But what becomes of old medical devices such as walkers, wheelchairs and prosthetic limbs? With nearly 2 million amputees in the United States alone, there are likely many households with prosthetic limbs not currently in use.
"Prosthetic limbs that are no longer being used often end up in the garbage or at the bottom of a closet. We are trying to change that," relayed Keith Poulin, MSPT, director of outpatient rehab services, New England Rehabilitation Hospital in Woburn, MA.
In collaboration with the FDR Center for Prosthetics and Orthotics, New England Rehabilitation Hospital began holding donation events so members of the community can drop off pre-owned artificial limbs. The prostheses are disassembled and sent to The Limbs for Life Foundation, a national nonprofit organization based in Oklahoma City that provides limbs to amputees in foreign countries who lack the financial means.
After disassembling each artificial limb that is donated, Paul Harney, CPO, president and founder of FDR Center for Prosthetics and Orthotics, and his staff test the parts to determine which ones are functional and in working condition. The pieces that are deemed unusable are discarded and the rest are shipped to Limbs for Life.
Limbs for Life was founded to provide a financial bridge between low-income amputees and the quality prosthetic care needed to restore their lives. Since the foundation began in 1995, Limbs for Life has helped more than 7,700 amputees obtain the prosthetic care that enabled them to move forward with their lives.
The collection of prosthetic parts to be used overseas perfectly suits the foundation's mission to provide fully functional prosthetic care for individuals who cannot otherwise afford it and raise awareness of the challenges facing amputees.
Limbs for Life's World Limb Bank accepts used but functional components, that reach hundreds of amputees in developing countries such as Turkey, Mexico and Africa. The parts are shipped to qualified nonprofit organizations that work in these countries to build new limbs, very inexpensively, with the provided components.
Limb by Limb
"Developing this program with a rehab hospital is a natural evolution because the patients in the community with prosthetics have already been to the facility and associate it with their device," Harney said. "Patients return proudly when they need a new limb and feel good about donating and giving back."
During donation days, staff members at New England Rehabilitation Hospital are confronted with a range of emotions from pure joy to sorrow. The donor may be an amputee who is upgrading to a new device and is elated that someone may be able to benefit from his current artificial limb. Or, the donor may be the family member of someone who recently passed away.
"One donor's husband had died three months before and she arrived clutching his limb," shared Poulin. "She was very emotional and explained that it was a piece of him. It was very difficult for her to give the limb over to us but she knew it would help other amputees." Months later, the facility received a thank-you letter from the woman saying that donating her husband's limb had helped her gain closure.
Other patients may decide that, due to declining functional levels, they no longer need to be ambulatory. A recent donor, a 92-year-old man, gave up his artificial limb when he was confined to a wheelchair. "It's a heartbreaking decision for those patients, but they generally feel good about giving back via a donation," Poulin shared.
According to Stacy McDonough, MSPT, physical therapist at New England Rehabilitation Hospital, a high-functioning individual typically uses an artificial limb for about three to five years before it is time for a new one. Life circumstances change as time goes on, necessitating a new limb.
"An amputee's leg may have changed and he needs a new socket or because technology is constantly advancing, he may have the opportunity to try something new," McDonough explained.
An above-knee amputee may need a new knee joint because the mechanics of walking are different and joints vary. "We are here to remind those individuals that something can be done to the limbs they are no longer using," McDonough relayed.
The donation events held by the hospital are worthwhile to get the word out to the community but artificial limb donations may be accepted at any time. To make the process as convenient as possible, the hospital's satellite locations also serve as drop centers.
According to Poulin, the media's focus is primarily on catastrophic injuries such as those sustained by our wounded soldiers returning from overseas as well as trauma victims. "We see a population of patients who have lost their limbs to chronic conditions such as vascular disease," he shared.
A program that benefits the indigent in the United States and third world countries helps to bring focus to a segment of the amputee population that may not otherwise have access to prostheses.
Since the donation program was established, 61 devices have been collected. The facility is hosting its third donation day in May and the organizers aim to break the triple digit mark in the number of artificial limbs collected.
"The program provides a unique opportunity to do something far reaching and to give back," Poulin shared. "We can make an impact across the world, not just locally."
Rebecca Mayer is senior regional editor of ADVANCE and can be reached at email@example.com
The amputee rehabilitation program at New England Rehabilitation Hospital boasts a multidisciplinary team that includes a board-certified physiatrist, a certified prosthetist and a physical therapist. This model of collaboration is designed for the rehabilitation of patients who have sustained amputation or have undergone vascular surgery. Through a coordinated effort and close communication with patients and caregivers, the team helps maximize abilities and independence, while simplifying patient care.
"Having the same individuals treat a patient throughout the rehab continuum allows the team to monitor the patients as their functional abilities and prosthetic needs change," explained Keith Poulin, MSPT, director of outpatient rehab services, New England Rehabilitation Hospital in Woburn, MA. "These experienced professionals assess how gait training with a prosthetic limb relates to individual levels of function and how the patient progresses with the device."
"Our team works hard to offer a full spectrum of personalized services for people recovering from amputation surgery," shared Daniel Lyons, MD, physiatrist, medical director of the amputee program at New England Rehabilitation Hospital. "By eliminating the hassle of multiple appointments at multiple locations, patients get a team that is focused on their care moving forward all under one roof."
The program's primary goals are to maximize the potential for independence and mobility, restore patient confidence and vitality, and facilitate the adjustment to loss, discomfort and disability. The team works together to design, craft and fit limbs that are sturdy, light, functional and comfortable. The staff members together provide volume control strategies, lifelong support, education and maintenance of the artificial limb.
According to Stacy McDonough, MSPT, physical therapist at New England Rehabilitation Hospital, there are just a few outpatient facilities in the area that offer comprehensive amputee rehabilitation services. In outpatient physical therapy, patients may progress quickly toward functional goals because of the many resources to draw on, from physiatry to prosthetics.
Dr. Lyons assesses function and determines if the patient is a candidate for a prosthesis and addresses wound healing and skin integrity issues that may arise. "Skin integrity issues are common once a patient with diabetes and other vascular conditions uses a prosthetic device," he said.
An above-knee amputation, for example, is most typically the result of diabetes coupled with non-healing wounds. Another large population of lower-extremity amputees is the result of trauma, most typically car accidents.
Patients may have vascular or premorbid conditions that result in amputation. "These patients typically lose their limbs in pieces until they are all gone," observed McDonough. "These are the patients who are typically most surprised to have more function post-amputation."
The PTs know they are fortunate to have Paul Harney, CPO, president and founder of FDR Center for Prosthetics and Orthotics, accessible at a moment's notice. "He's just a phone call away if a device isn't working or if one needs a quick adjustment," said McDonough. "The easy communication helps us to optimize our services to the best of our ability."
Harney attends therapy sessions to make sure the prosthesis is optimal for an amputee's gait training. He plays an active role in therapy by helping the PTs to analyze and problem solve with the patients, according to Poulin.
With an above-knee amputee patient, McDonough typically works on weight shifting, gait and balance activities so the individual may use the device to its greatest capabilities. "Watching a patient with a new limb realize that they can function better than before the amputation is gratifying for a therapist," shared McDonough.
Depending on an amputee's level of mobility and confidence, the goal is to have patients ambulating in the community and at home without an assistive device. While in the outpatient center, the PTs have the patients use walkers, crutches, canes and parallel bars to assist while learning to walk with a new limb.
Amputation is frequently viewed as a failure because it is often the final choice during a long road of illness. The multidisciplinary team at New England Rehabilitation Hospital is working hard to eradicate that stigma. "Amputation is a transition point for patients," Dr. Lyons explained. "We try to focus on amputation as a beginning and help the patients to move forward. The hardest part is often in the past."