The Living Well With Limb Loss Magazine

November | December 2014

TheProsthetics Printing Revolution

Research StudiesYour Role and RightsAdjustable Prosthetic FitWith a Twist of the Wrist

tech solutions

An Adjustable Fit With a Twist of the Wrist

Imagine being able to cycle, walk or do extreme sports without having to stop to adjust your socket, add a sock or get relief from cramping. What about not having to visit your prosthetist every time your weight fluctuates?

“People are constantly gaining and losing weight, retaining water and sweating,” explains Joe Mahon, CP, a Salt Lake City prosthetist-turned-inventor, the CEO and founder of Revolimb (Revolimb.com). “Shoes and belts are made to adjust for obvious reasons; why should prosthetic devices be any different? I think people have wanted adjustable prosthetic devices for a long time. Now they have a better solution.”

As a prosthetist, Mahon’s patients often complained about their sockets not fitting quite right. As a budding inventor, he wanted to develop a real solution. Mahon says he got the idea for Revolimb when he was snowboarding.

the Eureka Moment“I was on the chairlift when a patient called and wanted me to meet her at my office because she had recently lost some volume and wanted a pad put in her socket,” explains Mahon. “When I hung up the phone I selfishly thought, ‘If she could only adjust the socket herself, then I could continue to ski.’”

A minute later, watching his wife tighten the Boa® dials on her snowboarding boots, Mahon says the light bulb switched on. The Boa closure system (boatechnology.com) has

by Amy Di Leo

“The socket is designed with adjustable panels that, with a Boa dial attached to the panel, can tighten or loosen a prosthetic socket, reducing the need for removing or adding socks when your volume changes,” shares Stanley.

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been used in snowboarding and hiking boots, running, golf and cycling shoes since the mid-1990s. Instead of tightening laces by pulling on them the conventional way, the Boa system uses steel laces, nylon guides and a mechanical reel. Users simply turn a dial to tighten or loosen the fit.

On the slopes, Mahon wondered whether the Boa device could be used in the orthotics and prosthetics field. That night, he ripped apart his wife’s boots, removing the Boa system to see how it worked. His initial experiment yielded a promising result.

“The next day, I attached the Boa system to a prosthetic leg, chopped up the socket so it would articulate, and called my patient to come give it a try,” Mahon recalls. “She came in and put on the socket, walked around a bit, and then turned the dial to tighten the socket. As she walked down the hall she turned and said, ‘Joe, I think you are on to something.’”

Dial a thumbs upThat was 2009 and the patient was Tami Stanley, a 56-year-old mom and grandmother from Salt Lake City, Utah. Stanley became a below-knee (BK) amputee 10 years ago after developing

a bone infection from a softball injury. She enjoys team sports, cycling, skiing and hiking, and was the pilot of a two-person bobsled on the United States Adaptive Bobsled team from 2005-2009.

Now, thanks to Mahon’s invention, she can adjust the fit of her socket on her own while doing any and all of these activities – without stopping to add or remove socks, which often means removing clothing to get to the prosthesis.

“The Revolimb adjustable Boa socket is ideal for any amputee who experiences volume change while wearing a prosthesis, which is everyone,” shares Stanley. “The socket is designed with adjustable panels that, with a Boa dial attached to the panel, can tighten or loosen a prosthetic socket, reducing the need for removing or adding socks when your volume changes.”

Stanley adds, “My socket has an expandable back panel that can tighten and loosen to help reduce or increase volume pressure. I no longer find it necessary to remove my socket during high-activity levels. It has made a tremendous impact in relieving the pressure of my calf muscle during those activities and also allows for a much better fit when I experience volume changes throughout the day.”

“The main difference is that adjustment for current sockets mainly revolves around the changing of padding, or the addition of liners and socks to take up volume,” explains Jimmy Capra, director of Boa’s medical division. “The Revolimb solution allows users to continue to use their same well-tested liners and socks, but adds the functionality of simply dialing in the fit of the socket.”

Mahon says his invention has revolutionized the industry: “The Revolimb differs from previous products on a couple of different levels. Our products and designs give clinicians the tools they need to make a prosthetic device adjust. We also created a way to integrate the dial, the tubing and the housing into the composite matrix, as opposed to sewing, riveting or attaching it to the outside. This creates a stronger product and is a huge timesaver

Instead of tightening laces by pulling on them the conventional way, the Boa system allows users to simply turn a dial to tighten or loosen the fit.

Contact the Amputee Coalition at 888/267-5669 or amputee-coalition.org 35

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during the fabrication process. Plus, the Boa dial is also especially suited for those with limited or compromised hand function.”

“There is a wide range of prosthetics for which the Revolimb solution works well,” Capra adds. “The practitioner has a wide array of options for reel mounting and lace configuration, so they can utilize the system to create very customized solutions depending on the needs of the patient. Up to this point, we have had great luck with carbon fiber sockets, carbon ankle-foot orthoses, drop back sockets, sockets with elevated vacuum, supracondylar adjustment, Symes sockets, transfemoral sockets, and temporary sockets.”

lending Help for a HandToday, Mahon and his team continue working on devices to meet the needs of all amputees, not just those with lower-limb amputations.

For upper-limb amputees who use a myoelectric hand, a Revolimb device can put pressure on the sensors to give users a better contact for the electrodes that control the robotic hand. Arm amputees can experience fluctuations in volume throughout the day, so the Boa closure helps to control tension over the electrode sites, which reduces or eliminates erratic behavior by a bad connection.

“Our first patient tester was a professional bike racer who wanted to be able to tighten the fit of his leg during a race without stopping or taking off his socket to add socks. We soon had runners, skiers, climbers and sports enthusiasts wanting the same adjustability for the same reasons. Unexpectedly, a group of athletes who wanted an adjustable socket for the exact opposite reason – expansion – came to us. Their muscles would enlarge during some activities, and they wanted to be able to expand their sockets to avoid cramping.”

Asked about the future of this device, Mahon simply states, “You name it, we’ve most likely put a Boa dial on it for some reason or another.” And if he hasn’t, he surely will try it.

Mahon traveled to Haiti after the 2010 earthquake to provide low-cost prosthetics to victims in need; the Boa dial allows easy socket adjustment and they are impervious to water, sand and mud ... which is everywhere in Haiti.

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