While there are currently few recommendations for treatment of a person with bilateral transradial amputations during subacute rehabilitation, this longitudinal case study helped to describe the physical and occupational therapy interventions and recommendations.
A 53-year-old female with subacute bilateral transradial amputations received inpatient rehabilitation. Her physical impairments include decreased balance, global weakness, and need for assistance with activities of daily living (ADLs) as well as transfers. A physical therapist, occupational therapist, nursing staff, a peer mentor, and a prosthetist all collaborated on her care. Interventions included task-specific and generalized strengthening, standing balance re-education, assistive device prescription, education using body-powered prostheses, home adaption recommendations, and ADLs practice.
The report’s authors found that though the patient progressed to independent functional mobility, she required assistance for ADLs and stairs negotiation due to limited caregiver support and poor prosthetic dexterity. The patient was discharged to a skilled nursing facility.
Results of the study showed that rehabilitation of a person with bilateral transradial amputations requires clinicians experienced with prostheses; excellent interdisciplinary coordination; early discernment of the available social support system; task-specific strengthening and coordination exercises to prepare the patient for prostheses; significant task-practice with prostheses; and a working knowledge of home modifications and adaptive equipment. This article describes recommendations, successful interventions, and lessons learned for future therapists when rehabilitating someone with bilateral transradial amputations.
Bilateral transradial amputations are a life-altering, but rare condition, meaning that literature surrounding this population is sparse and that guidelines for rehabilitation are unclear. The author’s article provided recommendations so that clinicians can be better informed when treating these patients in the subacute phase and more quickly progress patients toward functional independence and discharge to the community.
