This article illuminates the major and often overlooked challenge of untethering soft robotic systems through the context of recent work, in which soft robotic gripper technology enabled by jamming of granular media was applied to a prosthetic jamming terminal device (PJTD). The PJTD's technical and market feasibility was evaluated in a pilot study with two upper-limb amputees. A PJTD prototype was tested against a commercial device (Motion Control electric terminal service with a one degree-of-freedom pinching mechanism) using two existing hand function tests: the first quantified the device's speed in picking and placing small blocks and the second evaluated a person's ability to perform activities of daily living (ADLs). The PJTD prototype performed slightly slower than its commercial counterpart in the first test. While both participants successfully completed all the ADLs with both devices in the second test, the commercial device scored marginally higher. Results suggested that PJTD can have potential benefits over existing terminal devices, such as providing the capability to firmly grasp tools due to the ability of PJTD to conform to arbitrary surfaces and reducing compensatory shoulder movements due to its axisymmetric design. Some downsides were that users reported fatigue while operating the PJTD, as most operations require pushing the PJTD against target objects to adequately conform to them. The greatest drawback for the PJTD is also a major roadblock preventing a number of soft robotic research projects from making an impact in real-world applications: pneumatic technology required for operating the PJTD is currently too large and heavy to enable compact untethered operation.
Introduction Individuals with upper-limb loss/difference often require specialized services, including occupational therapy that may be difficult to access. Also, individuals are likely to encounter secondary conditions that include pain, overuse, perceptions of isolation, and social stigma. The program was developed to meet the needs vocalized by the target population, to offer a pathway using telehealth (TH) to access peers, and to become better informed about strategies that would help to prevent physical overuse and social isolation and facilitate improved self-advocacy skills with medical practitioners. Methods Unlimbited Wellness is based on results of a needs assessment that specifically focused on the challenges experienced by this population. Participants of the Unlimbited Wellness program interacted with peers via a TH model to learn about physical and psychosocial health conditions that may cause them disparity and to share strategies to prevent or manage them. Results Effectiveness of the program was assessed via a survey of participant TH experiences and changes in perceptions of pain, ability, and quality of life as measured by the McGann Client Feedback Form and the Pizzi Health and Wellness Assessment. Overall, participant post-group perceptions of health, well-being, and prosthetic satisfaction improved as compared with pre-group experiences. During the 1:1 interviews, all participants stated they felt empowered due to their engagement in peer discussions and collaborative exercises during the Unlimbited Wellness program. Conclusions The program results indicate that a TH service delivery can be beneficial to enact health behavior change and empower individuals with upper-limb difference.
Purpose of Review The aim of this paper is to explore current trends and advancements that lead to improved practitioner knowledge and patient care resulting in better outcomes. It is common for the physiatrist to lead the team of interprofessional practitioners in the care of individuals with upper limb absence. The focus of the care is to understand and access prosthetic options, but there are often other health factors and relevant issues to consider. Recent Findings Some of the latest updates offer solutions to pain management, prosthetic control, access to relevant evidence, and outcomes-related data. An interesting finding was the influence of telehealth service delivery on multiple issues faced by this population. These issues include lack of information, pain management, monitoring skin breakdown and peripheral vascular disease, prosthetic training, and access to peers and specialized practitioners. Summary The diverse technology advancements in surgical techniques, materials, outcome measures, and data management, as well as telehealth, work together to assist the collaborative interprofessional team to provide contemporary and comprehensive care to this unique population.
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