Shaping the World Around Us

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By Andrea Spridgen
Andrea Spridgen

Our hands and sense of touch connect us with people and our environments and are one of the ways in which most infants begin to explore their world. Our hands are also the chief expression of our fine motor skills and help shape our understanding of the world around us. Upper-limb impairments can interfere with these processes. As such, O&P practitioners who help restore or improve function for those who have upper-limb damage or deficiencies face special challenges. While research continues, there are not yet any commercially available prostheses that can replicate the biological sense of touch, but advances in controls are improving prosthetic digit articulation and range of motion and providing ever expanding options for patients and practitioners alike. This issue of The O&P EDGE explores some solutions that are currently available to this patient population.

Rebekah Marine, featured on the cover, was born with a partial right arm, and like many people with upper-limb differences or upper-limb loss, she rejected prosthetic use for years due to the limitations she experienced. However, as Sherri Edge explores in "Going Cyborg: Advanced Prosthetic Technologies Take the Spotlight," the current generation of high-tech prosthetic hands are lighter weight, have multiple grip patterns, and have a more natural human hand shape than ever before. In addition to their functionality, many users are embracing these prostheses for their "cyborg" look. The users profiled in this feature share their reasons behind eschewing more lifelike cosmetic coverings and their prosthetists explain how they have seen this trend increase user compliance.

In "The Prevalence and Impact of Pain Associated With Upper-Limb Amputation," Phil Stevens, MEd, CPO, FAAOP, reviews recent literature surrounding musculoskeletal complaints experienced by people with upper-limb amputations and deficiencies. These are often caused by compensatory, awkward postures; repetitive movements; and overuse of the sound side limb.

Upper-limb prosthetic technology is generally agreed to be less successful at restoring the function of the biological limb than lower-limb prosthetic technology. Thus, when an individual experiences severe damage to an arm or a hand, the decision about whether to attempt limb salvage or undergo amputation is less clear cut. Jeremy Farley, CPO, discusses this dilemma in the American Academy of Orthotists and Prosthetists Society Spotlight article, "Considering Amputation to Gain Function." He also touches on O&P interventions that can be considered depending on the severity of the impairment.

While replicating the human hand remains elusive, O&P continues to improve the options for helping patients regain function and their sense of self after upper-limb damage. I hope you enjoy this issue dedicated to achieving that goal.