Prosthetic Management of Children with Unilateral Congenital Below-Elbow Deficiency

Davids, Jon R.; Wagner, Lisa; Meyer, Leslie C.; Blackhurst, Dawn W.

doi:10.2106/jbjs.e.00982

Cited by 38 publications

(33 citation statements)

References 35 publications

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“…Voluntary-closing upper-limb prosthetic devices are more suitable for children [ 1 , 3 ] and play a crucial role in improving gross motor development [ 1 ]. Currently, the most cost-effective option for pediatric populations is a passive prosthetic hook [ 1 ]; although functional, these devices have a high rejection rate, in part due to an unacceptable cosmetic appearance [ 4 - 6 ]. Most current prosthetics do not adapt to the normal growth of children’s limbs and require constant visits to health care providers for adjustments or replacement, which may lead to abandonment [ 1 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Cyborg beast: a low-cost 3d-printed prosthetic hand for children with upper-limb differences

et al. 2015

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BackgroundThere is an increasing number of children with traumatic and congenital hand amputations or reductions. Children's prosthetic needs are complex due to their small size, constant growth, and psychosocial development. Families’ financial resources play a crucial role in the prescription of prostheses for their children, especially when private insurance and public funding are insufficient. Electric-powered (i.e., myoelectric) and body-powered (i.e., mechanical) devices have been developed to accommodate children’s needs, but the cost of maintenance and replacement represents an obstacle for many families. Due to the complexity and high cost of these prosthetic hands, they are not accessible to children from low-income, uninsured families or to children from developing countries. Advancements in computer-aided design (CAD) programs, additive manufacturing, and image editing software offer the possibility of designing, printing, and fitting prosthetic hands devices at a distance and at very low cost. The purpose of this preliminary investigation was to describe a low-cost three-dimensional (3D)-printed prosthetic hand for children with upper-limb reductions and to propose a prosthesis fitting methodology that can be performed at a distance.ResultsNo significant mean differences were found between the anthropometric and range of motion measurements taken directly from the upper limbs of subjects versus those extracted from photographs. The Bland and Altman plots show no major bias and narrow limits of agreements for lengths and widths and small bias and wider limits of agreements for the range of motion measurements. The main finding of the survey was that our prosthetic device may have a significant potential to positively impact quality of life and daily usage, and can be incorporated in several activities at home and in school.ConclusionsThis investigation describes a low-cost 3D-printed prosthetic hand for children and proposes a distance fitting procedure. The Cyborg Beast prosthetic hand and the proposed distance-fitting procedures may represent a possible low-cost alternative for children in developing countries and those who have limited access to health care providers. Further studies should examine the functionality, validity, durability, benefits, and rejection rate of this type of low-cost 3D-printed prosthetic device.

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Section: Introductionmentioning

confidence: 99%

Cyborg beast: a low-cost 3d-printed prosthetic hand for children with upper-limb differences

et al. 2015

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“…Even as upper limb prostheses continue to advance, devices and outcomes continue to be unsatisfactory [29]. Training has a proven impact on device function and acceptance and is already widely accepted as part of prosthesis prescription [23][24][25][26][27][28][29][30]. By understanding motor learning with the commonly used BP prosthesis and what training's effect is on performance, providers may be able to tailor rehabilitation more appropriately.…”

Section: Discussionmentioning

confidence: 99%

“…Considering trainings proven impact on functional performance and device acceptance, as well as the current state of upper-limb amputee outcomes, we are presenting a kinematic study of the effect of prosthesis training on several motor learning variables [23][24][25][26][27][28][29][30]. Specifically, we asked whether changes occurred in traditional motor learning variables, such as quickness, smoothness, and efficiency, and in compensatory movement variables, such as range of motion, maximum angle, and joint moment, following five and ten training sessions using a within-subject paradigm.…”

Section: Introductionmentioning

confidence: 99%

Kinematic analysis of motor learning in upper limb body-powered bypass prosthesis training

2020

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Motor learning and compensatory movement are important aspects of prosthesis training yet relatively little quantitative evidence supports our current understanding of how motor control and compensation develop in the novel body-powered prosthesis user. The goal of this study is to assess these aspects of prosthesis training through functional, kinematic, and kinetic analyses using a within-subject paradigm compared across two training time points. The joints evaluated include the left and right shoulders, torso, and right elbow. Six abled-bodied subjects (age 27 ± 3) using a body-powered bypass prosthesis completed the Jebsen-Taylor Hand Function Test and the targeted Box and Blocks Test after five training sessions and again after ten sessions. Significant differences in movement parameters included reduced times to complete tasks, reduced normalized jerk for most joints and tasks, and more variable changes in efficiency and compensation parameters for individual tasks and joints measured as range of motion, maximum angle, and average moment. Normalized jerk, joint specific path length, range of motion, maximum angle, and average moment are presented for the first time in this unique training context and for this specific device type. These findings quantitatively describe numerous aspects of motor learning and control in able-bodied subjects that may be useful in guiding future rehabilitation and training of body-powered prosthesis users.

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“…However, care should be taken to ensure that children receive proper fitting, training, and follow-up with a multidisciplinary team to ensure success. Although Davids et al [ 36 ] documented the benefits of fitting children with upper extremity prostheses before the age of 3 years, many 3D-printed devices are not recommended for children under 4 years old because of their often-limited ability to express discomfort and the fact that free distribution of these devices is often not monitored by a health-care professional [ 34 ]. The resolution of the 3D printer might be limited to be able to fabricate prostheses for very young children, with smaller parts and hardware.…”

Section: Applications In Pediatricsmentioning

confidence: 99%

3D Printing and 3D Bioprinting in Pediatrics

Vijayavenkataraman

Fuh

2017

Bioengineering

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Additive manufacturing, commonly referred to as 3D printing, is a technology that builds three-dimensional structures and components layer by layer. Bioprinting is the use of 3D printing technology to fabricate tissue constructs for regenerative medicine from cell-laden bio-inks. 3D printing and bioprinting have huge potential in revolutionizing the field of tissue engineering and regenerative medicine. This paper reviews the application of 3D printing and bioprinting in the field of pediatrics.

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Prosthetic Management of Children with Unilateral Congenital Below-Elbow Deficiency

Cited by 38 publications

References 35 publications

Cyborg beast: a low-cost 3d-printed prosthetic hand for children with upper-limb differences

Cyborg beast: a low-cost 3d-printed prosthetic hand for children with upper-limb differences

Kinematic analysis of motor learning in upper limb body-powered bypass prosthesis training

3D Printing and 3D Bioprinting in Pediatrics

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