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As a physical therapist or occupational therapist, you help your patients reestablish the basis for mobility so they can find their way back to a life that is as active as possible. For training with amputees, this means practicing handling the prosthesis and other devices. The focus is on walking ‒ based on balance, strength and coordination. For the largest group of amputees ‒ older individuals with limited mobility ‒ training poses special challenges.
We support your efforts to achieve the best possible outcome for each of your patients: Here you will find important suggestions for therapy, additional information about amputations and prostheses and an overview of our ever-growing training and seminar program.
We have developed targeted seminars to support the work of therapists and impart specific knowledge about prosthetics. This will improve your training with amputees while simultaneously making it easier and more effective.
The best possible treatment at all times
The sooner therapy starts, the better for your patient. Therapy should ideally begin prior to the amputation and prepare the affected person for the following steps. At the latest, therapeutic measures should be carried out immediately after the operation in addition to the usual preventive treatment. Therapy starts with easy exercises for gradual, continuous strengthening of the muscles. Proper handling of the prosthesis is practiced at the same time. The type and intensity of training vary depending on the healing of the amputation wound.
Get an overview of possible therapy approaches in the different treatment phases here.
The focus is on the needs of older transfemoral amputees; however, the therapy recommendations also apply to other amputation levels and age groups.
Appropriate exercises prior to the amputation ensure that the muscles are strengthened and help prevent contractures.
Directly after the amputation, therapy focuses on oedema, mobilization and scar treatment.
Sequence of treatment: As a therapist, you play a crucial role in the treatment process. Together with the O&P professional, you help the amputee carry on their life as independently as possible and get the best out of their individual prosthesis solution. You can find out more about the treatment process after an amputation and your role as a therapist here.
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Information for therapists
Perfect-fit support for physical and occupational therapists working with older, less mobile lower limb amputees.
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Therapy recommendations – Before the amputation
The patient is prepared for the subsequent steps. Appropriate exercises strengthen the musculature so that contractions can be avoided.
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Therapy recommendations – After the amputation
Work begins directly after surgery, with a focus on oedema, initial mobilization and scar treatment.
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Therapy recommendations – Exercises for life at home
After healing has progressed sufficiently, the muscles are stretched and strengthened. After the patient receives their prosthesis, the focus is handling the individual prosthesis and corresponding gait training.
The terminology, clearly explained ‒ this useful glossary covers the most important terms related to amputations.
The amputation level describes the place where a body part is amputated. It is determined by the surgeon before the operation.
See transtibial amputation.
Both arms or both legs are amputated in part or entirely.
The limited flexion of a knee joint under load against a dampening resistance.
After the interim prosthesis, the amputee receives a final prosthesis that takes their individual needs into account and fits their lifestyle.
The donning sheath is a funnel-shaped piece of fabric that makes it easier for transfemoral amputees to put on their prosthesis. Using them makes it possible to pull the residual limb more smoothly into the prosthetic socket.
More than 12 different amputation levels are known in the area of the foot from the toe to a metatarsal amputation.
The entire leg and parts of the pelvis up to the sacrum are amputated.
Before amputees are provided with a definitive prosthesis, the volume of the residual limb must be stable and the surgical would must be healed and prepared for wearing a prosthesis. The O&P professional therefore initially provides the patient with a trial prosthesis in order to determine the optimum fit of the socket and identify suitable prosthetic components.
With this method, the knee joint is severed and the lower leg is removed, while the thigh bone remains intact.
A sock-like cover for the residual limb that acts as a sort of “second skin” between the movable soft tissue of the residual limb and the socket. The liner protects and cushions the pressure-sensitive areas of the residual limb and, together with a suspension system, connects the residual limb to the prosthesis. Selecting the right liner is essential in order to ensure the prosthesis fits perfectly and is comfortable to wear.
Thanks to a complex sensor system, a microprocessor in the prosthetic knee detects certain movement patterns and for example controls the swing and stance phases in real time. It makes intuitive use and a virtually physiological gait pattern possible for the user.
The amputee’s activity level plays an important role in selecting the prosthetic components. The following mobility grades are differentiated in orthopaedic technology:
1. Low mobility grade
Known as indoor walkers, these users are able to cover short distances on even surfaces and at low speeds – by using appropriate devices, such as walkers.
2. Moderate mobility grade
Known as restricted outdoor walkers, these users are able to also walk on uneven surfaces and negotiate low obstacles such as curbs and steps – by using appropriate devices, such as walkers or forearm crutches. Some may not require any devices in indoor areas.
3. High mobility grade
Known as unrestricted outdoor walkers, these users are able to walk on almost any surface and at various speeds, and also cover longer distances. Able to cross most obstacles, they can work as well as participate in therapeutic and other activities.
4. Especially high mobility grade
Unrestricted outdoor walkers with especially rigorous demands are able to master even more difficult challenges in sports, at work environment or during leisure activities with their prosthesis.
Consists of various components; for example, foot, knee, adapter and socket. Individual combinations can therefore be assembled according to the users’ needs. By contrast, the foot or knee is connected to the socket in an exoskeletal design. Modular prostheses are more commonly used today.
An artificial foot which the O&P professional carefully selects to ensure safe, comfortable standing as well as a smooth gait pattern.
An artificial knee that serves as a functional replacement for the physiological knee. The various prosthetic knee joints support the individual requirements according to the mobility of the user.
Interface between the patient’s body and the prosthetic components attached to it. It is a highly sensitive element since it determines the comfort of the prosthesis to a large extent. This is why it is individually fabricated in each case. To ensure the perfect fit of the socket, the patient’s body dimensions have to be determined with the highest precision.
A prosthetic component that allows the user to rotate the lower leg to the side – a characteristic that proves helpful, for example when putting on shoes. A rotation adapter is used for patients with transfemoral amputations and higher-level amputations.
The moment from first heel contact until the big toe lifts off within a gait cycle.
Describes the moment when the foot swings free in the air while walking.
Absorbs all rotation forces that act on the prosthesis in the stance phase. It also facilitates movement within confined spaces.
In a transfemoral or above-knee amputation, the limb is severed through the thigh bone.
In a transtibial or below-knee amputation, the procedure is done through the tibia.
A vacuum system that generates a vacuum between the liner and socket using an “active principle” (pump) or “passive principle” (pistoning movement of the residual limb). The objective is good suspension of the prosthesis on the body.
Stance phase flexion in the knee joint under load.