Featured Musculoskeletal Rehab

How Sunnybrook’s prosthetics team helps patients return to maximum function

Monica Matys
Written by Monica Matys

The Invictus Games will soon shine the spotlight on the incredible talents and spirits of wounded, injured and ill active duty and veteran service members. More than 600 military competitors will compete in this third Invictus Games in Toronto.

Some competitors will use various types of prosthetics during the competition, so we reached out to Shane Glasford, Sunnybrook’s Team Lead of Prosthetics, Sunnybrook Centre for Independent Living (SCIL) to learn more about these devices.

How long have you been working in this field?
I graduated in 1994 so I have been working for 23 years in prosthetics.

How big is the team you oversee?
We have four technicians and five prosthetists.

What kind of patients do you see in SCIL?
We see patients that have lost a limb due to a multitude of reasons including congenital defects, trauma, and complications to diseases like diabetes.

What is the process of being fitted with a prosthetic entail?
The prosthetic treatment path has many steps. Patients first receive a thorough physical assessment, which includes how they hope to use a prosthetic in their daily lives. After that comes a cast of the remaining limb that is removed immediately and filled with plaster-of-paris. The Prosthetist then reshapes and smooths the plaster to appropriately distribute the body weight over the surface of that residual limb. After the socket is fabricated, the next step is alignment. This involves positioning the knee (where applicable) and foot in a position that ensures knee stability, and proper foot function while the patient is walking. This varies for everyone, and for new amputees, needs to be adjusted as their walking improves. During the entire process, the patient is also working with the physiotherapist to optimize their gait and prevent bad habits.

For our upper extremity amputees, the shape capture, rectification, and socket provision is very similar.

An extremely critical piece of the process is the work of the occupational therapist. No prosthesis can accomplish the range of tasks — from fine control to powerful work — our bodies can, so we work with patients to find the best compromise or a selection of devices to fulfill the patient’s needs.

In addition to the physical needs of your patients, how does your team address the psychological needs of amputees?
The prosthetists work within a multi-disciplinary team. While I have found the use of a prosthesis often improves the patient’s psychological outlook, it can also signify a major step “back” to their former lives.

Both social work and psychology experts are available at Sunnybrook to provide further support to patients if needed.

Tell me more about the customized work happening here at Sunnybrook.
Every prosthesis, be it for everyday wear or for a specific use like sport, is a custom manufactured device. Even the manufactured components – including feet, knees and adapters – are chosen from thousands of options. We try to accommodate each patient’s desires, from pictures or logos on the prosthesis to a realistic “skin”.

Are the technologies around prosthetic devices changing quickly?
We seem to be in a period of change. Some older ideas are getting a fresh spin and there are also a number of advancements becoming available. Overall, it’s a very dynamic field that continues to offer more choices to patients every year.

Will you be watching the Invictus Games?
I hope to! Many of the events are during the workday, but there are a few events on the weekend that I would like to attend.

About the author

Monica Matys

Monica Matys

Monica Matys is a Communications Advisor at Sunnybrook.

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