Prosthetic Technology Enabling Accessibility
Dino Christodoulou - Prosthetic Manager Josephine Herriott - Occupational Therapy Sharon Byrne – Patient Introduction
• Prosthetic devices have come a long way today from their origins in the (in) famous wooden peg leg. Introduction
• Prosthetics today includes devices from simple aids to restore mobility, to state of the art devices using microprocessors and carbon fibre and other exotic materials. Introduction
• A prosthesis is no longer a hindrance, but has through research, modern techniques and refined skills of the Prosthetist, become a device to help restore the amputee to their former physically active being. What is a Prosthesis?
• A prosthesis is usually defined as a mechanical device that is used to replace the function of a limb after amputation of the limb. A prosthesis can be both cosmetic and functional or be of purely cosmetic nature. The Rehabilitation Team
• For a successful
Prosthetics outcome, it is Radiology Orthotics important that the patient is Volunteers Occupational an important & Students Therapy member of the team Rehabilitation Physiotherapy Medicine Patient
Nursing Dietetics
Clinical Pharmacy Psychology Health Care Social Work Assistants The Multidisciplinary Team Approach
• Each potential prosthetic patient is assessed by the MDT
• The MDT approach provides and comprehensive approach to the prosthetic technology to be used and the outcomes that could be expected
• This approach provides an objective assessment of the current and potential needs of the patient
• Each discipline within the MDT is able to voice their input to provide a holistic approach to the rehabilitation plan
• Rehabilitation does NOT just involve the use of the prosthesis, but rather applies the technology of the prosthesis to improve the mobility and quality of life of the patient Applying the technology to improve Quality of Life • Each prosthetic prescription is unique to the current expected activity level of the wearer
• Factors such as predicted activity level, physical ability, medical co-morbidities or conditions are taken into account
• Each prosthesis is custom made to suite the patients current needs Prosthetic Technology Applied
• The socket is designed to provide a weight bearing area to transfer the weight and forces through to the components
• The components are selected to provide the best combination of safety, stability and ability to walk and stand on
• Technology can be from materials used in the manufacture, to the componentry used in the prosthesis Prosthesis Fitting
• Getting the technology to work – The Prosthetist will do a preliminary fitting if needed • Use of special plastics to make clear diagnostic sockets – The definitive prosthetic socket is then fitted – The alignment, length etc. are reviewed • Prosthesis is prepared for fitting with the rest of the team – The Prosthetist, OT and Physiotherapist do a joint review and handover session with the patient to start the rehabilitation program – The Prosthetist is in regular communication with the rest of the team to monitor the progress, and make any adjustments if necessary Prosthetic Rehabilitation
• The patient is the most important member of the team!
• OT, Physio & Prosthetist all work closely together to provide the optimal therapy and rehabilitation program tailored to each patients needs and requirements How the Prosthetic Technology is introduced into daily living • The Occupational Therapist works closely with the patient in enabling them to incorporate the use of the prosthesis into their activities of daily living, thus enabling the person to participate in the life they wish to lead. Occupational Therapists focus on participation in meaningful occupations
• “Occupations are all the active processes of looking after ourselves and others, enjoying life, and being socially and economically productive over the lifespan and in various contexts, these include (but are not limited to) work, leisure, self care, domestic and community activities” Willard & Spackman (2008) Meaningful Occupations
• Research suggests that engagement in valued activities is a key to life satisfaction • There is a relationship between engagement in valued occupations and wellbeing and happiness
Technology to enable accessing occupations • Occupational therapists are continually urged to keep up to date with technological advancements and current day ‘meaningful activities’ (Brienes 2004; Chard 2007) Technology for self care Technology for the home Technology for work Technology for identity Technology for community participation Technology for leisure participation Case 1
• Uni lateral amputee • Main goal of participation: -Walk on beach • Prosthetic solution in componentry of foot Case 2
• Upper limb amputee • Main goal of participation: -To keep up with school and to ‘fit in’ • Non prosthetic solution - Use of iPad in school and dragon voice activation software for homework Case 3 & 4
• Same diagnosis, different people with different technological interventions & outcomes • Return to accessing the world through powered mobility and driving • Return to accessing the world through prosthetic technology…. References
• Breines, E. B. (2004) Occupation Therapy: Activities for Practice & Teaching, London: Whurr Publishers Ltd. • Chard, G. (2007) ‘Computer Games and Karate: the Arts and Crafts of Today’, The British Journal of Occupatinal Therapy. Vol 70. (8), 329. • Law M, Baptiste S & Carswell A et al (2005). The Canadian Occupational Performance Measure (4th ed) Toronto, CAOT Publications ACE. • Pierce, D. (2003). Occupation by design: Building therapeutic power. Philadelphia: F.A. Davis • Pierce, D. (2001a). Untangling occupation and activity. American Journal of Occupational Therapy, 55, 138-146. • Polatajko H, Townsend E & Craik J (2007) Canadian model of occupational performance and engagement (CMOP-E). In E.A Townsend & H J Polatajko. Enabling Occupation II: Advancing an occupational therapy vision of health, well-being and justice through occupation. Ottawa, ON: CAOT Publication ACE. • Trent International Prosthetic Symposium 2012