Tag Archives: amputee

lower limb amputation

Lower Limb Amputations

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The goal for every patient with a lower limb amputation is to walk normally again.
A patient with a lower limb amputation faces many challenges when it comes to walking safely in a variety of walking surfaces and without exerting excessive energy. Generally, the higher the amputation level, the more we can expect to see gait deviations or difficulty walking. This is because with each segment of the anatomy is lost to amputation, more muscle, sensory receptors and leverage are also lost. A Physical Therapy treatment program can be designed to assist a patient return to a “normal” walking pattern in terms of posture, step length, stability, balance, rate of speed, and limb positioning.

GAIT TRAINING
Almost all patients with a lower limb amputation will benefit from physical therapy and gait training at some point in their recovery to help them return to a more normal walking pattern. Pre-amputation exercises will assist the patient in arm and leg strengthening to help them prepare for using a walker during gait training with their prosthesis. After amputation surgery a prosthetist will work with the patient to fabricate and align a prosthesis to assure that it will optimize the patients walking pattern.

WHAT TO EXPECT DURING PHYSICAL THERAPY

  • The physical therapist will typically work with the patient 3 days per week

  • The physical therapist and prosthetest will remain in close communication with gait training is occurring since any changes in the prosthesis will affect the gait pattern

  • Initially physical therapy is focused on standing and walking with enough stability to ensure safety (this initial gait training is performed in parallel bars with the assistance of the physical therapist holding the patient with a gait belt for additional safety)

  • Initial gait training is supplemented with strength and flexibility exercises for the legs and trunk muscles since strong trunk and leg muscles make it easier to progress the patient’s gait training

  • The physical therapist will also work with the patient to improve balance and coordination to help the patient develop a more normal step length and walking speed

Physical therapists use many different techniques during gait training sessions

leg amputee

LEARNING HOW TO WALK AGAIN
Specialized Treatment Techniques

  • SPLINTER SKILLS: Technique where the walking pattern is broken down into a sequence of events that are practiced individually before putting them all together to build the walking pattern
  • WHOLE WALKING: Technique in which the entire gait pattern is performed all at one time without thinking about the individual components of walking therefore relying on the body’s natural tendency to find the most stable and energy efficient way to walk

BUILDING CONFIDENCE
Once the patient feels confident and the physical therapist believes that it is safe, a walker can be used instead of the parallel bars. When using a walker, the focus will change to helping the patient walk on uneven surfaces such as outdoors and walking around obstacles or stepping up and down stairs.

Even patients who have walked with a prosthesis for years can benefit from gait training for a “tune up” of their walking skills or to learn a new skill such as side stepping, tandem walking or even running.

avoiding workplace hazards for feet and hands

Avoiding Workplace Hazards for Feet and Hands

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avoiding workplace hazards for feet and hands

OSHA Estimates totals for foot and hand types of injuries annually at 320,000 hand and finger injuries, 70,000 eye injuries, 70,000 head and face injuries, and 110,000 foot and toe injuries in 1987. Close to 30% of the total injury base. Sharp or heavy falling objects are the primary sources of foot injuries. So how does one go about avoiding workplace hazards for feet and hands?

To help you get started we have listed out some of the common injuries and actions that lead to workplace injuries of the hand and foot. This is by no means complete as there certainly could be burns or lacerations or multiple levels of sprains/strains in either body area in addition to those noted.

Foot Injuries

One’s feet provide support and movement. Yet, the 26 bones in the human foot can be easily damaged. According to the BLS, 40 laborers suffer disabling injuries to their feet and toes every day. These injuries account for 8.5 percent of all lost-time injuries in the construction industry.

  • Compression – when foot or toe is squeezed between two objects
  • Puncture – when a sharp object like a nail, penetrates the shoe
  • Slipping – loss of traction due to oil, water or chemicals
  • Chemicals/Solvents – may penetrate ordinary safety shoes and can harm feet
  • Temperature Extremes – insulated boots may be necessary, depending on climate
  • Wetness – extended exposure to water may result in discomfort and possible infection
  • Electricity – a danger when using power tools or electric equipment

Some of the most common foot and leg injuries include:

  • Fractures – A fracture of the bones in the leg, foot, or knee may be caused by falling objects or an accidental fall from a height. Some fractures can be treated by using a lightweight cast and crutches, while more serious fractures may require surgery and extensive physical therapy.
  • Knee Tendonitis – Knee Tendonitis is a swelling of the tendons surrounding the knee. Individuals who spend a lot of time walking, standing, or lifting objects while at work are at risk of developing this painful condition. Older individuals are, particularly at risk.
  • Knee Bursitis – Knee Bursitis is a swelling of a fluid sac that provides cushioning for your knee joint. Like tendonitis, bursitis can cause severe pain, inflammation, and loss of mobility.
  • Loss of Limb – The most serious workplace accidents may require amputation. These life-altering accidents can have devastating effects on an individual’s quality of life and ability to work. Amputation cases are especially complicated because they involve issues of retraining, prosthetic replacement, wound care, and home modification. Leg and foot injuries can be among the most devastating for an individual to sustain as well as the most difficult to overcome. Using crutches or a wheelchair can severely limit a person’s mobility, and make it difficult to complete, let alone enjoy, everyday activities at work, at home, and in the community.
    Leg and foot injuries can also make it very difficult, if not impossible, to return to one’s pre-injury employment. Individuals who perform manual labor rely on the use of their legs and feet to perform nearly every aspect of their jobs. Furthermore, many workplaces are also not properly equipped for individuals with limited mobility.

hand injury


Hand Injuries

The hands are an extremely important part of the body and can be damaged in a matter of seconds, leaving a Laborer permanently disabled. According to the Bureau of Labor Statistics (BLS), Laborers suffer over 8,600 disabling hand injuries each year, accounting for roughly 18 percent of all disabling injuries.

The most common dangers include:

  • Pinch or crush points
  • Hot surfaces
  • Rotating devices
  • Chemicals
  • Machinery not properly locked out

Some common hand, wrist, and arm injuries that can occur in the workplace include:

  • Fractures – A hand, wrist, or arm fracture can occur due to falling objects or other accidents. Some fractures can be severe and may require extensive reconstructive surgery.
  • Nerve damage – An accident may damage the nerves in the hand and arm, which may cause numbness and pain.
  • Loss of limb – A serious accident may require the amputation of an arm or hand. This serious injury can dramatically affect all aspects of your life. Individuals must relearn how to conduct even simple functions, and while prosthetic limbs can help, they are expensive. Furthermore, approximately 60-80% of amputees experience phantom limb syndrome, causing them to feel sensations such as aching, itching, and burning to emanate from the body part that is no longer there.

In addition to hand and arm injuries that are caused by an accident, many common injuries are caused or worsened by repetitive stress.
These ailments include:

  • Carpal tunnel syndrome – People with carpal tunnel syndrome experience pain and tingling sensations in their thumbs and fingers. Although the exact cause of carpal tunnel syndrome is unknown, many researchers believe that performing repetitive manual tasks, such as typing on a keyboard, may cause or worsen the condition. Carpal tunnel syndrome may require wrist surgery, steroid injections, or the use of a brace.
  • Repetitive strain injuries – Repetitive strain injuries are characterized by painful sensations while performing a repetitive task, such as lifting heavy objects. These injuries can worsen the more an activity is performed. Injuries to the arm and hand, whether suffered by an accident or through repetitive strain, can permanently impact a person’s life. Even the completion of simple, everyday tasks may become difficult and exhausting, diminishing one’s overall quality of life.

Understanding what the injuries are is the first step in prevention. If you are looking to put protocols in place to help team members avoid workplace hazards for feet and hands, please reach out to a physical therapy clinic that specializes in industrial rehabilitation. They can work with you to improve the safety of the workplace and the employees.

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