Treatment for Amputee Patients

The treatment prescribed for the amputee patient is individualized and the treatment setting may vary among patients. Many factors such as whether the amputation was disease-related or traumatic, the physical condition of the patient prior to amputation, and the location of the amputation will determine the most appropriate setting. The patient may then be referred to either the inpatient rehabilitation unit or outpatient clinic.

Our interdisciplinary team of rehabilitation experts specialize in meeting the needs of patients with upper and/or lower extremity amputations. A Baylor physiatrist (a physician specializing in physical medicine and rehabilitation) leads the treatment team. Through frequent contact with patients and team members, the physiatrist closely monitors progress to maximize rehabilitation effectiveness.
The patient's specific needs determine which services are represented on his team. The team may include:

• physical therapist
• occupational therapist
• therapeutic recreation specialists
• social worker
• rehabilitation nurses
• psychologist
• prosthetist

Physical Therapist
The physical therapist works with the patient with lower extremity amputation to improve muscle strength, maintain range of motion, prevent contractures and improve endurance. Patients are then taught mobility skills such as how to get in and out of bed, maneuver a wheelchair and how to move from the wheelchair to surfaces such as the bathtub/shower, toilet, car and floor. The patient also works on walking without the prosthesis by using an assisted device such as a walker or crutches. If the patient is determined medically appropriate, the patient is then fitted for a prosthesis and begins training to walk with it. Physical therapists may also provide wound management services, if needed.

Occupational Therapist
Occupational therapists focus on activities of daily living. Patients learn how to bathe, dress and feed themselves by practicing techniques that compensate for problems with movement and balance. Occupational therapists also work with patients with upper extremity amputation to help increase range of motion, prevent contracture, improve muscle strength and provide training with upper extremity prosthetic devices.

Therapeutic Recreation Specialists
Therapeutic recreation specialists help patients re-enter the community and participate in leisure activities. Patients are encouraged to resume their previous lifestyle and are taught ways to adapt their activities. Group activities also provide an opportunity for patients to socialize and participate in recreational activities. Patients are also educated regarding community & leisure resources.

Social Worker
Social workers help the family address the emotional, social and financial impact of the patient's medical condition. They also help the patient in discharge planning which includes coordinating the transition of the patient from one setting to the next, whether it is from an inpatient to outpatient setting or from an inpatient setting to home.

Rehabilitation Nurses
Nurses provide education to the patient and family on how to care for the limb. They also focus on reducing the swelling and shaping the limb in preparation for a prosthesis. Nurses help the patient carryover any skills learned in therapy to their daily activities.

Psychologist
A psychologist helps the patient ease the trauma that results from the loss of a limb and help the patient adapt to the changes. Areas typically addressed include changes in self-esteem, body image, lifestyle, and quality of life. Psychologists are available through individual counseling and group meetings.

Prosthetist
A prosthetist typically meets with the physician, therapist and patient in a coordinated clinic so that each area of specialty may share valuable information in evaluating and determining the most appropriate prosthetic device.