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+ Prosthetics Courtney Berg Jess Farland Meggie Ferrari Ben Moruzzi.

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Presentation on theme: "+ Prosthetics Courtney Berg Jess Farland Meggie Ferrari Ben Moruzzi."— Presentation transcript:

1 + Prosthetics Courtney Berg Jess Farland Meggie Ferrari Ben Moruzzi

2 + Prosthetics History A brief timeline, the creators, relation to war Need-to-know basics The parts of a prosthetic, materials used, cost and health insurance coverage, the fitting process Issues/Concerns that occur Skin breakdown, infection, stump swelling, loss of suction Future of Prosthetics: Robotics The makeup, necessary surgeries, current problems, solutions Success Stories Andrew Lourake, Sgt. Juan Arredando, Kristen Shineberger, A Dolphin Tale: Winter

3 + Learning Objectives The significance of prosthetics in war The materials used for each part of a prosthetic The fitting process Issues that can occur with prosthetics The general makeup of robotic prosthetics

4 + History First prosthetics around 1500 B.C Egyptians were the pioneers Dark Ages Renaissance is the rebirth of prosthetics http://www.amputee-

5 + The Creators Ambroise Pare Lorrain Pieter Verduyn Sir James Syme Benjamin Palmer /Hand_Prosthetics/history.html

6 + Significance in America Civil War WWI WWII /Hand_Prosthetics/history.html

7 + g “Wounded In Action” at NMHM

8 + Under the Prosthetic Socks: directly on the skin wool Cotton synthetics Nylon Sheath Provides a moisture barrier Reduces friction between sock and prosthetic  An additional option is a Gel Sock, which is a sock attached to a nylon sheath, separated by a gel (silicone usually).

9 + The Prosthetic Itself Wood Plastic Thermosets Thermoplastics Metal

10 + Thermoplastics Used for prosthetic interfaces as well as structural components Efficient to create Efficient to fabricate Remain permanently fusible (unlike thermosets) One of the few cons - decreased durability because of material tears or splits and imprecise fit because of shrinkage of thermoplastic materials

11 + Over the Prosthetic (liner) Pelite: is a polyethylene closed cell foam used as an interface material. Most commonly used soft socket liner Thermoformable: meaning that it can be heated and formed over the plaster cast Easily adjusted by adding additional material when the residual limb shrinks

12 + Pricing of Prosthetics A lower extremity prosthesis (leg) can range in cost from $5,000.00 to $50,000 An upper extremity device (arm) can range from $3,000.00 to $30,000. Need to be replaced every 3-5 years

13 + Health Insurance? K0 (Level 0) - Does not have the ability or potential to ambulate or transfer safely with or without assistance, and a prosthesis does not enhance the quality of life or mobility. K1 (Level 1) - Has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence — typical of the limited and unlimited household walker. K2 (Level 2) - Has the ability or potential for ambulation with the ability to traverse low- level environmental barriers such as curbs, stairs, or uneven surfaces — typical of the limited community walker. K3 (Level 3) - Has the ability or potential for walking with variable cadence — typical of the community walker who is able to traverse most environmental barriers and may have vocational, therapeutic or exercise activity that demands prosthetic use beyond simple walking. K4 (Level 4) - Has the ability or potential for prosthetic use that exceeds basic walking skills, exhibiting high impact, stress or energy levels — typical of the prosthetic demands of the child, active adult, or athlete.

14 + The Fitting Process Prepatory prosthesis (temporary) Definitive prosthesis 1. Casting the residual limb so a custom socket can be made. 2. The cast is then used to modify and design a model that is custom to you and your particular needs. 3. Using the design model a clear socket is formed and this clear socket is used for a diagnostic test socket to make minor alterations. This clear socket allows the prosthetist to see the contour, fit and alignment of the socket. 4. Once the clear test socket is fabricated then the necessary components are added, and a foot is added to the prosthesis making it ready for the fitting.

15 + Skin Breakdown Pressure on skin causes moisture collection Redness, cuts, blisters, sores Easily preventable on-stump-06.jpg

16 + Normal vs. Broken Down Skin http:// =/ re actions/img/amputation-stump-02.jpg I/AAAAAAAAC58/B7W8QdN4_70/s1600/DSC_1007.JPG

17 + Infection Natural oils and body sweat collect Reddening, sores, discharge of pus, tender, bad odor Life threatening Easily preventable

18 + 2necrosis.jpg

19 + Stump Swelling When liner isn’t worn Causing difficulty wearing prosthetic Shrinker or elastic bandage can prevent

20 + Shrinker.png

21 + Loss of Suction Prosthetic malfunction Stump shrinkage Loss of weight Sock worn

22 +

23 + Psychological Issues Depression: 21% - 35% Posttradumatic stress disorder (PTSD) Phantom Sensation and Pain 80% - 100% non painful 46% - 90% painful

24 + Robotic Prosthetics from-hell

25 + Robotic Prosthetics make up Biosensors Mechanical Sensors Controllers Actuators

26 + Types of Biosensors Surface electrodes Needle electrodes Solid State electrode arrays robotic-arm-earns-fda-approval-gives-new-hope-amputees/10276

27 + Mechanical Sensors Pressure Gauge’s Accelerometers Force meters Gyroscopes W_O-u9PNUMU W_O-u9PNUMU

28 + Reinnervation Surgeries Target Muscle reinnervation (TMR) developed by Dr. Todd Kuiken at the Rehabilitation Institute of Chicago Target Sensory reinnervation (TSR) robotic-leg-thought-control.html

29 + Control and Actuation EMG sensing Control Feedback 719.html

30 + Current Problems User Acceptance Awkward Control (lack of feedback) Difficulty training the user Price: Robotic Leg is about $100,000 Solution Grasps preprogrammed Prosthetic modes that are manually adjusted Bebionic “Terminator”- $11,000 wars-inspired-robotic-arm-earns-fda-approval-gives-new- hope-amputees/10276

31 + Other Advancements Bomb Disabling robots- Developed at John’s Hopkins University equipped with with two modular prosthetic arms john-hopkins-bomb-disposal-robot-7.jpg Quadriplegic uses arm which connects directly to brain robot-arm-upmc.jpg BigDog Robotic dog uses prosthetic legs to maneuver Legged squad support system

32 + Andrew Lourake Motocross accident got launched 15 feet in the air Tibial plateau fracture led to an infection First Air Force pilot with an above-knee amputation to return to active duty's-x3- story%252F%3B960%3B540

33 + Sgt. Juan Arredando An Iraq veteran who lost his hand on patrol The arm contains a tiny computer chip that translates electrical signals made by the arm’s nerves into physical movement. Depending on the length of the amputation, tarms like this can cost from $60,000 to $15,000

34 + Kristen Shineberger Ewing's Sarcoma: a rare disease in which cancer cells are found in the bone or in soft tissue On September 11, 2012, Kristen’s leg was amputated. As she grows, she needs to continually buy a bigger prosthetic leg. The money that is raised for her goes to this cause un%252F%3B236%3B354

35 + Cieran Kelso Lost both his legs below the knee as a result of meningitis as a baby At age 8 his biggest concern was that he could swim with his friends, so his parents raised £1,000 to create prosthetic flippers for him thanks-amazing-custom-legs-fitted-FLIPPERS.html

36 + Winter She was found stranded in Mosquito Lagoon (Florida), tangled in a crab trap line missing her entire tail fluke and joint Tail flukes are the powerhouse of the dolphin and are attached to the peduncle, the muscular part of the dolphin When she’s not wearing the tail she swims by propelling her body forward in a side to side motion. But when the prosthetic is on, she swims with the up and down motion that is normal for dolphins.

37 + Winter She was fitted for a plastic stretchy sleeve. When the sleeve is in place, we can put the prosthetic on top of it and attach the fluke to her peduncle. Winter weighed just over 270 pounds and had tried over 50 tails. In general, adult bottlenose dolphins can weigh up to about 1,400 pounds.

38 + Learning Objectives The significance of prosthetics in war The materials used for each part of a prosthetic The fitting process Issues that can occur with prosthetics The general makeup of robotic prosthetics

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