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Prosthetics and Orthotics in Rehabilitation Phase 5 - 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.

Last time, we discussed the first two phases of Occupational Therapy of the rehabilitation process. This week we will explore the third phase of this process; Basic Prosthetic Training.


Phase 3: Basic Prosthetic Training Phase

During this phase, the patient will receive an initial prosthesis and begin learning how to use it. As the residual limb changes in shape and volume throughout this phase, the prosthetist may change the socket size. If the amputation involves an upper-extremity, the patient will likely receive three different types of prostheses:

  • An electric-operated (myoelectric) prosthesis
  • A body-powered, cable-controlled prosthesis
  • A passive, or primarily cosmetic, prosthesis.

The myoelectric prosthesis puts the least amount of pressure on the end of the limb, so if the limb is still tender, this may be the best initial choice. Batteries operate the motor of the electric prosthesis, and electrodes placed over the muscles of the patient send signals that operate his prosthetic wrist and terminal device (a hand, hook or prehensor). By prehensor, we are referring to a device that consists of a thumb-like component and a finger component and resembles lobster claws or pliers.

To operate your body-powered prosthesis, the patient uses his shoulder muscles to put tension on a cable that will open and close the prosthetic terminal device.

The passive prosthesis, sometimes called a semi-prehensile prosthesis, is lightweight and cosmetically pleasing. Though it can be used to assist in a variety of tasks, the terminal device does not open or close.

The patient will quickly learn to operate the prosthesis and then learn to use it for all daily activities, including teeth brushing, nail clipping, dressing and eating. The therapist and prosthetist will help the patient accomplish these goals every step of the way to patient independence


Next week, we will examine the final phase of prosthetic rehabilitation, Phase 4: Advanced Functional 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 professional 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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