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.