RJROL has a comprehensive and advanced upper extremity program. Ryan Spill, CP, is a former instructor of myoelectric fitting techniques who is experienced in difficult, partial hand presentations.
We are trained and certified in all manufacturers’ products, including advanced technology in the Michelangelo Hand and Axon-Bus systems, i-limb™ quantum hands and i-digits™, bebionic hands, the Utah Arm, and the multi-input DynamicArm and Boston Digital™ Arm for those patients who have undergone targeted muscle reinnervation (TMR).
Targeted Muscle Reinnervation is the medical term for the surgical procedure of reassigning the brachial plexus nerves to muscles that the patient has. These nerves that used to innervate the arm now are assigned to muscles within the person’s body. For higher level amputations, such as above the elbow or at the shoulder, the TMR procedure can result in more intuitive control of a myoelectric prosthesis.
Our expertise also encompasses pattern recognition systems such as COAPT. Pattern recognition controllers allow for additional EMG inputs for more intuitive control of multiple components such as an electric elbow, wrist rotator, and terminal device (electric hand or hook).
Ottobock’s Michelangelo® Hand has seven functional options, including a moveable thumb, allowing the user to pick up objects sideways, grip flat items from the side, carry cylindrical objects with a large diameter, and hold small objects securely using the thumb, middle finger, and index finger to form a three-point support. A neutral mode allows for resting the hand in a natural position. In combination with the Axon-Bus system, the user has more degrees of freedom than ever before.
Axon-Bus Systems: The Axon-Bus system developed by Ottobock for transradial and transhumeral fittings, consists of an optimized, self-contained data transmission system. The individual components communicate with each other perfectly, eliminating losses in terms of data transmission, speed and functionality. This results in safety and reliability for the user due to a significant reduction in sensitivity to outside interference.
Coapt Complete Control™ Pattern Recognition: The COAPT COMPLETE CONTROL™ system is an advanced control solution designed to enhance the functionality of a powered myoelectric prosthesis for upper-limb amputees. COMPLETE CONTROL uses a proprietary, clinically practical version of pattern recognition technology in a small electronic circuit board to non-invasively acquire and translate information from muscle signals. For example, when the muscles signal “hand open” or “hand close,” that is what the prosthesis will do. In contrast, standard myoelectric control only considers the signal level from one electrode, and patients are often required to make non-intuitive contractions to command prosthesis actions – such as using wrist extension and flexion contractions to command a prosthetic hand to open and close.
i-limb™ quantum Hand: Incorporating Touch Bionics’ patented i-mo™ technology, i-limb™ quantum operates as fully functioning hands, allowing users to change grips with a simple gesture. Gesture control enables an automated grip to be accessed by moving the i-limb quantum in one of four directions. The quantums respond to commands faster, are lightweight, and their anatomical styling in three sizes fits female amputees. Finger flexibility and grip options allow for typing, picking up small objects, holding delicate items, and much more.
i-digits™ quantum: With redesigned componentry and digits, the prosthesis for partial hand amputees from Touch Bionics is smarter, faster, stronger and smaller than its predecessors. Wearers can quickly utilize the many grips available for everyday tasks through the activation of gesture control. A recently introduced slimmer, lighter design allows users to easily wear their prosthesis all day.
bebionic3 Hand: The bebionic3 hand from Steeper features individual motors in each finger, which allows the user to move the hand and grip in a natural coordinated way. Powerful microprocessors continuously monitor the position of each finger for precise, reliable control over hand movements. The hand has 14 selectable grip patterns, proportional speed control, and auto-grip sensor. The hand has a wireless programmer and bebalance custom software, allowing the hand’s performance and control options to be fully customized.
Utah Arm: The Utah Arm is a leading myoelectric arm for above-elbow amputees. The Utah Arm 3+ features microprocessor technology and an easy-to-use computer interface, as well as, silent free swing and wireless Bluetooth communications. Its sensitive proportional control with simultaneous elbow and hand functions allows the user to have more natural movements. With its high performance wrist rotator, the Utah Arm 3+ is compatible with a variety of hands and terminal devices manufactured by Motion Control and others. These include the Motion Control Hand, the ultra-rugged ETD, as well as the bebionic and i-limb multi-articulating hands.
Ottobock DynamicArm Elbow: The DynamicArm Elbow incorporates a powerful electric motor to help both flex and extend the elbow – while holding up to 11 lbs. In addition to hand and rotation of wrist joint, elbow joint flexion can also be controlled by muscle signals. The elbow joint-forearm system with a natural, anatomic design, shape, and basic color blend in with the overall image of the human body.
DynamicArm Plus: For users with more than 2 myo signals the DynamicArm Plus elbow joint is intended for fitting users with transhumeral or higher amputation levels and TMR-surgery or users with more than 2 original signals. Apart from the advantages of a fitting with TMR, the DynamicArm Plus has the same features as the DynamicArm standard. In addition, it can also process up to 8 input signals.
Boston Digital™ Arm: The Boston Digital™ Arm System is a powered elbow with a microprocessor-based control system that utilizes state-of-the-art components. This digital system provides a “platform” for controlling various upper limb prosthetic devices such as hands, grippers, powered split hooks, wrist rotators and even powered shoulder joint actuators. It can control up to five devices and is compatible with virtually all manufacturers’ prosthetic components. The battery also has an on-board voltage regulator designed specifically to accommodate the new multi-articulating prosthetic hands; bebionic and i-limb™ Ultra.
Boston Digital Arm – Multi-input: For patients who have undergone TMR surgery. Patients can operate 5 powered prosthetic devices using their new EMG sites; elbow (flexion/extension), wrist (pro/supination), wrist (flexion/extension), humeral (internal/external) rotation, and shoulder (flexion/extension).
Silicone Restoration: Partial fingers/hands can be made to look whole again with silicone restoration. Medical grade silicone is used because of its realistic texture, durability, and hypoallergenic properties. The restoration is customized to skin color, shape and can include freckles, veins and hair. Silicone fingers are more than just a cosmetic restoration. The prosthesis also improves function including gripping, control, holding objects and producing an opposing force when lifting heavier objects using both hands.