Occupational Therapy

Preparing upper limb prosthetic patients for success

Prosthetic Therapy and Training

Our on-site therapists work exclusively with upper limb loss patients to support the fitting process, provide training that is relevant to each person’s goals, and help them shift into life as capable, independent prosthesis users.

Therapy services are integrated directly into the expedited fitting process and follow a phased approach to maximize the rehabilitation potential of each patient.

Clinical Therapy Specialist works with a patient in the Kansas City Center on using her new electric multi-articulating hand-1

Progression of Care

Arm Dynamics Therapy Progression of Care Graphic

Phase 1: Perioperative

Perioperative care is the initial phase of occupational therapy and begins soon after injury or surgery. This phase involves assisting the patient with wound care, sterile whirlpool, ultrasound, debridement and edema control. The therapist recommends adaptive equipment to help the patient achieve more independence prior to receiving a prosthesis. The perioperative phase also includes scar management, range of motion, soft tissue mobilization and desensitization of the residual limb. The early involvement of a therapist helps ensure that the patient moves through the rehabilitation process without lapses in care.
A Clinical Therapy Specialist works on strengthening a patients limb who was thermally injuredArm Dynamics Clinical Therapy Specialist works with a partial hand patient on skin desensitization

Phase 2: Pre-Prosthetic

Pre-prosthetic training helps prepare the patient for wearing and using a prosthesis. This can include scar and soft tissue management, and focuses on residual limb shaping, developing upper limb strength, and training muscles with biofeedback software. Verbal instruction and plenty of practice teaches the patient how to isolate and contract muscles in the residual limb to eventually control the prosthesis. Therapists also educate patients about how to reduce some of the long-term problems associated with upper limb loss such as overuse injuries on the uninjured side, scoliosis, injuries on the prosthetic side that stem from poor body mechanics, and generalized back and neck pain.

A Clinical Therapy Specialist works on strengthening a patients limb before wearing her prosthesisMyosite Testing at the Minneapolis Office

Phase 3: Prosthetic Training

Prosthetic training is where therapists guide patients in the functional use of their prostheses and offer a range of essential information that includes:
  • Putting on (donning) and taking off (doffing) the prosthesis

  • A wear schedule, which outlines a gradual progression of how many hours a day the patient wears the prosthesis so their residual limb is not injured

  • Skin hygiene for the residual limb and basic care and maintenance of prosthetic components and accessories

  • Controls training that focuses on teaching the patient how to use the prosthesis, including opening and closing the terminal device at various speeds, operating the wrist, flexing and extending the elbow, and operating the shoulder

  • Repetitive drills training where the patient uses the prosthesis to manipulate objects of various sizes, shapes, weights and densities while sitting, standing and walking

  • Pre-positioning the terminal device to facilitate grasp and to decrease awkward body movements

  • Engaging in basic activities of daily living (ADLs) like eating, dressing, toileting, bathing, grooming and writing

This phase also includes adjustments to the alignment and controls of the prosthesis, and modifications to the shape of the interface or socket. The patient, prosthetist, and therapist work together to resolve any prosthetic and therapeutic issues, maintaining steady progress toward the patient's functional goals.

Portland Prosthetist MacJulian Lang, CP, FAAOP, works with transhumeral amputee Wendi Parker on using activity-specific attachments with her prosthesisClinical Therapy Specialist Carina Geraldez, MOT, OTRL works with bilateral transradial patient Jason Koger at the Dallas Clinic

Phase 4: Advanced Training and Lifelong Care

Lifelong care focuses on the patient's long-term prosthetic use and begins after they complete training and return home with their definitive prosthesis. As they increase their independence and use their prosthesis for more complex tasks, therapists may visit patients in their home to help with minor modifications and recommend adaptive equipment and other outside resources. This can include information on driver training and vehicle modification services.

Prosthetic success rates improve dramatically when therapists focus on activities that relate to the patient's specific vocational and recreational interests. Therapists may go to a person’s workplace to guide them on how to efficiently use their prosthesis on the job. Therapists may also accompany patients on initial visits to the grocery store, gym, restaurants and other locations.

An annual appointment with the upper limb prosthetic team addresses prosthesis maintenance, ongoing therapy needs and emerging prosthetic technologies.

Angel Giuffria works out with her activity-specific prosthesis with Arm Dynamics Prosthetist Rob Dodson, CPO, FAAOP in DallasGerry Kinney, a bilateral patient from the Kansas City Clinic, drives his car as a bilateral transradial amputee

Continuing Education Courses (CEU)

Occupational therapy is a critical component of successful upper limb prosthetic rehabilitation.

Arm Dynamics wants to be a resource for occupational therapists who work with upper limb amputees and prosthetic users. It’s part of our mission to improve rehabilitation and lifestyle outcomes for all people who have lost an upper limb or were born with a limb difference.

We’ve presented AOTA certified CEU courses on upper limb prosthetic rehabilitation for OTs in New Jersey, Pennsylvania, Ohio, Minnesota, Oregon, Oklahoma and Texas. Attendees earn 0.10 occupational therapy CEU for a one-hour course. Some of the information you can expect at an Arm Dynamics CEU course includes:

  • An overview of limb loss, upper limb prosthetics and prosthetic rehabilitation

  • The opportunity to see and hold six types of prostheses: passive, body-powered, myoelectric, hybrid, activity-specific, finger and partial hand

  • The opportunity to network with other professionals and learn from the national experts in upper limb prosthetic rehab

An Arm Dynamics Clinical Therapy Specialist presents a lecture on our Holistic Care Model
Arm Dynamics Clinicians give lectures around the US

The annual requirement for CEUs/PDUs is mandated by each state’s Board of Licensure for Occupational Therapy and varies from state to state. For more information, go to our Continuing Education CEU Page.