Amputation

The goals of the amputation program are to assist the patient to achieve functional independence, to improve quality of life and to provide effective patient and family education. The Amputation Rehab Team works in developing individualized treatment plans aimed at assessing patient risk, promoting functional gains and teaching the patient and family effective coping skills for life after discharge from rehab. This program has an educational component that provides the patient and family the information they need during their rehab and when they return home. After a thorough assessment and consultation with the patient/family, the team establishes realistic goals for the patient to achieve.

The Amputee Program provides specialized evaluations and therapy for patients in the early post operative period to assess in the need for balance, transfer training, and wound and skin care. Improving strength, endurance and mobility are all a focus to assist the patient in reaching their goals. Prosthetic training directs attention to the patient’s activities of daily living, prosthetic gait and ambulation.

Specialized Care

Additionally, the program offers specialized care in important focus areas including:

• Adaptive techniques and utilization of assistive devices needed for completing activities of daily living.
• Coping with limb loss
• Techniques for desensitization of the residual limb
• Managing phantom limb pain
• Prevention of secondary complications associated with limb loss
• Prosthetic (Artificial Limb) options, management and proper fitting
• Skin/Wound Care of the residual limb
• Skin/Preventative care of the unaffected limb

The team provides training necessary to achieve those skills while focusing on the medical, social, emotional, spiritual and vocational needs of the patient and their family. As the patient achieves his/her goals, the team modifies the program to promote as much functional independence as able while ensuring the patient’s safety and well being. Rehabilitation psychologists assist patients and their family members/support system with learning techniques necessary for coping with limb loss. The program also incorporates peer visitors (individuals who have recently experienced limb loss) who will meet with patients to answer questions. The program also hosts monthly support meetings that are open to the community.

Technologies Involved

Therapies use the latest technology in rehabilitation to ensure the best results. A list of some of the technologies used in the amputation program follows:

LiteGait? The LiteGait is a therapy device used to promote the generation of walking patterns by controlling weight bearing, balance, and posture during walking therapy. LiteGait is like a second set of hands, because it frees the therapist to observe gait patterns and make manual adjustments in limb placement, weight shift, walking symmetry, and gait training. Proper upright posture is maintained throughout the training session, which facilitates changes in posture, balance, specific muscle strength, and overall gait patterns. The LiteGait can be used over ground or with a treadmill.

VTree A virtual reality system that works with both the physically and developmentally challenged. Programming works to promote: education, range of motion, life skills, balance, eye-hand coordination, speech, visual tracking, social skills, and behavior. Virtual programs are designed for both pediatric and adult clients.

Interactive Metronome Incorporates state-of-the-art technology that radically benefits patients with neurological disorders affecting motor skills and information processing. The incorporation of visual and auditory components enables patients to execute daily tasks and activities with great ease while assisting in the development of rhythm and balance. Interactive Metronome involves putting the patient into a technological environment in which he or she listens to various tempos and simultaneously performs corresponding actions.?This rehabilitation equipment proves to result in a dramatic improvement in brain development and coordination advancement.

Our Rehabilitation Team

The Amputation Rehab Teams at Allied Rehab Hospital and Heinz Rehab Hospital have dedicated teams of experienced professionals. Each individual’s treatment team is made up of a physiatrist (a doctor who specializes in physical medicine and rehabilitation), a physical therapist, occupational therapist, speech therapist, recreational therapist, respiratory therapist, a psychologist, rehabilitation nurses, a medical social worker, a dietician and rehab technologist, as required. They work together with the patient and their family to meet the unique physical, cognitive, social and emotional needs of the patient. Patients receive at least 3 hours of Physical Therapy, Occupational Therapy and/or Speech Therapy, 5 days per week. Prosthetic providers perform the construction and fitting of the prosthesis (artificial limb) and assist with the education regarding the use of a prosthetic device.

Plan of Care

Weekly team meetings are held to discuss each patient’s individualized plan of care and discharge plan. Patients and their families are encouraged to be active participants in the care and discharge planning process. The Medical Social Worker updates the patient and his/her caregiver to ensure full understanding of the current treatment plan and to address each patient’s concerns and challenges.

Upon discharge, patients continue with treatments designed to continue the transition toward an active, independent lifestyle. Allied Rehab and Heinz Rehab remain lifetime resources for the patient and their family. The Rehab team also maintains communication with each patient’s physicians to ensure the complete coordination of care throughout the recovery process.

The Transition Home

The ability to resume one’s life role and participate in the community to the extent desired is another goal of the Amputation Program. Community integration skills are taught as part of therapy and activities are practiced during the rehabilitation process. Patients and their caregivers are provided with a self-care training program based upon principles of self-advocacy and self-direction. Patients, with or without their caregivers, are taught how to direct their care and what to do if emergencies arise. They are provided with opportunities to practice these skills in the transitional apartment. This apartment helps the patients and their families get ready for the challenges they will face at home.

When appropriate, the team may perform evaluations of the home, school or work site to identify barriers and make recommendations for accessibility. The family works closely with the OT to assess the home and make accessibility changes as recommended. At discharge, patients and families are provided instructions necessary to ensure necessary follow up care. Discharge plans may include additional services from home health or outpatient. All pertinent discharge information is forwarded to the patient’s primary care physician and therapists to facilitate a? smooth and safe transition to the next care provider. After discharge, patients receive surveys and follow-up phone calls to assess their satisfaction with their service, assess their functional status and determine if there are any on-going needs.

At Allied Rehab and Heinz Rehab, rehabilitation does not end when a patient is discharged. In addition to inpatient rehabilitation, we offer a wide range of post-acute care services to meet the needs of the patients we serve including: Home Health, In Home Services, Outpatient Rehab, Long-Term Care and Personal Care. In addition, patients are educated on how to access physiatric and prosthetic follow up care.

Admissions and Referrals

Patients are admitted to the amputation rehabilitation program at Allied rehab when they are medically stable and determined appropriate for a rehabilitation program. Referrals may be made by a private physician, general hospital, family member, or those who have been injured themselves. To initiate a referral or for additional information, please call (570) 826-3885 (Wilkes-Barre) or (570) 348-1359 (Scranton).