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https://www.readbyqxmd.com/read/28628623/use-of-the-deka-arm-for-amputees-with-brachial-plexus-injury-a-case-series
#1
Linda Resnik, Christopher Fantini, Gail Latlief, Samuel Phillips, Nicole Sasson, Eve Sepulveda
OBJECTIVE: Patients with upper limb amputation and brachial plexus injuries have high rates of prosthesis rejection. Study purpose is to describe experiences of subjects with transhumeral amputation and brachial plexus injury, who were fit with, and trained to use, a DEKA Arm. METHODS: This was a mixed-methods study utilizing qualitative (e.g. interview, survey) and quantitative data (e.g. self-report and performance measures). Subject 1, a current prosthesis user, had a shoulder arthrodesis...
2017: PloS One
https://www.readbyqxmd.com/read/28624687/estimation-of-distal-arm-joint-angles-from-emg-and-shoulder-orientation-for-transhumeral-prostheses
#2
Aadeel Akhtar, Navid Aghasadeghi, Levi Hargrove, Timothy Bretl
In this paper, we quantify the extent to which shoulder orientation, upper-arm electromyography (EMG), and forearm EMG are predictors of distal arm joint angles during reaching in eight subjects without disability as well as three subjects with a unilateral transhumeral amputation and targeted reinnervation. Prior studies have shown that shoulder orientation and upper-arm EMG, taken separately, are predictors of both elbow flexion/extension and forearm pronation/supination. We show that, for eight subjects without disability, shoulder orientation and upper-arm EMG together are a significantly better predictor of both elbow flexion/extension during unilateral (R(2)=0...
June 11, 2017: Journal of Electromyography and Kinesiology
https://www.readbyqxmd.com/read/28575025/perceptions-of-satisfaction-usability-and-desirability-of-the-deka-arm-before-and-after-a-trial-of-home-use
#3
Linda J Resnik, Matthew L Borgia, Frantzy Acluche
OBJECTIVES: To: 1) describe perceptions of satisfaction with and usability of the DEKA Arm and preferences for the DEKA Arm or personal prosthesis; 2) compare perceptions of satisfaction and usability by DEKA Arm configuration level; and 3) evaluate satisfaction and usability for study completers and non-completers; and for those who did and did not want to receive a DEKA Arm. METHODS: The study had 2 phases: in-laboratory (Part A) and home trial (Part B). 32 participants with amputation, (50% transradial, 38% transhumeral and 13% shoulder) completed Part A and 18 completed Part B 16 (89%) of whom were prosthesis users at baseline...
2017: PloS One
https://www.readbyqxmd.com/read/28575012/characterization-of-interfacial-socket-pressure-in-transhumeral-prostheses-a-case-series
#4
Jonathon S Schofield, Katherine R Schoepp, Heather E Williams, Jason P Carey, Paul D Marasco, Jacqueline S Hebert
One of the most important factors in successful upper limb prostheses is the socket design. Sockets must be individually fabricated to arrive at a geometry that suits the user's morphology and appropriately distributes the pressures associated with prosthetic use across the residual limb. In higher levels of amputation, such as transhumeral, this challenge is amplified as prosthetic weight and the physical demands placed on the residual limb are heightened. Yet, in the upper limb, socket fabrication is largely driven by heuristic practices...
2017: PloS One
https://www.readbyqxmd.com/read/28526166/transhumeral-anterior-radial-nerve-transposition-to-simplify-anticipated-future-humeral-reconstruction
#5
REVIEW
David A Muzykewicz, Reid A Abrams
Anterior transhumeral radial nerve transposition has been described in the treatment of humeral shaft fracture to protect the nerve from implant irritation or callus entrapment. Transposing the radial nerve through a facilitating humeral defect also simplifies revision surgery should nonunion result. Here we describe a surgical technique for anterior transhumeral radial nerve transposition for complex humeral reconstruction when subsequent revision surgery is anticipated. Three cases are used for illustration: (1) revision of a total elbow arthroplasty with periprosthetic fracture; (2) revision of a total elbow arthroplasty after aseptic loosening from an allograft/prosthesis composite; and (3) septic humeral nonunion with substantial bone loss...
May 16, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28470463/-the-endo-exo-prosthesis-treatment-concept-improvement-in-quality-of-life-after-limb-amputation
#6
T Hoffmeister, F Schwarze, H H Aschoff
Osseointegrated, percutaneous implants as the force bearer for exoprosthetics after limb amputation have been used in individual cases for clinical rehabilitation of amputees during the past years. Most experience in this field in Germany has been accumulated at the Sana Klinik in Lübeck with the so-called endo-exo prosthesis (EEP) system. The two-step implantation procedure can now be considered as reliable. Following a well-documented learning curve initial soft tissue problems concerning the cutaneous stoma can now be regarded as exceptions...
May 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28396957/-transcutaneous-osseointegrated-prosthesis-top-after-limb-amputation-status-quo-and-perspectives
#7
Christian Willy, Christian Krettek
The majority of transfemoral and transtibial amputees can be functionally fitted with conventional suspension sockets; however, due to socket problems using conventional stump care, 60% of the patients have limited function and even in younger patients approximately one sixth are unable to wear the prosthesis daily. After the introduction of transcutaneous osseointegrated prostheses (TOP) the inherent problems of socket-stump care can be avoided for these patients. Against this background this article reviews the recent clinical development of TOP in Sweden, Germany, the Netherlands, Australia and USA currently in nine centers...
May 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28229193/osseointegrated-prostheses-for-rehabilitation-following-amputation-the-pioneering-swedish-model
#8
Yan Li, Rickard Brånemark
The direct attachment of osseointegrated (OI) prostheses to the skeleton avoids the inherent problems of socket suspension. It also provides physiological weight bearing, improved range of motion in the proximal joint, as well as osseoperceptive sensory feedback, enabling better control of the artificial limbs by amputees. The present article briefly reviews the pioneering efforts on extremity osseointegration surgeries in Sweden and the development of the OPRA (Osseointegrated Prostheses for the Rehabilitation of Amputees) program...
April 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28091278/brief-activity-performance-measure-for-upper-limb-amputees-bam-ula
#9
Linda Resnik, Matthew Borgia, Frantzy Acluche
BACKGROUND: Measures of activity performance for adults with upper limb amputation are needed. The purposes of this study were to evaluate the measurement properties of a new measure of activity performance for adults with upper limb amputation, which we call the Brief Activity Measure for Upper Limb Amputees (BAM-ULA) and to compare BAM-ULA scores for users of different types of prostheses. METHODS: In all, 35 persons with upper limb amputation were administered the BAM-ULA, twice within 1 week...
January 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28061779/a-motion-classification-strategy-based-on-semg-eeg-signal-combination-for-upper-limb-amputees
#10
Xiangxin Li, Oluwarotimi Williams Samuel, Xu Zhang, Hui Wang, Peng Fang, Guanglin Li
BACKGROUND: Most of the modern motorized prostheses are controlled with the surface electromyography (sEMG) recorded on the residual muscles of amputated limbs. However, the residual muscles are usually limited, especially after above-elbow amputations, which would not provide enough sEMG for the control of prostheses with multiple degrees of freedom. Signal fusion is a possible approach to solve the problem of insufficient control commands, where some non-EMG signals are combined with sEMG signals to provide sufficient information for motion intension decoding...
January 7, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/27824734/targeted-muscle-reinnervation-for-transradial-amputation-description-of-operative-technique
#11
Emily N Morgan, Benjamin Kyle Potter, Jason M Souza, Scott M Tintle, George P Nanos
Targeted muscle reinnervation (TMR) is a revolutionary surgical technique that, together with advances in upper extremity prostheses and advanced neuromuscular pattern recognition, allows intuitive and coordinated control in multiple planes of motion for shoulder disarticulation and transhumeral amputees. TMR also may provide improvement in neuroma-related pain and may represent an opportunity for sensory reinnervation as advances in prostheses and haptic feedback progress. Although most commonly utilized following shoulder disarticulation and transhumeral amputations, TMR techniques also represent an exciting opportunity for improvement in integrated prosthesis control and neuroma-related pain improvement in patients with transradial amputations...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27638013/attachment-of-upper-arm-prostheses-with-a-subcutaneous-osseointegrated-implant-in-transhumeral-amputees
#12
Stefan Salminger, Andreas Gradischar, Richard Skiera, Aidan D Roche, Agnes Sturma, Christian Hofer, Oskar C Aszmann
BACKGROUND: The stump-socket interface is of utmost importance for prosthetic function in transhumeral amputees. Stability of this connection may be improved using a newly designed subcutaneous implant. OBJECTIVES: The purpose was to determine the effect of the implant together with customized socket designs on the range of motion of the shoulder and the prosthetic function compared to conventional fitting. STUDY DESIGN: Case series. METHODS: The range of motion was measured with scaled metrics and the prosthetic function evaluated with the Southampton Hand Assessment Procedure and the Box and Block Test...
September 16, 2016: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/27534547/improving-arm-function-by-prosthetic-limb-replacement-in-a-patient-with-severe-arthrogryposis-multiplex-congenita
#13
Stefan Salminger, Aidan D Roche, Agnes Sturma, Laura A Hruby, Oskar C Aszmann
OBJECTIVE: In patients with severe bilateral congenital arm deficiencies, even simple activities of daily living, such as feeding, may be major challenges. We report here a case of a patient with arthrogryposis multiplex congenita affecting all 4 extremities, who underwent prosthetic replacement after elective transhumeral amputation of his right functionless arm. CASE REPORT: A 22-year-old man with arthrogryposis multiplex congenita had severe deficits of his upper limbs...
October 5, 2016: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/27166714/an-anthropomorphic-transhumeral-prosthesis-socket-developed-based-on-an-oscillometric-pump-and-controlled-by-force-sensitive-resistor-pressure-signals
#14
N A Abd Razak, H Gholizadeh, N Hasnan, N A Abu Osman, S S Mohd Fadzil, N A Hashim
While considering the importance of the interface between amputees and prosthesis sockets, we study an anthropomorphic prosthesis socket whose size can be dynamically changed according to the requirements of the residual limb. First, we introduce the structure and function of the anthropomorphic prosthesis socket. Second, we study the dynamic model of the prosthesis system and analyze the dynamic characteristics of the prosthesis socket system, the inputs of an oscillometric pump, and the control mechanism of force-sensitive resistor (FSR) pressure signals...
February 1, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/27164596/classification-of-phantom-finger-hand-wrist-and-elbow-voluntary-gestures-in-transhumeral-amputees-with-semg
#15
Nathanael Jarrasse, Caroline Nicol, Amelie Touillet, Florian Richer, Noel Martinet, Jean Paysant, Jozina Bernardina de Graaf
Decoding finger and hand movements from sEMG electrodes placed on the forearm of transradial amputees has been commonly studied by many research groups. A few recent studies have shown an interesting phenomenon: simple correlations between distal phantom finger, hand and wrist voluntary movements and muscle activity in the residual upper arm in transhumeral amputees, i.e., of muscle groups that, prior to amputation, had no physical effect on the concerned hand and wrist joints. In this study, we are going further into the exploration of this phenomenon by setting up an evaluation study of phantom finger, hand, wrist and elbow (if present) movement classification based on the analysis of surface electromyographic (sEMG) signals measured by multiple electrodes placed on the residual upper arm of five transhumeral amputees with a controllable phantom limb who did not undergo any reinnervation surgery...
January 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/26992713/-periprosthetic-humeral-fractures-strategies-and-techniques-of-revision-arthroplasty
#16
REVIEW
C Kirchhoff, M Beirer, U Brunner
The primary aims when performing revision arthroplasty of periprosthetic humeral fractures (PHF) are preservation of bone stock, achieving fracture healing and preserving a stable prosthesis with the focus on regaining the preoperative shoulder-arm function. The indications for revision arthroplasty are given in PHF in combination with loosening of the stem. In addition, further factors must be independently clarified in the case of an anatomical arthroplasty. In this context secondary glenoid erosion as well as rotator cuff insufficiency are potential factors for an extended revision procedure...
April 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/26932982/cutaneous-sensory-outcomes-from-three-transhumeral-targeted-reinnervation-cases
#17
Jacqueline S Hebert, K Ming Chan, Michael R Dawson
BACKGROUND: Although targeted muscle reinnervation has been shown to be effective in enhancing prosthetic control for upper limb amputees, restored hand sensations have been variable. An understanding of possible sensory feedback channels is crucial in working toward more effective closed-loop prosthetic control. OBJECTIVES: To compare sensory outcomes of different targeted sensory reinnervation approaches. STUDY DESIGN: Case series, cross-sectional, and retrospective...
June 2016: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/26780786/control-of-a-robotic-hand-using-a-tongue-control-system-a-prosthesis-application
#18
Daniel Johansen, Christian Cipriani, Dejan B Popovic, Lotte N S A Struijk
OBJECTIVE: The aim of this study was to investigate the feasibility of using an inductive tongue control system (ITCS) for controlling robotic/prosthetic hands and arms. METHODS: This study presents a novel dual modal control scheme for multigrasp robotic hands combining standard electromyogram (EMG) with the ITCS. The performance of the ITCS control scheme was evaluated in a comparative study. Ten healthy subjects used both the ITCS control scheme and a conventional EMG control scheme to complete grasping exercises with the IH1 Azzurra robotic hand implementing five grasps...
July 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/26737044/phantom-movements-from-physiologically-inappropriate-muscles-a-case-study-with-a-high-transhumeral-amputee
#19
Julie Gade, Rosa Hugosdottir, Ernest N Kamavuako
Individuals with high-level amputation have a great need for functional prostheses because of their vast functional deficits. Conventional techniques are considered inappropriate for high-level amputees due to the lack of physiologically appropriate muscles. This study investigates how accurate phantom movements (PMs) can be classified from physiologically inappropriate muscles. The study involves a case study of a 42-year-old transhumeral amputee. Suitable PMs and best electrode configuration were identified using the sequential forward selection method and brute-force technique...
August 2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/26314220/targeted-muscle-reinnervation-in-the-upper-extremity-amputee-a-technical-roadmap
#20
REVIEW
Michael S Gart, Jason M Souza, Gregory A Dumanian
Targeted muscle reinnervation (TMR) offers the potential for improved prosthetic function by reclaiming the neural control information that is lost as a result of upper extremity amputation. In addition to the prosthetic control benefits, TMR is a potential treatment for postamputation neuroma pain. Here, we present our surgical technique for TMR nerve transfers in transhumeral and shoulder disarticulation patients.
September 2015: Journal of Hand Surgery
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