Transport td

Transport td

Schafer, Kristin

2/27/2012

Hello All! Thank you to everyone for these insightful responses. Here
they are.
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I am actually just starting to work with a very similar patient. I'll be
fitting a test socket in two weeks. He is a short transhumeral with very
little shoulder ROM so I'll be mostly dependent on scapular ROM. I am
planning to use a type 2 socket and an elbow with live lift (a
hybridized version of the ergo-arm). As far as a TD for shifting the
transmissin, I'm planning to trial a TRS prehensor, a passive hand or
may have to be custom made.
I'll let you know how it goes.
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Before going too far in the design process I would want to know if the
patient can operate the shifter when not in motion. I am visualizing how
to interface the terminal device to the shifter, and unfortunately the
action of these seats is perfectly vertical, where as if the elbow is
fixed at some angle it won't accommodate the change in angle through the
action of the chair.
Instead I am thinking you could modify the vehicle, For instance more of
a 4 bar linkage between the current shifter and a seat mounted shifter,
all 4 bars would pivot on heim (ball joints) at the arm rest, the bars
would translate side to side and front to back motion between the chair
and the shifter, while isolating vertical motion. The throw of the
shifter would likely change slightly towards extreme end of travel.
Simpler would possibly be a delrin ring that would float on the stem,
and be tethered with elastic to the top. The ring could be engaged with
the terminal device and would permit translation of the terminal device
on the shifter with seat float.
If he owns the truck, modifications to the seating system and shifter
are likely the route.
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Had a truck driver when I was in SCIL - no elbow at all and used a kind
of claw type TD which grasped the shifter - it could even pull on the
over drive button on the shifter. Don't have a picture of the device,
but it wasn't very fancy so it could be reengineered. I don't think
that he steered much with it, but did use it to stabilize the wheel.
All the movement would come from his shoulder to take up the 8 - 10 of
ride in the seat. The length of the device would be set by feel - see
what he likes before committing to a length.
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Rather then adapting the prosthesis why not concentrate on the shifter.
Seems it would be easier to create a telescoping shifter.
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I have found over the years that you are better off getting in his truck
and evaluating the situation. I would question weather or not the
vehicle itself can be modified instead of the terminal device??? I love
questions like this!!!
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I read your transport post had an idea and question the td could be a
pair of adapted twister cables theseare similar to craftsman flex shaft
socket extentions
Q: what are Dept oftransport requirements? South of the border he has to
have min 20 lbs grip bilaterally
Me: I am not sure but I will certainly look in to this!
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Very interesting situation. I have had two truck drivers return to work
but their seats were not an issue.

Telescoping radial may be more doable.
For the TD think trailer hitch(ball & socket) QD socket to fit over the
shifter.
For the telescope: if body pwr, can your pt circumduct while
turning,etc. If yes, a simple cable pwrd compression clamp on the
outside tube(which could be anatomically shaped with clasp and slip
joint just prox to the wrist..
Inside tube, distal end, would have TD quick disconnect. Cable would
only work @ a set extended lgth.(remove extra length for std TD &
telescope
collaspted)

External pwr could be same with secondary funtion switch or
cocontraction to lock telescope and/or elbow. If your guy also needs to
actavate/deactavate overdrive you would need an additional channel and
maybe alter the truck's switch.

In both cases extending and retracting the telescope would be manual.
--------------------------------------------------------------



Kristin Schafer, B.Sc. (Kin.), C.P. (c)
Rehabilitation Engineering
Health Sciences North- Horizon Sante-Nord
41 Ramsey Lake Rd.
Sudbury, ON
P3E 5J1
(705) 523-7100 x3176




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