Occupational therapist discusses team approach for upper extremity amputations

ATLANTA — Amy Todd, MS, OTR/L, CHT, discussed the importance of therapists working with upper extremity amputations as part of an interdisciplinary team approach during her presentation at the International African American Prosthetic and Orthotic Coalition Annual Meeting.

“We want to look at this as a total team approach, and that is what will give us our best outcomes for everybody,” Todd, an occupational therapist and certified hand therapist, said in her presentation.

The team approach should include the physician, prosthetist, therapist, social worker, psychologist, rehabilitation nurse, case manager, dietitian and vocational counselor, according to Todd.

“You want to try to keep these lines of communication open as much as you can,” she said as to why prosthetists should work with therapists. This includes documentation for insurers and other payers.

She also explained the difference in therapist credentialing between occupational therapists, physical therapists and certified hand therapists, and how they evaluate patients. She explained that physical therapists focus more on the body and pain, while occupational therapists look more at activity and the person, and how it relates.

“What is that middle zone where the body and mind meet?” Todd asked the audience in explaining a therapist’s role in rehabilitation.

The length of time after the amputation matters to success of the patient with the prosthesis, Todd said. If a prosthesis is fitted within a month of amputation when appropriate, the success rate is more than 90% in integrating the prosthesis into a patient’s life; however, the rate drops to 42% if the person is fitted more than a month after amputation.

She added that while lower extremity amputations are most often due to vascular or planned amputation, upper extremity amputations are most often due to trauma. Men are more frequently affected by an acquired upper extremity amputation, she said.

As patients gain independence, they are faced with limitations, Todd said.

“Basically, encourage the patient to visualize what his life looks like in the future, since the accident has changed the prior course,” Todd said as a patient goal.

After the patient has become proficient with the prosthesis, higher-level activities include work task training, vocational retraining, sports and recreational activities, Todd said. – Bruce Thiel



Todd A. Therapist management of upper extremity amputations. Presented at: International African American Prosthetic and Orthotic Coalition Annual Meeting; Oct. 26-28, 2017; Atlanta.


Disclosure: Todd reports no relevant financial disclosures.

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