Occupational therapy in amputee rehabilitation
Rabeya Ferdous
Body parts are the main parts of human body. Human are incomplete without their body parts. Man cannot do their daily activities without any body parts like hand or leg. Unlike lower-limb amputations, upper-limb amputations are most often the result of sudden trauma to the body, although they also can be caused by malignancy, congenital deficiencies, and vascular disease. A person faced with such a life-altering change will have to make many physical and psychological adjustments to be able to fully participate in everyday life.
Common difficulties associated with amputations
The difficulties experienced by an amputee will have many varying factors including:
The location and type of amputation
Medical history and current health
Their home or work environment
Family and work roles and responsibilities
Occupational Therapy Treatment
The occupational therapy practitioner analyzes tasks and provides modifications to achieve functional goals
Providing education on compensatory techniques and equipment to accomplish tasks and activities
Providing prosthetic training
Identifying and addressing psychosocial issues
According to patients condition therapy can be changes.
What is assessed by occupational therapist:
Home Assessment: meet the individual in their daily situation, built rapport
Environmental Factors
Transfers
Mobility-Wheelchair/ discourage hopping
Personal and Domestic Activities of Daily Living (PADL and DADL)
According to assessment Occupational Therapist rehabilitates the patient in 4 stages. These are described below:
Acute Phase
The occupational therapist will begin evaluating the client and developing a client-centered intervention plan. Occupational therapy practitioners will provide wound care, address range of motion, begin desensitization, facilitate pain control, and provide psychological support. Short- and long-term goals related to activities that the client needs and wants to do will be identified.
Pre-Prosthetic Training Phase
The occupational therapy practitioner will introduce exercises for general conditioning as well as exercises specific to changes in posture due to limb loss or to the foreign weight of a prosthesis. During this phase, intervention will focus more fully on the skills needed to accomplish the activities that are most important to the client and to achieving the clients goals. In the acute setting, these goals often begin with basic daily living tasks such as feeding and dressing. During this time, adaptive equipment will be introduced and change of dominance training will be addressed if necessary.
As part of this phase, occupational therapy has a special role in preparing clients for fitting and optimal use of their prosthesis by using interventions such as edema control, desensitization, scar management, and noninvasive feedback for muscle control and instruction in body motions that may be used to operate the prosthesis.
Basic Prosthetic Training Phase
When the client receives the prosthesis, the occupational therapy practitioner will provide instruction donning and doffing, wear schedule, and basic controls. After the client has mastered these initial activities, he or she will begin to use the prosthesis for those basic daily living tasks previously identified as critical for achieving short- and long-term personal goals. The occupational therapy practitioner will monitor the clients ability to perform specific activities as competence in using the device continues to develop, and will provide modifications as necessary.
Throughout the rehabilitation process, occupational therapy practitioners provide support to help clients cope with the potentially devastating psychosocial effects of an upper-limb amputation. For example, they may facilitate interactions with others who have been through a similar experience, successfully met their goals, and achieved a good quality of life, which can offer critical hope and motivation.
Advanced Prosthetic Training
The occupational therapy practitioner will assist the client in integrating the prosthesis into more advanced activities such as child care, home maintenance, work activities, driving, sports, and hobbies. Discharge planning is occurring throughout this entire process.
