We asked two Upper-Limb Prosthetists Elise and Kameron to share their clinical perspective on the ideal residual limb the Hero Arm is most suitable for and how they make an assessment.
Here is what is on the assessment criteria for both Prosthetists.
Limb presentation (conical, bulbous, cylindrical, irregular) We also review if this presentation will work with supracondylar suspension.
Active muscle site(s) for positioning electrode(s) – at least one sufficient location for muscle activation
The shortest limb we have been able to successfully fit was 1.7 inches long (for children). This should be determined on a case-by-case basis through the use of a check socket trials, which the user should get as part of their Hero Arm trial.
Appropriate residual length and volume to provide adequate prosthesis suspension; enable loading of pressure tolerant soft tissues; and act as a sufficient lever for motion at the elbow joint.
Sufficient residual length for positioning electrode(s)
Residual limb skin condition
Is there significant scarring or skin grafting?
Are neuromas or extreme sensitivity present?
Fully healed amputation site and/or other associated wounds/lesions/abrasions.
Approximately 6 – 18 months post-amputation to ensure that residual shape has stabilized with minimal volume fluctuations and is able to tolerate the hydrostatic pressure and liner interface forces applied by the prosthesis.
Goals with the Hero Arm
Can the Hero Arm help an individual reach a goal?
Unilateral, Bilateral and Other Association Complications
Both persons with unilateral and bilateral upper limb absences can be considered
Consider whether bilateral Hero Arms would be the optimal solution for each patient. See how Kath uses two Hero Arms at work.
Consider other association complications i.e. lower limb amputations, inhibited vision/hearing, and what impact this has on their ability to use this device.
Who will the Hero Arm benefit and why?
The Hero Arm will benefit persons with below-elbow absence(s) seeking an increase in functionality and ability to perform everyday activities of daily living (ADLs).
Aside from helping with functional activities, the Hero Arm can also help improve patient confidence through customizable and interchangeable prosthetic cover options.
Those that would benefit from improved confidence and mental health.
Those looking to reduce postural and compensatory movements in the upper body and trunk.
Here is how the Hero Arm fits all shapes and sizes
Who is NOT a suitable Hero Arm candidate:
Extremely bulbous residual limbs
Unable to don the socket without a window
Unable to achieve suction suspension inside definitive liner
Evaluate whether styloid processes of the radius and ulna can recruited to aid with suspension
Elbow-disarticulation (through-elbow), transhumeral (above-elbow) or more proximal levels of upper limb absence.
Extremely short residual limb
Anything less than 3 inches should be determined on a case by case basis. The shortest residual limb we have successfully fit was 1.7 inches long (for children).
Those with an inappropriate residual length and volume to; achieve adequate prosthesis suspension; enable loading of pressure tolerant soft tissues; and provide a suitable lever arm for motion at the elbow joint.
Absence of active muscle site(s) for electrode positioning or muscle activation is deemed to be insufficient for consistent and reliable control.
Those with excessive scar tissue and skin grafts, or a skin condition/allergy that may be triggered by a specific material or wearing a prosthesis for prolonged periods.
Children that are unable to support the weight of a Hero Arm (typically those under the age of 8 years old) or those with insufficient cognition to fully understand myoelectric prosthesis control mechanism.
Still not sure if you qualify for a Hero Arm, register to speak to a professional
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