
How would you increase stability for a shoulder suspension
increase number of straps
Elbow/ wrist suspension
Self-suspended sockets grip bony prominence of elbow or wrist
What is a terminal device
What is at the end of the prosthetic
Passive vs active terminal device
Passive=don’t have any movement more for cosmetics
Active: open and close or hold objects
Types of Active terminal devices
BOdy powered and external powered
Body powered terminal devices
cable and harness
Voluntary opening or voluntary closing
External power terminal device
Control the operation with muscle signals or mechanical switches
Body powered voluntary opening
open in response to tension on the cable or harness
strength grasp is provided by springs or rubber bands
closes when tension is released
Voluntary opening types
hook: lateral pinch, split hook or heavy duty
Mechanical hand
Body powered voluntary close
closes in response to tension on the cable or harness
Grasp and holding objects while tension is maintained
wearer determines the strength of the pinch or grasp based on how much tension is applied
Myoelectric hand
Active, externally controlled TD
muscle contractions controls TD through electrical signals
typically flexor and extensor control
pediatric “cookie crusher”
1 muscle action to open and when the contraction is stopped it closes automatically
3 general types of prostheses
Passive
Body-powered
Myoelectric
Passive prosthesis
for appearance, no function at the terminal device
body-powered prothesis
active terminal device that dependents on movement of cables generated by body movement
Myoelectric prothesis
active terminal device that has motor and battery components reliant on muscle signals and contractions
below elbow components
tricep cuff- holds RL and elbow joint
elbow hinge
forearm socket
wrist unit
TD
cable system
Above elbow components
humeral socket
elbow turn table
elbow unit
forearm shell
wrist unit
TD
Cable system
Prosthetic ROM assessment
stump rotation, elbow flexion with prosthesis on if elbow exists
if no elbow how does the elbow unit move
Prosthetic TD Assessment
how well does it open in close in various ranges
Forearm at 90, at waist, at mouth
Control system efficiency assessment
force applied to TD and harness
measured in lbs
Prosthetic stability assessment
how far does it displace if load is added
should not slip more than an inch and harness should not tear
there should be no pain
Patient assessment
performance and opinion of comfort
function
appearance
What should you do after you know the prosthetic works and fits good
Start training
First step of prosthetic training
Bilateral control components
use with existing line
pick up objects with both limbs without any grasping
2nd step of prosthetic training
release of objects
being able to drop something, doesn’t have to be controlled
3rd step of prosthetic training
controlled release
ex.) dropping, placing and tossing objects
4th step of prosthetic training
grasp
reaching for an object, grasping securely
start with easy objects and move into harder
start in front of individual at midline and move out of midline
5th step prosthetic training
maintaining hold
using right amount of force and moving the object while holding it
Properties of objects that should be used when training
light to heavy
large to small
dense to fragile
Overview of steps of training
- bilateral control
2.release of objects - controlled release
- grasp
- maintaining hold and moving
