Driving with a Prosthetic Leg

Many people wonder if it’s possible, driving with a prosthetic leg after undergoing an amputation. Limb loss (amputation) affects the ability to control a vehicle. Depending on upper or lower limb amputation, it can affect usage of the steering wheel, controls or pedals, or even your stability in the vehicle. You must be assessed for the level of impact, which will determine the conditions on your license, any vehicle modifications, or additional training with a rehabilitation driving instructor to enable you to drive. Below is some general information to get you started on the journey to get back on the road.

Can you Drive with a Prosthetic Leg?

man driving with a prosthetic leg

Steps to take:

It is a legal requirement that you notify the transport authority in your state or territory of any change in medical condition or surgery that affects your driving, including an amputation where you find yourself driving with a prosthetic leg.

The driver licensing authority in each state and territory has slight variations in its policies and standards. The standards apply to private, commercial, light, and heavy vehicles and motorbikes and you may need to complete multiple driving tests.

To be able to drive a vehicle you must complete a variation of the following steps based on your state/territory:

Make an appointment with your doctor/GP
  • They will need to provide a complete medical record.
  • Fill in any forms from your state/territory authority.
  • You may need additional medical reports from specialists.
Complete off-road assessment
  • Including asking you about your driving and medical history, testing your knowledge of the road rules, and assessing visual, sensory, and thinking abilities.
Complete occupational therapy driving assessment
  • Health professionals such as an accredited occupational therapist assess a patient’s medical fitness to drive to advise the driver licensing authorities about how the patient’s health and medical conditions might affect their driving ability.

(AFTD Guidelines have basic standards for each states process).

User Ability & Car Modifications

Depending on the user’s ability, you can drive a car with the original pedals if you have had a lower limb amputation.

  • You will need to learn how to manoeuvre your limb differently and this may also be dependent on the sensation in your limb for feedback.
  • As you can no longer move your ankle joint you will rely on feedback from your residual limb and proprioception (the feeling of where your limb is in space).

Features of your prosthesis are also important:

  • You should speak to your prosthetist about wanting to drive as they may need to consider this in the componentry used for the prescription of your prosthetic limb.
  • Adaptive equipment can also be installed in many vehicles.
  • Hand-operated brake and accelerator, automatic transmission and height-adjustable seats, etc.
  • Modifications enable many drivers with impairments to operate vehicles safely.
  • Power steering makes driving much easier for upper limb amputees.

License Conditions When Driving with a Prosthetic Leg

You may have a license condition that states you must wear your assistive device, only drive a specific vehicle or you can only drive an automatic vehicle.

Please contact your local state or territory for further information, alternatively, you can contact your state’s amputee association for guidance.

 

Written by:

Darrel Sparke, President of Amputees NSW.

APC would like to thank Darrel Sparke, for collaboration in writing this resource article.

Content created and adapted from:

 

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Myoelectric Prosthetics

Myoelectric prosthetics (prostheses) differ from other upper limb prosthetic options in the way the terminal device (e.g. hand or hook) is controlled (open and closed). While other styles use harnessing and gross movements of the shoulder, myoelectric prosthetics use the movement of residual limb muscles to control the myoelectric hand. This is done by sensors placed within the socket that detect muscle movements and intuitively create movement at the hand. A benefit of a myoelectric prosthetic device is that they have a much more natural, intuitive way of using moving a prosthetic arm.

There are different types of myoelectric terminal devices that can be used, depending on the needs of the user and their ability to operate the various functions.

Single Grip Terminal Devices

These are simpler myoelectric devices that allow the opening and closing of a single grip position. These could be either a hand or a hook, depending on the users’ needs and requirements. In general, a hand is for lighter-duty activities and a hook would be used in heavier-duty and dirtier environments.myoelectric prosthetics

Multi Grip Devices

These are more sophisticated myoelectric devices that offer multiple grip positions. These always take the form of a hand and use a combination of thumb rotation and varying uses of fingers to allow various grip patterns.Myoelectric hand

Myoelectric Prosthetics Control Strategies

There are different control strategies that can be used in a myoelectric prosthetic arm. These are dependent on the users abilities and available funding.

  • Single Site – as the name suggest this uses a single sensor to detect and initiate movement of the myoelectric hand. this is the simplest form of control
  • Dual site – This uses two sensors to allow voluntary opening and closing of the myoelectric hand. This can also be used to adjust the grip when using multi-grip devices. This is one of the more common control strategies used.
  • Pattern Recognition – This uses a series of up to 8 electrode channels and allows recording/training of muscle movement “patterns” to create the various movements of the multi-grip terminal device. This also allows more intuitive use of powered wrists and elbows.

As with any prosthesis it’s helpful to have a conversation with your prosthetist to figure out what is appropriate for you and suits your needs. Get in touch with our friendly team below through our contact form and we’ll help you in any way we can.

Myoelectric grip options

 

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Diabetic Foot Care

Diabetes and How it can Affect the Foot

Diabetes is a serious complex condition that can affect the entire body, more specifically we cover diabetic foot care and how it can affect you. Diabetes requires daily self-care and if complications develop, diabetes can have a significant impact on quality of life and can reduce life expectancy. Your feet are at risk because diabetes can cause damage to the nerves in your feet, blood circulation, and infection. Having diabetes can increase your risk of foot ulcers and amputations. This damage is more likely if:

  • You have had diabetes for a long time
  • Your blood glucose levels have been too high for an extended period
  • You smoke – smoking causes a reduced blood flow to your feet, wounds heal slowly
  • You are inactive.

If your diabetic foot develops a wound this is known as an ulcer. If a diabetic foot ulcer is left untreated it can lead to an infection known as osteomyelitis inside the body/bone. Early and accurate diagnosis is necessary to ensure effective treatment and to reduce the likelihood of amputation. Improper diabetic foot care can increase the likelihood of amputation and is 15 times more common to occur in people with diabetes.

Diabetic Foot Care & What to Look out for

  • When you have diabetes, you need to take care of your feet every day
  • Daily care can prevent serious complications
  • Check your feet daily for changes or problems
  • Visit a podiatrist annually for a check-up or more frequently if your feet are at high risk

If you see any of the following- get medical treatment that *day*

  • Ulcer
  • Unusual swelling
  • Redness
  • Blisters
  • Ingrown nail
  • Bruising or cuts

If you see any of the following- get medical treatment within 7 days

  • Broken skin between toes
  • Callus
  • Corn
  • Foot shape changes
  • Cracked skin
  • Nail colour changes

Prosthetic Options

If you have had a partial foot amputation you can have a prosthesis custom made to suit your needs. This can also be called a ‘toe filler’ or bootie. The prosthetic device restores the anatomical shape of the foot and can be designed to reduce pressure and restore balance. Speak to your prosthetist about options best suited to you.

diabetes prosthetic foot option

 

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How To Get Into Prosthetics

how to get into prosthetics

In order to get into prosthetics and become a Clinical Prosthetist in Australia, clinicians require an accredited degree in the field in conjunction with the optional, yet recommended, membership with the Australian Orthotic and Prosthetic Association (AOPA).

In terms of study, there are currently two universities in Australia which offer bachelor’s degrees in Prosthetics and Orthotics: La Trobe University (Victoria) and The University of the Sunshine Coast (Queensland). Both courses feature prosthetic specific subjects as well as the opportunity to undertake clinical placements at Prosthetic and Orthotic facilities across Australia and around the world. University requirements vary and depend on a number of factors such as ATAR, previous study and availability of student positions.

A membership with AOPA is not essential, but highly recommended to work as a Prosthetist in Australia. AOPA is the professional body which regulates prosthetic and orthotic treatment in Australia and ensures its members are regularly up-skilling, exercising best clinical practice and adheres to the standard codes and conducts. AOPA organises an annual conference which features keynote speakers as well as allowing Prosthetists/Orthotists to share and collaborate their work.

Once these requirements and recommendations are met, clinicians are able to get into prosthetics and work as a Prosthetist in an Australian facility. Fortunately, both university degrees are recognised by AOPA and The International Society of Prosthetics and Orthotics (ISPO) which give graduates the opportunity to work as a Prosthetist/Orthotist around the world.

In order to get into prosthetics and become a Prosthetic Technician, applicants are encouraged to either reach out directly to prosthetic facilities or search ‘employment opportunities’ section of the AOPA website. There are no official study pathways in Australia to become a prosthetic technician, however, experience with hand tools and attention to detail are skills which are suited to the prosthetic industry. Often many P&O graduates will enter the industry as a prosthetic technician to broaden their skills and gain a more holistic understanding of prosthetics before moving into clinical roles as a Prosthetist.

Most importantly, many prosthetic facilities in Australia are very approachable and willing to provide information on how to get into prosthetics, albeit a Prosthetist or Prosthetic Technician.

For further questions on the various pathways to prosthetics, get in contact with the team at APC Prosthetics today.

For more information about the University Courses click on the links to see what both La Trobe University and The University of the Sunshine Coast have to offer.

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Hunter, we’ve relocated!

Come check out our new clinic at Suite 4, 240 Pacific Highway, Charlestown. 

 

Whilst we were looking forward to celebrating the move, we have made a difficult decision to cancel our Grand Opening to keep our patients and staff safe during the recent COVID outbreak.

The new clinic will continue operating using COVID safe practices, and all appointments have resumed as usual from our new location.

We want to thank everyone for their enthusiasm and support in celebrating our relocation and look forward to welcoming you into our new clinic at your next appointment.

Our Hunter Clinic opening hours are Mon – Fri 8:00am – 4:00pm.

If you would like to get in touch with our team at Hunter, contact us at +61 2 4969 8700

To learn more about the new APC Hunter Clinic, click the link to see photos from the event as well as a recap of the grand opening event.

 

 

Prosthetic Legs

Individuals with lower limb amputation or limb difference, may use a prosthetic leg to mobilise.

Prosthetic legs come in a wide range of designs, depending on individual circumstances, such as amputation level, residual limb length and size, skin integrity, activity level, body weight, wants, needs and many more.

Prosthetic leg by itself

If an individual is missing part of their lower limb or has a lower limb difference, they may benefit from a this prosthetic. Common amputation/limb difference levels include, but are not limited to, below-knee, above-knee, knee disarticulation, ankle disarticulation, partial foot, hip disarticulation and Proximal Femoral Focal Deficiency (PFFD).

Pictured above is a PFFD socket

Prosthetic legs are generally made up of a socket, which is custom made to the individual’s residual limb, prosthetic components (such as a prosthetic knee and/or prosthetic foot) and connective components, that join the socket and components together. A mould or plaster cast is taken of the individual’s limb, which is then modified, to achieve this custom socket shape.

Man with one prosthetic leg walkingfree standing prosthetic

Osseointegration Surgery

For amputees who have undergone Osseointegration surgery, their prosthetic legs do not incorporate a socket, as their prostheses are “bone anchored”. This means their prosthetic components directly connect to a metal rod which has been surgically inserted into their bone.

This particular prosthesis can be designed to serve multiple purposes, depending on the individual’s wants, needs and abilities. It is common for most people to have an ‘everyday’ prosthetic leg and a ‘waterproof’ prosthetic leg. For those who partake in specific sports or recreational activities, they may also have an additional leg. For example, a running leg with running blade, or a prosthetic leg specifically designed for snow skiing. We are happy to work with you to figure out what type will be best suited to your needs.

Click on the link for more information about Osseointegration 

Prosthetic Leg Wear

It is up to an individual how much or how little they wear their prosthetic leg. However, it is always recommended to remove your prosthetic leg overnight when sleeping. Some users may only use their prosthetic legs for short amounts of time during the day, say for transferring purposes, and may choose to spend the rest of their time in a wheelchair as their main mode of mobility. Others may put their prosthetic leg on in the morning and not take it off until they go to bed at night.

Many users require prosthetic socks to maintain the fit and comfort of their prosthetic leg. Sock use is completely dependent on individual circumstances. Many amputees find their stump volume fluctuates during the day and they must accommodate these fluctuations by adjusting their prosthetic socks to suit. We can provide you with a range of different socks so you can always keep your prosthetic leg fitting well and comfortable.

Prosthetic legs can come in a wide range of colours or designs. Many people choose a fabric or design that they like, which we then incorporate into the final lamination of the socket. Others prefer their prosthetic leg to look as cosmetic as possible, with a colour suited to their skin tone and foam cover shaped to look like their other limb covering their underlying prosthetic components. There are also companies that make 3D printed prosthetic covers that can be fitted to your prosthetic leg.

Click here to find out more about cosmesis for your prosthetic leg

For more information check out our other resource pages, FAQ’s below or contact the team today through our enquiry form.

Prosthetic Leg FAQ’s

How do prosthetics work?

There are many different types of prostheses that all work in different ways, depending on their intended purpose. Most lower & upper limb prostheses incorporate a socket, which is customised to suit the individual’s residual limb, that is then connected to prosthetic components, such as a prosthetic foot, knee joint or terminal device.

What are most prosthetic limbs made of?

Prosthetic legs and other limbs are made up of different parts, which in turn are made up of different materials. Prosthetic sockets are commonly made using fibreglass or carbon fibre. Most prosthetic feet are made of carbon fibre. Titanium, aluminium and steel are common materials that connective prosthetic components are also made up of.

What does it feel like to have a prosthetic leg?

We manufacture our prostheses to try and make them as lightweight, tight fitting and comfortable as possible. As prostheses are unique and customised to each individual, each amputee would likely have different sensations and experiences of what using their prosthesis feels like.

How strong are prosthetic legs?

We ensure that your prosthesis is rated to your body weight and select components that are suited to your weight, activity and impact level.

 

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Prosthetic Hands

Prosthetic hands are devices that are used to replace some of the appearance and function of a human hand. Some prosthetic hands have limited or no movement, but others can grip objects, hold pencils, and even move in a natural way. A prosthetic hand is also known as a terminal device, and this is because it doesn’t always look like a hand.

There are 3 main ways Prosthetic hands are used:

  • Passive – these prosthetics do no open or close. They are often used for cometic purposes but can also serve as a support for some activities such as catching, or stabilising an object etc.
  • Body powered – these prosthetic hands open and close using a harness that is suspended over the shoulders. Movements of the shoulder opens or closes the hand to hold items. These hands either look like a hook or a hand.
  • Myoelectric – these prosthetic hands are controlled electrically using sensors that detect your muscles moving to open or close the prosthetic hand. Similarly, these can be a hook or a hand. Typically, these can also incorporate multiple hand movements to improve the function of the prosthetic hand.

There are many different hands that are designed to do various unique tasks. Often upper limb (arm) prostheses are used for specific tasks and people might use several prosthetic hands interchangeably:

  • Bike riding – this hand allows grasp and release of the handlebars.

prosthetic arms

  • Gym/working out – these kinds of hands allow grasping of various gym equipment and can serve as stabiliser for floor-based workouts e.g., push-ups, planking etc.

prosthetic hand user in the gym

  • Custom tools – these prosthetic hands are generally used for everyday tasks such as preparing and eating food and allow use of tools perhaps for the purpose of the user’s job e.g., cutlery, hammer, saw etc.
  • Gardening/home maintenance – this prosthetic allows the user to grasp of larger two-handed tools e.g., broom, mop, rake, spade etc.
  • Sport specific – these prosthetic hands are designed for the specific sport the user plays or participates in e.g., golf, swimming, and cricket etc.

 

Please contact your prosthetist if you have any further questions, we are willing to go above and beyond to create a prosthetic hand to suit your needs and help you reach your goals.

 

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Support for Amputees

What support is available to amputees?

Whether its practical advice for new amputees, finding an amputee support group to connect with, or navigating the funding system, access to quality services and support networks is paramount for amputees. You can find a list below of amputee associations and amputee support groups that provide relevant information for new amputees and ongoing support throughout your life as an amputee. Here you can find prosthetic advice, peer support, health resources, funding information, prosthetic service information and more!

Amputee Support Groups/Associations

  • Amputees NSW – A non-for-profit amputee association, recognised by NSW Health, that provides a comprehensive range of support services for all people affected by amputation and limb differences. Amputees NSW provides support for individuals, families, schools, allied health professionals, government agencies, interstate support groups and the broader community.  www.amputeesnsw.org.au
  • Limbs4Life – The peak body for amputees in Australia with the vision of providing information and support to amputees and their families, while promoting an inclusive community so that no person is going through limb loss alone. www.limbs4life.org.au.
  • Limbs4Kids – A national program that supports parents of children born with limb deficiencies and children or adolescents who undergo an amputation early in life.  www.limbs4kids.org.au.
  • National Disability Insurance Scheme (NDIS) – The NDIS is an independent Australian Government statutory body that funds costs associated with disability and providing the necessary ongoing support for Australians who acquire a permanent disability before the age of 65. www.ndis.gov.au.
  • EnableNSW – A state-wide service of HealthShareNSW that provides assistive technology and related services to people in NSW with specific, short term or ongoing health needs to assist them to live safely at home. www.enable.health.nsw.gov.au.

Amputee support groups in Australia

APC Prosthetics is a certified registered NDIS provider.

For more information regarding Prosthetics please head to our resources section found here.

Prosthetic Arms

Our APC Prosthetics team can custom design prosthetic arms for you, for improved comfort and function using lightweight, reliable materials. Our team will work closely with you to agree on a prosthesis that is the appropriate fit for you based on level of amputation, functional capabilities, goals, and activities you enjoy to the best of your abilities.

Prosthetic Arms Cosmetic Prosthesis – Passive Prosthesis

prosthetic arms

A cosmetic prosthetic arm does not usually provide active functionality and they are commonly designed to resemble a lifelike arm. These can be used as a supportive guide when using your opposite limb and for maintaining muscle usage of the proximal muscles. Some options available to make this resemble a limb can include a cosmetic stocking, silicone cover or exoskeletal prosthesis with a pigment mixed in to match the colour of the skin. If there is a specific design that you have in mind and you’d prefer to have a pattern, logo, or picture on your prosthesis, it is important to discuss this with your prosthetist so we can design the perfect prosthetic to suit you.

Pictured here is a Passive Prosthetic Arm which allows this paediatric client to ride their bike. The terminal device can be easily unscrewed and replaced with other devices which makes this very versatile for the clients needs, goals and ambitions.

Specialty Prosthesis

There are a few options available, the most common type of specialty prostheses are body powered which allow the user to control the hand or hook by a harness system fitted around their chest and shoulder. Another option is the externally powered prostheses controlled by a battery powered electric motor, with sensors that pick up the EMG signal on the skin to control the prosthetic arms elbow or wrist. Hybrid systems can be used for above elbow amputees and are a combination of externally and body powdered prostheses which provide a functional elbow and hand.

To achieve the best outcomes for our clients, we are willing to go above and beyond to create a prosthesis to best suit your needs whether this be a cosmetic or a specialty prosthetic arm. If you would like to learn more about upper limb prosthetics click here.

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The Difference Between Bionics and Prosthetics

Bionics and prosthetics have continued to interweave across the last few decades and will continue at a rapid rate into the future with new ideas and concepts being developed all the time.

What Are Prosthetics?

So… what are Prosthetics (or prosthesis)? Prosthetics are an artificial body part used to replace function of a missing arm or leg.

Prosthetic limbs have come a long way in the past decades. Some 25 years ago the only types of knees clients with an above knee amputation could use were mechanical knees which worked off physics and the movement of weight around a knee axis and relied on the user’s strength and control to provide safety during walking. These days bionic systems have developed with knees capable of ‘reading’ the situation and responding in real time to provide safety for the user.

Similarly upper limb prosthetics were only available in body powered varieties which meant the user had to perform specific movements of their shoulders to cause excursion of a cable system connected to a harness and result in movement of the terminal device or joints in their upper limb prosthesis to achieve function. Now there is a wide range of upper limb technology which is getting closer and closer to mimicking more natural upper limb function.

As time has gone by and prosthetics have developed it is evident that bionics is a critical field that continues to expand the many options available to our clients to better meet their mobility, safety and functional needs.

What Are Bionics?

What are prosthetics?

What are Bionics? Bionics can be defined as the replacement or enhancement of organs or other body parts by mechanical versions.

Currently there are bionic above knee systems available which use state-of-the-art sensor systems to mimic a natural walking pattern and provide an extremely high level of safety and function for the user.

These knees have sensors which detect movement at up to 100 times per second and then respond by controlling resistance in their control mechanisms to provide the appropriate safety or mobility as required at each stage of the walking cycle. These types of knees can be controlled through hydraulic control or smart fluids such as magnetorheological fluid and these control mechanisms change the way the knee reacts in each situation; the sensors act like a ‘brain’ in the knee and control the knee function to keep the user safe.

Upper limb bionic technology has developed to include systems capable of reading muscle activity and muscle activity patterns and controlling upper limb components off this muscle function.

They can include sockets which have electrodes which are essentially specialised sensors built into the walls and positioned over functioning muscle bellies in the residual limb. These tiny ‘sensors’ detect a change in muscle activity so when the user wants to perform a movement they can squeeze the muscle and this activity is detected by the sensor and this is converted into movement of the terminal device (hand or hook) on the prosthetic limb.

There are even systems emerging which allow the user to simply think about performing a movement as they did pre-amputation and the sequence of muscle activation which occurs allows movement of multiple upper limb joints at a single time which is exciting and ground breaking technology in the field of upper limb prosthetics.

If you have any questions or would like to know more about this, please speak to your prosthetist.

 

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