Margaret F. Wise, OTR, CHT, CVE
Upper Extremity Specialists
Integrating occupational therapy through all phases of care of the person with upper limb amputations has a positive effect on the rehabilitation process and eventual long-term outcomes. With a strong background in physical treatment and functional care, the OT provides a valuable service to the prosthetist by coordinating comprehensive care as well as aiding in evaluation, planning and execution of the prosthetic plan.
The therapist is often one of the first professionals involved in the care of the upper extremity amputee. The initial goals of therapy during the acute phase of rehabilitation include the following:
Develop rapport with the family and patient.
Perform screening evaluation.
Promote wound healing.
Establish early edema control measures.
Preserve passive range of motion.
The rehabilitation program progresses, as the patient's medical condition is stable enough to allow for a more active role in care. Once stable, the patient is able to participate in other phases of rehabilitation which include:
Basic prosthetic training and
Advanced functional skills training.
The occupational therapist and prosthetist share information gathered to individualize the treatment program and to promote better overall care. The professionals communicate frequently and share information gathered to assure that all goals important to the patient are achieved at each stage of care. The occupational therapist and prosthetist, working cooperatively with the patient, help assure long-term prosthetic use.
Smith, DG, Michael, JW, Bowker, JH (eds), Atlas of Amputations and Limb Deficiences: Surgical, Prosthetic, and Rehabilitation Principles. 3rd ed. Illinois: American Academy of Orthopaedic Surgeons, 2004: Chapters 8-12.
Muzumdar, A (ed), Powered Upper Limb Prostheses: Control, Implementation and Clinical Application. Springer-Verlag Berline Heidelberg, 2004: Chapters 7-8.
Proceedings from the University of New Brunswick's Myoelectric Controls/Powered Prosthetics Symposium, August 25-27, 2002.
Hubbard S. Myoprosthetic management of the upper limb amputee. In Hunter J, Mackin, E, Callahan A (eds), Rehabilitation of the Hand and Upper Extremity, 4th ed. St. Louis: Mosby, 1995. pp. 1241-1252.