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Everything You Need To Know About Using Limb Prosthetic Devices

Disability of any form can be traumatic and could affect the victim's daily activities in a variety of ways. Rehabilitative services are of ample importance in such scenarios so that the differently-abled person can come to terms with his or her disability and look forward to leading one's life in a positive and confident manner [1] .

When an arm or other extremity is lost (amputated), a prosthetic device (or prosthesis) is required. Using an artificial limb improves mobility [2] and the ability to manage daily activities. It also enables a person to stay independent.

Read on to gain more insight about the types of prostheses used for an amputee, how to choose and use a prosthesis and how to care for your prosthetic device.

Limb Prostheses Parts

A prosthetic device (also referred to as prosthesis) is a device that helps in replacing, correcting or supporting a body part [3] . A wide variety of prostheses exist. These are designed not just to function but also to look like a natural leg, hand, foot or arm. Although different in most cases (as they are usually custom-made depending on the patient's requirement), most of the prosthetic devices can be summed up to have the following parts [4] :

• A socket - the stump of the amputated limb fits into this

• The suspension - this holds the prosthesis onto the stump

• The shaft

• The foot, hook or hand

• The covering - to provide a cosmetic appearance

The socket is most of the time lined using silicone or foam. This is done to protect the stump. Expert prosthetists (a person who holds the responsibility of designing and fitting the prosthetic device to the disabled person) recommend the use of special socks [5] that can be worn over the stump. This ensures a proper fit and also improves the comfort factor.

Limb Prostheses Types

The most common types of prostheses (for an amputee) are as follows:

• Lower leg and foot [6] : If the amputation has happened below the knee, then prosthetic feet can be made use of to simulate the action of a natural foot. With the latest technology (although expensive), one can go for microprocessor-enabled prosthetic devices. These use sensors such that adjustments can be made to the joint movement to enable more efficient walking. This feature also helps in reducing the risk of falls.

• Leg with knee [7] : When amputations are done above the knee, prosthesis provided would need a knee as well as an ankle joint. There are a variety of prosthetic ankle, foot and knee models available worldwide. The most common ones are those that use fluid or hydraulic-controlled devices. This kind allows users to vary their walking speed. The hi-end technology-oriented kinds make use of computerized parts allowing the user to make real-time adjustments while walking.

• Arm and hand [8] : The most common prosthetic arm is the one that is operated with the patient's own body's movements. The prosthetic device is fitted using a harness that extends in the figure eight shape across the back and under the opposite arm. Other forms available make use of a rechargeable battery. This kind runs small motors in the prosthetic hand or hook. The battery-kind facilitates improvement in grip strength.

Choosing And Using A Limb Prosthesis

The following are some of the factors that need to be considered while choosing a prosthesis [9] :

• The location and level of the amputations.

• The patient's activity level (especially in the case of a prosthetic leg or foot).

• The condition of the remaining limb after amputation.

• The patient's specific goals and needs.

The designing and fitting process is performed by a prosthetist [10] . The prosthetic devices can be used by the patient after the swelling (post surgery) has gone and the incision has healed.

The process of creating and fitting the prosthesis involves the following steps [11] :

• Measuring the stump and the healthy another limb

• Creation of a plaster mold

• Designing the socket

• Attaching the shaft

• Aligning the prosthesis

For some people, the wound heals really fast and they can begin practising with the artificial limb as early as a few weeks after surgery. Usually, the prosthetist, or in some case, a physical therapist, would train the person as to how to use and care for the artificial limb.

Prosthetic Comfort And Care

It is essential that you take care of the new limb. This will help prevent problems and complications related to the amputation's site and the patient's overall health in general.

Perform the following daily [12] :

• Remove the prosthesis before you go to bed

• Remember to briefly examine your device daily for the presence of any loose parts or damage.

• Check your stump to examine the presence of any blisters or other signs of irritation.

• Clean and put a mild lotion on the stump with a gentle massage, every time you remove the prosthesis.

• Whenever you are not wearing the prosthesis, place a bandage on the stump. This would decrease the swelling.

• In case you find it difficult, ask someone else to check the skin around the stump. Examine regularly to check for wounds or sores.

• Your therapist would ideally recommend certain exercises, practice them regularly. The usual exercises are for stretching, body positioning, endurance and range of motion.

• In case you are using a leg prosthesis, ensure that you wear proper-fitting shoes. Do not alter the height of your heels. The prosthesis is technically designed for one heel height only.

• Get into the habit of cleaning the prosthesis' socket with soap and water at least once a week.

• Always wear clean and dry socks with the prosthesis.

The person using a prosthetic device should do everything to maintain his or her overall wellness. This includes maintaining a stable body weight as well. Keeping an ideal weight would ensure that the prosthesis fits properly. The prosthesis should also be examined (or serviced, if required) at least once a year to ensure that it is in proper working condition.

View Article References
  1. [1] Kumar, S. G., Roy, G., & Kar, S. S. (2012). Disability and rehabilitation services in India: issues and challenges.Journal of family medicine and primary care,1(1), 69-73.
  2. [2] Wurdeman, S. R., Stevens, P. M., & Campbell, J. H. (2017). Mobility Analysis of AmpuTees (MAAT I): Quality of life and satisfaction are strongly related to mobility for patients with a lower limb prosthesis.Prosthetics and orthotics international,42(5), 498-503.
  3. [3] CBR: A strategy for rehabilitation, equalization of opportunities, poverty reduction and social inclusion of people with disabilities.International Labour Organization, United Nations Educational, Scientific and Cultural Organization, and World Health Organization; 2004. [30 March 2010].
  4. [4] Marks, L. J., & Michael, J. W. (2001). Science, medicine, and the future: Artificial limbs.BMJ (Clinical research ed.),323(7315), 732-735.
  5. [5] D'Silva, K., Hafner, B. J., Allyn, K. J., & Sanders, J. E. (2013). Self-reported prosthetic sock use among persons with transtibial amputation.Prosthetics and orthotics international,38(4), 321-331.
  6. [6] (2016). What people want in a prosthetic foot: A focus group study.Journal of prosthetics and orthotics : JPO,28(4), 145-151.
  7. [7] Saglam, Y., Gulenc, B., Birisik, F., Ersen, A., Yilmaz Yalcinkaya, E., & Yazicioglu, O. (2017). The quality of life analysis of knee prosthesis with complete microprocessor control in trans-femoral amputees.Acta orthopaedica et traumatologica turcica,51(6), 466-469.
  8. [8] Schweitzer, W., Thali, M. J., & Egger, D. (2018). Case-study of a user-driven prosthetic arm design: bionic hand versus customized body-powered technology in a highly demanding work environment.Journal of neuroengineering and rehabilitation,15(1), 1.
  9. [9] Kurichi, J. E., Kwong, P. L., Reker, D. M., Bates, B. E., Marshall, C. R., & Stineman, M. G. (2007). Clinical factors associated with prescription of a prosthetic limb in elderly veterans.Journal of the American Geriatrics Society,55(6), 900-906.
  10. [10] Magnusson, L., Shangali, H. G., & Ahlström, G. (2016). Graduates' perceptions of prosthetic and orthotic education and clinical practice in Tanzania and Malawi.African journal of disability,5(1), 142.
  11. [11] Wurdeman, S. R., Stevens, P. M., & Campbell, J. H. (2017). Mobility Analysis of AmpuTees (MAAT I): Quality of life and satisfaction are strongly related to mobility for patients with a lower limb prosthesis.Prosthetics and orthotics international,42(5), 498-503.
  12. [12] Marks, L. J., & Michael, J. W. (2001). Science, medicine, and the future: Artificial limbs.BMJ (Clinical research ed.),323(7315), 732-735.
Read more about: health wellness
Story first published: Saturday, March 23, 2019, 9:00 [IST]
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