Tag Archives: lower body

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.

shoulder surgery

Self Care: Safe Dressing Following Shoulder Surgery / Injury

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When recovering from shoulder surgery, it can be difficult to dress and undress without assistance. With the help of one of our trusted Certified Hand Therapists (CHT) they have compiled a list of tips to get dressed safely and independently while recovering.  It is highly recommended that you follow the instructions prescribed by your surgeon or attending physician.

DRESSING

Upper Body
• Bend forward at your hips and let your affected arm dangle loosely forward
• Always dress the affected arm through the sleeve of your shirt first
• Proceed to dress the unaffected arm

Lower Body
• One handed techniques to don socks: touch all fingers to your thumb, then slide the sock over your hand. Spread your fingers apart to open the sock and slide it onto the foot

Bra
• Clip the bra from the front and as low as possible to your waist. Guide the bra enclosure towards your back. Slide the strap over the affected arm and then slide

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GROOMING

• Bend forward at the hips and dangle arm in order to clean and apply deodorant

These post shoulder surgery dressing tips were provided by The Hale Hand Center, with locations in Melbourne and Rockledge, FL. The Hale Hand Center offers both physical therapy and certified hand therapy services, as well as provides custom splinting. More information about The Hale Hand Center can be found on their website here.