Abstract
Resnik L, Meucci MR, Lieberman-Klinger S, Fantini C, Kelty DL, Disla R, Sasson N.
Advanced upper limb prosthetic devices: implications for upper limb prosthetic rehabilitation.
The number of catastrophic injuries caused by improvised explosive devices in the
Afghanistan and Iraq Wars has increased public, legislative, and research attention
to upper limb amputation. The Department of Veterans Affairs (VA) has partnered with
the Defense Advanced Research Projects Agency and DEKA Integrated Solutions to optimize
the function of an advanced prosthetic arm system that will enable greater independence
and function. In this special communication, we examine current practices in prosthetic
rehabilitation including trends in adoption and use of prosthetic devices, financial
considerations, and the role of rehabilitation team members in light of our experiences
with a prototype advanced upper limb prosthesis during a VA study to optimize the
device. We discuss key challenges in the adoption of advanced prosthetic technology
and make recommendations for service provision and use of advanced upper limb prosthetics.
Rates of prosthetic rejection are high among upper limb amputees. However, these rates
may be reduced with sufficient training by a highly specialized, multidisciplinary
team of clinicians, and a focus on patient education and empowerment throughout the
rehabilitation process. There are significant challenges emerging that are unique
to implementing the use of advanced upper limb prosthetic technology, and a lack of
evidence to establish clinical guidelines regarding prosthetic prescription and treatment.
Finally, we make recommendations for future research to aid in the identification
of best practices and development of policy decisions regarding insurance coverage
of prosthetic rehabilitation.
Key Words
List of Abbreviations:
ACT (Amputation Care Teams), ADLs (activities of daily living), APOC (Amputation Points of Contact), ASoC (Amputation System of Care), DARPA (Defense Advanced Research Projects Agency), DoD (Department of Defense), FSR (force-sensitive resistor), IMU (inertial measurement unit), OT (occupational therapy), PANS (Polytrauma/Amputation Network Site), PT (physical therapy), RAC (Regional Amputation Center), VA (Department of Veterans Affairs)To read this article in full you will need to make a payment
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Article info
Footnotes
Supported by Veterans Administration Rehabilitation Research and Development (VA RR&D), VA RR&D A6780, and VA RR&D A6780I. DEKA's support of the VA optimization studies was sponsored by the Defense Advanced Research Projects Agency and the U.S. Army Research Office. The information in this manuscript does not necessarily reflect the position or policy of the government; no official endorsement should be inferred.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
