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Updated: Mar 28, 2026

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers
Published on: October 29, 2021
Upper Extremity Transplant Rehabilitation Protocol
Ravi Sankaran1, Subramaniya Iyer2, Mohit Sharma3
1Department of Physical Medicine and Rehabilitation, Amrita Hospital, Kochi, Kerala, India.
Background:
Multilevel upper extremity transplant presents unique rehabilitation challenges due to the complexity of restoring function and integration across multiple joints and tissue types.
Materials And Methods:
This article outlines the development and implementation of a pioneering rehabilitation protocol designed specifically for recipients of upper extremity transplant.
Results:
The rehabilitation protocol was structured in four progressive phases, emphasizing early preservation, neuromuscular re-education, activities of daily living retraining, and return to society.
Discussion:
The initial phase focuses on correct patient selection and preparation, wound healing, edema management, and maintaining passive range of motion while protecting the vascular anastomoses. As healing progresses, a tailored exercise regimen incorporating mirror therapy, task-oriented activities, and proprioceptive training is introduced to facilitate cortical remapping and sensory recovery.
Conclusion:
Multidisciplinary collaboration, including physiatrists and occupational or physical therapists, is crucial in addressing their recovery.

