Assessing the prosthetic needs of farmers and ranchers with amputations

Abstract

Farmers and ranchers with amputations have distinct prosthetic needs. Their return to farming can be facilitated by creating more durable, affordable, and adaptable prosthetic components. Our results can help guide design of more comprehensive surveys for further information gathering and new devices and establish best prosthetic practises for farmers and those in other physically demanding professions.

Case-study of a user-driven prosthetic arm design: bionic hand versus customized body-powered technology in a highly demanding work environment

“…Despite a wide ranging search, no solution to the failure of prosthetic components under PDW loads became apparent. User initiated development was chosen as the logical solution to address the known technological deficits [ 82 ], yielding the solutions specified here.…”

“…(TBI-1) sweat interference with the electrode function of the TBI with electrode malfunction after 10 minutes [ 84 , 85 ] (3 trials, see Fig. 2 for context) and in context of sweat, decreased tendency of suspension to support heavy weight lifts or pulls; (TBI-2) glove durability: gloves would deteriorate to the point of requiring replacement as early as after 10 min of car washing [ 86 , 87 ] or when left alone [ 88 ], without option to use gloves not issued by manufacturer [ 89 ]; (TBI-3) limb positioning interference with grip function causing inability to let go or hold grip [ 90 , 91 ]; (TBI-4) general lack of reliable electrode function [ 85 ] and disconnection of electrodes with excessive pull [ 92 ]; (TBI-5) weak grip and weak hand (with low hand weight and low grip force being mutually exclusive constraints) [ 87 ] as issue for some (but not all) body transport or laboratory work; (TBI-6) lack of reliable precision grip and within-grip-activity change of grip configuration [ 87 , 93 ] due to uncoordinated iLimb hand motors with the only synchronicity being simultaneous start and stop; (TBI-7) mechanical skin blisters after 10 hours of wearing the TBI for office work [ 72 , 94 ]; (TBI-8) center of gravity (COG) too distally located causing painful shoulder and elbow tension after a few hours of typing already [ 87 ]; (TBI-9) irreconcilable use vs. warranty issues such as risk to inflict damaged cover, risk to use tools not “approved” by Touch Bionics, risk to exposure to moisture, dust or vibration [ 82 , 89 ] and (TBI-10) problems with battery function at colder ambient temperatures ranging down to -15 deg C [ 95 ]; (TBI-11) Loud / irritating noise that distracts others (1) in meetings and (2) when working in the office or at home, emitting up to 72 dB [ 96 , 97 ] and (TBI-12) use with a low degree of sweat but no control disruption over a whole day incurred electric burn type skin injuries with tiny blisters that took about six weeks to heal (encountered twice) [ 98 – 100 ].…”

“…(CBPA-1) Cable tear down every 4-10 days using Otto Bock (OB) standard components [ 70 , 87 ] with particularly rapid wear down of components of cable housing or sheaths. (CBPA-2) Prosthetic wrist unit spring dilation and insufficiently large diameter variation range of adapter componentry caused the start of an irritating wiggle after a few weeks and loss of bolt fixation after two to three months [ 87 ] (both cable and wrist are well-known points of failure of body-powered arms [ 82 ]). (CBPA-3) Nerve compression using figure-nine harness (F9H) after prolonged usage of grippers with high voluntary opening grip forces [ 101 ] causing carpal tunnel syndrome in a double-crush injury constellation (there, radiologic, orthopedic and neurological examinations were obtained) [ 102 , 103 ] (Fig.…”

User-relevant factors determining prosthesis choice in persons with major unilateral upper limb defects: A meta-synthesis of qualitative literature and focus group results

“…Table). Seven of the included studies had a mixed methods design [9,12,19,23,[40][41][42]; seven included participants of whom more than 25% did not fit the target population but in which the relevant population was analyzed separately [9,13,20,21,[42][43][44]; and one contained data of using a prosthesis in both home and laboratory environment [45]. Of these studies, only the relevant parts were included.…”

“…Four studies only included men [19,23,42,47], and two only women [11,20]. In eight studies participants who did not fit the target population were included and not separately analyzed: three studies included participants younger than 18 years [12,40,44]; five studies included participants with bilateral upper limb loss [22,24,42,43,45]; two studies included participants with upper limb loss distal from the wrist [22,43]. In all of these studies, this involved less than 25% of the included participants.…”