Game Changers – Innovations in Upper-Limb Prosthetics

Despite major achievements and advances in upper-limb prosthetics technology during that past half-century, a high number of upper-limb amputees have generally decided to live prosthesis free relative to lower-limb amputees. On face value, this is relatively straightforward to understand as – unlike lower-limb amputees who require a prosthesis for walking – upper-limb amputees can generally function pretty well without one. There are also notable drawbacks to wearing an upper-limb prosthesis, including sweating, heat rashes, blisters, contact dermatitis, ingrown hairs, bacteria infections and abrasions. Beyond that, many have been faced with how inadequate their prosthetic hand has been relative to a real human hand, which is a tremendously complex body part and therefore difficult to mimic, and have opted to live unimpeded by a cumbersome prosthesis as a result. 

Thankfully for upper-limb amputees, never have technologies been more useful or better able to mimic a real human arm and hand than what is currently available. As opposed to the less-effective and unrealistic prosthetics of yesteryear, today’s incarnations look brilliant cosmetically, and they add real value to the lives of upper-limb amputees by making Activities of Daily Living (ADLs) achievable and also allow for more freedom and the ability to participate in the activities and hobbies they love most. Beyond the way in which innovations in upper-limb prosthetics have opened up the world to amputees, wearing a prosthetic mitigates the frequency and severity of phantom limb and lessens the likelihood of developing tendinitis, bursitis and arthritis by having to overwork one’s intact limb. We believe the medical community is standing on the threshold of even further innovation that will make life for upper-limb amputees even more seamless and amazing than ever before. We invite you to continue reading to see the miraculous prosthetics that exist today that will put your own life back in your hands.

Innovations in Below-Elbow Prosthetics

Recent innovations in below-elbow prosthetics evoke not only the Terminator movies, but also Luke Skywalker’s life-like bionic hand as seen in Star Wars – The Empire Strikes Back. What these prosthetics hands can do is amazing by any standard, as they make a range of ADLs extremely achievable and let wearers participate in both active and intense activities and exercise. The real difference maker that has allowed today’s cutting-edge prosthetic hands to offer so much to their wearer and mimic a real hand so accurately is that they are myoelectric-controlled, meaning they are powered, moved and negotiated through the electrical signals generated by the wearer’s muscles. The aptly named Michelangelo Hand is a fully articulated robotic hand prosthesis and is the first to feature an electronically operated thumb that beautifully mimics natural human hand movements. It allows the wearer the freedom perform a range of delicate every day tasks, such as gardening, tying shoelaces, operating tools and far more through holding, gripping and pinching motions. Another stunning innovation that boasts being ‘the world’s most lifelike bionic hand’ is the Bebionic Hand. Through its individually motored fingers, powerful microprocessors and auto grip it offers 14 different grip patterns to allow wearers to do pretty much anything an average day might throw at them. TheBebionic Hand is made to handle up to 100 pounds which means that wearers can enjoy unprecedented levels of freedom in their domestic, working and sporting lives. 

Innovations in Above-Elbow Prosthetics

The DynamicArmElbow prosthesis by Ottobock has been a real game-changer for above-elbow amputees. It is not just cosmetically pleasing and natural looking – it is built to allow wearers to use it in their active lives. The DynamicArm is myoelectric-controlled and allows wearers to both flex and extend the elbow and to carry up to 11 pounds while in motion and 50 pounds while static. The attached hand is the fastest available for above-elbow prosthetics and can open and close nearly 3 times faster than other hands. The wrist can also twist and turn through the myoelectric-sensors. The DynamicArm provides for a natural all-around experience, makes a range of ADLs possible and lets wearers seamlessly participates in activities that would not have been possible through previous generations of above-elbow prosthetics.

There been major innovations in upper-limb prosthetics in recent years and we expect technologies to become even more exciting, useful and capable of catalyzing amputees to a happy, healthy and active life filled with doing the things they love most. If you would like to speak about the latest developments in upper-limb prosthetics, please do not hesitate to get in touch with the team at the Mount Sinai Department of Rehabilitation Medicine at(212) 241-6321.

Behavioral Effects of Brain Injury

People who have sustained a brain injury can experience a range of physical and emotional issues that can affect their identity and personality, relationships and their independence. The more severe or traumatic a brain injury, the more likely it is that the effects will be more pronounced and longer lasting. The way in which a brain injury might affect someone is complex, varied and unpredictable: sometimes a patient may display exaggerated manifestations of pre-injury personality traits whereas others might act in a fashion that is completely out of character. Indeed, often we see a mixture of the two. At the Mount Sinai Department of Rehabilitation Medicine we offer a dynamic and structured rehabilitation program to those who have experienced brain injury, Traumatic Brain Injury (TBI) or a stroke. This includes our TBI peer mentoring program, our Stroke Club, evaluation and treatment of vestibular and visual impairment as well opportunities to participate in TBI research studies.  Our brain injury rehabilitation program is an integral part of Mount Sinai’s Traumatic Brain Injury Model System of care and is one of only two CARF-accredited programs in New York City. Our brain injury patients can also access our CARF-accredited outpatient services available once they have been discharged from hospital. 

Let us go through some of the most common behavioral effects of brain injury, including what they are, what to look out for and ways to help. 

Disinhibition

A common behavioral change in early recovery is disinhibition, or an inability to control or manage socially inappropriate behavior. This might manifest itself through unpredictable anger or rage, divulging secrets to others too freely, inappropriate remarks and even exhibitionism or making unwanted sexual advances. This might be difficult for family and friends to handle, but the best advice is to try to be calm as appearing shocked or distressed might make the sufferer feel there is something wrong with them. It is also wise to discuss the inappropriate behavior with the patient – always in a non-judgement way – and to set firm boundaries as well as discovering appropriate ways for them to express themselves, their personality and their sexuality. 

Impulsiveness

Another common behavioral effect of brain injury is an inclination to speak or act without thinking about the possible consequences. Aside from a range of embarrassing, awkward or even threatening social situations, there are some practical implications that may affect one’s ability to manage their own life independently. One of the most salient issues is the ability to manage one’s finances as patients might impulsively spend money quickly, rashly and above and beyond what is affordable. In helping patients manage their finances it is important to have a situation that allows a guardian to help compensate for their inability to manage money while also allowing for the least restrictive solution possible. A common practice is to have the patient agree to not have access to credit cards and finances while not being supervised, but to allow them a credit card with a modest maximum a well as some spending cash for everyday needs. Depending on the situation and your relationship with the patient, it might be necessary to seek legal advice from a lawyer or local court’s guardianship office to obtain information about how to create a suitable and legal guardianship over a brain injury patient’s finances.

Apathy and Disaffection

After a brain injury a patient may become passive, unresponsive, apathetic, emotionless and lacking the capacity for initiative. In the early stages of recovery, a patient will often appear unaware or unconcerned with their injury and resulting inabilities. Others may demonstrate a will to be active and to connect with others, but are often unable to follow through. For the patient with a brain injury, this apathetic and disaffected state is not just the result of depression, but also from the physical damage endured by the brain. As such, it is essential that friends and family are extremely sensitive to the patient’s needs and emotions or inability to express emotion. Often the best way to help someone showing these signs of brain injury is to support, love and accept them, along with offering plenty of affection and practical help to make their lives easier.

If you, a friend or family member has suffered a brain injury and you would like to discuss the ways in which the Mount Sinai Department of Rehabilitation Medicine can help, please get in touch with us at (212) 241-6321.

Game Changers – Innovations in Lower-Limb Prosthetics

In very recent memory, there was a time in which it was a medical and engineering achievement to have a prosthetic lower-limb merely able to provide an amputee with the ability to have basic ambulatory movement like being able to get around the house or take a short walk outside. Yet, as brilliant as this was, it simply was not good enough as amputation would often remain a barrier to leading the active life that many desired. Indeed before recent innovations, those with lower-limb amputations had to plan their days and lives around their limited ability to walk. For instances, places with stairs or uneven sidewalks would have presented a most daunting and intimidating obstacle for amputees, which meant that often many would have opted to stay at home and miss out on the fun and excitement outside their front door. Thankfully, as a result of some serious innovations to lower-limb prosthetics amputees need not sit on the sidelines of life any longer – they can jump head first into the active, happy and healthy life they deserve.

Innovations in Prosthetic Feet and Blades

Those with below-knee amputations can now benefit from prosthetics that will put the world back at their feet once again. Previous prosthetic feet were marred by an unnatural or limited range of ankle motion, which often resulted in strain on knees, hips and back, or – worse yet – nasty trips and falls. The latest technology – seen in prosthetic feet like the Ossur Proprio Foot with Evo – offers a motor-powered ankle that increases ground clearance and allows the user to walk across all kinds of terrain in a natural and safe fashion. Such an innovation allows lower-limb amputees to walk virtually anywhere again: to the shops, long country walks or even exploring cities like New York, Paris or London on foot!

Walking is brilliant, but how about running? Thanks to the emergence of the Paralympics as a bona fide sporting event, we have all seen the so-called ‘blade runners’ – the world class track and field athletes that defy their disability to achieve feats about which able-bodied persons might only dream. But it is not only paralympians who can access this life-altering blade technology – it is available to all amputees who either want to resume their old sporting lives or to explore new ways to be active. Technologies like Blatchford’s Elite Blade – a lightweight, e-carbon foot with flexible, independent springs that reduce shock transmission – let users participate in high impact sports from serious running to football, basketball and more. These amazing innovations to prosthetic feet and blades mean that those with below-knee amputations can live their lives to the fullest and most active extent, unimpeded by their disability.

Innovations in Prosthetic Legs

One of the most exciting innovations in engineering – not to mention prosthetics – in recent years has been the multi-award winning Blatchford Linx. This prosthetic leg for above-knee amputees is practically out of a science fiction movie as it is the first one ever that is integrated with robotic control of both the knee and foot that communicate with each other to move just like a human leg. It uses a network of sensors that act like human nerves to continuously collect data about the way in which the user walks, their activity and the terrain on which they are moving. This information is processed by Linx’s central computer to adapt its responses so its wearer can always walk confidently, knowing that they will always be at the right speed and enjoy the right support at all times on practically any terrain and on slopes and steps. Beyond walking and navigating one’s world happily and uninhibited, users can participate in a range of sporting activities, notably cycling. Linx has even innovated the mere act of standing still, which has long been a difficult and painful task for amputees, by sensing when it has come to a standstill and automatically locking so its wearer can relax in a normal standing position. Lastly, unlike previous cutting-edge prosthetic legs, there is no need to endure the lengthy process of recalibrating the ankle and knee joints again and again; Linx uses a smart algorithm to calibrate the limb automatically.

There been major innovations in lower-limb prosthetics in recent years and we expect technologies to become even more exciting, useful and capable of catalyzing amputees to a happy, healthy and active life filled with doing the things they love most. If you would like to speak about the latest developments in lower-limb prosthetics, please do not hesitate to get in touch with the team at the Mount Sinai Department of Rehabilitation Medicine at (212) 241-6321.

A Personalized and Dynamic Amputation Treatment and Rehabilitation Plan

As each amputation patient carries with them a range of unpredictable factors – which limb or limbs have been amputated, age, fitness levels, reason for amputation, mental health and far more – it is essential that the Mount Sinai Department of Rehabilitation Medicine offer a treatment and rehabilitation plan that is as personalized, flexible and dynamic as it is cutting-edge, empathetic and motivating. When a patient is young and is standing on the threshold of a brilliant life ahead, we offer a treatment plan that gives them the physical and emotional tools to return to the path that was interrupted by amputation. When the patient is an avid sports person, our goal is to make sure that through physical and occupational therapy – along with the help of one of our leading prosthetists – they can get back on the field, surf board or even resume extreme hobbies like jumping out of an airplane as soon as possible. For patients who have suffered a traumatic amputation, we lovingly nurturer them back to physical health, offer robust and caring emotional and group therapy and guide them to a place of peace and acceptance where they can begin to see the light at the end of their harrowing tunnel. 

These examples barely scratch the surface of the spectrum of patients we look after at the Mount Sinai Department of Rehabilitation Medicine – and yet it shows that a ‘one-size-fits–all’ plan will not cut it. Our patients require a treatment and rehabilitation plan that takes into consideration their physical condition and life outside of a rehab setting, their age, life goals and temperament, with a robust emphasis on providing the emotional support so that they can pursue a post-amputation life that is comfortable and fulfilling. 

Each personalized and dynamic amputation and treatment rehabilitation plan is focused on the following features:

• Access to and care from Mount Sinai’s world-leading team of physicians who will look after you and any potentially complex medical needs from the moment of amputation until you fully recover.
• Compassionate and evidence-based care from our rehabilitation nurses who will help patients with goal-setting and managing pain and discomfort.
• Therapy from our physical and occupational therapists who will begin working with patients from the moment they wake up from general anesthesia until they are pursuing life again on their own terms, as well as increasing independence and teaching self-care and Activities of Daily Living (ADLs).
• Access to and care from psychologists who will help patients develop coping skills to emotionally handle the stresses that may come with experiencing amputation as well as community re-integration.
• Access to and care from dietitians who will work to make sure patients’ diets are nutritious, promote healing and mitigate the potential for diabetes and other conditions.
• Being put in the hands of an expert prosthetists who will make sure the patient has the full range of prosthetics they require to live life to the fullest.
• Access to our Limb Loss Support Group, our monthly peer support for patients following an amputation. It is led by a psychologist and discusses topics like body image, social acceptance and techniques for maintaining a positive attitude. 

At the Mount Sinai Department of Rehabilitation Medicine the full weight of our expertise and experience in treating and rehabilitating amputee patients is passed through a bespoke prism to ensure that it is personalized, dynamic and that it seamlessly fits into the patients needs and sensibilities so they can return to their old selves again.

If you are – or somebody you know is – scheduled to have an amputation and you would like to discuss the ways in which the Mount Sinai Department of Rehabilitation Medicine can offer a personalized and dynamic post-amputation treatment and rehabilitation program, please get in touch with us at (212) 241-6321.

Compassion and Understanding Motivate Amputees to Recovery

One thing that all amputees can likely agree on is that limb-loss is a life-altering experience. The only question that remains for many is whether it is an unfortunate blip in an otherwise healthy and active life, or is it a blow that sinks the patient into depression, immobility and serious mental health issues. In the case of elderly and less-fit patients, the struggle is trying to recover and maximize quality of life and avoid succumbing to the palpable physical and emotional loss that comes with amputation. In both cases, amputee patients exist on a threshold where ‘Door 1’ opens to an arduous path that culminates in an amazing recovery and return to a happy and vibrant life, and ‘Door 2’ where the patient feels alone, empty, scared and a shell of their former self. If it were as easy as merely opting for ‘Door 1’, the recovery process would be easy; unfortunately it is not. And yet, even after something as life-altering as amputation, safely navigating the long and difficult journey to recovery is very possible and actually likely, provided you have the right medical treatment and support.  By putting yourself in the hands of our specialists and therapists at the Mount Sinai Department of Rehabilitation Medicine, you can guarantee to have among the world’s leading experts motivating you to a brilliant return to the ‘old-you’ through our cutting-edge medical services that are informed and guided by compassion and understanding.

In the first instance amputation seriously disrupts the little things that you might have previously taken for granted, like going to the toilet or doing the dishes. It can affect mobility and all that entails, including nipping out to the shop for some milk or going out to meet friends for a meal. It can also create a seemingly insurmountable wall preventing you from staying physically active, including riding a bike, rock climbing or participating in the sports you love. And, of course, there are a range of implications for the ways in which your physical limitations might impact on your family, not to mention your social and love life. Yet, perhaps counter-intuitively the most palpable adversity an amputee faces is mental and emotional, including anger, denial, depression, poor body image, self-esteem, quality of life and even thoughts of suicide. Those who have suffered traumatic amputations can even suffer from post-traumatic stress disorder (PTSD). Beyond this, even the most physically fit, upbeat and positive amputee patient might find their spirits dampened when faced with the almost-always long and hard road to recovery, mobility and activity that involves countless hours of physical therapy. One could say that an amputee’s best friend is patience, positive energy and their mental health; and yet, these are the aspects on which patients are often most challenged, which can impede and derail the return to a fulfilling and physically active life without the proper medical, emotional and psychological support. 

Through your whole journey to recovery – beginning with pre-amputation – it is imperative that you are guided by specialists and therapists with the expertise to make you better and the compassion and understanding to prepare you to face successfully the challenges that amputation will present. Our amputation treatment plans at the Mount Sinai Department of Rehabilitation Medicine are always personalized and consider your physical condition, mental and emotional health and life outside of a rehabilitation setting. We make sure that all patients have a full range of necessary emotional support at their disposal, including group, family and one-on-one therapy. We know how difficult it is to experience an amputation, but we also know the amazing life that is waiting for you at the end of your recovery. As such your treatment plan will guide you sensitively but with encouragement so you are able to fulfill your rehabilitation goals. We are proud to have as the foundation of our treatments the fact that we are New York City’s first amputation and prosthetic training program to be accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), which recognizes our expertise in and commitment to supporting the needs of amputees by always improving our program and becoming the standard for modern amputation and prosthetic training care.

Here is a snapshot of some of our key inpatient and outpatient services that will guide you to recovery:

• Developing coping skills to handle the emotional stresses that may come with experiencing amputation.
• Helping you set goals every step of the way from preparation for your prosthetic to getting you ready for full mobility and participating in your favorite outdoor and sports activities.
• Helping you manage pain and discomfort.
• Providing support to increase independence and self-care.
• Access to our Limb Loss Support Group, a program designed to provide peer support to patients following amputation. It meets monthly and is led by a psychologist to discuss issues relating to body image, social acceptance and techniques for maintaining a positive attitude. 

If you are scheduled to have an amputation – or are a family member or friend of somebody who is – and would like to discuss the ways in which our specialists’ and therapists’ expertise, compassion and understanding can motivate you through the recovery process, please get in touch with us at (212) 241-6321.