Upper Extremity Prosthesis Users Develop Unparalleled Creative Skill Set

A congenital unilateral transradial amputee, Debi Latour, OT, realized
early in her life that she was different from most other children, including
her five siblings. She also learned, however, that there was nothing she would
be unable to accomplish, thanks to the determination instilled in her by her
parents, and a little bit of brainstorming.

Latour, senior occupational therapist at Shriners Hospitals for Children
in Springfield, Mass. — the same hospital where her parents fought for her
to receive a prosthesis when she was just 3 months old — did not let her
limb deficiency keep her from doing all the things she wanted and, as a result,
developed her creative thinking skills differently from her peers. It is
possible, she said, that this difference in problem-solving has even given her
a substantial lead over those peers.

“‘I can’t’ is not an option. I definitely was not
allowed to say that,” Latour said.

Her parents also did not shield her from the fact that she was different
— they helped her to embrace it. They told Latour they would help her find
a way to do whatever she wanted in life, despite the fact that she may have to
take a slightly different approach.

Latour said her disability is an asset as a clinician, and she uses that
to challenge her patients to expect more from themselves.

“There are times when I will sit on my left hand and only
accomplish the task with my prosthesis,” she said. She tells patients,
“‘If I can do it with this side, you can do it with your hand.’
It’s a great therapeutic tool.”

Congenital amputees innately understand how to complete
activities with their residual limb. However, to learn to use a body-powered
prosthesis with a traditional figure 8 or figure 9 harness suspension system, a
child must first learn to stabilize the prosthesis with the opposite shoulder
in order to use the terminal device and still have use of the intact hand, she
explained — a process she dubbed strategic motor planning.

This kind of learning can become intuitive in “super users,” a
title she gives to amputees like herself who wear prosthetic devices for most
of their waking hours.

“They will automatically do things, even to the point where
they’re reaching for something with their prosthetic side,” she said.

Latour also helped herself learn this by eliminating her harness system,
so that she is less constricted by the device. Now when she uses her prosthesis
to complete tasks, the process consists of more intuitive motor planning and
less strategic motor planning.

People other than “super users” can learn to employ these same
creative thinking skills, Latour told O&P Business News.

“When a person has the encouragement to move beyond a challenge,
and that includes thinking outside of the box, that ignites creative
thinking,” she said.

She said she also hopes to see more of that thinking to lead to simple,
but efficient solutions to problems instead of more advanced prosthetic

“It’s not to minimize the smart technology or the higher tech
ideas — those are needed and there is a population that needs that for
function. It certainly does have its place,” she said. “[However], I
love the idea of coming up with simple solutions that can be highly efficient
and effective, like a paperclip or a Post-It note.”

Or like the eraser on a pencil, a tool she uses to type on a keyboard to
avoid switching her terminal device. She shares tips like this on her blog,
Single-Handed Solutions, which she created during the summer as a way to have
the greatest impact on others trying to navigate the world with only one arm.

On the website, she uses anecdotes and photographs of herself to explain
how to perform functional daily life activities, from cutting meat and cooking,
to holding a bowl and scraping brownie batter into the pan, as well as how to
incorporate special prosthetic tools, although she personally does not use

“I may walk around with Mary Poppins bags of tricks, but most of
them are mental tricks; few of them are a literal bag,” she said.
— by Stephanie Z. Pavlou


  Chris Lake
  Chris Lake

Latour’s insight as both a prosthetic user and a clinician give her
a unique perspective that is informative and inspiring. It is a very exciting
time for the advancement of prosthetic technology, but the role of the
prosthetist can be much more than simply a provider of a prosthesis. Our
ultimate goal should be for the prosthesis to function as a natural extension
of the patient themselves.

Professionals have an opportunity to form lifetime relationships with
their patients, to understand how they as individuals learn and how we can best
help them adapt to their environment. Not just to support and encourage their
creative thinking process, but be willing to think outside of the box ourselves
and be a part of a team that finds solutions. As a prosthetic professional, I
continue to be impressed by the resiliency and creativity of my patients in
adapting to life with their prosthesis.

— Chris Lake, L/CPO, FAAOP
Chief clinical
director, Lake Prosthetics and Research, and chair, Academy Upper-Limb
Prosthetics Society

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