Step 1: Building confidence, conditioning and strength Step 2: Walking on short prosthetic legs with training feet Step 3: Gradually increasing height and eliminating wheelchair use Step 4: Walking on full-length prostheses with microprocessor-controlled knees, or computerized legs.
Full Answer
When can I start physiotherapy with a prosthesis after below knee amputation?
limb up toward the ceiling, keeping your knee straight. Pause at the top. Relax. Repeat. (See figure 9) Exercise 11: Knee Flexion— Keep your hips flat on the bed. Bend the knee of your residual limb as far as possible. Relax until your knee is completely straight. Relax. Repeat. (See figure 10)
What can I do to help a below knee amputee?
Lie on your back. Bend your knee so the foot of your non-amputated leg is resting flat on the floor. Place your hands in the small of your back. Push your low back into your hands. Hold for a count of 5. Relax. Repeat this _____ times. Partial Sit-up: Lie on your back. Bend your hips so the foot of your non-amputated leg is resting flat on the floor.
How do you treat an amputee with a prosthesis?
Apr 21, 2016 · It’s also important to note that your incision will need to heal completely before you’re able to walk using a prosthetic leg. However, below knee amputation patients are usually able to walk with crutches soon after surgery. Many below knee amputee patients are able to use the iWALK hands-free crutch two or more weeks after surgery. This enables them to use both …
Can you walk with crutches after a below knee amputation?
Aug 13, 2019 · Repeatedly (and gently) kick a ball across the room with your prosthetic leg. Roll a tennis ball back and forth and side to side under your foot on both sides. See how quickly you can gain control over the ball using your balance. Hold onto a rail when lifting your non-prosthetic leg up to the step, then bring it back down to the floor.
How long is rehab after below knee amputation?
Some patients who need more assistance with walking or have multiple medical problems may benefit from a stay in a rehabilitation facility until they are ready to return home. The incision will heal over a period of 2-6 weeks.
Can a double amputee walk with prosthetics?
Prosthetic legs, or prostheses, can help people with leg amputations get around more easily. They mimic the function and, sometimes, even the appearance of a real leg. Some people still need a cane, walker or crutches to walk with a prosthetic leg, while others can walk freely.
What exercises can you do with a prosthetic leg?
Strength ExercisesSeated push up. Place a stable chair against a wall to prevent it from tipping over. ... Wall squat (More advanced) Stand with your back against the wall beside a sturdy piece of furniture in case additional support is needed. ... All fours. ... Kick ball. ... Hip lift. ... Uneven surfaces. ... Braiding. ... Ball toss.Jan 1, 2004
How can I walk with below my knee prosthetic?
0:313:06How to put on a below knee prosthesis with one-way valve and ...YouTubeStart of suggested clipEnd of suggested clipPlace the base of the aligner at the distal end of your residual limb taking care not to trap anyMorePlace the base of the aligner at the distal end of your residual limb taking care not to trap any air between your liner and your skin then gently proceed to roll up your liner on your residual limb.
How long does it take to learn to walk with two prosthetic legs?
Overall, this learning process can take up to one year, especially if you have had an above-knee amputation. Remember that building confidence and staying healthy is key to the process of learning to walk with a prosthetic leg.Jan 16, 2016
How long does it take to recover from a double leg amputation?
Practice with the artificial limb may begin as soon as 10 to 14 days after surgery. Ideally, the wound should fully heal in about four to eight weeks.Feb 5, 2020
How can I strengthen my legs below my knees?
Tip-toe on the plate with your right foot and hold the contraction for two seconds, working your calf muscles, your gastrocnemius and soleus. Repeat the exercise for 10 total repetitions then switch legs. Hold the dumbbell in your left hand and complete 10 repetitions of calf raises.
How do I strengthen my legs after amputation?
The following exercises can help:Leg Raise. Doing straight leg raises can help in increasing the strength of the hip flexors.Resistive Band Exercises. The use of resistive bands in certain exercises can strengthen the hip flexors, internal rotators of the hip, hip abductors, and hip extensors.Step-Down Exercise.Aug 14, 2017
Can you do squats with a prosthetic leg?
0:408:31Squatting With Prosthesis (feat. Melvin Gonzalez) [Full Leg Routine]YouTubeStart of suggested clipEnd of suggested clipBecause the knee in relation to is real knee on the left side is actually they're completelyMoreBecause the knee in relation to is real knee on the left side is actually they're completely different lengths. So it does throw his hip alignment off a little any spots.
How hard is it to walk with a below the knee prosthetic?
The feeling of walking with a prosthetic is very difficult to describe - it's like trying to describe how it feels to taste ice cream to someone without a tongue. It's really difficult to use at first and feels like walking on a boot with an extremely thick sole, with tight laces that go all the way up to your knee.Jan 3, 2018
Can you take a shower with a prosthetic leg?
Showering with a prosthesis is a possibility, although most people do not choose to do this because it's necessary to clean the residual limb anyway. Equipping the shower with grab bars and a shower chair is important to reduce the chance of falls.May 28, 2021
How much does a below the knee prosthetic leg cost?
If you want a basic, below-the-knee prosthetic, the average cost is around $3,000 to $10,000. A more flexible, below-the-knee prosthetic costs a little bit more, while one with special hydraulic and mechanical assistance ranges between $20,000 and $40,000. The computerized leg is the priciest option.
How to tighten a thigh muscle after amputation?
Push the back of your knee down against the bed to tighten your thigh muscle. Hold for 5 seconds and release. Do this exercise on your amputated and non-amputated leg.
How to get rid of a leg that is amputated?
Lie on your back. Bring your non-amputated leg up to your chest and hold it with your arms. Have someone push your amputated limb down to the bed and hold it for a count of 20. Relax and repeat. When your amputated leg can easily lie on the bed, scoot to the side and dangle your amputated limb over the side of the bed. Repeat the above exercise.
How to stretch a leg after a sprain?
Lie on your back. Bring your non-amputated limb towards your chest. Put your arm around your thigh and pull even closer. Hold for 20 seconds. Bring your non-amputated knee towards your chest. Straighten your leg until you feel a stretch in the back of your thigh.
How to get rid of a swollen leg after an amputation?
Lie on your back and bend the knee of your amputated leg to your chest. Bend it as far as possible and then straighten the knee completely. Return to the starting position.
How to reduce sensitivity after amputation?
After surgery you may feel more sensitivity of the leg where the amputation occurred. To reduce this sensation, rub your leg with your hand or a towel. Be careful when you rub around the area of the incision.
How to stretch a hip flexor muscle?
Lie on your stomach. Place a rolled towel under your amputated limb. Lie in this position for 20 minutes. As you stretch the hip flexor muscle, you may increase the size of the towel roll.
How long after knee surgery can you use a crutch?
Some below knee amputee patients are able to use iWALK crutch, a hands-free crutch device, within two weeks after surgery. This enables them to use both legs instead of relying on crutches or a wheelchair and promotes exercise, blood flow, and independent living.
What is the most common amputation?
Below knee amputations are the most common amputation surgery and comprise approximately 23% of lower limb amputations. The majority of below knee amputations are performed on individuals aged 65 and older. While any amputation is a life-changing event, it is important to remember that amputations are viewed as a reconstruction surgery with ...
What causes a person to have poor circulation?
Causes of the injury or generally related to the following (2): Trauma – a severe injury resulting from and event such as a vehicle accident or serious burn causing severe fractures and/or nerve injury. Diabetes – people who suffer from diabetes may experience poor circulation because of the narrowing of the arteries.
Why is emotional support important?
You will also need to adjust to your new body image. Emotional support is equally as important as physical therapy, so turning to counselors, social workers , and other below knee amputees to discuss your new lifestyle is integral to the recovery process
How to recover from surgery?
Your body needs nutrients to maintain muscle mass and to heal properly. Exercise is important, but a healthy diet can eliminate weight gain and prepare your body for a quick recovery and successful rehabilitation.
What causes pain in the foot?
Neuroma is the thickening of the nerve tissue, which can cause severe pain. Neuroma most often affects the feet. Congenital Limb Deficiency is a common cause of below knee amputation among small children and takes place when a limb does not completely form.
How long does it take for a syringe to heal?
Immediately following surgery. In general, the incision from the surgery will heal over a period of two to eight weeks. During the first few days of recovery, a physical therapist will help the patient form some basic exercises and functions. These will include gentle stretching and range of motion exercises.
Abstract
Due to improper care of his first below knee amputation, a 65 year old male patient developed a complication to his contralateral limb that resulted in a second below knee amputation seven years later. The patient was then fitted with bilateral below knee prosthesis and was given training at a rehab hospital.
Key Words
transtibial, bilateral amputee, diabetic amputee, below-knee prosthesis
Client Characteristics
BC is a 65 year old male patient with bilateral below knee amputation. His first amputation was his R leg in 2008 and his L leg amputation was in Jan 2015. His L leg amputation was secondary to a necrotic diabetic foot ulcer. His co-morbidities include: poorly controlled Type II diabetes, sleep apnoea, smoking and bladder cancer.
Examination Findings
Subjective:#N#Patient reports he has pain with both right and left foot and he reports his phantom pain in his right foot is 7/10 and 5/10 with his left foot. Pt states that he had an excellent rehab training with his bilateral below knee prosthesis, however, he still has difficulty with balance.
Clinical Hypothesis
This patient has bilateral below knee amputations six years apart and he also has history of poorly managed type II diabetes. Patient recently spent 4 weeks learning how to use bilateral below knee prosthesis and has completed basic ambulation training. Patient is able to ambulate with standby assistance with decreased balance.
Intervention
Gait: Practised ambulating in heel to toe pattern; education for patient to decrease trunk flexion, decrease body/hip swaying, increase hip extension and bigger stride length.
Outcome
Gait: Pt was able to ambulate with heel to toe pattern and less body/hip swaying and less trunk flexion. Patient is more confident with using both below knee prosthesis. Stride length has increased to within normal limits.
How to train for below knee amputation?
Strength Training Exercises for Below-Knee Amputees. One effective strength-training exercise involves hanging weights from the residual part of your amputated limb, then building up the weight capacity until it gets higher and higher – in other words, a fairly typical weight-training procedure, only it’s been adapted for a below-knee amputee.
How to adjust to prosthetics?
With that said, you can help your brain adjust to your new normal by practicing very simple activities, such as: 1 Standing as much as during your daily activities such as brushing your teeth, washing, doing the dishes, or even just loading the dishwasher. 2 Reaching out for objects while sitting, kneeling down, or standing with even pressure placed on your prosthesis for as long as possible. 3 Performing mini squats where you remain standing with even pressure on both feet and your knee bent just a little bit. While doing this, attempt to turn from side to side as many times as possible. Try this first without your prosthesis (carefully), then again with your prosthesis.
How to get rid of a prosthetic leg?
Try this while standing still or walking! Repeatedly (and gently) kick a ball across the room with your prosthetic leg. Roll a tennis ball back and forth and side to side under your foot on both sides.
Is it possible to return to a lower extremity amputation?
However, returning to a fulfilling lifestyle is far from impossible, especially when you have a reliable team and support system on your side.
How long does it take for an amputee to recover from surgery?
Stages of Rehabilitation. Rehabilitation for amputees normally starts two-days post-surgery. The physiotherapist will work with the individual to develop goals and a treatment plan to meet their needs. Initially the physiotherapist will work to progress the individuals activity levels and to promote independence.
What is the role of a physiotherapist in rehabilitation?
The physiotherapist will: Teach walking skills with the prosthesis. Build up overall body strength and fitness levels. Teach skills to manage everyday obstacles such as stairs, getting in and out of cars etc.
Title
- The rehabilitation of the Bilateral Below Knee Amputee in the acute hospital setting: Amputee Case study
Abstract
- A 66-year-old male, known case COAD and a previous Left BKA who underwent the contralateral BKA due to gangrene of the amputated 1st and 2nd metatarsal. This case study looks at the patient's rehabilitation during his stay in hospital where emphasis was on the management of his COAD and treatment focused on rehabilitating the patient to make him a suitable candidate for …
Client Characteristics
- The patient is a 66 year old male who was being followed in view of a non- healing ulcer over the right 1st and 2nd metatarsal amputation site which developed an infected ulcer down to the bone with infected sinuses involving the ankle resulting in a gangrenous foot. He was admitted in hospital at the end of May 2015 in view of fever, chills and rigors due to his gangrenous foot. Du…
Examination Findings
- Immediately post- operative the main priority was chest physiotherapy since the patient suffers from COAD. That, in addition to the effects of anesthesia, put him with the increased risk of chest infections and shortness of breath. He had low oxygen saturation on room air (81%) with shortness of breath resulting in the need of oxygen therapy via a venturi mask. On auscultation, t…
Clinical Hypothesis
- I believe that the patient's main problem is a combination of multiple factors that might affect the rate and quality of his rehabilitation. The patient is a bilateral below knee amputee and is over 65 years of age, rendering him in the elderly bracket, with multiple co-morbidities. He is an insulin dependent diabetic with PVD which will affect the rate of healing in the amputated limb, making …
Intervention
- Physiotherapy treatment was initially limited due to the patient's pulmonary condition, which rendered him medically unstable. Chest physiotherapy was a priority focusing on chest expansion and encouraging deep breaths to increase air entry in the bases of the lungs and strengthen the chest wall. As oxygen saturation started to improve, physiotherapy treatment started with range …
Outcome
- Chest: Blood oxygen saturation improved on room air and the patient no longer requires the need of oxygen therapy. Chest expansion and air entry is good and the patient is able to comply with physiotherapy treatment without getting short of breath. Range of movement and Strength: The patient manages full knee extension and has full range of movement in all movements in both li…
Discussion
- The patient is a geriatric amputee who falls in both categories being already a major amputee of having a fresh amputation over the age of 65. Age- associated physiological changes, in combination with his co-morbidities give an increased likelihood for post- operative complications. Post- operative there was an exacerbation of the patients' COAD resulted in the p…
Abstract
- Due to improper care of his first below knee amputation, a 65 year old male patient developed a complication to his contralateral limb that resulted in a second below knee amputation seven years later. The patient was then fitted with bilateral below knee prosthesis and was given training at a rehab hospital. Upon his discharge, he was still lacking balance and was referred to outpati…
Client Characteristics
- BC is a 65 year old male patient with bilateral below knee amputation. His first amputation was his R leg in 2008 and his L leg amputation was in Jan 2015. His L leg amputation was secondary to a necrotic diabetic foot ulcer. His co-morbidities include: poorly controlled Type II diabetes, sleep apnoea, smoking and bladder cancer. He is currently retired and living with his wife in his h…
Examination Findings
- Subjective: Patient reports he has pain with both right and left foot and he reports his phantom pain in his right foot is 7/10 and 5/10 with his left foot. Pt states that he had an excellent rehab training with his bilateral below knee prosthesis, however, he still has difficulty with balance. Pt states he has not had a fall with the new prosthesis. Patient had a history of poorly controlled ty…
Clinical Hypothesis
- This patient has bilateral below knee amputations six years apart and he also has history of poorly managed type II diabetes. Patient recently spent 4 weeks learning how to use bilateral below knee prosthesis and has completed basic ambulation training. Patient is able to ambulate with standby assistance with decreased balance. Further balance and strength training will benefit patient an…
Intervention
- Gait: Practised ambulating in heel to toe pattern; education for patient to decrease trunk flexion, decrease body/hip swaying, increase hip extension and bigger stride length.
- Balance: Patient worked on improving balance between the parallel bars, first beginning with weight shifting from side to side and shifting forward and backwards with support. Patient progressed to...
- Gait: Practised ambulating in heel to toe pattern; education for patient to decrease trunk flexion, decrease body/hip swaying, increase hip extension and bigger stride length.
- Balance: Patient worked on improving balance between the parallel bars, first beginning with weight shifting from side to side and shifting forward and backwards with support. Patient progressed to...
- Strength: Open chain exercise for hamstrings, quads, glut med and glut max. 3 sets of 10 reps a day.
- Flexibility: Hamstring and hip flexors stretches, 30s hold, 3-4x a day or as tolerated.
Outcome
- Gait: Pt was able to ambulate with heel to toe pattern and less body/hip swaying and less trunk flexion. Patient is more confident with using both below knee prosthesis. Stride length has increased...
- Balance: Patient has improved balance compared to before outpatient physiotherapy training. Patient is able to stand without support for up to 1 minute. Patient is able to stand with his fe…
- Gait: Pt was able to ambulate with heel to toe pattern and less body/hip swaying and less trunk flexion. Patient is more confident with using both below knee prosthesis. Stride length has increased...
- Balance: Patient has improved balance compared to before outpatient physiotherapy training. Patient is able to stand without support for up to 1 minute. Patient is able to stand with his feet toget...
- Strength: Hamstring, quads, glut med all has improved strength to 4+/5.
- Flexibility: Hamstring and hip flexors bilaterally both has decreased tightness compared to initial assessment.
Discussion
- The leading cause of non-traumatic lower in the US is diabetes and it accounts for 60% of the total non-traumatic amputations. A main goal of is of rehab is to prevent further injury and a potential amputation of the contralateral limb. Patients with diabetes are more susceptible to injury and tissue failure due to compromised healing rates. This specific patient originally had his R leg am…