A prosthesis can play a significant role in the rehabilitation process for amputees who have lost an arm, a leg, or other extremities to amputation. The prosthetic device or the artificial limb can help improve mobility and endow the individual with the ability to conduct essential daily activities. Most importantly, it equips the individual with the means to stay independent.
What Are Prostheses?
Prostheses replace a missing body part and are a critical component of the rehabilitation process following an amputation. Prostheses help restore mobility, resulting in better amputee outcomes and lesser co-morbidities. After the amputation, amputees with prostheses experience fewer mishaps that require visits to the hospital and, consequently, lower overall medical expenses.
Prosthetics may be body-powered or controlled through microprocessors or other electronic means. Like other areas of medical care, prosthetics have leveraged technology to develop prosthetic devices that very closely mimic the function of the actual body parts that they are intended to replace.
The Many Prostheses Options
While amputees’ options in the range of prosthetic devices have increased, it has also placed an added burden on them to choose the right prosthesis carefully.
Careful deliberation in making a choice is critical since the prosthesis will be used for a long time. The prosthesis chosen needs to be pain-free during use and should enable the individual to achieve the targeted lifestyle.
There are key factors that need to be considered by an amputee when choosing a prosthetic device, and here’s what they are:
The Prostheses’ Parts and Types
There is a wide range of prostheses that are designed to look and function like an actual hand, arm, leg, or foot. Typically, the parts of these prostheses include:
● The Socket: this is for seating the stump of the amputated limb. By necessity, the socket is an exact mold of the stump for it to fit snugly over the limb. It helps attach the prosthetic leg to the body. The socket is usually lined with foam or silicone to protect the stump. Special socks may also be worn over the stump for enhanced comfort and a better fit
● The Suspension: this helps hold the prosthesis onto the stump. The holding action could be sleeve suction, vacuum suction, or distal locking through a pin or lanyard
● The Pylon: this part of the prosthesis mimics the bone that the prosthesis replaces, and ensures strength and stability for the prosthesis
● The Foot, Hand, or Hook: depending on the type of prosthetic, this is the business end of the prosthetic that will receive the most wear and tear. There are several types of prostheses that range in the functionality of this part and can provide different uses depending on what is required of the limb
● The Cosmetic Covering: a covering that provides a cosmetic appearance to help the prosthetic blend in/be less noticeable to the naked eye
Additionally, as would be fairly obvious, the factors to be considered while choosing a prosthesis also include the location and level of the amputation, the condition of the remaining stump, and the desired level of physical activity and functionality. Also, the upper and lower prosthetic limbs have different care needs. Lower limbs experience higher stress levels and are difficult to stand on compared to the upper limbs. This is also, therefore, another key factor to consider when choosing a prosthetic.
What is the Priority – Form or Function?
What individuals desire from their prostheses varies. Some desire to revert to their original level of physical activity, while some may settle for only the basic functionality and replicating the original limb’s natural look. Depending on the level and type of activity aimed for, the choice of prosthetic will also differ. It is also possible to not choose between form and function and instead have multiple prosthetics for different activities.
The Nature of Targeted Activities
The most critical factor in the choice of the prosthetic device is the range of physical activities targeted. The daily activities, both at work and home, that the amputee needs to perform and recreational physical activities such as walking, running, playing, etc. affect the choice of prosthetic.
Prosthetics are classified based on the level of activity the amputee is likely to engage in. The classification called the K-Level ranges from K-0 to K-4. Each level indicates the lifestyle of the amputee.
The Cost
There is a wide variation in the quality of available prosthetics, and hence there is also a wide variation in the cost of the prosthetics. For example, an advanced prosthesis such as an artificial bionic limb designed for a high frequency of usage costs many times more than a mechanical limb. Some insurance providers cover the cost of the prosthetics, and some do not.
The Expected Benefits from a Prosthesis
While most people benefit from the prosthesis, some do not. Factors to be considered and discussed with the doctor by the amputee include:
● The extent of available soft tissue to cushion the remaining bone
● The extent of pain being experienced
● The condition of the skin on the stump
● The residual range of motion in the amputated limb
● The health of the other limbs
● Previous and desired activity levels
● The amputee’s mobility goals
The reason behind the amputation, the amputee’s physical health, and lifestyle are also important factors. For example, an amputee who had a sedentary lifestyle and underwent amputation due to peripheral vascular disease or diabetes will find it difficult to adapt to life with a prosthesis compared to a person with a previously active lifestyle who lost a limb in an accident. The final choice before moving forward in pursuing a prosthesis is therefore a consultative process between the amputee and a specialist medical professional.
Climatic Conditions
It is essential to also consider the climatic conditions of the place where the prosthesis is intended to be used. The weather impacts both the prosthetic and the stump. The efficacy of the prosthetic is affected by dry weather, humidity, and cold. Dry skin can cause friction and chafe as well. Humid weather causes excessive perspiration and discomfort. Dust in the prosthetic joints results in abrasion and damage, and saltwater leads to corrosion.
Wearing Schedule
Getting used to wearing a prosthetic takes time and effort. After the initial fitting of the prosthetic, many iterations in the fit are made to achieve the exact fit. A prosthetist works with the amputee on the wearing schedule to make the individual comfortable using the prosthesis with a minimum amount of wear-time. The wear time is gradually increased until the amputee becomes comfortable. The wearing schedule is, therefore, a key factor in the choice of the prosthetic.
Changing Needs
As the residual limb stabilizes, it might become necessary to transition to a new prosthesis. Initially, the amputee might need to choose a temporary prosthesis and then switch to one intended for long-term use. New pain, discomfort, lack of stability, etc. may also make it necessary to change the prosthesis. Ordinarily, prostheses need to be changed every three to five years and require the user to take some time to get used to, which is another factor to be considered when choosing the right prosthesis.
The Rehabilitation Process
The process of rehabilitation is inherently collaborative and ongoing. The amputee will need to learn to use the prosthesis and work on strengthening the limbs and the cardiovascular system. It is important to keep healthy limbs in good physical condition.
Getting used to a prosthesis can be tricky. The most common difficulties include:
● Excessive sweating that degrades the fit of the prosthesis and also causes skin problems
● Changing the shape of the stump. Typically, this continues for the first year after the amputation before the stump settles into a final shape. This can affect the fit of the socket
● Weakness of the residual limb may restrict the prosthesis use for long durations
● Phantom limb pain can also limit the use of the prosthesis
The Reliability of the Manufacturer
Finding a reputable manufacturer/supplier of good-quality prostheses is also important. A good supplier will work with an amputee’s prosthetist to provide the best fit to enable the amputee to achieve the desired lifestyle.
Is a Prosthesis Right for You?
Several factors determine prosthesis choice. This indicates that preferences among amputees vary significantly. User participation in the selection process greatly influences the successful match between the user and the prosthesis, leading to a decrease in abandonment and an increase in cost-effectiveness.
Interested in pursuing a prosthesis? Reach out to us at FIT Prosthetics to learn more about the range of prostheses and more! Our skilled and compassionate staff will be there to help find the perfect prosthetic for your particular needs, so contact us today.