rehabilitation of the upper limb amputee from acute care to through rehabilitation

90 Pages·2017·3.86 MB·English

by  Kathrin Gamble

REHABILITATION OF THE UPPER LIMB AMPUTEE
FROM ACUTE CARE TO THROUGH REHABILITATIO
N
Objectives
• Develop basic understanding of the rehabilitation
phases of amputee care
• Be able to describe options for upper limb
prostheses
• Describe the benefits of multi-articulating hand
terminal devices
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Etiology
PVD Trauma Tumor Congenital
BKA 43% 47% 7% 3%
AKA 37% 18% 33% 11%
UE 2% 79% 4% 15%
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The Rehabilitation Team
A team approach is of upmost importance for a person with an
amputation to function in an able-bodied society. The team should be
designed to meet the individual needs of the patient. As the patient
progresses through the different stages of the rehabilitation process,
the composition of the team will change as the needs of the amputee
will also change.
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Team Approach
• Patient and family
• Case Management
• Orthopedic Surgery
• Social Work
• Physical Medicine
• Religioous Ministry
• Occupational Therapy
• Psychological Specialists
• Physical Therapy
• Nutrition Care
• Recreation Therapy
• Administrative Support
• Prosthetics and Orthotics Team
• Biomedical Engineering • Anesthesiology
• Nursing • Pain Management Team
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Touch Bionics’ Philosophy
• Optimum patient outcomes are achieved when the Prosthetist
and Therapist work closely together with the patient
• Early therapy nearly doubles the rate of daily use (Fletchall,
2005)
• New research suggests skilled,
individualized therapy with the
prosthesis takes an average of 20-
30 hours (Resnik, et al., 2012)
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Treatment- 3 Phase Program
• Phase I: Wound Healing and Preparation of Residual Limb
- Wound care; Edema management/limb shaping; Exercises; Pain control
(mirror therapy); Desensitization; Adaptive Equipment Training; Discuss
Grieving in Limb Loss; Expectation Discussion (Peer Visitor)
• Phase II: Pre-Prosthetic Training
- Change of Dominance Training (Challenge); Independent ADLs;
Strengthening; Endurance; Balance; Scar Management
• Phase III: Prosthetic Training
- Don/Doff; Prosthetic Care/Limb Care; Operation of Device; ADLs with
Prostheses; Advanced Training
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Nine Phases of Amputee Rehabilitation
1.Amputation with surgical reconstruction
2.Acute postoperative
3.Preprosthetic
4.Prosthetic prescription and fabrication
5.Prosthetic training
6.Preoperative
7.Community reintegration
8.Vocational rehabilitation
9. Functional follow up
R.H. Meier, III, M.D, and A. Esquenazi, M.D
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Treatment- 3 Phase Program
• Phase I: Wound Healing and Preparation of Residual Limb
- Wound care; Edema management/limb shaping; Exercises; Pain control (mirror therapy);
Desensitization; Adaptive Equipment Training; Discuss Grieving in Limb Loss; Expectation
Discussion (Peer Visitor)
• Phase II: Pre-Prosthetic Training
- Change of Dominance Training (Challenge); Independent ADLs; Strengthening; Endurance;
Balance; Scar Management
• Phase III: Prosthetic Training
- Don/Doff; Prosthetic Care/Limb Care; Operation of Device; ADLs with Prostheses;
Advanced Training
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PHASE ONE
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