Therapy seen as integral in rehabilitation for upper limb amputees

LAS VEGAS —Therapy for upper limb amputees is integral to O&P practices, as it fosters user satisfaction and lifelong relationships, according to a speaker at the Hanger Education Fair and National Meeting.

Joyce Tyler, OTR/L, CHT, a rehabilitation specialist for Hanger Clinic, said the lack of therapy could result in patients not using their prostheses. “We want a prosthesis to make a person more functional, not less functional. I think training helps with that,” she said. “If a patient uses their prosthesis, they are going to come back for another prosthesis. However, often times, they are not using the prosthesis because they were not appropriately trained.”

Joyce Tyler

Tyler said occupational therapists should act as coaches and provide three phases of prosthetic training: controls training; repetitive drills; and ADL/bimanual skills training. Bimanual activities can start with tying a shoelace, opening a tube of toothpaste, using scissors to cut paper, zipping a jacket and other common tasks, she said.

She added that good quality of myoelectric control includes smooth and fluid movements with minimal pauses before using a terminal device, spontaneous opening and closing, minimal device visualization when using the prosthesis, holding objects without dropping or crushing the objects, and minimal compensatory motions and postures.

“It is important that if you are fitting a patient for [an] upper limb prosthesis that they are trained in how to use it,” she said. “If a patient is going to be fit with a multiarticulating hand, it is important for the prosthetist to say at time of evaluation, ‘This is a great prosthesis, but you may need many hours of therapy to learn how to use it.’ I think it is important that it is stated upfront, so the patient is [not] frustrated when it is not as easy to operate as they thought it was going to be.” – by Jason Laday


Tyler J. Presented at: Hanger Education Fair and National Meeting. Jan. 30-Feb. 3, 2017; Las Vegas.

Disclosure: Tyler reports employment with Hanger Clinic.

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