Advanced Arm Dynamics

ISPO 13th Congress in Leipzig, Germany

“It's a conference on steroids.” -John Miguelez, CP, FAAOP, president and senior clinical director, Advanced Arm Dynamics, Redondo Beach, California

Leipzig brings O&P to the World Stage

From the O&P EDGE, July 2010

Dancers, performance artists, music, and multilevel product display booths complete with bars, cafe tables, and mini-theaters set the tone for the combined meeting of the International Society of Prosthetics and Orthotics (ISPO) 13thWorld Congress and the ORTHOpADIE + REHA-TECHNIK 2010 International Trade Show, held from May 10-15 in Leipzig, Germany.

But when Miguelez summed up his experience at the record-setting event, he was referring to more than the electric atmosphere created by exhibit hall booths the size of a small city block. He was also referring to the palpable energy created by the global exchange of ideas. The combined meeting "gives you the opportunity to spend the day visiting the exhibit hall and listening to presenters, and then in the evening go out in a group and ... share your clinical experience with people from all over the globe;' Miguelez said. "That's so invigorating. It's a really unique opportunity to extend past the borders of the United States and open yourself up to new approaches, techniques and technologies.” 

'Most Successful’ World Congress Ever

Building on the theme, "Research and Innovation for Human Technology;' the ISPO World Congress brought together 630 speakers from 55 countries. Presentations covered the latest developments and research results in the fields of orthotics, prosthetics, orthopedic technology, orthopedic footwear technology, and compression treatment, and drew in approximately 2,600 visitors. Sessions focusing on neuroprosthetics were well received, with one in five participants saying they were strongly interested in the subject. 

"It was our most successful Congress ever;' said Dan Blocka, immediate past-president of ISPO. "In some keynote presentations, all seats were taken.”

The l3th World Congress also marked the end of Blocka’s three-year term as ISPO president. During the closing ceremonies, Blocka officially handed over the baton to incoming president Ian Geertsen, MD, a specialist in physical medicine and rehabilitation (PM&R) at the Center for Rehabilitation, Groningen, Netherlands. Exhibitors seized on the global marketing opportunity presented in Leipzig.

More than 550 exhibitors from 45 countries filled 40,000 square meters of exhibition area, presenting mobility aids in the fields of prosthetics and orthotics technology, orthopedic and rehabilitation technology, orthopedic footwear technology, medical foot care, and compression therapy. ORTHOpADIE + REHA-TECHNIK drew in 21,200 visitors from 108 nations, according to Area Manager Klaus Ernst.

More than 50 new products were launched at the trade fair, including the world premier of the SacroLoc lower-back orthosis by Bauerfeind AG, Zeulenroda-Triebes, Germany; the world premier of the  PowerKnee by Ossur, Reykjavik, Iceland; the world premier of the bebionic myoelectric hand system by RSLSTEEPER, Rochester, Kent, England; the European premier of the Pro Digits partial hand system by Touch Bionics, Livingston, Scotland; and the world premier of the Genium lower-limb bionic prosthetic system and the Michelangelo Hand, both by Otto Bock HealthCare, Duderstadt, Germany.

"This was the best ORTHOpADIE + REHA-TECHNIK we have ever seen;' said Hans Georg Nader, CEO of Otto Bock HealthCare. "Combining the ISPO Congress and Trade Fair is a model for the future. The world comes together in Leipzig.”

“Regardless of what discipline a clinician specializes in-upperlimb, lower-limb, orthotics, prosthetics, or pedorthics, “Miguelez said, "The World Congress is an incredible, unparalleled educational opportunity. The World congress offers a unique opportunity for clinicians to exchange ideas with other experts from around the world.”

The next ORTHOpADIE + REHA-TECHNIK International Trade Show will be held in Leipzig May 16-19, 2012. ISPO will hold its 14thWorld Congress February 4-7, 2013, in Hyderabad, India.

Grabbing Gracefully, With Replacement Fingers

New York Times
By ANNE EISENBERG

Published: April 9, 2010

ERIC JONES sat in a middle seat on a recent flight from the New York area to Florida, but he wasn’t complaining. Instead, he was quietly enjoying actions that many other people might take for granted, like taking a cup of coffee from the flight attendant or changing the channel on his video monitor. These simple movements were lost to Mr. Jones when the fingers and thumb on his right hand were amputated three years ago. But now he has a prosthetic replacement: a set of motorized digits that can clasp cans, flimsy plastic water bottles or even thin slips of paper.

“Pouring a can of soda into a cup — that is a mundane daily action for most people, but to me it is a very big deal,” said Mr. Jones, who lives with his family in Mamaroneck, N.Y. “I slip my bionic fingers on like a glove, and then I have five moveable fingers to grasp things. It’s wonderful to have regained these functions.”

Mr. Jones’s prosthesis, called ProDigits, is made by Touch Bionics in Livingston, Scotland. The device can replace any or all fingers on a hand; each replacement digit has a tiny motor and gear box mounted at the base. Movement is controlled by a computer chip in the prosthesis.

ProDigits was released commercially last December, said Stuart Mead, the chief executive of Touch Bionics. About 60 patients have been fitted worldwide, he said, and some have been wearing it for three or four years. The cost is $60,000 to $75,000, including fitting and occupational therapy.

The technology used by Touch Bionics is based on prostheses that the National Health Service in Scotland developed for children there who suffered effects of the drug thalidomide, he said. The company, founded in 2003 as a spin-off from the health service, adapted the technology from custom prostheses into ones that could be produced commercially. It had funding from investors including Archangel Informal Investment and the Scottish Co-investment Fund.

The company’s first product, released two and a half years ago, was the i-Limb Hand, an entire hand that opens and closes and can grasp objects. It has been a success, Mr. Mead said, with more than 1,200 patients fitted with it in 40 countries.

The company then turned to creating ProDigits. “We decided to develop the technology to mechanize not just a hand, but individual fingers,” he said. “We always knew that it would be the bigger market — more people lose individual digits than lose entire hands — but also the most challenging technically."

The individual, motorized fingers are a new and promising development in the field, made possible in part by miniaturization of components, said John Miguelez, founder and president of Advanced Arm Dynamics of Redondo Beach, Calif. The company specializes in prosthetics for hands and arms for, among others, soldiers returning from Afghanistan and Iraq at Walter Reed Hospital in Washington. “More voltage and current can be applied to the motors,” he said, “creating increased speed and force.”

Dr. Douglas G. Smith, a professor of orthopedic surgery at the University of Washington and Harborview Medical Center in Seattle, agreed. “Motors are getting stronger and smaller, and the batteries are thinner and smaller, too,” he said, making it possible to fit mechanical components into the space formerly occupied by a finger.

Eric Jones has been wearing a ProDigits prosthetic for 18 months. The artificial fingers are slightly larger than the originals, but that is not a problem, he said. “The fingers look cool,” he said. A switch on the side turns the power on and off, and he charges the digits overnight, as he would a cellphone

Mr. Jones starts the action by flexing or relaxing a muscle in the palm of his hand. Sensors built into the prosthesis pick up the signals sent by the muscles and send the message to the computer chip that controls the motor. The artificial fingers stop closing when they detect resistance, said Karl Lindborg, professional services director for Touch Bionics.

A single, outstretched prosthetic finger can operate a microwave oven or a cellphone; a finger and a thumb can hold a chess piece; three or more fingers can grasp a sphere. Mr. Jones said the fingers also provided a touch of class. “I can grasp a wine glass with my bionic fingers,” he said. “My pinkie and ring finger curve under the bowl very elegantly.”

PRODIGITS may be opened and closed not only by sensors that pick up muscle contractions, but also by dime-size pads put at the base of the fingers to detect pressure exerted by remnant bone. “If you can wiggle the bones in your palm, Mr. Miguelez explained, “that wiggle can be translated into controls to open and close the fingers.”

Robert J. Green of Bel Air, Md., who lost the fingers and thumb on his dominant left hand last year, operates his ProDigits in just that way. He uses his prosthetic fingers, for example, to write with a pen or a pencil. The artificial digits have actually improved his handwriting, he said, and he likes their appearance, too. “I look something like Arnold Schwarzenegger in ‘The Terminator,’ ” he said.

Watch the video, click here.

Program teaches amputee vets the game of golf

"I saw this leg come off," he said. "It came up and flew over me and splattered me with blood everywhere."

"And this one," he added, pointing to his damaged left leg, "one bone was sticking out from the leg that way and one the other way, and everything was shredded."

Flowers recalled the violent day while holding a golf club at the driving range on a gorgeous, peaceful autumn morning at Woodmont Country Club, not from the Walter Reed Army Medical Center. He has been at Walter Reed for six months, ever since triggering a booby trap while trying to clear a weapons cache in what he described as "a little crappy house" near Bagram, Afghanistan.

Flowers and about a half-dozen other amputee veterans from Walter Reed took swings at the driving range for about an hour, then played a couple of holes in the afternoon as part of a program called "First Swing." Some of the veterans were returning to a game they love. Some were trying it for the first time. All had recently lost at least one limb while serving their country.

Flowers sat in a specially designed golf cart, called a SoloRider. Operated with hand controls, the cart's seat swiveled so that he could remain strapped in place while addressing the ball. The 29-year-old Air Force staff sergeant, who used to play four or five times a week back home in Diamondhead, Miss., was on a course for the first time since his injury.

"I can't get a full shoulder turn," he said after hitting a ball about 100 yards downrange on one of his first attempts. "But it's not bad. I just don't have the distance, but other than that I'm making contact with the ball. I'm used to playing with some better clubs. It's not a big deal. I don't care what they give me, just as long as I'm hitting the ball. I'm extremely happy they let us come out here."

The program is a joint undertaking by Disabled Sports USA, the National Amputee Golf Association and the military. The goal is to give veterans a break from endless stir-crazy days at Walter Reed, where it can be all too easy to sit in a room and play video games or succumb to self-pity and depression. Instead they are shown that sports are not off limits to amputees.

"Some are really motivated and want to go do everything in every sport," said Kat Poster of Disabled Sports USA. "Others, it's very hard to get them out of the hospital. But what we find is we get them on one event, whether it's a day of golf or a week of skiing, they're hooked. They want to do more. If they can do one thing, they can do anything."

Other programs allow Walter Reed veterans the chance to master kayaking, scuba diving and rock climbing, among other sports. Similar programs have been set up near other military bases and hospitals around the country. Veterans are encouraged to bring families along, with the goal of making sports an option for a family outing once they're done with rehab and are back in civilian life.

Gabriel Garcia, who brought his wife, brother and son to Woodmont, needed some persuading to give golf a try. A strong 27-year-old Army staff sergeant from Yuma, Ariz., he was into more physical sports before losing his right arm to a suicide bomber in Afghanistan.

"I used to be a cage fighter. I used to do a lot of jujitsu. I used to compete in the army tournaments. I was the top guy at Fort Hood for my weight class. I was actually really good. That was my sport," Garcia said. "Golf was never a thing I liked back in the day, but it's 'Go out here and have a good time.' It's what I'm going to be doing now. It's one of the sports I can do."

Naturally right-hand, Garcia had to be convinced that he should play left-handed instead of trying to hold the club with his prosthetic right arm. He took several awkward swings, saying "This is weird" before finally making contact, topping the ball a short distance.

"Twenty yards. Pretty good," he said with a smile to his family. "Lucky bounce."

For inspiration, Garcia can look to his friend Ramon Padilla, a true success story. Padilla had never played golf before he arrived at Walter Reed in July 2007, having lost his left arm when a rocket-propelled grenade blew up next to him while returning from patrol in Afghanistan.

Source

David Flowers knew his right leg was gone as soon as he stepped on the mine.

"At first I'm like, 'Are you crazy? I've only got one hand' or whatever," Padilla said. "They encouraged me to go, so I went, and as soon as I hit my first good ball, one thing led to another, and next thing you know I'm out there hitting thousands of balls."

Padilla played the back nine at Woodmont while the others were on the driving range. He birdied the par-5 No. 10, the hardest hole on the course, and feels he can shoot a score in the 80s.

He helped steady his club with an ingenious homemade apparatus attached to his prosthetic left arm, something he calls "the pinch hitter." It's a piece of rubber attached to a huge ball bearing with a piece of a gasoline hose, and it gives him the flexibility to achieve something close to a standard two-handed golf swing. It was designed by several people, including his therapist and prosthetist.

"It's probably going to end up being a marketed thing," he said.

The 34-year-old Padilla spent two years at Walter Reed and retired from the army last month. Originally from Los Angeles, he is making Maryland his home with his wife and four children and wants to devote himself full-time to helping other amputee veterans.

"I feel I've still got to educate, mentor and support the solders that are coming in behind me," Padilla said. "That's actually my full-time job right now, golf as much as I can and take these guys out and show them how to network out here."

Flying Like Superman

Advanced Arm Dynamics patients in Oregon become part of a unique flying experience

Five Advanced Arm Dynamics patients participated in a glider ride adventure last weekend in Hood River, OR. Sponsored by the Oregon Active Foundation, the participants each had the opportunity to ride with the glider pilot who was towed to altitude and then released by the tow-plane for a 30 minute ride. Some passengers chose to sail quietly, taking in the breathtaking views while calmly floating through the air. The more daring of the bunch encouraged the pilot to take twists and turns before gliding gently back to earth.  Riding a sailplane or glider is the purest form of flying there is.

  "I flew like Superman," said Brendan Mandara (pictured left).  "It was more fun than I could ever imagine."

“ It was the best rollercoaster ride I have ever been on!” commented Lynn Whitehead (at right).

The Oregon Active Foundation is a non-profit organization that sponsors active adventures for disabled individuals. 

 

Advanced Arm Dynamics Develops All-New Silicone Skin Protection for Upper Extremity Amputees

Redondo Beach, Ca – February 2009 – Advanced Arm Dynamics (AAD), the nation’s leading provider of upper extremity prosthetic rehabilitation introduced an all-new synthetic silicone skin protection for upper extremity amputees.

The state of the art skin protection provides amputees with a more comfortable fit along with a significant increase (up to 50 percent) in their range of motion. 

 

Before

After

The custom silicone skin protection eliminates the outside sleeve and creates an air tight seal.  The all-new skin protection was developed by a team of upper extremity specialists from Advanced Arm Dynamics including Chris Lake, CPO, FAAOP, Rob Dodson, CPO, Ryan Spill, CP and Dan Conyers, CPO.

READ MORE

Farming with an Arm Amputation

Farmers with upper-extremity amputations are at risk of secondary injuries because they may:

(a) have decreased padding or scar tissue around a stump that may make it vulnerable to damage from bumping or brushing against farm machinery or buildings,

(b) wear a prosthesis is that may get entangled in farm machinery, materials, crops, livestock, or equipment,

(c) use the non-effected arm or hand to break a fall or perform a hazardous task, and

(d) be susceptible to frostbite in areas with nerve damage or decreased circulation.

Farmers throughout the United States who have experienced upper-extremity amputations provided the information below that may help others avoid secondary injuries.

Click here to read the tips.

Advanced Arm Dynamics Adds Senior Justifications and Authorizations Coordinator to Expanding Team of Professionals

Carrie Johnson joins AAD as the senior justifications and authorizations coordinator.  She will be overseeing the letter creation process and authorizations efforts between AAD and insurance companies for all of AAD’s Centers of Excellence. 

Prior to working with AAD, Johnson worked as the Administrative Manager for the Upper Extremity Prosthetics Program for Hanger Prosthetics & Orthotics in Anaheim, California for close to ten years.  Her responsibilities included acting as the internal liaison and coordinator between Hanger internal employees and patients to ensure all parties understood the authorization process.  She also managed the Inner Wheel Funding Program, a charitable organization for children in need of myoelectric prosthetic arms.

AAD Clinicians to present at the Texas Rehab Action Network Conference

Chris and Rob will be speaking at the Texas Rehab Action Network (TRAN) Conference on October 3rd in one of the breakout sessions from 1:30 to 2:30pm. The conference is at the Hyatt Regency of Dallas at Reunion.

Texas RehabACTion Network (TRAN) is a non-profit organization that promotes the public vocational rehabilitation program's ability to provide employment services to persons with disabilities and disability related solutions to the business community. TRAN works to foster effective partnerships with state and national vocational rehabilitation programs, community rehabilitation providers, other community resources, and universities to promote research and expand knowledge of best practices in the field of Vocational Rehab.

Limb-It-Less

LEAVENWORTH, WA — Vince Hein could have died the day a logging machine crushed his arm. Three years ago, the Leavenworth resident, was working on a yarder, a machine that uses a link belt, when his right arm was pulled in through a half-inch opening. He tried unsuccessfully to free his arm as a co-worker attempted to turn off the machine. Hein lost his arm above the elbow but was able to pull himself out before the machine took his shoulder.
Hein, 51, is a member of Limb-It-Less, a group of amputees that meets in Leavenworth and Wenatchee. Members say the group began meeting in March as a way to trade stories, cope with problems and discuss issues that affect amputees. It is now four members strong and seeking more members...READ MORE

Limb-It-Less
Cindy Potter
509-548-4847

Upper Extremity Amputee Peer Support Video on YouTube