May|June 2014 Volume 24, Issue 3

A magazine dedicated to A Publication living well with limb loss of the

Golf: The Perfect Rehabilitation Adaptive Soccer Therapy More Than Just a Team

Marksman on Ice

Tot Te n Tips: for One-Armed Adaptive Gardening Parents of Toddlers Custom Seating Solutions for Drivers and Passengers . ssur, © Ö

NEWStable enough for Ellie. Dynamic enough for Tim.

ASK YOUR PROSTHETIST IF RHEO KNEE  IS RIGHT FOR YOU. WWW.OSSUR.COM/RHEOKNEE

RK3 inMotion 0314.indd 1 1/30/14 6:28 PM message from the editor

BE AN INFORMED READER

Editorial content (articles, news Adaptive Recreation items, columns, editorials, etc.) in & Activities inMotion often contain healthcare information. As an informed reader, Getting Back in the Game you should never make a decision about managing or treating your condition without consulting your own clinicians: They know you best.

Sometimes, in our interviews with When a person is injured or has a condition that requires amputation, the loss can be traumatic. There is not only loss of the limb, but also the loss of what that people who are amputees, the person limb enabled the person to do. The ability to participate in hobbies, recreational being interviewed will say something and even professional activities that were once enjoyed is jeopardized. about his or her personal experience that may not be entirely consistent Although it is a challenge to become active again after amputation, many people with standard practice. In these cases, are driven by their former lifestyles. People with limb loss want to participate we print what the person said because in the same level of activities after amputation as they did before, regardless of we think it gives readers insight into their level of amputation or number of limbs lost. W that individual’s experience that we But the physical aspects of healing are just the beginning, however. Sometimes believe will resonate with others. But: it’s not the physical adjustment, but the psychological adjustment that takes a We urge you to always check with your longer period of time. medical team before changing your own healthcare regimen. Many amputees say the hardest part is learning how to participate with their new body. Having lost the limb, walking, running or swinging a golf club is no Advertisements in inMotion are longer intuitive. There has to be some training involved. reviewed according to established criteria and guidelines. We aim Organizations such as Disabled USA and the Orthotic and Prosthetic to support public awareness of Activities Foundation (OPAF) are devoted to give people with disabilities the commercially available products – ability to learn or re-engage in recreational activities that they may have things that might be helpful to you thought they would never be able to experience again. In addition to the and to avoid advertisements that obvious physical benefits, participation also enables them to rebuild their self-confidence, self-esteem and social skills. might deceive or mislead the reader. Acceptance of advertisements in Disability doesn’t equal disabled, and amputation does not automatically inMotion is not an endorsement by mean the end of an active life. Yes, you have a new challenge – but with the the Amputee Coalition. The Amputee appropriate adapted equipment and a little practice, you should be able to Coalition does not test advertised return to just about any activity you were doing before the amputation. products, conduct independent It may take longer to become proficient with your new equipment than it scientific reviews of them or ensure did before the amputation, and you may have to learn to do things a little their claims. Companies that sell differently. You may also prefer to compete against other amputees instead through the mail must comply with of your previous competitors. But you will find that recreation and sports activities are just as enjoyable, perhaps even more than before. federal regulations regarding customer notification if the product is not Bill Dupes, Senior Editor available within 30 days. The Amputee Coalition reserves the right to reject any advertisement for any reason, which need not be disclosed to the party submitting the advertisement. “Leave all the afternoon for exercise and recreation, which are as necessary as reading. I will rather say more Opinions expressed in signed necessary because health is worth more than learning.” articles are those of the authors and ~ Thomas Jefferson are not necessarily endorsed by the Amputee Coalition.

Printed in the of America.

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 3 I’m POSSIBLE

Surfing, skateboarding, hanging with friends. Cameron Clapp epitomized “California teen” until one night when, in an instant, his life changed. At 15, Cameron was struck by a train. He lost both legs and his right arm.

Encouraged and cared for by staff at Hanger Clinic locations nationwide, Cameron not only learned to walk again, he now surfs, runs competitively, swims and inspires others through peer-to-peer mentoring and motivational public speaking.

In 700 clinics throughout the U.S., Hanger Clinic delivers integrated rehabilitative solutions to help more than 1,000,000 patients each year like Cameron turn their hopes and dreams into reality, break down barriers and move their lives forward. “IMPOSSIBLE IS AN To experience what’s possible at OPINION, NOT A FACT.” Hanger Clinic, call 1-877-4HANGER or visit www.hanger.com.

150 YEARS 700 CLINICS 1 VISION 1-877-4HANGER www.hanger.com

Hanger Clinic Ads_8.37x11.25.indd 1 8/16/12 9:17 AM contents May | June 2014 Adaptive Soccer More Than Just a

sections 14 Federal Affairs Marksman on Ice 18 16 Parenting as an Amputee The Tot 10 Tips for One-Armed Parents With Toddlers

26 Technology Review Getting In and Out of a Vehicle Made Easier: departments Custom Seating Solutions 3 Message From the Editor 28 Living With Limb Loss GOLF: Adaptive Gardening 8 Advocacy in Action The Perfect Rehabilitation 30 Exercise & Fitness 11 Events Calendar Common Issues Therapy 12 Special Message 22 32 Well-Being Warning Signs: Stopping 36 Advertiser Index Depression Before It Goes Too Far

34 Phantom Fashionista Tips From a “Fellow” Fashionista: Part Deux

38 Perspectives On the Cover Getting Back in the Water Nicolai Calabria, USA National Amputee Soccer Team, Field Tester for SideStix. Photo taken by Carl Calabria in Mazatlan on April 16, 2012, two days after international match between USA and .

The Amputee Coalition recognizes the following National Sponsors for their valuable support.

Platinum Sponsors Gold Sponsors Silver Sponsors Bronze Sponsors

The Board of Purdue Pharma Certification/ Accreditation (BOC) Rusk Rehabilitation at NYU Langone College Park Medical Center Industries Scheck & Siress

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 5 contributors

Cindy Asch-Martinis a Laurel Krasne spent most of certified personal trainer her career as an award-winning A Publication of the Amputee Coalition and lifestyle fitness coach, corporate communicator and InMotion magazine publishes unbiased journalism that seeks to “empower and motivate” living well and thriving and a left below-knee strategic planner for several with limb loss. The magazine targets amputees and their families and is provided free electronically to all friends of amputee. Fortune 100 companies within the Amputee Coalition and in hard copy to all subscribers. the financial services industry. Each issue covers health, well-being, exercise, life issues and Amy Di Leo is the founder of advocacy for amputees and their families. Stories showcase She is the cofounder of amputees living and thriving with limb loss and profile Aim Hi Public Relations BrainNovation.net, teaching people Amputee Coalition programs and services. (AimHiPR.com) and has whole-brain thinking – primarily been a television and through mind mapping and Editorial Board print journalist for more memory techniques. Laurel, a right than 20 years. below-knee amputee, Marshall J. Cohen Immediate Past Chair, Robert S. Gailey, PhD, PT, is an is on a personal mission Amputee Coalition Board of Directors associate professor at the University to help get amputees Lisa Ann Cairns, PhD Senior Market Analyst for Smith & Associates of Miami Miller School of Medicine, back in the water. Scott Cummings, PT, CPO, FAAOP Department of Physical Therapy. He Leif Nelson, DPT, ATP, CSCS, is the Scientific & Medical Advisory Committee also has a joint appointment as a assistant chief of clinical care for VA/ Steve Custer health science researcher with Miami DoD Extremity Trauma and Amputation Production Manager, O&P Almanac for AOPA Veterans Affairs Medical Center and Center of Excellence (EACE). He is a Lacey Henderson is the director of the Amputee Coalition Paddy Rossbach Youth Camp doctor of physical therapy, a certified counselor Functional Outcomes assistive technology Jason T. Kahle, CEO, CPO, FAAOP Research and Evaluation professional, and a certified OP Marketing Center. strength and conditioning Stephen Luce specialist. Associate Director for Communications, CDC Harleen Gupt Chhabra is an artist, David McGill writer/ blogger, a communications Vice President, Reimbursement & Compliance and marketing advisor for a Fortune 5 for Össur company and a mother (harleengupt. Nancy Miller Marketing Communications Specialist com). Drawing from her almost lifelong Phantom Fashionista Leslie Pitt Schneider above-elbow amputee experiences, Amputee Coalition Board of Directors she is working on children’s books and parenting resources for Staff the limb loss community. Susan Stout Interim President & CEO Guy Hanford is the director Coming up in the Mary Beth Gibson July/August Chief Marketing & Communications Officer of marketing for MobilityWorks, a mobility issue of inMotion: Bill Dupes dealer headquartered in Senior Editor, inMotion Housing & Personal Akron, Ohio. Transportation inMotion is published six times a year by the Amputee Coalition, 900 E. Hill Avenue, Suite 290, Knoxville, TN 37915-2568. Send address changes and other requests to the Amputee Coalition at this address. Print subscriptions to inMotion are $24 per year. This publication (journal article, etc.) was supported by the Cooperative Agreement Number 5U59DD000904-03 from The Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC, the sponsoring organizations, or the Amputee Coalition. It is not the intention of the Amputee Coalition to provide specific medical advice but rather to provide readers with information to better understand their health and healthcare Our Mission To reach out to and empower people affected by limb loss to achieve their full issues. The Amputee Coalition does not endorse any specific treatment, technology, company or device. Consumers are urged to consult with potential through education, support and advocacy, and to promote limb loss prevention. their healthcare providers for specific medical advice or before making any purchasing decisions involving their care. No funding from the CDC is used to support Amputee Coalition advocacy efforts. ©2014 by Amputee Coalition; all rights reserved. This magazine may not be reproduced in whole or in part without written permission of the Amputee Coalition.

6 inMotion Volume 24, Issue 3 May | June 2014

advocacy in action

U.S. Department of Education Guidance for Students With Disabilities to Participate in Athletics by Dan Ignaszewski

On January 25, 2013, the U.S. Department a competitive team, it does require that of Education’s Office of Civil Rights issued students with disabilities not be excluded groundbreaking guidance clarifying school from participation because of their disability. districts’ legal obligations to provide equal access to extracurricular athletic activities for The guidance further explains that as long students with disabilities. Almost a year and a as reasonable accommodations can be made half later, we’re revisiting the issue and letting for students with disabilities to participate, Oyou know about some of its direct impacts. then those accommodations must be made. If accommodations would “fundamentally The issued guidance clarified that students alter” the game or create an unfair with disabilities have the right, under Section advantage, schools will be obligated to 504 of the Rehabilitation Act, to an equal create separate but equally supported opportunity to participate in their schools’ opportunities for kids with disabilities to The issued extracurricular activities. >> participate, such as wheelchair . guidance Secretary Arne Duncan stated that, “Sports In many ways, this guidance could do clearly sets can provide invaluable lessons in discipline, for people with disabilities what Title IX the precedent selflessness, passion and courage, and this did for women. While we haven’t seen guidance will help schools ensure that that students many instances of the creation of separate students with disabilities have an equal with disabilities opportunities such as school-sponsored opportunity to benefit from the life lessons leagues, there have have the right they can learn on the playing field or on already been nationally recognized positive to participate the court.” in competitive impacts. The guidance says that students with school athletics. disabilities must be given a fair chance to play In January 2014, the guidance helped Bailey on traditional sports teams within the school Roby, a senior at Mountain Vista High School system, or have their own leagues. in Colorado, and a double amputee. Bailey made his school’s varsity basketball program This is a significant step forward for children his senior year, and while he had been able living with disabilities, especially those to play at the junior varsity level, and got a with limb loss or limb difference. While waiver for one game to play at the varsity the guidance doesn’t guarantee a spot on level, the school was unable to get approval for more than that one game to play by the Colorado High School Activities Association (CHSAA).

The reason provided was concern about whether Bailey’s prosthetic equipment could cause a safety concern for him, as well as the other players on the court.

8 inMotion Volume 24, Issue 3 May | June 2014 Bailey’s parents worked to spread right to participate in competitive the word, and after his story went school athletics. viral, disability rights groups and petitions were created to ask that In our letters to the U.S. CHSAA allow Bailey to play. The Department of Education and Amputee Coalition even contacted the Office of Disability, we the Department of Education recognized that concerns may and the White House’s Office of continue to be raised about the Disability about the situation. safety of both students wearing While we recognized that there prosthetic devices and the other will likely still be concerns about students participating with them all players’ safety, the Amputee in the sport. That being said, we Coalition, among others, felt have already heard of instances that reasonable accommodations where amputees have been able could be made in these kinds of to successfully cover up the rigid situations to allow Bailey to play. portions of their prosthesis with some sort of padding to help After the attention the state and ensure the safety of all involved, school district received, the CHSAA and that this kind of padding is issued a statement that Bailey common for individuals who may Roby would “…be permitted to have to wear a cast or rigid orthotic play in games, so long as there is device as well. We stressed that an agreement in place between our expectation is that reasonable both schools involved to ensure accommodations can and should the situation on the floor remains be made to enable all students who safe for all participants. CHSAA want to participate to do so. will consider approving this participation on a game-by-game With this guidance, the Amputee basis…” Coalition is confident that there Keep up on will be a continued emphasis on While there is still much to be the need to accommodate students up-to-date sorted out about exactly what the who live with limb loss or limb information at... guidance means for students with difference to be able to participate disabilities, the issued guidance in athletic programs, and there’s no clearly sets the precedent that doubting that this will be good for amputee-coalition.org students with disabilities have the all involved.

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 9 Do more of the things you love to do

Unpaid advocate, Alyssa

“It’s like I have my “I don’t feel a dead ankle back” spot with the RUSH foot - it’s smooth” “This is the closest thing I’ve ever had to my real foot”

“I don’t get as tired “My overall pain as I did with my old level is decreased foot - I can stay with the RUSH active longer” foot”

Unsolicited Facebook comments from RUSHTM foot users

Ask your prosthetist about trying the RUSHTM foot risk free and discover why the RUSH87 and the new low profile RUSH81 are changing amputee’s lives one step at a time.

Find out why amputees are raving: facebook.com/rushfoot Unpaid advocate youtube.com/user/AbilityDynamics Abilitydynamics.com Carol events calendar

A Publication of the Amputee Coalition May JUNE Volume 24, Issue 3 Published six times a year by Amputee Coalition 9303 Center St., Ste. 100 Manassas, VA 20110 Healthy Vision Month Men’s Health Month 703/330-1699 nei.nih.gov/hvm menshealthmonth.org Fax: 703-330-1688 900 E. Hill Ave., Ste. 290 National Osteoporosis Month National Fireworks Safety Month Knoxville, TN 37915-2568 nof.org fireworkssafety.org 865/524-8772; 888/267-5669 Fax: 865/525-7917; TTY: 865/525-4512 E-mail: [email protected] National Physical Fitness National Safety Month Web site: amputee-coalition.org and Sports Month nsc.org/Pages/Juneis fitness.gov NationalSafetyMonth.aspx Interim President & CEO Sue Stout Chief Marketing & Communications Officer Mary Beth Gibson Older Americans Month Vision Research Month Senior Editor Bill Dupes acl.gov/NewsRoom/ preventblindness.org Graphic Design Sexton Printing Observances/oam/2014 Advertising 703/330-1699 June 1 Stroke Awareness Month National Cancer Survivors Day Board of Directors stroke.org ncsdf.org Executive Board: June 8 Chairman Dennis Strickland Trauma Awareness Month Immediate Past Chair Marshall J. Cohen nationaltraumainstitute.org Silicon Valley Tour de Cure Chair-Elect Dan Berschinski Palo Alto, California Vice-Chair Jeffrey S. Lutz, CPO May 3 diabetes.org Secretary Mahesh Mansukhani Treasurer Leslie Pitt Schneider Limb Loss Education Day/First Swing Flint, Michigan June 9-15 Directors: amputee-coalition.org National Men’s Health Week Ron Drach menshealthmonth.org/week Michael Estrada Col. Greg Gadson May 6-12 Miles O’Brien National Nurses Week June 21 Jack Richmond nursingworld.org Limb Loss Education Day/First Fit David S. Sanders Raleigh/Durham, North Carolina Terrence P. Sheehan, MD May 10 amputee-coalition.org Charles Steele San Antonio Tour de Cure Scientific and MedicalA dvisory Committee San Antonio, Texas Fort Worth Tour de Cure Fort Worth, Texas diabetes.org Danielle Melton, MD, Chair diabetes.org Roberta Cone, PsyD May 11-17 David Crandell, MD National Women’s Health Week Scott Cummings, PT, CPO, FAAOP Joseph Czerniecki, MD womenshealth.gov/whw David Dunville Troy Farnsworth, CP, FAAOP May 17 Robert Gailey, PhD, PT Bellco Colfax 5K Col. Donald Gajewski, MD Denver, Colorado Jacqueline Herbert, MD, FRCPC [email protected] Samuel Johnson, PharmD, MPH Grant McGimpsey, PhD Nancy Payne, MSN, RN May 28 Bruce Pomeranz, MD National Senior Health & Fitness Day Terrence P. Sheehan, MD, Medical Director fitnessday.com Stella Sieber Troy Turner, MBA Stephen T. Wegener, PhD, ABPP, Past Chair May 31 Note: Dates listed for events are subject to Limb Loss Education Day/First Kick change. Check Amputee Coalition online New York, New York calendar and listed Web sites for current amputee-coalition.org information.

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 11 special message

A BMI Calculator for People With Limb Loss by George Gondo

Obesity as a Public Health Issue many prosthetic components and may Obesity is one of the nation’s leading public contribute to complications with socket health issues. According to the Centers for fit. Additionally, losing a limb already Disease Control and Prevention, more than increases a person’s risk of cardiovascular 35 percent of Americans over the age of 18 disease, which is even further complicated are obese. For adults, obesity is commonly by being overweight or obese. Although determined by calculating their Body Mass carrying excess weight can have negative Index (BMI). BMI estimates a person’s consequences for amputees, many body fat based on their height and weight. healthcare providers may be hesitant to Having a BMI above 30 is considered to discuss the topic of weight status with their be obese. patients with limb loss. One possible reason why healthcare providers may not want to discuss the topic is a lack of tools to assess the weight status of a person with an amputation. Existing consumer tools do not account for the estimated weight of a person’s missing limb(s). As a result, they may not accurately assess the amount of body fat for amputees A Tool and are not appropriate estimates of body composition for people with limb loss. This Designed to lack of tools creates an unnecessary barrier to receiving the same quality of healthcare Encourage from their healthcare providers as non- Being obese is associated with an increased amputees. Healthcare providers often use risk for many health conditions, including a person’s BMI to initiate a conversation Healthy heart disease, stroke and diabetes – three of about a patient’s weight status and discuss the leading causes of death in the United possible weight management interventions. States. Losing weight by eating a healthy Living for Developing a BMI Calculator diet and being physically active is among for People With Limb Loss the easiest ways for individuals to reduce Amputees their risk of these serious health conditions. To address the lack of tools, the Amputee Coalition and members of our Scientific Obesity and Limb Loss and Medical Advisory Committee (SciMAC) For amputees, being obese or overweight worked to develop a BMI calculator for can have many implications on their people with limb loss. Having the ability health and well-being. For example, being to be aware of their weight status and be overweight or obese may cause an amputee engaged by their healthcare providers to exceed the maximum weight rating of about possible weight interventions is an important part of living well with limb loss.

12 inMotion Volume 24, Issue 3 May | June 2014 “It is important for amputees to Using the Coalition’s be aware of their weight status,” BMI Calculator for says Danielle Melton – chair of the People With Limb Loss SciMAC and director of the Amputee To use the Coalition’s BMI calculator, Program at TIRR Hermann Memorial visit our Web site at amputee- Hospital in Houston, Texas. “For coalition.org. You can find the many people, knowing that their calculator by navigating your Web weight may be a concern is a first step browser to the “Resources by Topic” toward taking action to lose weight – portion of the site and selecting the Although the tool has not been whether through increased exercise or “Healthy Living” link. changing their dietary habits.” validated, it does provide amputees with a tool to assess their weight You can also help us publicize “This is why the Coalition wanted status and talk to their doctor about this tool by sharing it on your blog to develop this tool,” says Sue Stout, appropriate steps they can take to lose or Web site. The Coalition has the Coalition’s interim president & excess weight. However, BMI is not a provided a widget (a piece of HTML CEO. “We wanted amputees to have diagnostic tool. Only your healthcare code) on the BMI page that users can the same opportunities to understand provider can assess whether you are copy and paste into their blogs and their weight status as non-amputees. at an increased risk for certain health Web sites. Creating a BMI calculator for conditions. You should talk to your amputees embodies the Coalition’s healthcare provider if your BMI is efforts to help amputees live well outside the normal range. with limb loss.”

Instructions for Using the BMI Calculator Tool To use the calculator, enter your height and weight using standard (pounds/feet) or metric (kilograms/ meters) measures. You should enter your weight without your prosthesis, walker or wheelchair. People with bilateral lower-limb amputations should use their pre-amputation height. Users then select their level of amputation and click on the button to calculate their BMI.

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 13 federal affairs Marksman on Ice by Leif Nelson, DPT, ATP, CSCS | photos by Joe Kusumoto

Josh Sweeney is a U.S. Marine Corps veteran from 2009, when an improvised explosive device (IED) Phoenix, Arizona, and more recently, a Paralympic landed him in San Antonio, Texas at the Center for gold medalist. Sweeney was selected by his coaches the Intrepid (CFI) at Brooke Army Medical Center. to be the alternate captain on the Team USA Sled Team during the 2014 Paralympic Seven months of intense rehabilitation at CFI Games in Sochi. When asked about this honor, included full days of physical and occupational he modestly speaks first about his co-captains, therapy (PT/OT) every Monday through Friday. Jthe established leaders on the team, and what he Sweeney worked daily with Dr. Alicia White, a learned from them. As a reluctant explanation for physical therapist with the Department of Veterans being named a team captain, Sweeney offers, “I Affairs who is integrated within the Department have a crazy hard work ethic; I show up every day, of Defense Advanced Rehabilitation Facility. Dr. no matter what, and I try my best to motivate the White recalls, “Josh always gave 110 percent every rest of the guys.” He finds motivation in being part day. He was asking for prosthetics with knees on his of a team. first day.” On Fridays, Dr. White says they typically took a break from the standard PT/OT regime to have “Fun Fridays.” Sweeney’s recollection differs, calling these adaptive sports excursions “Forced Fun Fridays.” Shortly after arriving at CFI, Sweeney was introduced to the sport of sled hockey that would

Josh Sweeney (center) with Paul Schaus (left) and Rico Roman after winning the gold against .

Sport has been a recurring motif throughout allow him to serve his country once again. As an Sweeney’s life. Growing up his mother signed him observer sitting in the stands, he found instant up for T-ball, soccer and swim team. He participated solace thinking back to his high school hockey for years, but as 6th grade rolled around, his interest days. in these sports faded. Pursuing other activities, athletics took a back seat until a friend introduced When asked what he enjoyed most about his Sweeney to . In high school this hobby rehabilitation at CFI, he doesn’t mention sled transitioned to , where Sweeney found an hockey or the “forced fun” on Fridays, but simply identity in skating, forechecking (his specialty), and said “the guys,” referring to his brothers and sisters what he found to be most compelling, contributing in arms, all overcoming combat-related limb loss. to a team. In 2005, Sweeney hung up his skates and Sweeney continues, “You don’t know who you joined a different team, the United States Marine are, or what you’re doing anymore, when you’re Corps, where he proudly served his country until injured.” He continues to say that it helped in his

14 inMotion Volume 24, Issue 3 May | June 2014 recovery “to see that he is not the only one going through this.” He witnessed other veterans returning to CFI to visit, having achieved success in sports and other endeavors. He recalls that at that moment, “I knew my life was not over just because I was injured.” As Sweeney’s team evolved from high school hockey to the Marine Corps to rehabilitation with fellow amputees, he continued to find his own motivation.

It’s that motivation that led Sweeney to become an elite sled hockey athlete. With “USA” on his chest, Sweeney once again found himself at home on a team – the United States National Sled Hockey Team. Throughout the Paralympics, Sweeney was arguably the fastest man on ice. During the gold medal game, he seemed to continually get faster. Moving like a whirling dervish on the forecheck against Russia, the home team, he stole the puck near the blue line and raced toward the net, and with equally slick stick skills fired a “frozen rope” into the top shelf of the net. This second-period goal proved to be the game winner. When asked if he is fast, Sweeney replies, STOP THE HOPTM “Being a double above-knee amputee, I’m automatically labeled as being fast.” Instant Mobility... What many see as a disability, Sweeney used as an advantage to bring the gold whenever you need it! home to the country he continues to serve.

“I knew my life was not over just because I was injured.”

Jim W. Buffalo NY Veteran

Hartford Walking Systems, Inc. www.legsim.net . 315-735-1659

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 15 parenting as an amputee TheTot Te n for One-Armed Tips Parents With Toddlers by Harleen Chhabra Gupt

A child can make you ecstatic and tired, give you joy and frustration and can instantly make you feel like a genius or a moron. Needless to say, handling a toddler as a one-armed parent requires some extra tricks. Here are my “Tot 10”:

TIP #1 | Brace theA race. TIP #3 | A safe haven. Whether your toddler is running When establishing a gated playing area, follow or just getting the hang of walking, the usual child-proofing steps but ensure the area he or she can be everywhere and is large enough for your toddler to want to play anywhere in seconds. Carrying in. Handpick toys that can be played with safely your child to safety can strain without much supervision. I found such an area your only good arm. Get help very helpful as a one-armed parent. or try to lead your child to walk/crawl. Offer a “surprise” every now and then. I still TIP #4 | Goodbye diapers, hello potty. race with my son to get him somewhere and he loves to Start potty training early. Get a potty seat that you win those. and your child are comfortable with and keep wipes handy. Make sure the seat is light enough to carry around. TIP #2 | A moving traget. Consider buying more than one if you have a big house For emergencies, identify or one with stairs. high places around your house where you can put When alone, I still get away that sharp knife or your nervous about using public iPad to get to your child restrooms with my tot. I have quickly. I settled on top him use the potty before of a wine cabinet, the going out. I carry one purse kitchen bar counter and with all the potty essentials the fireplace mantel as in a separate zip-lock bag, my go-to spots. making it easily accessible. Occasionally, I ask strangers to help with holding stuff or the door.

16 inMotion Volume 24, Issue 3 May | June 2014 TIP #5 | Out and about.

Getting your toddler into a car seat by yourself can be difficult. To TIP #8 | Rub-a-dub. avoid carrying your child, play a “Monkey Climbs the For safe, low-stress baths, use Tree” game to encourage your tot’s baby tub or transfer him or her to climb into the him or her to the regular sized car and into the toddler car seat one. I’ve often sat with my toddler unassisted. (Allow yourself time for inside the big tub during the dreaded this, as this can be a slooow process.) shampoo episodes to minimize slip hazards. Nevertheless, I find Always have a lightweight stroller handy, as the little showering the easiest and fastest ones tire quickly. When shopping, consider a toddler way to bathe mine. Baths are also harness. You can wrap your end of the harness around an easy and fun clean-up solution your residual limb or tie it to your bag, leaving your during potty training when other arm free. At a grocery store, if your tot is being accidents happen. difficult, ask the store staff for help. And it helps to keep your grocery list short and sweet. TIP #9 | Sleeping beauty. TIP #6 | Where’s your other hand? Read about good sleep habits; avoid carrying around your tired tot to put him or her to sleep Your toddler may notice that you’re not using both so you don’t stress your good arm. If you need to hands to do things he or she does with two hands. console your child during a bedtime tantrum, lie With mine, it was a gradual realization over a period down beside him or her or have your child lie in of about a year. His friends at school noticed the your lap. If you find a crib and later a toddler bed difference before he did. with rails that works for you, great. My tot didn’t like them, so we resorted to a mattress on the floor Explain things in a casual way and avoid for his naps, with a long pillow to keep him from complaining; I came up with a fairy tale about my rolling off. arm. I also used parables such as Nemo’s little fin (Finding Nemo) or Toothless’ tail and Hiccup’s missing foot (How to Train Your Dragon). Avoid trauma details; now is not the time for a safety lesson. Remember, TIP #10 | Expect the best. children can understand more than you think – Think and believe but they may not remember the facts every time. that your kids will Be prepared to explain over and over again have Easy Ones and without getting impatient. Terrific Twos! But when that doesn’t happen, take a TIP #7 | The robot arm. deep breath and count to 10. If you wear a prosthesis, work with your therapist You’ll soon be to figure out how best to use it around your toddler. teaching your I’ve tried having mine sit on my prosthesis and using child the same my body and good arm for support to carry him; this trick to control minimizes the strain on my good shoulder and arm. his or her Also talk to him about being mommy or daddy’s little feelings. helper – it may take your child a year or two to catch on but it will make your life a lot easier later. Harleen and her son Atharv

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 17 Adaptive Soccer More Than Just a Team Sport by Amy Di Leo

“He said he closed his eyes and from the chatter on the field, the griping at the referee and the cheers after a score, he couldn’t tell our game from any other game … and that’s the point. This is real soccer; played with the [same] spirit [and intensity] as it is everywhere.”

The general manager of a soccer complex, who shared Hthose words with Rick Hofmann years ago, was referring to the international sport of amputee or adaptive soccer. The comment was made right after a national 3v3 tournament. Hofmann, a former player from Wilmington, Delaware, and the past president of the American Amputee Soccer Association, says it was one of the most powerful statements he had ever heard about the game, a game that he says “has the power to redeem souls.”

A New Start “This sport means so much to me. It has given me the opportunity to not only return to a sport I love and am passionate about, but to show others that life doesn’t end after you lose a limb … in fact, it can be a whole new beginning!” That’s what U.S. National Amputee Soccer Team goaltender Eric Westover says about it. Westover, of Myrtle Beach, South Carolina, is also chairman of the board & CEO of the American Amputee Soccer Association and head soccer coach for the NubAbility Athletics Foundation, which Rick Hofmann introduces kids with limb difference to the game.

As goalkeeper, Westover is the only player on the field allowed to stand on both legs. He has been a right below- elbow amputee since 2004, after a work injury more than a decade prior and recurring complications with surgeries from it.

Westover was a catcher and goalie in hockey and soccer when he was growing up in Minnesota. But after the amputation, team sport was the furthest thing from his

18 inMotion Volume 24, Issue 3 May | June 2014 Carl Calabria Rick Hofmann

Exhibition match between USA National Amputee Soccer Team and able-bodied club.

mind. In 2006, however, his life changed forever: “I The game must be played on forearm crutches – no was recruited through Facebook to try out at a camp in prosthetics are allowed on the playing field. But the ball Philadelphia. I went, and I dove around like a lunatic. may not be controlled or advanced with the crutch – They liked what they saw and asked if I would like to that would be considered a hand pass. Additionally, come and play. I said, ‘Absolutely!’ Then they asked if the residual limb may not be used to control or direct I’d like to be the starter. I was floored and said, ‘YES!’” the ball.

The Rules And, as Hofmann explains, safety is taken very seriously: “Any offensive use of the crutch, which might draw a Amputee soccer rules are very similar to FIFA rules two-minute penalty in hockey, such as slashing, tripping (FIFA, or Fédération Internationale de or high-sticking, results in an immediate red card and Association, is the governing body for international game ejection.” soccer). Some differences include smaller pitch (field), goal size and team size. For amputee soccer, the The Power to Play international game is 6v6 with a keeper. Hofmann is a U.S. Army veteran who served in Vietnam. Other differences are: two 25-minute playing halves He ran track and cross-country in high school, played instead of the FIFA 45-minute halves, the throw-in is a collegiate soccer and also completed a marathon. kick-in, and there are unlimited substitutions without In 1995, he lost his right leg above the knee in a limits and no offside penalty. motorcycle accident. Although he prefers “abbreviated” to “amputated,” Rick says, “Our game is a sport for those But perhaps the biggest difference is the players with ‘alternative configurations.’” themselves. The goalkeeper is the only player on the field who doesn’t have to have a leg amputation. Like Westover, Hofmann got involved in amputee soccer Goalkeepers can have arm amputees, at or above the two years after his “abbreviation.” He shares, “I was wrist instead. As for the rest of the players, they must looking for something to do – something that could help have a leg amputation at or above the ankle. Two me work up a sweat. I went to a demonstration of the players per team with congenital birth defects affecting game and got thoroughly hooked. After a few exercises the limbs – “Les Autres” – may play at a time. in ball handling, we scrimmaged. After a few minutes,

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 19 Carl Calabria

I actually forgot I was on crutches. They were there, of course, but they didn’t matter – I was engaged in sport and competing with others like me. I fell in love with the game and never looked back.” Hofmann was named to the 2000 World Cup Team.

Though it’s surely about the competition and camaraderie, as Hofmann explains, the sport offers so much more: “Emotionally, the game fills me up. There’s a power of belonging that comes with engaging in a sport with and against others just like you. Players from around town, around the country and around the world are just getting on with it, refusing to be ‘disabled,’ deciding to be athletes, deciding to go out and play.”

Rick co-founded the World Federation in 2005 and is the current president.

The First Kick Adaptive soccer began by accident in the , Washington driveway of Don Bennett. As the story goes, he was watching his son practice basketball outside the family home. At one point, the ball escaped and began rolling down the driveway. Bennett, on crutches and without his prosthesis, simply raised himself up on his crutches and kicked the ball back to his son. From there, he figured if he could kick a basketball then surely he could kick a soccer ball. That simple act became the impetus for a worldwide adaptive soccer movement.

In 1984, the first international soccer tournament was held in Seattle, with U.S., Canadian and Central American teams participating. The first World Cup Tournament was held in 1988 Carl Calabria

“This sport means so much to me. It has given me the opportunity to not only return to a sport I love and am passionate about, but to show others that life doesn’t end after you lose a limb … in fact, it can be a whole new beginning!” [ Nicolai Calabria, May 2004

20 inMotion Volume 24, Issue 3 May | June 2014 Carl Calabria with eight teams participating. The game has been coed since day one, with both men and women playing together in elite international competition.

Today there are 24 members of the World Amputee Football Federation, hailing from Africa, Asia, Europe, Central, North and South America, and the Middle East; five more countries are in the application process preparing for the next major competition – the World Cup in December in Culiacan, Mexico.

Team USA “We haven’t chosen a current team for the 2014 World Cup,” shares Westover. He says there is a pool of 15 to 20 players from around the country actively training and trying out to be one of the 15 chosen to represent Team USA.

“Most, if not all, national team players play able-bodied soccer in their home areas,” says Westover. Among the hopefuls are teenager Nicolai “Nico” Calabria (pictured on cover) and three seven-man team, a 3v3 configuration with no keeper, war-wounded military veterans. None of the players are paid 3v3 with keeper, 4v4 with keeper and 5v5 with keeper and as there is no official sponsor or funding for the team, are all recognized. the players actually pay their own way and expenses. Hofmann adds that in recreational games, people with Open tryouts will be held in Myrtle Beach, South Carolina both limbs can join in by removing one shoe and in June and San Antonio, Texas in July. Another two tryouts playing on crutches, and not putting the shoeless foot (locations to be determined) will be held later in the year. down during play; or as a keeper, by putting one arm inside the jersey. Interested Yet? But there’s more to the game than world-class competition. “Amputee soccer is played with people just like “We’re currently in the process of building local and regional yourself,” Hofmann explains. “So there’s no ‘ego teams and leagues throughout the country,” shares Westover. danger.’ At its root, it’s kicking a ball on crutches. “Last year, we became full members of the U.S. Soccer You can do that. And if you can do that, you can Federation, which is the governing body for soccer here in walk and kick a ball on crutches, then run and kick the U.S.” a ball on crutches, and 20 minutes later you’re playing real soccer.” “We’re always looking for local sparkplugs who want to play and can help develop [recreational and competitive] National team captain Ignacio Medrano, four-time teams in their home areas,” shares Hofmann. He adds that amputee soccer World Cup veteran, simply says, for local play in geographic areas that can’t support the full “The sport gives me life.”

Related Resources American Amputee American Amputee Fédération NubAbility Athletics U.S. Soccer Federation Soccer Association Soccer Internationale de Foundation ussoccer.com (Official site) ampsoccer.org Football Association nubability.org ampsoccerusa.org .com

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 21 The Perfect Rehabilitation Therapy

by Robert S. Gailey, PT, PhD | drawings by Frank Angulo

Putting Golf is one of the most popular There are many aspects to putting, from stance to club selection. sports enjoyed by amputees of For the purpose of this exercise, the classic pendulum-type stroke all ages. It encourages people to has been selected. get outside, compete within their Stroke | Your hands, comfort level and enjoy social g arms and shoulders all exchange. It’s one of the best work together, creating activities for improving balance, a pendulum-type coordination, range stroke. Your shoulders of motion, strength and arms create a and endurance. triangle that moves an equal distance on both the backswing and the through swing, with the head remaining still at all times.

Stance | Set up with a comfortable, Prosthetic Foot | You wide stance; bend your knees slightly, should feel the points as if you were going to sit. For of the heel, little toe transfemoral amputees, the prosthetic and great toe on the knee is straight with the sound limb prosthetic foot. This slightly flexed, if possible. Feel the will help balance weight over the center of your feet, the weight over the with a little more weight on the foot. Start with equal front foot. You should feel secure and weight distribution balanced over both feet. Your upper between both feet, arms should rest lightly on your ribs, then move the weight and your forward eye should be slightly toward the directly over the ball. forward foot.

22 inMotion Volume 24, Issue 3 May | June 2014 Chipping and Pitching Getting on the green and close to the hole can reduce your score dramatically. Chipping and pitching is all about balance and repeating the same stance and stroke consistently.

Exercises |

1. From the narrow stance position used for chipping, hold your Exercises | hands in a golf grip position and practice 1. From your putting stance, short strokes. Focus on | Use a narrow, open stance, shift your weight side to side Stance getting the weight down with your feet positioned fairly close slowly and gently from one into the forward leg. The together. The forward foot is slightly foot to another. Find the point trick is maintaining the back, and your body is aligned slightly where your weight is equally balance over the forward left of the target. The ball is positioned distributed between both legs. leg at the end of the back toward your back foot with a fair stroke. 2. Again, from your putting amount of weight on your forward side. stance with the weight equally Knees are slightly flexed with your back 2. Once comfortable with distributed, shift your weight straight and rear end out a little. motion and weight- from your heels to your toes. shifting without using a Your hands move ahead of Focus on the prosthetic foot, Stroke | club, use a sand wedge the ball, wrists firm (no bending), with sensing when you are on the and perform the same your weight moving toward the forward heel and then on the toes. Find motion. Again, hold your leg. The distance of the backswing and the point where your weight is finished position with through swing dictates the distance you equally distributed. your weight well forward. want the ball to go. Both movements 3. With your weight equally are usually equal in distance. A short 3. Since golf courses are distributed, move the weight chip requires only a short back and neither flat nor firm, just slightly to the front foot. through swing, whereas, if you want practice the stroke with a Bring your hands together, the ball to fly farther, a more complete foam cushion under both fingers straight, trunk and stroke is required, along with a little feet. Hold the finished knees flexed. Keep your head wider base with your feet. position. still and move your shoulders, arms and hands together in a Prosthetic Foot | Getting the weight 4. As your comfort level stroking motion. down into the prosthetic foot is improves, take a half essential for consistently successful swing, then three-quarter 4. Take a putter and start chipping and pitching. A prosthetic and finally a full swing. with short three-foot putts, foot that permits vertical and rotational As you increase your progressing to longer putts. shock absorption can make this stroke swing, widen your stance. Maintain the same swing, smoother and more comfortable, Focus on the weight shift focusing on a stable base especially when the prosthetic limb and holding the finished within the lower body. is forward. position.

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 23 Full Swing Exercises | 1. Take your stance position, then take a half swing and progress to a three- quarter swing and a full swing. Focus on the weight shift between your feet. Keep the weight inside your back foot during the backswing, Figure 1 Figure 2 Figure 3 Figure 4 and allow the weight to move to your forward Stance | Feet should be shoulder width Prosthetic Foot | As the magnitude foot during follow- apart and turned outward slightly. Bend your of your swing increases, the need to through. Hold the knees slightly until you feel your weight have a sense of where your prosthetic follow-through over the center of your feet. Transfemoral foot is increases. The more you can feel position for a amputees will need to keep their prosthetic where your weight is distributed over couple of seconds. knee straight; as a result, the sound knee will the prosthetic foot, the better your be straighter as well. Stick your rear end out balance and swing control. Also, the 2. To help keep the a little, keeping your lower back straight and greater the forces that are generated weight distributed your chin up (Figure 1). throughout the prosthesis, the more a equally on the shock absorber or torsion-control device inside of both feet, Strokes | will reduce the forces and permit greater place a half-buried motion and comfort. golf ball under • Backswing – Make a smooth, one-piece the outside border turn, moving the club, hands, arms, chest of each foot and shoulders together, sweeping the club (Figure 5). head back low with a full, wide swing. Keep the weight on the inside of your 3. To maintain pelvic back foot with your front foot firmly on stability, place the ground (Figure 2). a ball between your knees. Take • Downswing – The lower body initiates Figure 5 a swing, keeping the movement as the body unwinds, and the ball in place. the hands remain soft as the club head This will help moves through the ball. Your body weight maintain a stable shifts smoothly from the rear foot to the base and prevent front foot. Your body must be encouraged overshifting to rotate all the way through the shot, (Figure 6). with the majority of the weight finishing Figure 6 over the front leg (Figure 3).

Benefits With practice, not only will your game improve, you will improve weight shifting, stability and balance over the prosthetic limb in various positions. The strength in your legs, as well as your overall balance, will increase, especially as you take bigger swings.

24 inMotion Volume 24, Issue 3 May | June 2014 This is Shannon. With three little boys and a baby on the way, Shannon needs strong, dependable prosthetics to keep up with her active children. Shannon’s practitioner chose the ORION Microprocessor Knee and the élan to do just that.

Utilizing our patented microprocessor technology, both the ORION and the élan provide the user with the in stability and safety. The ORION is able to rapidly select support as needed and adapt from slow to fast walking speeds providing a visually natural gait. The élan’s hydraulic yielding function is a self aligning feature that provides stability while standing or traversing varied terrain.

From playing by the creek, maneuvering the monkey bars to blowing bubbles in the park, the ORION and élan allow Shannon to be there every step of the way.

www.spsco.com www.endolite.com 800.767.7776 800.548.3534

InMotion Winter 2013.indd 1 10/16/2013 9:32:54 AM technology review

To find a seating solution provider near you, visit the National Mobility Equipment Dealers Association Web site at nmeda.com and look for their dealer locator. Getting In and Out of a Vehicle Made Easier Custom seating solutions for drivers and passengers by Guy A. Hanford

For people who struggle with getting options readily available from the in and out of a vehicle, a little extra mobility industry, designed for maneuverability is often all that’s just about any type of vehicle and needed to make daily travel a lot physical need. easier. With or without the use of a wheelchair, challenges with Individuals with muscle balance, strength and flexibility deteriorating conditions (such as can make getting into and out of a neurological disorder or stroke) certain vehicles a difficult process, can also benefit from this type of particularly for seniors and some adaptive technology, significantly people with limb loss. aiding a caregiver with transporting a loved one. Certainly, no one is So imagine a seat that doesn’t just immune to back or hip ailments move forward and back, or up and that can make travelling more Fdown. Imagine a seat that turns out difficult. 90 degrees, extends out beyond the driver or passenger door, and then Here are some of the more popular lowers to the ground if needed. All custom seating options that can controlled with the push of a button. help to make daily travels a more This is just one of several different pleasurable experience.

26 inMotion Volume 24, Issue 3 May | June 2014 Custom Seating Solution Options

Turning & Lift-Up Seats and models to make transfers much easier. Using the A combination turning existing OEM seat, the new base allows the person to and lift-up seat eliminates electronically control the seat going up or down, forward physical contortions that or back, and to swivel in or out into the desired position. can make it difficult to Seats can turn in by as much as 100 degrees and move enter a vehicle. Providing front to back over 21 inches. for easy access, this type Finding the Right Custom Seating Product of solution replaces the existing OEM (original equipment manufacturer) A quality mobility dealer will be able to provide a variety seat located on the driver or passenger side of a of options from the industry’s leading manufacturers. vehicle. They are available for front and rear seating Each product, with its own unique features and benefits, positions and can be installed in most standard- will be matched to the physical need and mode of sized automobiles or in higher-level vehicles such transportation. They will know where to find the right as minivans, SUVs or pickup trucks. Models are solution and properly install it to the manufacturer’s available that simply rotate the seat 90 degrees out specifications. and then back into position, to more advanced designs that rotate, extend out of the vehicle and Photos courtesy of Bruno Independent Living Aids, then lower toward the ground. They are powered by Adapt Solutions and MobilityWorks. the existing battery and operated with easy-to-use push button controls. Seating material and colors can be specified to match the rest of the interior.

Retractable Transfer Boards, Seats and Lifts For assistance with entering a vehicle, several BetterBetter different types of hybrid combinations are available that include the use of a transfer board, custom seat and unoccupied lift. There are motorized and non-motorized retractable options. Many of these “niche” solutions are relatively new to the market and keep evolving as technology and innovation keeps up with demand. Which single solution, or combination of several, is best suited for a specific need depends on many different considerations: physical ability, vehicle, mobility device, the use of driving aids and so on. A certified mobility consultant can help an individual with researching all of the available options and in determining if a desired product will work for their needs.

6- Way Transfer Seat Bases For those who use a wheelchair (or scooter) for nonprosthetic mobility and travel in a minivan or full-size van, many transfer to the driver or PERFORMANCE n QUALITY n RELIABILITY passenger front seating positions. Specially designed Toll Free: 800.279.1865 “6-way” seat bases are available in different makes on The Web: www.trsprosthetics.com n www.oandp.com/trs

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 27 living with limb loss

Adaptive Gardening

Limb loss need not prevent those A bench or stool or a seat Soaker hoses ($5-$30) or spray with metaphorical green thumbs with wheels (many such wands ($15-$40) for watering to from participating in activities rolling seats like the tractor minimize bending and lifting. they enjoy. Assistive devices and scoot or garden seat caddy are ideas for adapting equipment and available – prices range from For upper-limb loss, a few environment can allow those with $60-$140) gardening-specific terminal devices limb loss or limited mobility to are available from Texas Assistive A tool cart to transport tools, garden to their heart’s content. Devices. These include: seeds, watering cans, etc. Hand hoe Adaption Ideas Hand trowel, fork, hoe and Hand cultivator cultivator heads on broom or LFor those with limited mobility, Hand spade mop sticks or other similar consider designing accessible plots Pruning saw. and using assistive devices. These poles – or purchasing long- include: handled versions of these implements; add-on handles, Raised beds (kits range from sold by many retailers (prices $7-$900, range from $15-$18), can depending on be attached to allow greater

complexity Devices Assistive Texas leverage and materials), trellises, planters, A long-handled grabber to Pruning saw used with myoelectric prosthesis. window boxes or retrieve clippings and tools ($10-$30) other containers, All Texas Assistive Device tools such as the Ratcheted pruners and shears and implements, including hanging tomato with telescoping handles gardening tools, can be used with planter (prices (prices range from $8 to over either body-powered or myoelectric range from $150), which don’t require as prostheses. You will need to check $7-$13) much leverage with your prosthetist or orthotist regarding availability and pricing of these items.

Related Resources Active Forever Breaking New Ground Gardener’s Supply Company Kmart activeforever.com engineering.purdue.edu/~bng gardeners.com kmart.com

AgrAbility eziMate Idaho Center for Assistive Technology Life Solutions Plus agrability.org ezimate.com idahocat.webs.com/services.htm lifesolutionsplus.com fyi.uwex.edu/agrability

28 inMotion Volume 24, Issue 3 May | June 2014 Photo courtesy of Randy Geile courtesy Photo

TRS, which also builds custom offers a series of videotapes on how sports and recreational to construct your own one-armed terminal devices for upper- gardening implements, using low- limb amputees, does not list cost materials like PVC piping. gardening tools among its The adaptive tools include: sports and recreation devices, Belt and extension assembly but invites customers to inquire Pedal hoe about custom projects. Garden trencher If purchasing assistive devices is Rake not an option, the Idaho Center Tree trimmer for Assistive Technology (ICAT) Shovel.

For more intensive agrarian work, the University of Wisconsin- Madison’s National AgrAbility Project and Purdue’s Breaking New Ground Outreach Program Texas Assistive Devices Devices Assistive Texas offer resources and suggestions for adaptable and assistive Hand hoe used with body-powered farming devices. prosthesis.

Life With Ease Plow & Hearth TRS lifewithease.com/garden.html plowhearth.com oandp.com/products/trs

National Public Raised Garden Beds The Wright Stuff W ebsite on raised-garden-beds.com wrightstuff.biz AssistiveT echnology assistivetech.net Texas Assistive Devices n-abler.org

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 29 exercise & fitness

Common Issuesby Cindy Asch-Martin

As amputees, we all share common For new amputees or for amputees who issues with our bodies being off balance. choose to not wear a leg(s), you can still Our hips and back hurt, and we don’t do core exercises, abduction/adduction seem to be able to strengthen our exercises, back extensions and pelvic residual limbs like we think we should. tilts to strengthen the ligaments and tendons that help to support your If your sockets aren’t adjusted correctly skeletal structure. Ato be at the same level as both hips, All of these then you will experience a lot of We seem to have this notion that unless exercises soreness. If that is the case, you should we’re pumping tons of weight, nothing are meant have them checked by your prosthetist positive will happen. You will be and have any necessary adjustments surprised how much better and stronger to help your made. you will feel with these simple exercise moves. body stay as Strengthening your lower back, hips, pain-free as and gluteal and core muscles will make a huge difference in how well your [possible. body feels on a daily basis.

hip abduction/adduction and gluteal exerices | Hip abduction/adduction and gluteal exercises can be done very easily while lying on your side on either the floor or a bed. The use of gravity is a hidden bonus with exercise – it creates more resistance. Remember that your form is extremely important to get good results. Being able to do these exercises without assistance from another person, equipment, or even having to go to a gym should be a big motivator.

30 inMotion Volume 24, Issue 3 May | June 2014 P lank – BK without prosthesis

Start Position End Position core exercises | Having a strong core will help your torso with better balance. The plank is one of the best exercises to help strengthen your abdominal muscles, as well as your erector spinae (the back muscles that surround your spine). Even if you’re an above-knee (AK) or knee disarticulation (KA) amputee without your prosthesis, you can be on your quadriceps (thigh) with your arms placed shoulder width apart. If you’re a below-knee (BK) amputee without your prosthesis, you can be on your knees. If you’re wearing your prosthesis, you can start on your knees and work up to your toes.

Try to hold the plank for as long as you can, making sure your back is not swaying downwards – that will cause stress in your back, which could lead to injury. If you’re a beginner with the plank and can hold it forever, that’s usually an indication that your form is not quite right. A true beginner can only hold the correct form for 10-15 seconds. As your abdominal muscles strengthen, you’ll notice that you can hold it for much longer. Once you reach that stage, add a second repetition and then a third. When you can do three repetitions for one minute each, it’s time to progress to the next level.

Bck a Extension All of these exercises are meant to help your body stay as pain- free as possible. However, the only way to accomplish this is to ensure that you are doing Start Position - Your entire body should lie flat on surface End Position - Lift your upper body only the exercises correctly. It is also critical to make sure back extensions | Back extensions can be done with or without your that your prostheses fit prosthesis. Begin by lying on your stomach on a flat surface, such as the comfortably and correctly. floor or your bed. With both legs straight and shoulder width apart, and your arms under your chin, press your legs (residual limb[s]) down firmly By following these steps, while lifting your upper body – hold for a count of three, then lower back it will make a difference. down. Repeat this 10 times; you can do three sets of 10 with a 30-second Keeping moving forward! pause between sets.

Pelvic Tilt

Start Position End Position - Push your back down into your hand or flat surface

pelvic tilts | Pelvic tilts are done on your back on a flat surface, with knees bent (for bilateral AK/KA amputees, put a pillow under your residual limbs – your back will have a natural arch). Tilt your hips upward and toward you, trying to flatten your back on the flat surface. Imagine a bucket of water on your lap – when you lift your glutes, the water would spill toward you.

Photos provided by Cindy Asch-Martin

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 31 well-being

Douglas G. Jacobs, MD, president and CEO of Screening for Mental Health, Inc., and a leading Warning Signs: expert on suicide, stresses the importance of teaching people how to recognize the signs and take action. “Suicide is a fatal response to a treatable, and reversible, condition – that condition most often being depression,” says Jacobs.

Warning Signs of Suicide Call 911 or seek immediate help from a mental health provider when you hear or see any of these behaviors: • Someone threatening to hurt or kill, or talking of wanting to hurt or kill, himself or herself “Suicide is a • Someone looking for ways to kill himself or fatal response to a herself by seeking access to firearms, pills or treatable, and reversible, other means condition – that condition • Someone talking or writing about death, most often being dying or suicide, when these actions are out depression.” of the ordinary for the person. Seek help by contacting a mental health professional or calling 800/273-TALK for a referral if you witness anyone exhibiting any Stopping one or more of these behaviors: • Hopelessness • Rage, uncontrolled anger, seeking revenge Depression Before • Acting ecklessr or engaging in risky activities, seemingly without thinking • Feeling trapped – like there’s no way out It Goes Too Far • Increased alcohol or drug use • Withdrawing from friends, family and society • Anxiety, agitation, inability to sleep or sleeping all the time Each year, nearly 34,000 people die • Dramatic mood changes by suicide in the United States, and • No reason for living; no sense of purpose 70 percent of those give warning signs in life. Eor tell someone about it in advance. Related Resources

American Foundation National Suicide Prevention Lifeline Screening for Mental Health for Suicide Prevention 800/273-TALK (8255) mentalhealthscreening.org afsp.org suicidepreventionlifeline.org

32 inMotion Volume 24, Issue 3 May | June 2014

phantom fashionista

Tips from a“F ellOW” FASHIONISTA Welcome back to all of you Fabulous As a Fashionistas! fitness buff, you are the only person I Due to all the love we know who can majorly rock head-to-toe felt for our last column’s Spandex. What are some favorite fitness contributing “fellow” brands that you wear, and why? fashionista (November/ Gracias! Los Angeles is the fitness compression gear means you December 2013 inMotion, capital of the world, so I’m just have to stay in shape to pull it page 34), he’s back for a fighting to keep up with the off, so it’s actually a source of second session. Joneses. For the last couple of motivation – you don’t want to years, I’ve used CW-X for lower rock this stuff with the wrong So, you ask: Just who is this body gear and the UFC AIM physique. That’s not a good idea. “fellow” fashionista? He’s a compression tops (both short and I wear Swiftwick socks, both for West Coast attorney with a long sleeve) for the upper body. I my feet and for my arm that penchant for fashion, music like CW-X because they have great goes inside my body-powered and fitness, rocking an lines and have options that are prosthetic arms. They are thin and upper-limb prosthesis. understated and others that are comfortable. I wear Inov-8 flat- visually busier or right in-between. soled shoes for weight training I like the UFC tops because they’re and currently use Reebok Zigs for monochromatic and masculine – running, but I also use ASICS and at a glance, they look very simple some of the more comfortable Nike but up close there’s some really running shoes. I usually switch >> keep your nice detailing. And, wearing brands of running shoes every year. success stories and solutions coming to me at: Fashionista@ amputee-coalition.org!

“I usually switch brands of running shoes every year.”

34 inMotion Volume 24, Issue 3 May | June 2014 “I’ve had a pair of elaborate Celtic bands tattoed on each arm that extend from just above each elbow to just below.”

How long have you used a prosthetic device? What is your most I lost my left hand in an significant prosthetically accident in June 1984, induced fashion situation? and I’ve been wearing prostheses since July 1984. Funny you should ask. It’s a work in I started with a standard progress. A few weeks ago, I made a fairly body-powered prosthesis significant addition to my body art – with a Dorrance hook in I’ve had a pair of elaborate Celtic bands 1984, but in 1985 I was tattooed on each arm that extend from one of the first people to just above each elbow to just below. start using a TRS Grip 2. The tattoos are symmetrical and In 1987, I switched over to identical, which is nearly impossible an Ottobock myoelectric for a tattoo artist to pull off. However, hand, and I’ve been Pat Fish is, without exaggeration, the wearing them ever since. I best Celtic tattoo artist on the planet got new ones in 1993, 2000 (luckyfish.com). and 2004, and, at long last, Now that that’s finished, the second the Michelangelo in 2012. part of the process will be to have the When I’m at the gym or top portion of the arm I use to wear the doing some kind of heavy Michelangelo airbrushed to match the physical activity, I use a part of the tattoo on the left arm that body-powered prosthesis will be inside the socket and integrate and switch between several with the part that is visible, and it TRS terminal devices: will make for an absolutely seamless the Grip 3, the Shroom visual transition between man and Tumbler and a custom machine. But all things considered, this version of the TRS Dragon is absolutely a prosthetically induced that I use in conjunction fashion situation – I can tell you that with the Carter Cuff for this idea did not zing into my head weight training. until I had a fully lifelike hand like the Michelangelo.

Let’s give lots of love and gratitude to our fellow fashionista for sharing some tips! Until next time, let a prosthetic device be your most fabulous accessory!

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 35 advertiser index

Ability Dynamics ...... 10

Amputee Supplies ...... 35

Award Prosthetics ...... 36

College Park Industries ...... 37

Comfort Products ...... 35

Disabled Motorcycle Riders ...... 36

Endolite ...... 25

Ferrier Coupler ...... 29

Fred’s Legs ...... 15

Hanger Clinic ...... 4

Hartford Walking Systems ...... 15

Motion Control ...... 7

Össur ...... 2

Ottobock ...... 40

Scott Sabolich ...... 39

Texas Assistive Devices ...... 33

TRS ...... 27

WaterGait ...... 9

We wish to thank our advertisers for their support, which helps to make it possible for us to provide important services such as peer visiting, advocacy, our youth camp and national conference to the limb loss community.

36 inMotion Volume 24, Issue 3 May | June 2014 ALL NEW IDENTIFY K2 FOR 2014

a loving husband fun grandpa retired teacher sport fi sherman diabetic dependable enjoying life. I AM COLLEGE PARK.

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My new quest has just begun...spreading the word that there are I have been a transtibial (BK) This is the best quality-of-life comfortable, affordable amputee since I was seven years investment I’ve ever made and old. I’m well-adjusted and consider I’m on a mission to let other BK options out there. myself to be reasonably athletic. amputees know that getting back I regularly work out, enjoy biking, in the water – on two legs – is jogging and hiking. If I were given possible and affordable. three wishes, none of them would involve my leg. But one day, None of us wants to risk ruining I was given the gift of “water,” our primary prosthetic leg(s) with iand what a gift that is! My life has water. I only recently learned that been transformed ever since. some amputees simply wear their old prosthesis in the water until My prosthesis fabricator came to they rust, smell and simply fall apart. me about a year ago with his new My old legs are too uncomfortable invention. It’s a waterproof swim leg to even think about doing that. Why for BK amputees that looks lifelike, didn’t anyone ever tell me what fits great (made from a duplicate my options were? One thing I have of my primary prosthesis) and is learned: We all need to be our own affordable (less than $2,000). I advocates. Getting the word out is ordered and received mine and for my way of “paying it forward.” the first time in my life I walked into Lake Michigan with my friends on My new quest has just begun. I want a hot summer day. I had tears in my to continue enjoying water activities eyes from the sheer joy. that I always thought were off limits to me and get more amputees back Since then, I’ve gone swimming in the water by spreading the word at river parties, walked into pools that there are comfortable, affordable on “two” legs and combed beaches options out there. (Lake Michigan and the Atlantic Ocean). I feel more confident Let’s all go out and make waves! walking in and out of showers and If you have questions or want to help me by Laurel Krasne saunas. I no longer avoid water spread the word, please contact me at activities – and I don’t want [email protected]. anyone else to either!

38 inMotion Volume 24, Issue 3 May | June 2014

Non-Profit Org US Postage PAID Twin Cities, MN Permit No 1096 900 E. Hill Avenue, Suite 290 Knoxville, TN 37915-2568

by Showing Your Metal

April 27, 2013 is National Show Your Mettle Day for amputees across AAmerica. standing As part of National Limb ovation FiveLoss Awarenessacres, four Month, dogs, the (almost!) Amputee three kids and a life big enough to hold themCoalition all. is As asking one amputees of the rstwho peoplefeel t with a C-Leg, and a prosthetist himself,comfortable Brad (and hasare able) a unique to make perspective their when it comes to tting the prosthetics (or chairs) visible on April 27. most studied,For more information, most go tto knee amputee- in the world. coalition.org or visit us on Facebook at ™ Joinfacebook.com/AmputeeUSA us in applauding him—and. all the other Ottobock microprocessor knee wearers out there—for helping make C-Leg the standard. Stand Proud. Stand Together. Nationally Sponsored by To nd out if the C-Leg is right for you, visit us at ottobockus.com/tryout.

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