Indikationsprüfung neuer Armprothesen

Abstract

The patient-centered provision of a suitable prosthesis after amputation of upper limbs is a major challenge. Ultimately, the goal of this care is a final situation comparable to that of a healthy person. In Germany, the right of direct compensation of a disability is anchored in the Social Security Books V, VI, VII and IX together with the right of rehabilitation. Within the field of statutory accident insurance, it is possible to select the type and extent of the treatment in relation to the provision of auxiliary means; however, the accident insurance providers have to examine the specific needs for providing therapeutic appliances. In order to select the right prosthesis type and, if necessary, its most favorable configuration from a variety of options, a measurement system is required in which the levels of the International Classification of Functioning, Disability and Health (ICF) are depicted and which takes the individual requirements of patients into account. Validated assessments, such as OPUS and AM-ULP are part of the test for the indications. Within the process, the operation of the prosthesis at the functional level and the utilization at the activity level are tested. To evaluate the ability to participate, complex activities are examined in everyday situations, which are determined together with the patient. The probability of long-term care plays a major role throughout the whole assessment. Special attention is given to spontaneous use, possible evasive movements and the relief of the contralateral healthy side as well as the spine. To maintain a high degree of objectivity, patients and medical personnel evaluate the individual tests independently. At the same time, video analysis of significant sequences regarding the function, activity and participation test are prepared.