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Prosthetics and Orthotics in Rehabilitation Phase 4 - Occupational Therapy

As part of a comprehensive rehabilitation program, the patient will also need occupational therapy, especially if the patient has lost an arm. Independence is the ultimate goal of any therapy.

As in physical therapy, there are four phases to occupational therapy.

In Part 2 of the rehabilitation process, we will explore the first two phases of Occupational Therapy; the Healing Phase and the Preprosthetic Training Phase.


Phase 1: The Healing Phase

At this point, the patient’s limb will be tender, swollen, sensitive and weak. So this phase will focus on:

  • Controlling swelling and pain
  • Improving tolerance to sensations
  • Increasing range of motion (ROM).

The patient’s limb will be wrapped in an elastic bandage called a “shrinker”. This will help to control pain and swelling. The patient will likely feel like the missing limb is still there. This phenomenon is called, “phantom” sensation”. While these sensations may feel uncomfortable, the experience is quite normal. The therapist will massage the limb and teach the patient techniques to decrease phantom sensations and the sensitivity to touch of the residual limb. Range-of-Motion (ROM) exercises, will not only actively decrease swelling, but will prepare the muscles for use with the prosthesis they will operate.


Phase 2: Preprosthetic Training

If the dominant arm is lost, the patient will have to begin to learn how to change his hand dominance. The process may be frustrating, but that is to be expected. As the patient is learning to accomplish tasks with one hand, s/he will begin a rigorous strengthening program. It can be difficult to learn to complete daily activities with one hand, but the therapist understands that and will help patients work through these difficulties. Part of the process involves working with the therapist on a computer to train the remaining muscles to operate a myoelectric prosthesis. Electrodes will be placed on the skin over the muscles, and the patient will soon become aware of how those muscles work to operate a myoelectric prosthesis. Until the patient is proficient in activating these muscles, the therapist will work closely with him. This makes the next phase of therapy much easier to complete.

Next week, we will examine the next phase of prosthetic rehabilitation, Phase 3: Basic Prosthetic Training.

As always, if you are in need of post-operative prosthetic or orthotic rehabilitation, don’t wait for your family physician; visit Excel Rehabilitation Services on Burnside Ave. in Gonzales, Louisiana. You will receive one-on-one pr`ofessional care from an experienced physical therapist!


Online Sources:



Rosenbaum-Chou, Teri PhD; Daly, Wayne CPO; Austin, Ray ATA; Chaubey, Pravin MS; Boone, David A. PhD, CP, MPH. Development and Real World Use of a Vibratory Haptic Feedback System for Upper-Limb Prosthetic Users

Patterson PE, Katz JA. Design and evaluation of a sensory feedback system that provides grasping pressure in a myoelectric hand. J Rehabil Res Dev 1992;29(1):1–8.

Meek SG, Jacobsen SC, Goulding PP. Extended physiologic taction: design and evaluation of a proportional force feedback system. J Rehabil Res Dev 1989;26(3):53–62.


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