Zusammenfassung

Rehabilitation nach Armamputation

Zunächst muss die Stumpfwunde gut heilen. Wenn dieser Heilungsprozess nach einigen Wochen abgeschlossen ist, beginnt die eigentliche Rehabilitationsphase. Sie dauert in der Regel bis zu einem halben Jahr.

Wann Sie mit der intensiven Rehabilitation beginnen können, wird Ihr Behandlungsteam anhand Ihres Genesungsfortschritts entscheiden. In der Rehabilitationsphase werden Sie gezielt auf das Tragen einer Prothese vorbereitet. Ziel ist es, Ihnen ein Höchstmaß an Mobilität und Unabhängigkeit zu ermöglichen, damit Sie Ihr Leben in Zukunft so normal wie möglich führen können. Entscheidend für den Rehabilitationserfolg ist jedoch Ihre aktive Mitarbeit. Auch Ihre Motivation und ein hohes Selbstvertrauen können einen wichtigen Beitrag leisten.

MyoTest

MyoTest and myo-training

Modern arm prostheses allow you to selectively approach and grasp objects. The prosthesis receives the commands for these movements from the muscles in the residual limb. Control of the prosthesis is myoelectric – that is, via muscle contractions. For example, contracting a certain muscle in the residual limb causes the hand to open.

The first step is completing what is called a MyoTest so the prosthesis can be customised to your precise needs. During this test, measurements are taken to determine whether you are able to control a myoelectric arm prosthesis. The process of determining the most suitable type of prosthesis for you is a joint effort based on this test and the capabilities ascertained in the subsequent myo-training. Only then does fabrication of the prosthesis begin.

Prosthesis training

Using the prosthesis

Putting on and taking off

There are various ways to put on and take off a prosthesis, depending on the type of prosthesis and the characteristics of your residual limb. Another crucial aspect is whether the orthopaedic technology used for your treatment is unilateral or bilateral. Your therapist will show you what method is most suitable for you during training in the use of the prosthesis.

You can moisten the skin in the area of the electrodes a bit before putting on the prosthesis. This reduces the skin resistance and improves the conductivity between the muscles or skin and the electrodes in the prosthetic socket. Without moisture, it may take a moment to get a good contact so you can optimally control the prosthesis.

A prosthetic glove touches the tip of the finger of an Ottobock bebionic hand

Care and cleaning

Your prosthesis requires daily cleaning and care. Wipe the inner socket with a damp cloth to remove any remaining perspiration and skin particles. Also clean your prosthetic glove according to the care instructions and check it for cracks. You will need to get the prosthetic glove replaced if it has any cracks. If you wear a liner, please care for it daily according to the instructions for use.

Control training and repeated exercises

Depending on the components in your prosthesis, you now learn how to open and close the hand, rotate it to the inside and outside, and also how to flex and extend the elbow joint. You also practise switching between various components.

The next step is practising movement sequences repeatedly. These sequences then become largely automatic so you don’t have to think as much about controlling the prosthesis and you can increase your endurance when tensing your muscles.

Cones, various games with shapes or a clip tree with individual clips that can be repositioned vertically and/or horizontally, for example, are suitable ways of practising. This requires precise rotation and grasping with your prosthetic hand.

Everyday training

After control training and the repeated exercises, you will be well prepared for more complex movement patterns. Everyday training is tailored to your personal needs. The exercises are chosen according to what is important for you in your everyday life and at work.

This training starts with simple activities, such as folding a towel, and goes all the way to preparing a complete meal. Training can also include getting dressed and undressed, opening a bottle and pouring a drink into a glass or handling items at your office workstation. Using a knife and fork so you can eat without any help again is also a big step towards renewed independence. You’ll be surprised at how much your prosthesis can help you with this.

Further therapy measures

Balance and coordination training

Since an amputation always affects your sense of balance as well, balance and coordination training is recommended. In the case of the latter, practising eye/prosthetic hand coordination is especially important, because your eyes now have to control the hand’s movements to compensate for the lack of feeling in the hand.

Advice on devices

If you find you have difficulties during certain activities with your new prosthesis in the course of rehabilitation, you can test various devices. Your therapist can evaluate whether this makes sense in your case.

However, the rule for all devices is always “less is more”. The less you need them, the more independent you will be in your everyday life. If you use a lot of devices in your home environment, you will be that much more dependent outside your home when you don’t have your special devices with you. That being said, such devices are sometimes indispensable if you have a bilateral amputation or a high amputation level.

Recreation and sports

Your prosthesis opens up new possibilities for recreational activities. Be sure to take advantage of this, because physical activity is always beneficial for your overall physical fitness. Please ask your therapist for information about this.