Note: In 2011, AOTA identified this and many other topics as emerging niches in occupational therapy. Today, many of these topics have become mainstream. Learn more about the 2011 Emerging Niche series here.
Why emerging? Approximately 1.7 million Americans live with a limb loss, and an estimated 1 in 200 Americans have had an amputation.1 As technology and scientific research advance, the possibilities for people who have lost a limb become seemingly endless. From bionic limbs that move with a person's brain and hand transplants that graft a donated hand, a new world of life after amputation is emerging. The need for occupational therapy following a hand transplant surgery, for example, is enormous—some clients receive more than 8 hours of occupational therapy a day.2
Get Involved: For the past 5 years, Marie Pace, MHS, OTR/L, CHT, and Kimberly Maguire, MS, OTR/L, CHT, have worked with the hand transplantation team at the University of Pittsburgh Medical Center (UPMC). The surgeon who championed the hand transplantation program asked the two OTs to be involved in planning and to provide therapy after the client received the transplant.
"I have observed the development of hand transplantation programs across the country and around the world in the last 2 years," says Pace. "It's going forward at a rapid pace and occupational therapists will need to get on board." Pace says that an occupational therapy practitioner working in this area will have a large time commitment and will be working with the hand transplant client for years. She recommends that practitioners be thoroughly familiar with published literature in the area of hand transplantation, which is also known as composite tissue allograft (CTA), and read books and articles about rehabilitation following CTA. Occupational therapy practitioners will need to work on a team with experienced therapists for practical reasons, such as scheduling therapy and enhancing problem solving, but also to prevent burn out.
"I feel that occupational therapists with specialized knowledge in hand therapy are critical to the success of the hand transplant clients," says Pace. "Our unique background of using and understanding activity provides the means by which the client can learn to use these new hands. Anatomy alone does not produce a greater sense of function and skill."
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Emerging Niche in All Practice Areas