Training in the use of the motorised hand
An Occupational Therapy perspective

Occupational Therapists: S. Vimal, Hubert Arul, Sangeetha Martin, Helen Mini & Lydia E.Raj

GOAL

Independence in Occupational Performance tasks (ADL, Work and Leisure) without the undue need to modify the external environment.

Pre Prosthetic Phase - Preparing the limb for a prosthesis

Prosthetic phase

• Improve prosthetic wearing tolerance
• Functional use
• Adaptive methods to complete Independent living skills
• Psychological Support

The Pre Prosthetic Program

• Wound care
• Desensitization
• Residual limb Bandaging
• Maintaining Passive and Active ROM
• Increasing Upper Extremity Strength
• Education regarding the Prosthesis

Prosthetic Phase

• Wearing and removing the prosthesis
• Control Training
• Functional Training
• Community Participation
• Home Program
• Follow Up

Bilateral Amputee Wearing the Prostheses

Prosthetic Training

• Hygiene and care
• Prosthetic tolerance - Initially ½ hour; slowly increased to 2 hours

Functional Training

• Pre positioning: Pre position hand in optimum position to grasp an object or perform an activity
• Prehension Training: Progress from large hard objects to soft, then to crushable objects
• Activities of daily living
• Community use
• Return to work

Training in handling Objects (Prehension Training)

Handling medium objects

Handling small objects (fine motor tasks)

Bilateral Activities

• Unilateral amputee doing bilateral task:
  
• Bilateral amputee doing bilateral task:
  

Activities of Daily Living

Unilateral prosthesis users: Pre position the hand and use the Prosthetic extremity as a stabilizer and the sound limb as the active mover

• Eating
  
• Grooming
• Toileting
  
• Dressing - Upper body and Lower body
• Communication
• Work
  
• Leisure time Activities
  
• Home Making

Eating and Drinking

Video: Bilateral Amputee eating with prosthetic hands

Recommended Activities

Activities of daily living Including

• Eating and Drinking
• Dressing, Grooming
• Simple Household tasks (Mopping, Sweeping, Cutting vegetables, etc.)

Heavy Tasks including

• Stabilizing during cutting
• Holding nails, blocks of wood, etc.

Video: Bilateral Amputee using prosthetic hands riding a bicycle