Occupational Therapy Practice Patterns for Military Service Members With Upper Limb Amputation

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Occupational Therapy

Background:

• Military Service Members (SMs) with upper limb (UL) amputation have access to occupational therapy (OT).
• Understanding OT practice patterns is crucial for developing best practice guidelines.
• This study examines OT utilization in U.S. Military SMs with deployment-related UL amputations.

Purpose of the Study:

• To identify preferred occupational therapy (OT) practice patterns for U.S. Military Service Members (SMs) with deployment-related upper limb (UL) amputations.
• To analyze OT intervention utilization based on amputation level and clinical rationale.
• To provide insights for developing best practice guidelines for OT services in this population.

Main Methods:

• Retrospective observational study using the Expeditionary Medical Encounter Database.
• Identified SMs with unilateral major UL amputation (Jan 2001-Dec 2014), excluding those with concurrent lower limb amputation.
• Quantified OT outpatient visits and treatment units in 3-month increments during the first year post-amputation, comparing above-elbow and below-elbow groups.

Main Results:

• A total of 29,878 encounters were analyzed for 148 patients in the first year post-amputation.
• Active treatments constituted 79.2% of all interventions.
• Above-elbow amputation patients received significantly more OT encounters and treatments from months 4-12 compared to below-elbow amputations.

Conclusions:

• SMs with UL amputation actively utilize OT services within the first year post-injury.
• Amputation level influences therapy utilization, with proximal (above-elbow) amputations receiving more visits in later months.
• Prosthetic training, therapeutic activities, and exercise are anticipated key interventions; further research on specific utilization patterns is recommended.