Limb Loss Awareness Month & OT Month
There is probably a reason why Occupational Therapy (OT) Month and Limb Loss Awareness Month fall at the same time. No matter if you were born with a limb difference or went through an event that led to limb loss, your trusty OT is the one you can rely on. Acknowledgement and awareness of both of these scenarios is crucial.
For the purposes of this blog, we will focus on upper limb difference and loss.
There are a number of ways one might suffer from upper limb loss. There are also a number of amputation levels that one may encounter depending on the severity of the incident they were involved in. The level of amputation or limb difference will impact the rehabilitation and prosthetic care plan.
When it comes to fitting someone with an upper limb prosthetic device the “Golden Period” to do the fitting in is within 30 days. If an individual is fit with their new upper limb prosthetic device within that 30 day window, the success rate of them using that device as their new every day tool is 93%.1
A study by Biddis and Chau (2008) also found that individuals fit within 6 months of an acquired amputation were 16 times more likely to continue to wear their prosthesis than those fit after 6 months.
Taking all of that into consideration, as well as someone’s readiness for the next phase, someone who suffers from upper limb loss typically has 6 prosthetic options following a traumatic event:
1. No Prosthesis
2. Passive Functional
3. Body Powered
4. Myoelectric / External Power
6. Adaptive/Activity Specific
For those individuals who have chosen to be fit with a prosthetic device, of any kind, it is important to note that early therapy nearly doubles the rate of daily use (Fletchall, 2005), and research suggests that skilled, individualized therapy with the prosthesis takes an average of 20-30 hours (Resnik, et al., 2012). It is important to commit to training to learn to use the prosthesis functionally.
Achieving successful outcomes with any upper limb prostheses can be challenging and, without the correct training, an advanced prosthesis may ultimately be rejected. To achieve the best outcomes, prosthetists and therapists must work together with the client.
We feel that there are a number of key elements of ensuring a successful outcome:
1. Experienced medical and rehabilitation team management
a. Making certain that the prosthetist and therapist are knowledgeable and trained in upper limb fittings.
2. Prescribing a prosthesis to those who are appropriate candidates
a. Unless an upper limb has been appropriately screened for candidacy, the outcome will be compromised. It is important that the user’s goals match the capability of the prosthesis.
3. Skilled fabrication of the prosthesis
a. This is critically important. A poorly fitting prosthesis will limit the user's ability to succeed with it.
4. Skilled occupational therapy training of the client in the use of the prosthesis
a. A client's success with an upper limb prosthesis will be greatly increased if they are properly trained in how to use it to achieve the tasks they undertake on a daily basis.
5. Comprehensive follow-up with consistent data gathering and documentation of functional needs
a. Analyzing a user's experience with an upper limb prosthesis is the only way to truly learn what benefits it brings them.