Occupational Therapy: Training Postural Control For Functional Upper Limb Prosthesis Use

Abstract

Healthcare professionals working with upper limb (UL) amputees more often than not, have the privilege of working with a generally healthy patient population. Traumatic loss of the upper limb in previously active and productive persons does not remove their intrinsic motivation for active participation in life. As they recover from the abrupt change in their functional status, this innate drive may be somewhat diminished for a time. However, with a supportive environment for recovery, it is possible to return to a healthy and productive lifestyle. It is incumbent upon rehabilitation professionals to create optimal conditions for patient success. Meeting this challenge requires the coordinated efforts of a rehabilitation team focused on the dynamic functional use of a prosthesis by the primary team member-the patient. Partial or total loss of the UL and the associated harmful impact to motor, sensory, perceptual and biomechanical systems coalesce to influence the amputee’s rehabilitation process. Of these, research suggests the potential sequelae of conditions status post UL amputation include lateral curvature of the thoracic spine. This orthopaedic abnormality in conjunction with deficits in motor systems, may have a negative influence on the dynamic function of the upper quadrant. Occupational therapists experienced in treatment of UL amputation patients utilize evidence-based methods of treatment to mitigate the physical deficits impacting functional UL prosthesis use. A review of literature to examine the effects of UL amputation to the upper quadrant and a broad view of the applicable therapeutic modalities to address resultant deficits will be presented. Specific emphasis will be given to the rehabilitation team approach to dynamic postural control for UL prosthesis use in functional activity.