Upper Extremity Transplant Rehabilitation Protocol

Abstract

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.

Keywords

hand transplantation - rehabilitation - functional recovery - motor re-education - occupational therapy - nerve regeneration

Patients' Consent

Written informed consent was obtained from the patient(s) for publication of this case report and any accompanying images.

Ethical Approval

This study was approved by the Institutional Ethics Committee, and conducted in accordance with the Declaration of Helsinki and applicable national guidelines.

Publication History

Article published online:
20 August 2025

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