Medical rehabilitation of the person with limb loss© Ozana Pope-Gajic
Jan 13, 2002
Kinesitherapy plays a prominent role in medical rehabilitation of the person with limb loss. Some kinesitherapeutic techniques used in all the phases of rehabilitation are presented in this article. The presented kinesitherapeutic techniques are highly effective on the entire motoric activity as well as on a good postural adjustment, at the same time giving a number of proprioceptive information for a successful use of the prosthesis.
Immediately after the amputation exercises are extremely important to prevent contractures (tightening of the muscles) which, when present, prevent efficient use of a prosthesis. Pre-prosthetic Training
Education on shrinkage device use
Reinforcement of residual limb (stump) skin care
Range of Motion activities and positioning
Education on progressive strengthening exercises of all extremities. Goal is to improve strength of all muscles to their maximum in preparation for prosthetic training. Active exercises progressing to resistive exercises including a variety of concentric, eccentric, and isometric therapeutic exercises
Reinforcement of bed mobility skills - patient must be independent moving in bed in all directions
Mobility on floor training - patient must be able to move in all directions on the floor
Wheelchair Mobility Indoors and Outdoors
Education and reinforcement on transfers at all levels
Balance and coordination exercises
Endurance training
Reinforce content of Home Exercise Program to patient, family or caregiver as necessary. Prosthetic Training
Fitting of prosthesis
Education to patient on appropriate use of prosthetic socks
Education on skin care
Education for proper independence in application and removal of prosthesis Activities of Daily Living Skills with the prosthesis
Transfers training to all surfaces wearing the prosthesis
Balance and gait training with prosthesis. Outdoors and Indoors. Stairs, ramps, curbs, elevators
Family training as necessary
Reevaluate ambulation skills periodically and "upgrade" assistive device as applicable. The rehabilitation of the person with limb loss is a complex process and period of training to learn how to function using the prosthesis, with the aim of being independent in all the activities of daily living, vocational and avocational activities. The final aim is to live, in the way of life which the person used to live before the amputation. The purpose of physical therapy is to empower the person with an amputation to develop the best level of physical and emotional function that can be achieved. The rehabilitation program should be design to restore a meaningful quality of life through return to function in the family, community and workplace. We should focus not only on the prosthesis but on the individual amputee.
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