Amputee Rehabilitation

 Amputee rehabilitation is essential after limb loss to restore independent mobility and enhance quality of life. Amputations are carried out through surgical procedure, where all or part of a limb or extremity is removed. An amputation may be minor, involving fingers or toes or a small part of a hand or foot due to a a congenital condition or a traumatic injury. A major amputation often involves the removal of all or part(s) of the hand or arm, a leg, or a foot. Research shows that successful mobility in people with lower limb amputation through physiotherapy is the single most important contributor to quality of life after limb loss. 

Amputee Rehabilitation can help with alleviating some of the common factors associated with an amputation:

• A negative emotional response due to losing a body part;

• Potential weight gain or poor health which could make the individual more susceptible to contracting secondary health conditions;

• Re-establishment of body awareness and adapting to the loss of function following an amputation;

• Dealing with chronic pain from Phantom Pain;

• Altered sense of body image;

• Risk of depression or other psychological problems.

The timing of commencing prosthetic rehabilitation may be limited in the acute post-amputation period due to post-operative pain and wound healing, and in sub-acute rehabilitation due to limited endurance initially for use of the prosthesis. Cogent physiotherapy program for amputees is designed to achieve optimum recovery through alternative approaches such as motor imagery and mental practice in addition to routine rehabilitation practice such as exercise,  gait training, skin care, assistive device prescription and conditioning.

The goal of rehabilitation after an amputation is to help the patient return to the highest level of function and independence possible, while improving their overall quality of life physically, emotionally, and socially. In order to help reach these goals, amputation physiotherapy programs may include the following:

• Treatments to help improve wound healing and stump care

• Activities to help improve motor skills, restore activities of daily living (ADLs), and help the patient reach maximum independence

• Exercises that promote muscle strength, endurance, and control

• Fitting and use of artificial limbs (prostheses)

• Pain management for both post-operative and phantom pain (a sensation of pain that occurs below the level of the amputation)

• Emotional support to help during the grieving period and with readjustment to a new body image

• Use of assistive devices

• Nutritional counseling to promote healing and health

• Vocational counseling

• Adapting the home environment for ease of function, safety, accessibility, and mobility

• Patient and family education

•  Detailed physical examination to assess the residual limb (stump) and any remaining limbs by evaluating your skin condition, wound healing, joint range, muscle strength, sensation, and presence of any contractures or joint stiffness.

• Assessing the residual limb for prosthetic fitting, which may involve evaluating the shape and size of the stump, skin integrity, and overall healing progress.

• Assessing your functional abilities including mobility (walking with assistive devices or without), balance, transfers (e.g., getting in and out of a chair), and performing activities of daily living (ADLs).

• Assessing pain levels related to the residual limb, including phantom limb pain (sensation of pain in the missing limb), residual limb pain, and any associated musculoskeletal problems.

• Considering your emotional and psychological well-being related to the amputation. This includes assessing for signs of adjustment difficulties, depression, anxiety, and coping mechanisms.

• Discussing your lifestyle, vocational activities, recreational interests, and personal goals to personalize your rehabilitation plan as needed.

• For lower limb amputees, analyzing gait patterns and functional mobility with and without assistive devices (prostheses, walkers, crutches) to identify areas needing improvement and optimize prosthetic fitting.

• Assessing for any orthopedic issues that may affect prosthetic fitting or function, such as joint instability, limb length discrepancy, or residual limb shape.

• Providing education about the rehabilitation process, prosthetic options, skin care, residual limb management, and adaptive strategies. Counseling may also address concerns about body image and adjustment to limb loss.

• Coordinating care with other healthcare professionals, such as your surgeon, occupational therapists, and psychologists, as part of a multidisciplinary team approach.