expletive-ethereal
expletive-ethereal
expletive-ethereal
expletive-ethereal

Category: Overuse Reduction

TRS Jaws [new product - first use report]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - TRS Jaws [new product - first use report]; published August 10, 2019, 10:51; URL: https://www.swisswuff.ch/tech/?p=9769.

BibTeX: @MISC{schweitzer_wolf_1574228179, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - TRS Jaws [new product - first use report]}}, month = {August},year = {2019}, url = {https://www.swisswuff.ch/tech/?p=9769}}


3 Comments

The TRS Jaws is a voluntary opening gripper where you can set the grip strength by a lever. The grip then varies between very light, maybe under 1 kg or so, to somewhere above 5 kg. This is a first real use report, after I used it permanently since roughly around May 21, 2019, give or take a few hours.

There are just a few points to address at this stage. If you wear a body powered arm for real work [link], you may now buy one.

Read More

Embodiment of a prosthetic arm [reflections, thoughts, considerations]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Embodiment of a prosthetic arm [reflections, thoughts, considerations]; published September 16, 2018, 15:42; URL: https://www.swisswuff.ch/tech/?p=8513.

BibTeX: @MISC{schweitzer_wolf_1574228179, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Embodiment of a prosthetic arm [reflections, thoughts, considerations]}}, month = {September},year = {2018}, url = {https://www.swisswuff.ch/tech/?p=8513}}


So, apparently I had been "identified" as a "super prosthesis user" by a group of researchers. And I was invited to talk about embodiment in context of the "rubber hand illusion" at a user interface or robotic control workshop [link].

So is that what I am: a "user"?

Tsk.

Read More

Modifying Shimano Ultegra road bike setup on a Colnago C40 for left handed use - second approach [technical right below elbow amputee core focus work / bike adaptation]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Modifying Shimano Ultegra road bike setup on a Colnago C40 for left handed use - second approach [technical right below elbow amputee core focus work / bike adaptation]; published January 27, 2018, 15:30; URL: https://www.swisswuff.ch/tech/?p=8196.

BibTeX: @MISC{schweitzer_wolf_1574228179, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Modifying Shimano Ultegra road bike setup on a Colnago C40 for left handed use - second approach [technical right below elbow amputee core focus work / bike adaptation]}}, month = {January},year = {2018}, url = {https://www.swisswuff.ch/tech/?p=8196}}


After a first approach, where also the history and idea where it came from is detailed [link], I now set up and tested a second approach to modifying my Colnago C40 carbon bike with a triple chainring Shimano Ultegra chainset.

The extensive testing of my first approach that I had performed there lead to a range of concise detailed issues and problems. There were now addressed, all, and thus a second (and significantly better) approach resulted.

As stated before, no disability sports advocate specializing in road bikes and no bicycle mechanic specializing in individualization and custom solutions over the years ever thought this was possible in this way. They all said it could not be done. And I had asked a few of them, since it had bugged me a lot. And as I had sold my Cannondale road bike after the amputation, thinking there was no way, I now got myself a road bike back and decided to go down my own path to really use it the way it is meant to be used.

Generally and as part of riding a road bike, I wanted fast and comfortable gear switching, fast and accessible and comfortable braking, and I wanted to be able to enjoy various and if possible equally comfortable sitting positions or body positions. A great road bike trip may be a lot longer than a fast mountain bike trip into the forest. Last but not the least, as amputee my stump usually would suffer from vibration induced pain after 20 minutes  particularly with hard connectors such as the Mert or Freelock adapters, so padding definitely was an issue.

Read More

Case-study of a user-driven prosthetic arm design: bionic hand versus customized body-powered technology in a highly demanding work environment [article out]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Case-study of a user-driven prosthetic arm design: bionic hand versus customized body-powered technology in a highly demanding work environment [article out]; published January 4, 2018, 14:29; URL: https://www.swisswuff.ch/tech/?p=8066.

BibTeX: @MISC{schweitzer_wolf_1574228179, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Case-study of a user-driven prosthetic arm design: bionic hand versus customized body-powered technology in a highly demanding work environment [article out]}}, month = {January},year = {2018}, url = {https://www.swisswuff.ch/tech/?p=8066}}


 


This is a blog post of one of the rare focused and well based scientific journal articles that really explains how real work, body powered and myoelectric arms relate and go together for a unilateral right below elbow amputee in a physically demanding work environment.

The prior presentation of this paper [poster at Cybathlon symposium 2016], which had been more pragmatically worded (with me thinking people would know anyway), this was now written up as article and published. During that process, the reviewers clearly made great points of all kinds of aspects I never knew were not sky clear to everyone.

So maybe, writing a ~ 30 page case study with > 210 references does clarify stuff, at least potentially and for those that actually read it. But possibly, it still requires attention to even just read it.

Knowledge does not come easy, Highlander! (Nakano, in: Highlander III The Final Dimension)

 

If you are more interested in visionary posts, read about the gadget features of the prosthetic arm in Kingsmen: The Golden Circle [link]. And technically, myoelectric control did have it coming. That technology remained uncool for four decades [link].

Publication [link]

Read More

Modifying Shimano Ultegra road bike setup on a Colnago C40 for left handed use - first approach [technical right below elbow amputee core focus work / bike adaptation]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Modifying Shimano Ultegra road bike setup on a Colnago C40 for left handed use - first approach [technical right below elbow amputee core focus work / bike adaptation]; published December 3, 2017, 15:11; URL: https://www.swisswuff.ch/tech/?p=7816.

BibTeX: @MISC{schweitzer_wolf_1574228179, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Modifying Shimano Ultegra road bike setup on a Colnago C40 for left handed use - first approach [technical right below elbow amputee core focus work / bike adaptation]}}, month = {December},year = {2017}, url = {https://www.swisswuff.ch/tech/?p=7816}}


I got myself a Colgnago C40 carbon road bike / race bike / Rennrad for leisure amateur purposes. That is, for the colloquial ride. With that, I am not a professional or competitive racer. Modifying my Shimano Ultegra road bike setup for left handed use therefore aims towards leisure purposes.

How to go about riding a road bike as arm amputee. This is the first approach and test. If you are after the improved set-up, head over to the page with the second approach [link] because that really worked a lot better.

Read More

ADL learning and body powered prosthesis control [paper review]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - ADL learning and body powered prosthesis control [paper review]; published October 9, 2016, 11:42; URL: https://www.swisswuff.ch/tech/?p=6484.

BibTeX: @MISC{schweitzer_wolf_1574228179, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - ADL learning and body powered prosthesis control [paper review]}}, month = {October},year = {2016}, url = {https://www.swisswuff.ch/tech/?p=6484}}


Learning to use a body-powered prosthesis: changes in functionality and kinematics. Laura H. B. Huinink, Hanneke Bouwsema, Dick H. Plettenburg, Corry K. van der Sluis and Raoul M. Bongers. Journal of NeuroEngineering and Rehabilitation 2016 13:90.

Abstract [1]

Background: Little is known about action-perception learning processes underlying prosthetic skills in body-powered prosthesis users. Body-powered prostheses are controlled through a harness connected by a cable that might provide for limited proprioceptive feedback. This study aims to test transfer of training basic tasks to functional tasks and to describe the changes over time in kinematics of basic tasks of novice body-powered prosthesis users. Methods: Thirty able-bodied participants and 17 controls participated in the study, using a body-powered prosthetic simulator. Participants in the training group were divided over four groups and practiced during a 2-week-period either direct grasping, indirect grasping, fixation, or a combination of these tasks. Deformable objects with different compliances had to be manipulated while kinematic variables and grip force control were assessed. Functional performance was measured with the Southampton Hand Assessment Procedure (SHAP) prior to and after the training sessions, and after 2 weeks and 3 months retention. The control group only performed the SHAP tests. Results: All four training groups and the control group improved on the SHAP, also after a period of non-use. Type of training had a small but significant influence on the improvements of the SHAP score. On a kinematic level movement times decreased and hook closing velocities increased over time. The indirect grasping group showed significantly shorter plateau times than the other training groups. Grip force control only improved a little over training. Conclusions: Training action-perception couplings of body-powered prosthesis in basic tasks transferred to functional tasks and this lasted after a period of non-use. During training movement times decreased and the indirect grasping group showed advantages. It is advisable to start body-powered training with indirect grasping tasks but also to practice hook-object orientations. Keywords: Upper-limb prosthesis, Body-powered prosthetic

Read More

[1] [doi] L. H. B. Huinink, H. Bouwsema, D. H. Plettenburg, C. K. van der Sluis, and R. M. Bongers, "Learning to use a body-powered prosthesis: changes in functionality and kinematics," Journal of NeuroEngineering and Rehabilitation, vol. 13, iss. 1, pp. 1-12, 2016.
[Bibtex]
@Article{Huinink2016,
author="Huinink, Laura H. B.
and Bouwsema, Hanneke
and Plettenburg, Dick H.
and van der Sluis, Corry K.
and Bongers, Raoul M.",
title="Learning to use a body-powered prosthesis: changes in functionality and kinematics",
journal="Journal of NeuroEngineering and Rehabilitation",
year="2016",
volume="13",
number="1",
pages="1--12",
abstract="Little is known about action-perception learning processes underlying prosthetic skills in body-powered prosthesis users. Body-powered prostheses are controlled through a harness connected by a cable that might provide for limited proprioceptive feedback. This study aims to test transfer of training basic tasks to functional tasks and to describe the changes over time in kinematics of basic tasks of novice body-powered prosthesis users.",
issn="1743-0003",
doi="10.1186/s12984-016-0197-7",
url="http://dx.doi.org/10.1186/s12984-016-0197-7"
}

What prosthetic arm to use? [flow chart / algorithm]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - What prosthetic arm to use? [flow chart / algorithm]; published April 17, 2016, 14:11; URL: https://www.swisswuff.ch/tech/?p=5844.

BibTeX: @MISC{schweitzer_wolf_1574228179, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - What prosthetic arm to use? [flow chart / algorithm]}}, month = {April},year = {2016}, url = {https://www.swisswuff.ch/tech/?p=5844}}


Algorithm to chose best option for prosthetic arm, based on eight years of consecutive experience and extensive hard work.

Read More

Vacuuming with iLimb Ultra Revolution [ADL]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Vacuuming with iLimb Ultra Revolution [ADL]; published February 29, 2016, 18:29; URL: https://www.swisswuff.ch/tech/?p=5727.

BibTeX: @MISC{schweitzer_wolf_1574228179, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Vacuuming with iLimb Ultra Revolution [ADL]}}, month = {February},year = {2016}, url = {https://www.swisswuff.ch/tech/?p=5727}}


Allegedly, one can actually use the iLimb for vacuum cleaning floors. I set out to try that.

Read More

Hard Bimanual Activities (HBM) [overview]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Hard Bimanual Activities (HBM) [overview]; published August 12, 2015, 20:26; URL: https://www.swisswuff.ch/tech/?p=5330.

BibTeX: @MISC{schweitzer_wolf_1574228179, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Hard Bimanual Activities (HBM) [overview]}}, month = {August},year = {2015}, url = {https://www.swisswuff.ch/tech/?p=5330}}


Hard manually hazardous work as unfortunate requirement to arrive at "overuse"

After reading research presented at the ISPO 2015 in Lyon, France, that contends that "overuse" is regarded as consequence of not having a flexible prosthetic wrist unit (link) and that texting is the apparent cause for "overuse" in arm amputees based on somewhat questionable data (link) and after reading that they now are trying to reduce "overuse" through quantification of compensatory motions in the clothespin test by having an amputee report "overuse" after placing clothespins (link), it occurred to me that the authors of these studies, and most likely most researchers in that field, lack tangible experience and knowledge as to what in fact constitutes manual work that lends itself to actual "overuse" (rather than normal strain that happens after a somewhat unusual but quite singular very light weight activity that equates to lifting a fork, a spoon or possibly a tiny plastic clothespin).

Read More

Asymmetry due to below elbow amputation and consequences [analysis]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Asymmetry due to below elbow amputation and consequences [analysis]; published December 10, 2014, 20:10; URL: https://www.swisswuff.ch/tech/?p=3789.

BibTeX: @MISC{schweitzer_wolf_1574228179, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Asymmetry due to below elbow amputation and consequences [analysis]}}, month = {December},year = {2014}, url = {https://www.swisswuff.ch/tech/?p=3789}}


Asymmetry causes long term problems. Not wearing a prosthetic (at least over a longer time) is not an option. Overuse [link] and back problems are a serious issue. While overuse of the other / remaining / "intact" arm and hand is one aspect, asymmetry is the other aspect.

Both aspects require prosthetic arms to be comfortable to wear, and to be - grip wise, push wise, hold item wise - functional in an everyday sense. Any other type of prosthetic arm will be discarded or not worn in the long run, and thus not offer sufficient function to take load off the other overused extremity.

Both asymmetry and overuse as serious long term problems are usually neglected in current prosthetic arm design.

Read More

Comparing elbow torque for iLimb Ultra Revolution, passive arm (new, old), body powered arm (hook alu, hook steel, Becker hand) [tech]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Comparing elbow torque for iLimb Ultra Revolution, passive arm (new, old), body powered arm (hook alu, hook steel, Becker hand) [tech]; published June 22, 2014, 20:32; URL: https://www.swisswuff.ch/tech/?p=3328.

BibTeX: @MISC{schweitzer_wolf_1574228179, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Comparing elbow torque for iLimb Ultra Revolution, passive arm (new, old), body powered arm (hook alu, hook steel, Becker hand) [tech]}}, month = {June},year = {2014}, url = {https://www.swisswuff.ch/tech/?p=3328}}


I measured weights, center of gravity and thus lever arm length, and from these, I obtained torque estimates for my elbow (reminder: I am talking about that elbow, yes, THAT elbow, contained in the tag "below elbow amputee").

The elbow thus carries the weight and moves the prosthesis in a major way. It is the last joint that I have on that arm before it ends. The results are interesting and explain what I have already observed about my posture and handling of these prosthetic options.

Read More

Torque values for prosthetic arms and lifting weights when considering forearm osseointegration [estimation]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Torque values for prosthetic arms and lifting weights when considering forearm osseointegration [estimation]; published July 29, 2013, 10:20; URL: https://www.swisswuff.ch/tech/?p=1817.

BibTeX: @MISC{schweitzer_wolf_1574228179, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Torque values for prosthetic arms and lifting weights when considering forearm osseointegration [estimation]}}, month = {July},year = {2013}, url = {https://www.swisswuff.ch/tech/?p=1817}}


Currently, socket technology appears to have a technical competitor, at least in theory, and that is "osseointegration".

There, the prosthetic terminal device - hand, hook - is mounted on a bolt that sticks through the stump's skin and resides inside the stump's bone. With sockets, a liner, embracing type of socket, straps or vacuum type principle is used to keep a socket in place, that is attached to the remaining components of the prosthetic limb.

Some drawbacks of osseointegration include that the bolt has to be implanted surgically over a series of several operations, that the skin will provide a chronic wound that carries the permanent risk of infection, that the bolt or stump's bone are relatively brittle and thus can and will break as they broke in the past, that many repairs then involve surgery rather than just a prosthetic technician, as well as temperature sensitivity particularly to cold temperatures. Also, most health insurances might not cover the procedure nor its complications or after care, so one requires some 80'000 USD for the operation, then more money for all the rest, essentially pointing to a privately paid 150'000 to 300'000 USD expense with no guarantee of function.

The advertising promotes bolt implants or "osseointegration" by suggesting that sockets are a main problem of discomfort and hygienic problems. Comparing between both systems, it would be honest to say that one needs to clean equipment and skin frequently anyway. With the efforts one must provide to clean an osseointegration wound many times a day using special disinfecting solutions, one can also keep a prosthetic socket and liner clean. In other words, who cannot keep a socket clean also might be a candidate for implant infections.

That aside, I cannot see how my normal life (outside wearing a prosthetic arm) could survive with a hard bolt sticking out of my otherwise (mostly) soft body surface (other people actually complain about any hard metal type material anywhere around, so, no bolts due to intimacy reasons to begin with).

Furthermore, I have relatively bad circulation on my stump, in such a way that it needs compression all the time anyway. And with that, I am (in fact) better off with wearing tight sockets rather than no sockets - for simple reasons of circulation and associated stump and phantom pain.

When one considers the metric performances that one would wish to achieve with an arm, or more interestingly here, a prosthetic arm, one might want to take actual facts into account. Such as: what type of forces (in terms of numbers and figures) might we be looking at.

Upper extremities and prosthetic options are getting it from left and right these days. So what are we going to believe? As I am currently suffering from post traumatic instability in my left wrist and elbow (the "healthy" arm), working the hard parts of life with my prosthetic arm become a real very day issue. Now, negotiating single grams is not an option any more.

For the most part, osseointegrated bolts may be nice to wave a prosthetic arm around the office. But it appears that the fun ends there. Since a considerable while now, some outspoken members of the osseointegrated community had been invited several times by me to provide videos demonstrating how they lift some usefully heavy 25 kg bags or more or such, but no such demonstration so far has been provided so far. In fact, we even lack a side by side comparison in how osseointegrating an arm stump will in any way improve ADL (activities of daily living). So the ratio of C (cost) over V (number of videos that provide proof  of superior force and ADL function) C/V is indefinitely high for the osseointegration of arms application.

Because, it is about overuse. Suspecting also that the world's most proverbially notorious osseointegrated patient admits to suffering from overuse of his other extremity himself already points to a serious flaw in just how much (read: how little) an osseointegrated bolt will accept in terms of (ab)use. So the C/V ratio is estimated to be so high for good reason: there is no actual function that osseointegration gives "back". Furthermore, even pulling a regular Becker hand's cables might just be too much for these bolts which is an assumption from other backchatter, pointing at failure risk levels around 5 kg just from that. So much for the anecdotal bits.

Real life has numbers and costs attached to it.

After all and in the long run, there is just one thing that we could keep in mind for being the real reason why we would like to wear prosthetic arms (if not for additional reasons): to prevent overuse of the other arm by any means conceivable. Not to dance for the public, to expose one's armpit or wave around passive weights with the goal of wearing some arm without real function. And to work towards overuse prevention, extensive mechanical vibrations, serious blows and hits, strong pulls and torques, high repetitions and high loads, simple but reliable function, and tight control options are what a prosthetic arm needs to be primarily built for. Not shee shee froo froo pantsy boy demonstrations like "I can hold a water bottle" or "I can hold a tooth brush" but lifting a table, moving a shelf. moving 20 filled up box moving containers, scrubbing a toilet or shower, wood working, actually getting some real stuff done.

To provide minimal symmetry for posture demanding tasks such as typing, choosing a bionic or other myoelectric arm is an error! The correct answer is to wear a light weight and vibration insensitive arm with either a hook or a hand, that may be equipped with a pencil. My favorites here are my passive arm or the hook.

To provide reliable support for garden tools, high pressure cleaning or vacuum cleaning, ironing or other manually tasking work, the Becker hand or a hook proved to be best.

Personally, I have ripped out wrists from their prosthetic socket mount, I have ripped off 1,5 mm steel cables due to poor mount points, and I have irreversibly damaged prosthetic wrists or prosthetic hands built by lesser able companies. Now, I wear my own customized body powered arm, I use a Puppchen wrist, I wear Alpha gel liners, and I  routinely pull and lift weights of up to 25-30 kg, occasionally up to 40 kg. And that is not considering sports.

So, figures now.

Read More

Requirements for prosthetic arms in context of chronic overuse and strain symptoms and carpal tunnel syndrome [explained again, now, for the dummies]

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - Requirements for prosthetic arms in context of chronic overuse and strain symptoms and carpal tunnel syndrome [explained again, now, for the dummies]; published January 14, 2013, 00:05; URL: https://www.swisswuff.ch/tech/?p=1256.

BibTeX: @MISC{schweitzer_wolf_1574228179, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - Requirements for prosthetic arms in context of chronic overuse and strain symptoms and carpal tunnel syndrome [explained again, now, for the dummies]}}, month = {January},year = {2013}, url = {https://www.swisswuff.ch/tech/?p=1256}}


I previously went into detail of the requirements for prosthetic arms to reduce overuse and strain [link].

Now, again.

Read More

Do NOT follow this link or you will be banned from the site!
HTML Snippets Powered By : XYZScripts.com
PtlMI Oj
I footnotes
x2