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Because this group is statistically small, therapists receive limited education on the rehabilitation needs of upper limb amputees. As a result, when seeing these patients in acute, subacute or outpatient settings, therapists may be unsure of how to best assist them. With more than 20 years of experience focusing on people with upper limb loss, our therapy team is available as a helpful resource for therapists who would like to know more about the rehabilitation process.
Trauma is the most common cause (see introduction) of upper extremity amputations. This is a significant difference from lower limb loss, where the leading cause is disease and the amputation is often a planned surgical intervention. The experience of trauma can magnify the psychological impact of limb loss, resulting in issues with anxiety, depression and substance abuse.
Therapists are trained to address both the physical and psychosocial impact of traumatic injury. The early involvement of a therapist gives patients professional support and guidance to cope with their injury and begin the process of recovery. Initially, therapists can assist with care of the residual limb, including pain management, swelling, shaping and stretching. They also help patients maintain their range of motion, endurance and strength. If a patient needs more psychological support, the therapist can refer them to a counselor or support group.
Connecting patients with resources for upper limb prosthetic rehabilitation is another key service that therapists provide. As they learn more about what to expect, patients begin to set goals and make informed decisions about their care. Upper limb prosthetic rehabilitation is a challenging process, and patients experience better outcomes (see introduction) when an occupational or physical therapist is available to help them integrate a prosthesis into their life.
Going to a prosthetic care center may give the patient an opportunity to meet and talk with other amputees, some of whom are further down the road in the rehabilitation process. At our Arm Dynamics centers, new patients are often introduced to their peers and are able to see videos of prosthetic users who have a similar amputation level and prosthetic device. Peer support and discussion (pg. 14) are critical factors in successful upper limb prosthetic rehabilitation.
Before prosthetic fitting begins, the patient should be informed of the range of prosthetic options that are available. The patient and prosthetist discuss the activities the prosthesis will be used for in order to determine what type of device is most appropriate for the individual. Our Arm Dynamics clinical therapy specialists play a key role in the discussion of prosthetic options. Once a device is selected, a request for authorization of prosthetic rehabilitation is then submitted to the insurance provider.
The initial fitting is for a preparatory prosthesis that will be used to test and perfect the fit of the socket and the design of the prosthesis. The preparatory device allows the patient to feel what it’s like to wear a prosthetic limb. The final, or "definitive," fitting is when the patient receives the optimized version of the prosthesis that they’ll use for several years. Throughout the fitting process, Arm Dynamics patients receive prosthetic training from a therapist who specializes in upper limb prosthetics.
After patients receive their definitive prostheses, they often return to the care of a local therapist. This is an ideal time for local therapists to connect with an Arm Dynamics therapist to ensure a smooth transition of care and support successful use of the prosthesis in daily life.
Upper limb prosthetic patients benefit from lifelong care. When a patient receives their definitive prosthesis and functional training from our Arm Dynamics clinicians, they’re contacted at regular intervals to check on their progress and offer assistance as needed.