Page 182 - Handbook of Biomechatronics

180 Georgios A. Bertos and Evangelos G. Papadopoulos

1.2.2 What Would be Ideal?
Amputation is a very traumatic experience. A team of disciplines is needed
for the optimal rehabilitation of the patient, namely a team of surgeon,
physiatrist, prosthetist, psychologist, occupational therapist, etc.
According to Beasley (1981), the only measure of success is: “how well
the patient will be reintegrated in normal life.” Normal life could be dif-
ferent things for different people according to their priorities and experi-
ences. For example, a teenage girl would prioritize more the cosmesis of
the hand: how natural her hand looks and how she is not perceived by
others to wear a prosthesis. A farmer might be more interested in using
his hand as a tool to perform everyday farming activities. So, where we
conclude is that everyone would prefer to have his/her natural hand which
is very versatile in functionality. Is this the best we can do? The best we
could do is to make the prosthesis to have characteristics that are better
than the natural’s hand and therefore one might be eager to have a pros-
thesis better than the natural hand.

1.3 Characteristics of a Prosthesis
1.3.1 Cosmesis
As we mentioned before, cosmesis plays a big role for many amputees.
Humans do not want to be different in a negative manner. Cosmetic pros-
thesis for upper-limb amputees, especially of lower levels (transradial, wrist
disarticulation, or finger amputation) is the choice from a lot of amputees.
For example, in one study 19 out of 30 upper-limb participants had cosmetic
prosthesis (Dudkiewicz et al., 2004). Many amputees, if they can afford it,
have a cosmetic prosthesis for social activities, for example, going to a gath-
ering, concert or a festival and have another functional prosthesis at work or
at home. It all depends on the character, how social the person is, what age
the person is, how the person feels psychologically, and how the environ-
ment (family and social group) is treating the person. This is a multivariable
subjective situation.

1.3.2 Function: What the Expected Set of Movements Is
Functionality in upper-limb prosthetics is a controversial subject. The
human hand is a very delicate, functionally “flexible” instrument which is
difficult to replace. By “flexible” we mean ability to perform a broad spec-
trum of tasks (from piano to heavy lifting). In its entirety, the human hand or
arm has a very complicated anatomical structure and control. What matters,
is again how that capable “instrument” is used in one’s life. That localization