1 - 4 Weeks Before Surgery
Biofeedback, muscle stimulation, and visualization techniques are used to isolate and exercise the flexors and extensors to facilitate functional motor control after the transplantation. You will be taught these techniques and required to practice them at home before the transplant surgery.
Therapy sessions will be about one hour in length. You will attend one to three times per week for two to four weeks, depending on how quickly you learn the concepts and exercises. These treatments are not painful. You will have to perform the home program at least five times a day for 10 minutes.
2 - 10 Days After Surgery
Patients wear a splint on the transplanted hand at all times. The shoulder and elbow will be exercised several times a day, and the arms will be positioned in bed to help manage swelling. At this point, you cannot use your hands for any daily living tasks. You will be in the hospital and participating in therapy for one to two hours twice a day.
10 Days After Surgery
Patients wear a splint when not exercising the transplanted hand. Using adaptive techniques, you can start using the hand with daily living tasks. Your splints will likely need modification as the swelling goes down. Daily therapy sessions last from two to six hours.
3 Weeks After Surgery
Patients continue to wear the splint when not in therapy. Therapy during this phase focuses on adapting functional tasks so that you can start to be as independent as possible. You will be seen in the outpatient clinic daily for two to six hours.
6 Weeks After Surgery
Patients continue to wear the splint when not exercising. A smaller splint will be made for you to wear while exercising. You will be able to start moving the hand and wrist more. Therapy sessions will involve exercising the hand, practicing functional tasks (combing hair, using a cellphone), and reintegrating the hand into daily life. You will continue to be seen in the outpatient clinic daily for two to six hours.
3 Months After Surgery
Patients continue to wear the smaller splint for daily living tasks and when not exercising. In therapy, you’ll begin stretching and strengthening the hand. You will be able to complete a variety of functional tasks by this time. You will continue to be seen in the outpatient clinic daily for two to six hours.
6 Months After Surgery
If you are experiencing tightness, you may be wearing a new splint that stretches out the hand. By this point, therapy sessions focus on strengthening and improving motor skills. There may be some loss of range of motion as muscle tone increases. The frequency of therapy will depend largely on your progress and support system, but it often takes one to four hours a day, three to five times a week.