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movement science II > week 11 learning objectives > Flashcards

week 11 learning objectives Flashcards

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1
Q

prosthetic

A

artificial body part

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2
Q

residuum/residual limb

A

remains after amputation

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3
Q

sound side

A

opposite limb

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4
Q

don/doff

A

on/off prosthetic

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5
Q

socket

A

interface between residual limb and prosthesis

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6
Q

terminal device

A

hand functioning device in upper extremity

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7
Q

suspension

A

how device attaches to body

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8
Q

force

A

through body or device, motors

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9
Q

excursion

A

ROM needed to operate upper extremity prostheses

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10
Q

UE amputation statistics

A

9% of all patients with amputation
70-80% traumatic
56% of amputees use prostheses

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11
Q

concepts behind UE amputation

A

cosmesis is more important than function
proficiency with UE prosthesis takes longer
most successful when viewed as tool/AD
functional difficulty proportional to amputation level

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12
Q

UE amputation level

A

shoulder disarticulation, trans-humeral/elbow disarticulation, trans-radial/wrist disarticulation, trans-metacarpal/partial hand
longer is more pronation/supination

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13
Q

suspension

A

how prosthesis is attached

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14
Q

power strategies

A

how you move limb (generate force)

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15
Q

control strategies

A

how you manipulate devices linked to limb

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16
Q

UE types of suspensions

A

harness
pin-lock liner
suction
anatomical/self-suspending

17
Q

harness suspension UE

A
  • the classic
  • (+): simple (cables), easy to maintain (few parts), durable, accomodate heavy applications (carry heavy loads), easy donning and doffing
  • (-) can be uncomfortable (into axilla, impingement), poor cosmesis
  • system of straps/buckles around shoulders, back, chest
  • used at all amputation levels - but is only option with should disarticulation or very short TH amputation
  • many variations
18
Q

UE pin-lock liner suspension

A
  • (+): comfortable, cushion bony prominences, reduce shear forces
  • (-): somewhat difficult to don, harnessing usually still needed
  • silicone or gel garment worn on surface of limb with distal attachment point which engages a mechanical lock
  • ideal for passive prostheses
  • mid-short length TH and TR
19
Q

UE suction suspension

A
  • (+): interface with myoelectric control, reduce or eliminate harnessing
  • (-): difficult to don - pull sock, donning sleeve, distal end discoloration, very sensitive to volume fluctuations
  • skin-tight fit, seal to walls of socket, one-way expulsion valve
  • most often used at TH level, some TR
20
Q

anatomical suspension/self-suspending UE

A
  • (+): integrates with myoelectric control, reduce or eliminate harnessing
  • (-): difficult to don, push in or pull sock, reduced ROM - risk of losing contact with epicondyles if too much flexion/extension
  • socket encompasses bony prominences (humeral epidcondyles)
  • trans-radial and wrist disarticulation
  • can hybridize with suction
21
Q

types of power strategies

A

body power
passive
externally powered

22
Q

body power

A
  • most common, highly functional
  • older tech, not obsolete
  • individual generates force necessary to cause movement
  • body power and cable control operate together - scapulothoracic
  • harnessing and cable system capture Force and Excursion produced by other body movements and use it to operate the prosthesis
23
Q

force and excursion

A
  • force: strength or energy causing motion
  • excursion: movement from axis, distance traveled, translates to cable travel
  • each amputation level requires different movements to capture force and excursion
24
Q

force and excursion examples

A
  • shoulder disarticulation: biscapular abduction, scapular elevation, chest expansion
  • TH/elbow disarticulation: GH flexion, biscapular abduction, scapular depression/extension/abduction
  • TR/wrist disarticulation: GH flexion, biscpaular abduction
25
Q

passive power

A
  • primarily prosthetic/aesthetic
  • passive does not mean non-functional: can be function
  • functions: swivel shoulder, locking elbow, rotating wrist (can also lock), passive spring-loaded terminal device
  • prepositioned with sound side
26
Q

UE externally powered

A
  • controlled by body, powered by motor
  • on-board motor provides force for motion
  • terminal device, wrist unit, and elbow each motorized and user-selected to function independently as determined by the control strategy
27
Q

types of control strategies

A

cable control
myo-electric
hybrid

28
Q

cable control

A

integrated with body power
* harnessing to capture force and excursion
* proper harnessing is essential (fit)
* analogous to bike brake lever/shifter

integrated with external power
* harness connects to a linear transducer or switch

29
Q

myo-electric control

A
  • most common externally powered prosthesis
  • electrodes embedded in (usually suction) scoket wall for contact with skin
  • electrodes capture electrical activity of a muscle for contact with skin
  • electrodes capture electrical activity of a muscle contraction and convert it into a signal
  • electrode placement: 2 electrodes on antagonistic muscle groups, 1 electrode on any viable site
  • many control strategies are possible based on number of electrodes and programming
30
Q

UE myo-electric control example

A

TH 2 electrodes
* flexor: elbow flexion, pronation, TD close
* extensor: elbow extension, supination, TD close
* co-contract: component selection

1 electrode
* contraction: one selected movement, TD close
* program opens TD when relaxed

31
Q

UE hybrid control

A
  • combo of cable control and myo-electric control

examples:
* body power cable control elbow, external power 1 channel myo control TD
* OR
* external power 2 channel elbow, body power cable control TD

32
Q

terminal devices replicate

A

some/all hand function

33
Q

grasp patterns

A
  • cylindrical grasp
  • tip
  • hook or snap
  • palmar
  • spherical grasp
  • lateral
34
Q

voluntary open terminal devices

A
  • most common - default is closed
  • use force/power to open
  • force and excursion open, spring or rubber bands close
  • pinch force is preset
  • max pinch force when fully relaxed
35
Q

voluntary close terminal devices

A
  • open by default
  • force and excursion close, spring or rubber bands open
  • pinch force is determined by force exerted by user
  • TD is fully open when relax
36
Q

facts about terminal devices

A
  • can be activity specific
  • harness good for increased load
  • body power for more gross motor control

movement science II (7 decks)

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