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Occupational Therapy

Preparing upper limb prosthetic patients for success.

Prosthetic Therapy and Training

Perioperative Phase

Pre-Prosthetic Phase

Prosthetic Training Phase

Advanced Training and Lifelong Care Phase

Continuing Education (CEU)

Prosthetic Therapy and Training

Our on-site therapists work exclusively with upper limb loss patients to support the fitting process, provide training that’s 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. There are four key phases to prosthetic therapy and training: perioperative, pre-prosthetic, prosthetic training and advanced training.

Each phase focuses on different aspects of a patient's rehabilitation journey, making sure that they receive the support and training they need to progress.

Progression of Care

 

Perioperative Phase

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.

Pre-Prosthetic Phase

Biofeedback Therapy
Jennifer Peterson Pre Prosthetic Therapy
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.

Prosthetic Training Phase

Interim Care
Interim Care

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
  • The 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.

Advanced Training and Lifelong Care Phase

Patient playing fun games outdoors with therapist Kerstin Baun and Dan Conyers, National Clinical Director
Angel Giuffria training with clinician Rob Dodson in gym

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.

Continuing Education (CEU)

Therapist Kerstin Baun with Pediatric Patient Jameson Davis
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.
Joby Varghese On Site Job Therapy

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: cosmetic/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
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.