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TRANFEMORALPROSTHETICS
A PATIENT CARE
MANUAL FOR THE
NEW AMPUTEE
This booklet was created for informational
purposes only. The information contained
herein should only be used for reference
material and is not intended to replace the
advice of your healthcare provider(s). You
should always consult with your physician or
healthcare provider concerning any medical
issues and before beginning any treatment
regiment.
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TABLE OF CONTENTS
INTRODUCTION...1
COMMONLY USED TERMINOLOGY...2
COMMONLY USED ACRONYMS6
BASIC ANATOMY......7
STATISTICS.........8
HEALING RATES..9
MEETING YOUR PROSTHETIST....10
POST OPERATIVE CARE.11
IPOP PROSTHESES..11
SHRINKERS....13DESENSITIZATION....14
POSITIONING....14
PHANTOM LIMB SENSATION..16
PHANTOM LIMB PAIN.16
EXERCISE...16
TEMPORARY PROSTHESIS...17
PROSTHETIC PROCESS..18
CHECK SOCKET FITTING.21
TEMPORARY PROSTHETIC FITTING...22
PROSTHETIC FOLLOW UP..24
SOCK MANAGEMENT24
HYGIENE..26
PHYSICAL THERAPY..26
DEFINITIVE PROSTHESIS..28
PROSTHETIC PROCESS..28
PROSTHETIC HYGIENE....30
EXERCISE...31ASSISTIVE DEVICES..31
AMPUTEE ATHLETIC RESOURCES..33
RESOURCES FOR THE AMPUTEE.....35
REFERENCES..36
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INTRODUCTION
An amputation can be both physically and emotionally
challenging for anyone. It is important to understand
that many new amputees function very well and
pursue the same active lifestyle as prior to limb loss.
This booklet aims to provide you with answers to
many of the questions that arise before and after an
amputation. When speaking with your healthcareprovider, it is important to know which questions to
ask and have an idea of what to expect. Many
questions will arise throughout the rehabilitation
process. This booklet will answers to some of them
and give you resources to get further information.
Having the answers to commonly asked questions
readily available will help you prepare for the stepsand procedures that will occur before, during, and
after your amputation. This information can assist
you in your return to the things you need and
hopefully enjoy participating in.
This booklet also provides many other resources that
you may find useful in your recovery. There are many
organizations that offer a variety of assistance thatrange from driving devices to sports related
activities. This booklet attempts to turn your
disability into a possibility by sharing the collective
rehabilitative experiences of others with you.
2
Commonly used
terminology
Abduction a movement which brings the limb closer
to the midline of the body
Adduction a movement which positions the limb
further away from the body
Alignment the spatial relationship between the
prosthetic socket and the prosthetic foot
Anterior towards the front of the body
Check Socket a temporary socket made of
transparent plastic that is used by the prosthetist to
diagnose the fit of the socket
Contracture tightening of the muscles, tendons, or
ligaments that prevents normal movement of a jointCosmesis the outer covering of a prosthesis,
aesthetics
Definitive Prosthesis a replacement for a missing
limb after all post-surgical swelling has subsided
Disarticulation amputation through a joint (i.e.
ankle, knee, hip)
Donning and Doffing the process of putting on and
taking off a prosthesis
Dorsiflexion pointing the toe or foot upwards
Edema swelling of the tissues
Eversion to turn outward
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Exoskeletal a prosthesis that is hollow on the inside
and has a rigid outer coveringExtension a position of increasing the joint angle,
straightening out
Flexion a position of decreasing the joint angle,
bending
Gait Training learning, usually from a physical
therapist, how to walk safely and properly with a
prosthesis
Immediate Post Operative Prosthesis an artificial
limb that is applied in the operating room after the
amputation has occurred
Inversion to turn inward
Lateral away from the midline of the body, to the
sideLiners a sleeve or covering of the residual limb that
is used for suspension, cushioning and protection
Medial towards the midline of the body
Myodesis a process during an amputation where the
muscles are attached to bone
Myoplasty a process during an amputation where
the muscles are attached to opposing muscles
Neuroma a nerve ending that is cut during an
amputation that can ball up. Neuromas are usually
extremely sensitive and painful
4
Occupational Therapist a person trained in gaining
greater independence for patients throughrehabilitation and relearning how to perform
activities of daily living efficiently and safely
Occupational Therapy evaluation and training
performed by a licensed occupational therapist which
focuses on maximizing the activities of daily living
Pedorthotist a trained healthcare practitioner who
specialized in orthopedic footwear and foot orthosesPhantom Limb Pain pain that appears to come from
an area below where the amputation occurred
Phantom Limb Sensation the feeling that an
amputated limb is still attached to the body
Plantar Flexion pointing the toe or foot downwards
Physical Therapist a person trained in therehabilitation process of patients who have limited or
lost functions of mobility
Physical Therapy evaluation and training performed
by a licensed physical therapist which focuses on
exercise, reducing pain and regaining mobility
Posterior towards the back of the body
Prosthesis an artificial body part
Prosthetics the profession of evaluating,
fabricating, fitting and adjusting an artificial limb
Prosthetist - a trained healthcare practitioner who
evaluates, fabricates, fits and adjust prosthetic
devices
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Pylon a structure that is used to connect the
prosthetic socket to the prosthetic ankle/footcomplex
Residual Limb the portion of a limb that remains
after amputation
Shrinker a prosthetic sock created of elastic
material that is used in reducing swelling of the
residual limb
Socket the part of the prosthesis that fits aroundand protects the residual limb; usually made of
thermoplastic, laminated, or carbon composite
material
Socks a sock that is fabricated to fit the residual
limb. It is used to manage the loss of volume in the
residual limb throughout the day
Sound Side Limb the non-amputated or non-affected limb
Symes amputation through the ankle joint that still
maintains the fatty heel pad for cushioning
Temporary Prosthesis a prosthesis that is
fabricated soon after amputation. This prosthesis is
used until post-surgical swelling has subsided.
Transfemoral amputation that occurs at a level
above the knee joint but below the hip joint
Transtibial amputation that occurs at a level below
the knee joint but above the ankle joint
6
Commonly used
acronyms
ABC American Board for Certification
ACA Amputee Coalition of America
AKA Above Knee Amputation
AP Anterior-Posterior
BKA Below Knee AmputationCP Certified Prosthetist
CPed Certified Pedorthotist
CPO Certified Prosthetist-Orthotist
OT Occupational Therapy/Therapist
PT Physical Therapy/Therapist
PTB Patellar Tendon Bearing
TF Transfemoral
TT Transtibial
SACH Solid Ankle Cushioned Heel
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Basic anatomy
Femur Thigh boneGreater Trochanter Upper, prominent part of the
femur
Ischiopubic Ramus Flat, sharp bone that connects
the Ischial Tuberosity to the front of the pelvis.
Ischial Tuberosity Lower and back part of pelvis.
The bone you sit on.
Pelvis Bony structure located at the base of the
spine
Pelvis
Femur Ischial
Tuberosity
Greater
Trochanter
Ischiopubic
Ramus
8
Statistics
It is important for you to know that you are not alone
in your rehabilitation process as a new amputee. The
number of people living with an amputation is rising in
the United States, particularly as a result of diabetic
and dysvascular conditions.
In the United States, there are approximately 1.9million people living with limb loss. It is estimated
that one out of every 200 people in the U.S. has had
an amputation.6
Loss of a limb can occur for a number of reasons.
With regard to amputation of a lower limb, the most
common causes of amputation include dysvascular
complications (possibly resulting from diabetes),
trauma, cancer and congenital limb deficiency.
Amputation Statistics by Cause from the National Limb Loss
Information Center, 2006
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Healing rates after
amputation
The recovery rate after amputation is different for
each person. There are no two surgeries or people
that experience the same healing times and rates.
Following surgery, you will not return to your room
until about four hours after you wake up. When you
awake, many people say that they feel as though theyhave not had the amputation because they have the
sensation that the limb is still attached.
On your residual limb, there will likely be a drainage
tube to remove the excess fluids following your
amputation. This tube usually remains in place for 24
hours following the surgery. The surgical dressings
are typically changed within 48 hours followingsurgery. Your physician may alter these times to suit
your unique needs.
Within 7-10 days, most patients are able to go home.
Two to three weeks post-operatively your physician
will remove the staples. During the healing period,
which lasts anywhere from three to twelve weeks,
the suture line will close and heal.
When the suture line has healed, fitting for a
temporary prosthesis may begin. Again, the time
frames mentioned in this portion of the booklet are
typical. Some people may experience shorter time
frames, while others may experience complications
that lengthen them.
10
Meeting your
prosthetist
Choosing a prosthetist is an important step in your
rehabilitation process. You will develop a life long
relationship with your prosthetist and will be seeing
them often for the care of your residual limb and
prosthesis.
When choosing a prosthetist, you should meet with
several different practitioners in your local area to
determine who you feel most comfortable with. Your
prosthetist should be open to your needs and listen
to what you have to say. A list of ABC Certified
practitioners can be found at http://www.abcop.org
When you meet with your prosthetist for the first
time, you should be prepared to ask any questions
that you may have about the prosthetic process.Consider making a list of questions to bring to your
appointment to ensure that all of the questions that
all of your questions are answered. Without a list, the
experience may be overwhelming causing you to
forget important questions.
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Post operative
prosthetic care
After the amputation there are several ways of
dressing the residual limb. The most common way of
dressing the limb is with the use of simple gauze
dressings. This is typically done in the operative room
by your physician immediately following surgery.
These dressings will then be changed periodically.
Ipop prosthesis
There are more aggressive approaches to post
operative care that may include the use of a rigid
dressing or what is termed an Immediate Post-
Operative Prosthesis or IPOP. An IPOP is an
immediate postoperative prosthesis that is used as anearly form of prosthetic intervention.
The benefit of being fit with an IPOP prosthesis is
early ambulation if allowed by your physician. An IPOP
prosthesis is also said to help with phantom limb
sensation, because you can see that there is a leg, or
in this sense, a prosthesis attached.
IPOP prostheses also protect the residual limb frombeing injured. Many times, a patient will wake up in
the middle of the night to use the restroom, and
forget that their limb has been amputated. When
they get out of bed and try to stand on both limbs,
they fall down and re-injure the surgery site.
12
An IPOP prosthesis will protect the end of the
residual limb should this occur. There are many
different types of postoperative care and your
physician will help you choose which the best is for
you.
Photo from Flo-Tech. O&P Industries, Inc.Accessed 2May2007 online at:
http://www.1800flo-tech.com/products.html
Flo-Tech Brand IPOP prosthesis.This IPOP has all of the same basic
components of a typical prosthesis
(socket, knee and foot).Socket
Knee
Foot
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Prosthetic shrinkers
At some point after your surgery, your healthcare
providers will discuss several things with you including
the use of shrinkers, desensitization, positioning,
contracture prevention, exercise, phantom sensation
and phantom pain.
To manage post-operative edema, you may be
prescribed a shrinker or ace wrap as a means ofcompression therapy.
Shrinkers are elastic garments that are simply pulled
on or wrapped around the limb. They are typicallyused when the suture line is reasonably healed. Until
that time, an ace wrap may be used. Both methods
help to expel excess fluid that remains inside the
limb. This helps to prepare you to wear a prosthesis
by providing an appropriate limb shape.
14
Desensitization
Desensitization is important to prepare your residual
limb for the forces that will soon be applied with a
prosthesis.
The most common and easiest way to desensitize the
limb is to gently massage the entire area several
times a day; this will decrease the skins sensitivity.
There are several different techniques, you shouldspeak with your physical therapist about which one is
best for you.
positioning
Positioning is extremely vital to help prevent
contractures that can cause problems when fitting aprosthesis.
If you are going to be sitting in a wheelchair you
should always sit up straight, keep equal weight on
both hips and try not to slouch. Avoiding any
prolonged periods of sitting is best if possible.
If you sit with your hips bent (flexed) for a long
period of time, the limb may develop a contractureand prolong the necessary therapy. This will
negatively effect your rehabilitation. Contractures
can cause you to be uncomfortable in your prosthesis
and/or effect how well you are able to walk. If a
severe enough contracture occurs, this will limit your
prosthetic options and candidacy.
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Proper positioning can be achieved with the use of a
pillow while lying face down in bed. If you are lying on
your back, avoid placing any pillows under your limb.
One simple position that can greatly increase
flexibility is to lay on your stomach and stretch the
limb backward.
When lying in bed remember to keep your legs
together and try to avoid any type of rotation.
Keeping these strategies in mind can help prevent
unwanted contractures.
Left: Person sitting in a wheelchaircould be at risk of developing a hipflexion contracture. Below: personlying on the stomach (prone) to
stretch the hip flexors. Consult
your healthcare provider.
16
Phantom limb
sensation
Almost every amputee experiences the sensation that
the amputated limb is still present.1 These feeling can
occur due to a variety of factors including pressure
or even weather changes. These sensations may
disappear quickly or in some cases can remain for
quite sometime. Phantom sensations are different for
everyone and should not present any problems toprosthetic fittings.
Phantom limb pain
In addition to phantom sensations, some people
experience various types of phantom pain in the
amputated limb.
1
The causes of these phantom pains remain unknown
but there are treatments available to help manage
symptoms. If you experience phantom pain you should
contact your physician or nurse so that they can
recommend the appropriate treatment.
exercise
After an amputation it is common to feel weak and
unsteady. This is why it is important to begin
stretching and exercise as soon as you are able.
There are many different types of exercises; some
can be done while lying in bed, some standing, some
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sitting, and more. At times, home exercise is
important and at other times you may need to visit
your physical therapy clinic. Your physical therapist
will be able to explain and demonstrate these and/or
other exercises that are appropriate and beneficial
for you.
Temporary Prosthesis
This section will attempt to guide you through the
process of receiving a temporary prosthesis. A
temporary prosthesis is fit about four to twelve
weeks after surgery, depending on how well and
quickly the suture line heals. The temporary
prosthesis is your first prosthesis. It will help you(r):
1. get accustomed to putting on and takingoff (donning and doffing) a prosthesis2. skin get accustomed to the new pressures
and forces of prosthetic use
3. learn to walk on a prosthesis
18
4. helps you to learn to manage the socksyou need to wear as your residual limb
volume changes.
In order to accomplish these things, the way this
first prosthesis is designed and looks will quite likely
be different from your future prostheses.
Prosthetic process
Upon successful healing and control of edema, your
physician will most likely prescribe a temporary
prosthesis for you. It is very important to inform the
practitioner of any goals and aspirations you have.
With your goals in mind, the process of prosthetic
selection can begin.
As a part of your first visit to the prosthetist, your
residual limb will be evaluated for any scarring,redness, blisters, or any other problems that might
effect the fit and function of a prosthesis.
Your prosthetist will then go over the different
options for prosthetic interfaces. Depending on your
needs, you and your prosthetist will choose which is
best for you.
The most common types of prosthetic interfaces
include pelite, flexible plastic and gel liners. Each has
pros and cons that must be considered.
Flexible plastic is a common choice in prosthetic
design interfaces. There are many types of plastics
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available. Flexible plastics are moisture proof, will
not compress and provide the ability to make
numerous alterations to the fit of the prosthesis.
They are very durable but do not offer the same
amount of cushioning that gel liners do.
Probably the most common type of interface is the
gel liner. These liners are worn directly against the
skin to provide cushioning while still allowing the
ability for socket adjustments. It is important tounderstand that because the liner is worn directly
against the skin they must be washed on a daily basis
and allowed to dry thoroughly before reapplying.
There are many different types of gel liners available
and your prosthetist will work with you to choose the
best one for you.
20
After the socket design and interface choices are
made, the prosthetist will take a series of
measurements from your residual limb that will be
used in the fabrication process.
Your prosthetist will then take an impression of the
limb using plaster wrap. It is from this impression
that your prosthetic socket will be fabricated. This
visit with the prosthetist usually takes about one
hour. Following the visit, your prosthetist will
schedule an appointment for you to be seen back in
the office for a check socket fitting in about one
week.
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Check socket fitting
When you return to see your prosthetist for the
check socket fitting, you should bring a pair of shoes
with you. This visit will last about one hour.
The check socket is typically made of a clear plastic
that allows the practitioner to view the pressures
exerted on the residual limb prior to fabrication of
your temporary prosthesis.
During this visit, the prosthetist will allow you to
stand in the prosthetic check socket.
After adjustments are made to the socket to
alleviate pressure points, your prosthetists will ask
you to walk in the parallel bars to dynamically align
the prosthesis.
22
Your practitioner will work with you to make any
necessary adjustments to the socket for a better fit
and to optimize how you walk.
Following this visit, the practitioner will fabricate the
temporary prosthesis. This process normally takes
about a week from the check socket fitting.
Temporary Prosthetic
socket fitting
A temporary prosthetic socket is usually fabricated
out of thermoplastic. The thermoplastic is used for
its high adjustability to accommodate the changes in
volume of your residual limb. It is commonly worn for
3-6 months. During this time period, you will have
several follow up visits with your prosthetist to
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evaluate and adjust the fit of your prosthesis. The
need for adjustability is crucial and therefore the
temporary prosthesis may not look like a natural leg.2
During this visit, your prosthetist will again have you
walk in the parallel bars and make any necessary
alignment changes to optimize how you walk. Once all
the adjustments have been made and you and your
prosthetist are satisfied with the fit and function of
the prosthesis, you will most likely be able to takethe prosthesis home with you.
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Prosthetic Follow up
After you receive your temporary prosthesis, your
prosthetist will provide you with follow up
appointments. It is imperative that you maintain
these appointments and follow any instructions given
to you by your prosthetist. Some of your obligations
in between appointments will be sock management,
hygiene, skin assessment, and exercises.
Follow up appointments are usually made once a week
after receiving your temporary prosthesis. These
appointments allow your prosthetist to monitor any
changes in your residual limb, and proactively manage
any issues that may arise.
After the first two months, the follow up
appointments are less stringent, and are usually on anas needed basis determined by you and your
prosthetist.
Sock management
While wearing your prosthesis it is common to
experience a loss of volume in the limb throughoutthe day. This is commonly referred to as sock
management or volume management.
As your residual limb loses volume, the space between
your residual limb and prosthesis will become greater
and must be filled. Your prosthetist will provide you
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with several socks, of various thickness, that will fill
in this space.
Sock ply is determined by the thickness of the sock.
The sock ply can visually be determined by either a
number on the sock or the color of the sock stitching.
The lower the sock ply, the thinner the sock. It will
be your job to determine when socks are required and
what size will best fill in the gap. It takes some time
to get proficient with this. Be sure to talk with theprosthetist and physical therapist when you have
questions. You will be taught how to manage your sock
wear. This skill will be frequently reviewed because it
is important in maintaining the fit and function of the
prosthesis and health of your residual limb.
Left: multiple plies of socks (6 ply, 5 ply, 3 ply and 1 ply
socks). Also shown are socks made of specialized materials(silver threads in this case). Right: Person wearing socks in a
transfemoral prosthesis due to volume loss.
26
Prosthetic hygiene
You should wash your residual limb on a daily basis to
help prevent the accumulation of bacteria or
development of cysts or pimples. Simply wash your
residual limb with warm water and a mild soap. The
soap should be fragrance free to prevent any skin
irritation. A good soap to start with is the same
brand you use to wash the rest of your body with. If
this does not work for you, consult your physician or adermatologist for other recommendations. Always be
sure to rinse thoroughly and remove any residual soap
from your limb.
When drying, try to pat with a towel rather than
rubbing the limb. While this action is soothing to
some peoples limbs, it is irritating to others.
During this process you should check your skin for
any abnormalities such as redness, blisters or
anything that is otherwise abnormal to you. Any signs
of prolonged redness or soreness should be reported
to your healthcare provider right away. Early
identification of problems tends to result in less
complications. If something does not appear to be
normal, always ask a professional.
Physical therapy
Often times your physician will decide whether your
physical therapy should be on an inpatient or
outpatient basis.
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Your physical therapist will work with you on safety
and gait training (walking) with your new prosthesis.
Gait training is a process in which the physical
therapist teaches you how to walk safely and
efficiently with your prosthesis with either an
assistive device or without assistance.
Your therapist will train you on gait patterns as well
as how to navigate stairs and any other every day
challenges that may occur. You will be introduced tomany different exercises that may be accomplished
at the therapists office and/or at home.
A physical therapist will begin with certain exercises
to help strengthen the muscles needed for
ambulation. Some strength training exercises may be
able to be performed at home with the use of
TheraBand, a rubberized and resistive material.
Left: Physical Therapist assisting person learning to walk
with a transfemoral prosthesis. Right: Person with
transfemoral amputation, performing strengthening exercise
with an elastic, resistive band.
28
It is important that you follow the regiment given to
you by the therapist. The exercises and training you
get in physical therapy will help you improve strength,
balance and efficiency for walking with your new
prosthesis.
Definitive prosthesis
Receiving your definitive prosthesis is a similar
process to when you were given your temporaryprosthesis.
Your prosthetist will take several measurements and
an impression of your residual limb in preparation for
a check socket. The process for fabricating the
check socket normally takes about a week.
Once your check socket is ready you will see theprosthetist again so that adjustments can be made to
the fit and alignment of the check socket in
preparation for the definitive socket.
In about a weeks time your prosthetist will have a
definitive socket fabricated. The visit to fit the
definitive socket typically takes about one hour. Theprosthesis is dynamically aligned for optimal
performance.
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The definitive socket may be fabricated of alaminated carbon or other composite materials.
Definitive sockets may also be made of
thermoplastics as well. Once all adjustments have
been made, you will be able to take the definitive
prosthesis home with you. You will be given a follow up
appointment in about one week. At this time, if the
prosthesis is functioning well and no changes have to
be made, a cosmetic covering may be considered ifyou wish.
Cosmetic covering may be made of a soft foam or a
rigid foam. It gives the prosthesis a natural
appearance, typically matching the previous shape.
The outer coloring/tone is typically incorporated into
a nylon or a rubberized prosthetic skin that is applied
30
over the cosmetic cover. The prosthesis can typically
be finished to match your sound side.
You will be given follow up appointments which will
allow your prosthetist to assess your progress and
make adjustments as needed.
Prosthetic hygiene
During the time between follow up appointments withyour prosthetist, it is imperative that you maintain a
high quality of personal hygiene.
Any part of the prosthesis that is in direct contact
with your skin should be washed daily and all residual
soap needs to be removed. This includes but is not
limited to: washing your liners (if you have one),
washing shrinkers that you may be using and washingany socks that are used to maintain proper fit inside
the prosthesis.
It is also very important to wash your residual limb
everyday to prevent skin irritations, infections,
and/or other complications. Proper hygiene
instruction will be given to you by your prosthetist.
As always, ask is something seems unclear.
exercise
Now that you have your definitive prosthesis you may
be a candidate for new types of exercises and
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activities. This is an important time to reintroduce
your goals and desires to be sure that your therapist
and other providers are working with you to best
accomplish them.
Simple standing and seating exercises can greatly
increase your stamina and make your road to recovery
much quicker. If you feel that you can accomplish
more than you are given, do not hesitate to ask your
therapist and prosthetist what other types ofexercises and activities are safe for you.
Assistive devices
Throughout your rehabilitation process, you may be
prescribed different assistive devices to help you
transfer, walk, and exercise.
In the early stages following your amputation your
therapist will begin training you to utilize various
assistive devices to aid in walking. Some of the most
commonly used devices may include the use of a
wheelchair, walkers or crutches or a cane
.
It is common to start off with one device before you
receive your temporary prosthesis. After receiving
the temporary prosthesis, you may switch to
something else. The situation is highly variable
between different people. Your healthcare providers
will discuss this with you. Similarly, you are
encouraged to ask questions if you are unsure about
32
which device is best for you, how to use it, and how
long you will use it.
Many people express a desire to walk without the use
of any assistive device and many people with an
amputation are able to accomplish this. Again, be sure
to talk with your healthcare provider about what is
realistic for you.
Assistive devices are not only used for walking. Somespecific activities such as driving require them as
well. If your amputation involves the right side there
are devices available that switch the pedals of your
car to allow driving with the left foot. In the back of
this booklet there are several organizations that
offer assistance in obtaining these devices.
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Amputee athletic
resources
Living with an amputation does not mean that you
cannot live the active lifestyle that you once had.
Below is a list of amputee athletic resources that you
may find helpful.
Activeamp.org
Activeamp.org is an online connection for amputeeswith active lifestyles. This resource has many links to
sports related amputee associations. Please visit
their website at http://www.activeamp.org/ for more
information.
Disabled Sports USA
Disabled Sports USA is a national nonprofit,
501(c)(3), organization established in 1967 bydisabled Vietnam veterans to serve the war injured.
DS/USA now offers nationwide sports rehabilitation
programs to anyone with a permanent disability.
Activities include winter skiing, water sports, summer
and winter competitions, fitness and special sports
events.3 For more information you can visit their
website at http://www.dsusa.org/
Extremity Games
The O&P Extremity Games is an extreme amateur
sporting competition for individuals living with limb
loss or limb difference. The O&P Extremity Games
allows participants to demonstrate skill, persistence
34
and passion while competing for cash and other
prizes.8 For more information, contact Beth Geno at
586.354.2260 or visit their website athttp://www.extremitygames.com/
National Amputee Golf Association
The National Amputee Golf Association was
incorporated in 1954. At that time, NAGA was
comprised of a small group of amputee golfers who
played friendly games that quickly developed intoregional tournament play in various cities across the
United States. Today, NAGA has over 2500 members
worldwide.5 For more information, please visit their
website at http://www.nagagolf.org
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Amputee resources
The following is a list of online resources for new
amputees. These websites have valuable information
for every situation imaginable!
American Coalition of America
http://www.amputee-coalition.org/
Amputee Information Exchange
www.amp-info.org
Amputee Information Network
www.amp-info.net
Barr Foundation
http://www.oandp.com/resources/organizations/barr
Diabetes Resource Center
www.diabetesresource.comFord Mobility Program
www.fordmobilitymotoring.com
Life Center at the Rehab Institute of Chicago
http://lifecenter.rehabchicago.org
National Center on Physical Activity and Disability
www.ncpad.org
National Limb Loss Information Center
http://www.amputee-coalition.org/nllic
For additional amputee related websites, please visit
http://hometown.aol.com/alegnomore/amputee/alpha
beticalamputeelinks.htm
36
references
1. American Academy of Orthotists andProsthetists. For the New Amputee. (1991). pp 6-
7.
2. American Academy of Orthotists andProsthetists. Patient Care Booklet for Below
Knee Amputees. (1998). pp 8-9
3. Disabled Sports USA. Improving the Lives ofthose with Disabilities. (2005). Retrieved on
March 2, 2007 from http://www.dsusa.org/
4. Muilenberg AL, Wildon AB. A Manual for BelowKnee Amputees. (1996). Retrieved on March 17,
2007 from
http://www.oandp.com/resources/patientinfo/manuals/bkindex.htm
5. National Amputee Golf Association. What isNAGA?. (January 3, 2007). Retrieved on March
28, 2007 from http://www.nagagolf.org/
6. National Limb Loss Information Center.Amputation Statistics by Cause. (2005).
Retrieved on March 14, 2007 from
http://www.amputee-
coalition.org/fact_sheets/amp_stats_cause.html
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7. National Limb Loss Information Center. FacingSurgery. (nd). Retrieved on March 28, 2007 from
http://www.abcamputee.com/facingsurgery.pdf
8. O&P Extremity Games. Never Say Never NeverSay Cant. (2006). Retrieved on March 17, 2007
from http://www.extremitygames.com/event/
9. University of Utah Health Sciences. PhysicalMedicine and Rehabilitation. (2001). Retrieved onMarch 14, 2007 from
http://healthcare.utah.edu/healthinfo/adult/Reh
ab/amput.htm
38
This Informational Pamphlet was made possible by
the contributions of the following:
Department of Education
Rehabilitation Services Administration
Award #H235J050020Demonstration Project on Prosthetics and Orthotics
St. Petersburg College
College of Orthotics and Prosthetics
University of South FloridaCollege of Medicine- School of Physical Therapy &
Rehabilitation Sciences
College of Engineering-Mechanical Engineering Department
Chris Lemonis, CPO(c)Amy Mountain, CPO(c)
M. Jason Highsmith, PT, DPT, CP, FAAOP
Samuel Phillips, PhD, CP, FAAOP
Scott Sanford, MEd, CO
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