A harness may be part of a prosthesis, depending on the level of limb difference and the type of prosthetic terminal device the person is using. In the image below, you can see our patient Ernesto, who has an above elbow or transhumeral limb difference using his body-powered hook. Most transhumeral patients require a harness so their prosthesis can stay on their arm comfortably and securely.

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In addition, most body-powered devices worn by people with either above or below elbow limb differences require a harness so they are able to use the tension provided by the harness to move the device. Here you can see our patient Sherry with her harness:

Scott Explains Social

In the gif below, you can see our patient Jason, who has a bilateral limb difference, show how the harness works to open and close body-powered devices:

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Our prosthetists and occupational therapists know that a harness must be as comfortable as possible, because if any part of the prosthesis is uncomfortable, the patient may stop wearing their device. Making a harness comfortable means focusing on the specific shape and size of the individual. Do they have a larger body? Are breasts a factor? Is there scar tissue that needs to be cushioned? What about muscles that need to be worked around? Will they be using this harness with a lighter body-powered device or will they need extra harnessing to accommodate for a heavier myoelectric device? All of these things are taken into account by each of our prosthetists before they begin to custom-design a harness, and are considered by our occupational therapists when they are teaching our patients how to use their device and making adjustments to harnesses as they watch the patient move with it. Below you can see some examples of the different custom devices we create:

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Marissa, pictured above, asked for a custom mermaid frame for her prosthesis and specified that she did not want it to have an elbow joint. She wanted to focus on learning how to use her wrist and V2P terminal device , which is body-powered, and opens and closes when she moves her shoulder and harness.

Our patient Dakota had gone to another provider before coming to an Arm Dynamics center, but found the prosthesis they made for him was too heavy. When he came to us, we focused on making a lighter frame and creating balance. Dakota’s new, well-balanced prosthesis, pictured below, can help a lot with the perception of weight.

Gloria, Dakota SD Myo

Our patient Heather, pictured below, has a bilateral below elbow difference. She’s using a body-powered hook and harness on one side, and an ETD on the other. This combination works for her some tasks she finds easier using a body-powered device, other tasks are better with a myoelectric device.

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As you can see, there are so many ways to make a harness work for each individual. In addition to these options, there are others, especially for women. There is a “Brathesis” Prototype that the VA has been developing. There is also a “sticker” made by TRS Prosthetics, also known as a “Cutaneous Anchor.” If either of these type of options interest you, please speak with your prosthetist. Once they understand that you are looking for something different from the traditional options, they may be able to create a custom design that works best for you.

We have a few patients who’ve asked us to include unique design features on their prostheses.

Our patient Wendi underwent an elective, above elbow amputation, and then went without a prosthesis for a few years after. During that time, she had adjusted to life with a shortened limb, and she wasn’t interested in a “regular” prosthesis. Her prosthetist, Mac, in our Portland center, designed her unique prosthesis. Because of the length of her residual limb, and the fact that she didn’t have a forearm frame on her prosthesis, adding to the weight and length, she is able to have a transhumeral limb difference and a prosthesis that does not require a harness. Instead, her prosthesis utilizes the adjustable BOA lacing system, allowing her to use dials on her prosthesis to tighten the device when needed:

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Our patient Max, who has a congenital, above elbow limb difference, is also able to utilize the BOA lacing system that allows him to workout without a harness and to adjust his socket to a tighter or looser fit.

Max Feature

Wendi uses a body-powered device and Max uses an activity-specific, but our patient Sherri, pictured below, who has a transhumeral limb difference, uses a myoelectric device. Sherri was born with her limb difference, and so grew up wearing a harness. After years of doing so, she felt she just couldn’t subject her body to anymore harnesses. We were able to accomodate her needs because we use fitting techniques that allow us to minimize the need for harnessing whenever possible. She was willing to get surgery on her residual limb to allow her to wear a transhumeral prothesis using suction:

Sherri McCall on her scooter - Emily - with her transhumeral myoelectric prosthesis

We wind up creating a lot of very unique upper limb devices for our patients, partially because we give them the freedom to tell us what they need and partially because we have the experience to fulfill their requests. When a patient is in need of a prosthesis that may require a harness, coming to a prosthetic care provider like us is crucial, since we only offer care to patients with upper limb differences. The majority of prosthetic care providers see mostly lower limb patients. Lower limb harnessing is rarely needed, and suspension requirements for an upper limb prosthesis are very different. We believe that a comfortable, custom-fit harness makes an important difference in how well an upper limb prosthesis feels and functions.

Sam Rosecrans

The word harness may sound restrictive, but when fit correctly, it can offer people the freedom that comes with having a comfortable and functional prosthesis.

If you or someone you know is interested in learning how we can provide well-fitting harnessing as part of our overall prosthetic care, please contact us. If you would like to leave a comment, please do so below.

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