Baker Orthotics & Prosthetics

Plié™ 2.0

• Water Resistant
• Interchangeable Batteries
• Integrated Kneeling Pad
• Replaceable Cover
• Protective Finish
• Open System Compatibility

To provide individuals with a more natural experience of mobility, Freedom Innovations examined biological norms to establish performance criteria for the new Plié 2.0 with microprocessor controlled swing and stance. By integrating high-performance processing capabilities and a cutting-edge hydraulic system, the Plié™ 2.0 is the most responsive MPC knee ever developed

C - Leg Prosthetic Knee System

Otto Bock HealthCare introduced the C-Leg® microprocessor-controlled knee-shin system to the United States in 1999. Since then, thousands of wearers have benefited from this quantum leap in prosthetics - a dramatic improvement over all other prosthetic knees. Featuring unique microprocessor swing and stance phase control, its customized settings and constant readjustments, the C-Leg is truely one of a kind. The efficiency of the C-Leg's swing phase dynamics, even at varying walking speeds and uneven terrain, provides a more secure, natural, and efficient gait.

Getting started is easy. Using a PC-based custom software, a C-Leg Qualified Prosthetist customizes the C-Leg®'s settings to fit the individual's optimal gait pattern. The wearer is also trained and observed while walking on level and uneven terrain, and down stairs. In addition, a second set of settings can be created for a different activity, which the wearer can access by simply tapping their toe - offering choice without mechanical changes!

Rheo Knee®

The newly redesigned RHEO KNEE® is an advanced prosthetic device that liberates its users to focus on their chosen activity, instead of having to think about how they are walking.

New developments in Össur's proven bionic technology mean that the RHEO KNEE can recognize and respond even better to the most subtle changes in walking speed and terrain. Using sophisticated artificial intelligence, it continuously learns and adapts to an amputee's walking style and environment.

As a result, it restores people's ability to walk naturally, comfortably and confidently at any speed.

The RHEO KNEE is now available with a female pyramid insert or a Threaded Top adapter ideal for knee disarticulation amputees, those with long transfemoral residual limb or where the low build height is required.

Product Highlights:

• Strong design - now for use by people weighing up to 275lbs / 125kg.
• Light weight and streamlined, anatomical shape - for easy cosmetic covering.
• Extremely smooth swing extension - for natural, confident, energy-efficient gait.
• Optimum stance support - for unparalleled safety, even for less agile, heavier or compromised users.
• Plug and play design - for fully automated set up and continuous adaptation.

Power Knee™

The world's first powered bionic prosthesis for above-knee amputees, the POWER KNEE offers unprecedented levels of functionality and performance. This bionic knee replaces true muscle activity to bend and straighten the knee as required.

Working as an integrated extension of its user, it synchronizes motion with that of the sound leg. When walking on level ground, the user is gently propelled forward, allowing greater distances to be covered without becoming as tired as before. On stairs and inclines the knee actively lifts the user up the next step, producing a secure and natural ascent, foot over foot.

Product Highlights

• Powered stance - by replacing concentric muscle activity of the quadriceps, the POWER KNEE can lift the user when standing from a seated position; support the user while ascending inclines; and power them up stairs.
• Powered swing extension - with an active pendulum motion, swinging forward when the user walks, the POWER KNEE restores walking dynamics during each step; propels the user forward; and enhances pelvic rotation for a more natural gait.
• Active heel rise and knee flexion - on level ground as well as on changing terrain, the POWER KNEE actively lifts the heel off the ground. The result is sufficient toe clearance during swing which prevents stumbling and improves user safety.
• Artificial proprioception - the POWER KNEE anticipates and responds with the appropriate function required for the next prosthetic

Endolite - The Adaptive

Going Places? The Adaptive Knee from Endolite is the first microprocessor controlled knee that combines the power and stability of hydraulics with the natural comfort of pneumatics - a true partnership of three technologies that enables the knee to respond to the amputee's body movements and the terrain for a smoother, more confident performance.

The subtle balance between body power and limb control is what makes the Adaptive different from all other knees. Whether walking at fast or slow speeds; negotiating stairs or ramps; in crowded malls or out on the golf course - the Adaptive Knee gives the amputee the most freedom possible to feel secure enough to get to their destination with confidence.

For added comfort and confidence, the Adaptive Knee allows the amputee to wear any existing foot and/or socket designs and both a standard and a shock & torsion pylon are included with every knee... Get there with the ADAPTIVE.

www.endolite.com

Proprio Foot

The world's first intelligent foot module, the PROPRIO FOOT provides unprecedented physiological benefits for transtibial amputees. A wide and automated range of ankle flexion with proven Flex-Foot® dynamics means function is as close as you can get to the human foot today.

The PROPRIO FOOT thinks for itself, responding beautifully to changing terrain and transforming the approach to stairs and slopes, as well as level-ground walking. Angling itself appropriately, it also helps amputees to sit and stand up easily and more naturally. The PROPRIO FOOT also has a calibrated alignment control feature. Overall, the effect is a feeling of improved proprioception with a more balanced, symmetric and confident gait.

Product Highlights:

• Cutting edge sensor technology and artificial intelligence identifies sloping gradients and the ascent or descent of stairs after the first step, and instructs the ankle to flex appropriately. Users can place the foot fully on a step when climbing or descending stairs and it will automatically adapt its ankle position to enable the next step.
• This active ankle motion also allows users to tuck both feet back behind their knees when getting up from a chair. It also points the "toe" down for a more natural appearance once seated. When walking, it automatically gives the 'toe' a lift at the exact moment in swing phase that will allow sufficient ground clearance.
• This anatomically correct response creates a more symmetrical and balanced gait, reducing the need to "hip hike" when walking or compromise stability by rolling over the edge of a step when going down stairs. Nor is there any need to load the entire body weight on the sound limb when getting out of a chair.
• Despite its sophisticated technology, the PROPRIO FOOT has an extremely user-friendly design and is easy to set up and operate. During a simple calibration process involving 16 steps the device evaluates and memorizes an individual's unique gait pattern.
• The PROPRIO FOOT adapts to varying heel heights quickly and easily with no impact on alignment of the prosthesis.

Helix3D Hip Joint System

The new Helix3D Hip Joint System also is a trend-setter. It sets new standards in terms of safety, dynamics, and comfort, and redefines the mobility of hip amputees.

The patented multi-axis joint structure produces a three-dimensional hip movement to compensate for pelvic rotation and promotes a symmetrical and natural gait pattern. Allows for leg length reduction during the swing phase with the aim to reduce the risk of falling and thereby to increase functional safety. ensures optimal sitting characteristics and reduces pelvic obliquity to a minimum. Makes a large flexion angle possible, to facilitate everyday situations like putting on shoes or getting into a car.

The new kind of spring-hydraulics combination supports initiation of the swing phase of the prosthesis wearer with integrated expansion springs. Energy stored during the stance phase is used to compensate during the swing phase initiation for the lacking hip muscles and to reduce the amount of energy needed for walking. Controls the three-dimensional movement during the entire step cycle. Allows for dampened, controlled heel strike in the stance phase with significantly reduced hyperlordosis as well as harmonious hip joint extension. Controlled and smooth roll-over on the prosthesis under full load becomes possible. Allows for individual stride length setting and to control the pendulum motion in the swing phase.

i-LIMB Hand

"The worlds first fully articulating and commercially available bionic hand."

The i-LIMB Hand, developed by Touch Bionics, is a first-to-market prosthetic device with five individually-powered digits. This replacement hand looks and acts like a real human hand and represents a generational advance in limb bionics and patient care.

The Touch Bionics i-LIMB Hand was developed using leading-edge mechanical engineering techniques and is manufactured using high-strength plastics. The result is a next-generation prosthetic device that is lightweight, robust and highly appealing to both patients and healthcare professionals.

Fitting the New i-LIMB

The i-LIMB hand and associated technology can only be obtained, fitted, and serviced at facilities with specially-trained clinicians. Baker is one such accredited facility.

The i-LIMB Hand is controlled by a unique, highly intuitive control system that uses a traditional two-input myoelectric (muscle signal) to open and close the hand's life-like fingers. Myoelectric controls utilize the electrical signal generated by the muscles in the remaining portion of the patient's limb. This signal is picked up by electrodes that sit on the surface of the skin. Existing users of basic myoelectric prosthetic hands are able to quickly adapt to the system and can master the device's new functionality within minutes. For new patients, the i-LIMB Hand offers a prosthetic solution that has never before been available.

Advanced Design

The modular construction of the i-LIMB Hand indicates that each individually-powered finger can be quickly removed by simply removing one screw. This means that a prosthetist can easily swap out fingers that require servicing and patients can return to their everyday lives after a short clinic visit. Traditional devices would have to be returned to the manufacturer, potentially leaving the patient without a hand for many weeks.

Grip Patterns

The inclusion of a thumb that can, like the human thumb, be rotated into different positions enables important grip configurations, many of which have not been available to amputees before.

The grasp of the hand is much more like that of a human hand with the articulating fingers able to close tightly around objects. Built-in stall detection tells each individual finger when it has sufficient grip on an object and, therefore, when to stop powering. Individual fingers lock into position until the patient triggers an open signal through a muscle signal.

Utah Arm 3

Since 1981, the Utah Arm has been the premier myoelectric arm for above elbow amputees. It was originally developed at the University of Utah by the Center for Engineering Design, led by Dr. Steve Jacobsen. In 1987, Motion Control released the Utah Arm 2, with entirely re-engineered electronics that made the Utah Arm the most durable and dependable myoelectric arm avaialable.

The Utah Arm 3 - One Step Closer to Nature

In 2004, the Utah Arm 3 introduced microprocessor technology into the Arm, with a Computer Interface that allows the prosthetist or wearer to fine-tune the adjustments to achieve maximum performance. A variety of inputs may be used, so more options are available to more wearers. Meanwhile, the U3 still delivers the same sensitive, proportional control of elbow, hand and wrist (optional), letting the wearer move the arm and hand slowly or quickly in any position.This provides a more natural response with less effort than the traditional on/off movement.

What's new about the U3?

• Simultaneous Elbow and Hand control! Because the Utah Arm 3 has two microprocessors, two functions can be controlled at once (optionally), thus producing a more natural movement.

• More Input Options

  • EMG Preamps using disc or snap-type electrodes
  • Motion Control Linear Potentiometer
  • Motion Control Touch Pads
  • Motion Control Force Sensor
  • Otto Bock Linear Transducer

• Easy to Use Computer Interface. For adjustments by the prosthetist The Set-Up Wizard guides you through the process of setting up your system step-by-step. Once set up, users can readjust by routing directly to the adjustment screens.

• Maximum Function. The Utah Arm 3's mobility and fine tuning allow any patient to achieve maximum function, including transhumeral, forequarter amputees and shoulder disarticulation. Many arm wearers master function quickly, after training with a qualified Therapist.

The Utah Arm 3 Technical Specifications:

• Excursion Range: 135°
• Excursion Time With Myoelectric Hand TD: 1.20 seconds
• Active Lift: 1 kilogram (2.2 lbs.) in the Terminal Device and using a fully charged Battery
• Load Limit: 22.7 kg (50 lbs.), w/ elbow locked at 90o flexion15.9 kg (35 lbs.), when forearm extension installed
• Humeral Rotation: Unlimited
• Wrist Rotation: Quick-Disconnect Wrist: 360° in each direction
• Weight: Without Hand: 913 grams (2 lbs.)Hand Weight: 450 gm (1lb.), plus glove
• Heat Tolerances: Operating Temperatures: 0° to 44°C (32° to 110°F)
• Storage Temperatures: -18° to 60°C (0° to 140°F)
• Current: Maximum: 4.0 Amps Quiescent: 10 mA
• Battery Specifications: (5 Battery Packs supplied) Rechargeable NiMH, (1100 mA Hours capacity)
• Voltage: Dual Supply, ± 6 Volts D.C. (total 12 V.)
• Charge Time: 2.5 Hours, maximum

• Forearm Length: (from rearmost point of the forearm to the end of the wrist)

  • Standard: 27.3 cm (10.75 in.)
  • w/Extension: 32.4 cm (12.75 in.)
  • Minimum: 24.8 cm (9.75 in)..

See also:

Who is an appropriate candidate for a myoelectric arm?
Rental and Trial Fitting Program
Download Techniques for using snap-on electrodes with roll-on gel liners (PDF)
Download the U3 Quick Set Up Guide (includes parts catalog) (PDF)

www.utaharm.com

M.A.S. Socket : A Transfemoral Revolution

The M.A.S.® socket design is an evolution--and perhaps even a "revolution"--in the development of ischial containment (IC) socket concepts. Since 1999, when Marlo Ortiz Vazquez del Mercado, Ortiz Internacional, Jalisco, Mexico, first unveiled his new design, it has continued to arouse interest throughout the O&P worldwide community. Recently the design was featured in the Thranhardt lecture series during the American Academy of Orthotists & Prosthetists 2004 Annual Meeting and Scientific Symposium.

The new design provides several clinical benefits: patients can sit more comfortably; there is no plastic beneath the gluteus; the prosthesis is easier to don; patients enjoy full range of motion, better functional gait--and important to patients and family members too--much better cosmesis. Seeing a video of patients walking, sitting, and demonstrating the range of motion possible is truly amazing.

Ortiz, who is a prosthetist and engineer, has fit hundreds of patients with the design to date. These patients reportedly have had no difficulty in wearing the socket for long periods of time. In fact, one amputee, due to his work schedule, actually wore the socket for 28 straight hours with no discomfort.

Agnes Curran, CP, OPGA prosthetist, pointed out that the design seems to be surprisingly skin-friendly despite the intimately fitting contours. Generally there is no skin irritation, and some amputees who had worn previous prostheses found that existing skin problems cleared up.

OPGA, Waterloo, Iowa, along with O&P1, Waterloo, hosted an initial seminar in January 2004 in which Ortiz taught how to cast, modify, and fit the design. An office worker who came with prosthetists from Nebraska attending the first seminar served as one of the patient models. She wore her check socket all the way home to Nebraska and asked the prosthetists to come in over the weekend to laminate it so she could begin wearing it immediately. Another patient waited all day for his new socket rather than go home with the old one. This patient enthusiasm is testimonial to their acceptance of this new design.

Bob Tillges, CPO, FAAOP, Tillges Certified Orthotic Prosthetic Inc., Maplewood, Minnesota, is enormously enthusiastic about the new design. Tillges, who attended the initial OPGA seminar in 2004, has since successfully fit over 150 amputees with the socket. He is receiving continual inquiries from local and out-of-state amputees that are interested in coming to Tillges Certified orthotic Prosthetic, Inc. in Maplewood, Minnesota for socket replacement with the MAS style.

"All my patients have been very satisfied," he said. "They have no discomfort; there's better ischial containment and range of motion. In fact, one of my patients' wives called me and said, "This is the most awesome prosthesis my husband has ever worn! I can't even see it under his slacks." She added that it had always bothered her before when her husband's prosthesis outline was visible.

"I'm taking time to learn and understand the mechanics of Marlo's system, and I'm getting very good results," Tillges added. Although most of Ortiz's patients are younger, Tillges has a large percentage of geriatric amputees. He has fit amputees aged from 44 to 81, including several in their 70s. Four of the 11 use some auxiliary suspension, but the others use true suction suspension only. "These sockets stay in total contact with flexion, extension, adduction, and abduction," Tillges said. "Something that has always bothered me as a professional is when you can see gapping, spaces, or outline of the socket under clothing." Although many were skeptical at first and thought the design would cause proximal tissue roll development, Tillges said, "We have not experienced that problem." He added, "With better ischial containment, you reduce the amount of tension values needed for suction, get more comfort, and achieve better suspension.

"Tillges started his O&P career carving and fitting wood sockets in the 1970s; he has seen socket technology develop through 30 years up to the present. Some iterations of the ischial containment concept through the years have included the quadrilateral "quad" socket shape taught by the O&P schools at New York University (NYU), Northwestern, and the University of California-Los Angeles (UCLA). Ivan Long, CP, developed his Long's Line, and John Sabolich, CPO, came up with the Contoured Anterior Trochanteric Controlled Alignment (CAT/CAM) method. Tillges feels that Ortiz has gone beyond these in IC design excellence. He noted how much his patients who have worn other socket designs appreciate the new sockets: "No way do they want to go back to what they had before." Tillges is also educating his company's residents and young practitioners in the technique.

The Design: What Is It?

So, what is the M.A.S. socket? Ortiz describes his design: "It is very important to consider the angle of the ischial ramus. The ischial tuberosity and part of the ramus as well as the medial aspect of the ramus are encapsulated within the medial aspect of the socket brim." Generally, the medial wall is lowered anteriorly to avoid pressure on the ascending ramus; effectively ischioramal weight-bearing eliminates the need for gluteal support, so those tissues can be excluded from the socket, he explained.

In the conventional design, posterior trim lines include part of the gluteus maximus. In the M.A.S. design, the height of the posterior wall has been lowered to the gluteal fold, so the entire muscle belly can be free of the socket. "This will not only improve cosmesis but with this configuration, we have found that ischial tuberosity and part of the ischial ramus are encapsulated more effectively with no restriction in hip movement," Ortiz said."With the gluteal cutout, no weight bearing occurs in this area, and weight-bearing forces are vectored from the captured medial aspect of the ramus with a resultant force projecting to the anterior/lateral area of the socket," explained Al Pike, CP, in "A New Concept in Above-Knee Socket Design"

www.opga.com/MAS