The Upper Limb Issue - January 2017

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A Device for Every Season… or Every Activity

Feature

This is an example of a custom silicone socket that has no rigid lamination. The TRS Swinger terminal device used here was designed for hanging, but also works well for swinging a bat. Photograph courtesy of Handspring .

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Success at the Highest Level: Achieving Function and Aesthetics With an Interscapular-thoracic Prosthesis

Feature

Photos courtesy of Advanced Arm Dynamics For 24 years, Sam Rosecrans relied on his right arm to do his bidding. When he cast his fishing line, ate dinner with his family, or headed out to work, his arm was there, effortlessly completing every task. Billions of neurons were sending electrical messages between his brain and nervous system, dictating the fluid motion of his shoulder, elbow, wrist, and fingers, a natural biomechanical process that functioned unnoticeably until July 1, 2015.

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Improving the Human-machine Interface: Revolutionary Advancements in Upper-limb Prostheses

Feature

There are many limitations associated with the current interface between the residual limb and the prosthesis for individuals with upper-limb deficiencies. The suspension of the device, which can be heavy, is often a product of awkward harnessing, localized pressures over bony elements in the residual arm, or sometimes unreliable suction environments. Prosthetic control is both limited and limiting.

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Jake McGehee: The Music Plays On

Today’s Consumer

Making a living without a forearm is manageable for Jake McGehee, but living without playing his guitar is another matter. With the help of friends and a prosthetist, the Choctaw, Oklahoma, man rekindled his passion for playing music after a chemical explosion took part of his arm and nearly his life. On May 12, 2012, McGehee was working to help rebuild a tool that was used in the Oklahoma oil fields.

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O&P Certification Pathway for Allied Professions

Perspective

It's a question O&P professionals have been asking for years: How can we feel confident that our certifications have a competitive advantage in providing prosthetic devices and care when other medical providers, such as physical therapists (PTs), occupational therapists (OTs), registered nurses, and physician's staff, are legally permitted to do so without the education or certification we have worked for? I recently took a phone call from a PT who requested that I add a buildup to a patient's shoes after she had fit him with bilateral AFOs. I instantly went from being an orthotist to repairing shoes. These types of encounters have made me think about what the future holds for O&P.

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Time Well Spent

Residency Reflection

O&P practitioners wear many hats: We are care providers, problem solvers, scientists, motivational speakers, marketers, teachers, and psychologists. As a new practitioner, it is easy to focus on the plan of care and lose focus on the patients themselves. What are they thinking and feeling? What are their intrinsic and extrinsic motivations? How will this information affect the plan of care and, more importantly, the outcome? I have learned that the best practitioners wear all the hats I mentioned at once, quickly transitioning from care provider and problem solver, to psychologist, listener, and teacher.

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Standardizing Clinical Notes for Professional Success

On Topic

Over the years, I have read countless clinical notes from hundreds of orthotists and prosthetists. Using those notes, I have fought audits, assessed the contents for prior approvals and authorizations and for compliance with Centers for Medicare & Medicaid Services (CMS) regulations, and just plain tried to figure out what the notes were supposed to communicate. As you may imagine, clinical notes are anything but standardized in O&P.

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Helping Patients Return to a Well-rounded Life

Viewpoint

Losing a limb or losing function of a limb is difficult no matter the circumstances, but for those with upper-limb amputations or impairments, it can be particularly difficult due to the types of tasks for which we use our arms and hands. In this regard, patients often require more than one type of O&P solution, and clinicians may need to tap into their creative processes to meet those needs. " A Device for Every Season.

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Brain Stimulation Can Produce Ownership of a Prosthetic Hand

Online Exclusive

Being able to replace the function of a missing or paralyzed limb with a prosthetic device that acts and feels like the user’s own limb is one of the goals of applied neuroscience. Researchers have successfully used electrical stimulation of the brain to induce the feeling of ownership in two participants’ artificial hands.

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Össur Completes Integration of Medi Prosthetics

Online Exclusive

As of January 1, global prosthetics innovator Össur, Reykjavik, Iceland, has completed the full integration of medi prosthetics.

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