Summary/Responses to: Questions on Pediatric UE Myoelectrics

Summary/Responses to: Questions on Pediatric UE Myoelectrics

Jeremiah Uronis

1/14/2010

Thanks for the great responses everyone.

 

Original Post:

 

>Hi-
>

>I am looking for thoughts/experiences on using pediatric myoelectric hands
>for transradial (or transhumeral) patients.
>
>What brand did you use? What is the smallest myoelectric hand available?
>What problems did you encounter? What is your suspension of choice? Any
>other thoughts?
>

>I have a 3 year old that is interested.



 

HI Jeremiah. We here at the Salt Lake City Shriners used to fit many, many
myoelectrics- probably 20 plus a year. Truthfully, regardless of which
system you use, the chance that your little friend will use the arm is slim.
Also, there has been at least one recent study indicating that on a battery
of manual skills tests that myo's did not increase bi-manual dexterity.
That said, we have had at least 5-10 people (probably 5 percent) of our myo
kids who use them religiously to adulthood.
Budgetary concerns have long ended our myo program but my intuition is that
kids who start very young with a myo incorporate them better into their body
image. Also, they are more cosmetic than other options with grasp -e.g.:
capp, trs, or hosmer hook.

Otto Bock has by far the most complete, lightweight, and accessible system.
I wouldn't even consider any other manufacturer. Their pediatric myo
systems are reliable and long lasting. Definitely consider the three in one
controller which allows you to do a 'cookie crusher' (single electrode opens
hand, and hand closes by itself), and then switch out the 'coding plug' to
make it voluntary opening and closing with 2 electrodes.

 

Good luck, and don't take it personally if he/she doesn't really wear it.

 

Hello,

 

I enjoy working with Liberating Technologies:

 < <URL Redacted>>
<URL Redacted>

 

They have the smallest, lightest hands with proportional control. They will
also work with you to find the best configuration/components. Of course,
Otto Bock also has their System 2000 hand:

 < <URL Redacted>>
http://www.ottobockus.com/cps/rde/xchg/ob_us_en/hs.xsl/6902.html

 

Good luck!

 

 

Hello Jeremiah:

For your 3 year old and things to consider...first of all, has the child
worn a prosthesis? I usually like to see that the child has a consistent
wearing pattern and could benefit from the grip force of an electric hand;
and especially wants to wear a prosthesis. As you know, the cost of a
myoelectric prosthesis is rather expensive and should be justified with good
wear and use. Next, the child should also have enough residual limb to
suspend a myoelectric prosthesis, it is difficult to fit a very short BE or
a very short AE with the additional weight/lever arm (with an electric
hand). We use a self-suspending type of socket, if there is not enough room
in the forearm for a battery, we will attach the battery onto a cuff
(humeral cuff for a BE). We would use a 2-6 VASI electric hand for a 3 year
old. A 3 year old can usually learn how to control a two site system
(opening and closing). If the child already has developed a bimanual (two
handed) pattern with a prosthesis, then it would make use training a lot
easier and faster. If not, then the child will need consistent therapy to
improve prosthetic use and skill. I would definitely encourage full time
wear, especially at the beginning.

We haven't fit a lot of AE's in our clinic, mostly BE's with myoelectric
prostheses.

Hope this helps, I can answer any other questions you may have.

 

Just did a single site for a 3 year old.....used Liberating Tech for the
hand and battery system because it was the smallest. Bock electrode for the
best response. Child took 15 minutes to become fully adapted to it.

 

 

Carl Brenner, CPO, FAAOP in Livonia Michigan is a pediatric specialist and a
good resource.

  Jan