Physical therapy and occupational therapy management of a person with bilateral transradial amputations: a case report

Abstract

Objective This longitudinal case study describes the physical and occupational therapy interventions and recommendations for treatment of a person with bilateral transradial amputations during subacute rehabilitation, as there are currently few recommendations. Materials and methods A 53-year-old female with subacute bilateral transradial amputations received inpatient rehabilitation. Impairments include decreased balance, global weakness, and need for assistance with ADLs and transfers. Physical therapy, occupational therapy, nursing, a peer mentor, and a prosthetist collaborated. Interventions included task-specific and generalized strengthening, standing balance re-education, assistive device prescription, education using body-powered prostheses, home adaption recommendations, and activities of daily living practice. Results Patient progressed to independent functional mobility but required assist for activities of daily living and stairs negotiation due to limited caregiver support and poor prosthetic dexterity. She discharged to a skilled nursing facility. Conclusion 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. IMPLICATIONS FOR REHABILITATION Bilateral transradial amputations (BTAs) are a life-altering, but rare condition, meaning that literature surrounding this population is sparse and that guidelines for rehabilitation are unclear. This article provides recommendations so that clinicians can be better informed when treating BTA patients in the subacute phase and more quickly progress patients toward functional independence and discharge to the community.