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Always: the importance of controlling your weight

During rehabilitation and beyond, it is important to eat as healthily as possible and keep your weight stable. Maintaining a consistent, healthy weight is important for everybody, but for those who have lost a limb it is even more important, for the following reasons:
• to maintain the proper fit of the prosthetic socket attached to your residual limb,
• to reduce the energy required to use your prosthesis,
• to prevent or reduce secondary conditions, such as back pain, and
• to control diseases such as diabetes and high blood pressure.

Exercises for above-knee amputees 

The following training exercises will help you recondition your muscles and adapt to walking with a prosthesis. They should initially be supervised by your physiotherapist or biokineticist to ensure that you perform them correctly, and later you can start exercising at home in your own time. This type of training will enable you to master the correct walking technique from the start and also help you through your reintegration phase.

Don’t underestimate the importance of exercise and training: they are a vital part of getting you walking again. (Please remember that they are just suggestions and may not be the best exercises for your particular situation. Always follow the advice given by the medical professionals in your team, who have physically assessed you.)

 

1. Side-to-side pelvis shift: Place your feet approximately 10 cm apart and shift your pelvis slowly from left to right and back again. Feel how your weight is shifting from one foot to the other.

2. Stepping up: Move your weight slowly over the prosthetic leg, then push your residual limb into the socket and place the sound side foot on the step. Feel your full weight loaded on your prosthetic knee. Try to control your balance on the prosthetic side using the muscles around your hip.

3. Stepping forward: Step forward with your sound side foot, actively loading your weight onto the prosthetic side. Focus on your balance over the prosthesis as you move forward and backward.

4. Walking: Practice walking while your prosthetist or physiotherapist gently restrains your pelvis on the prosthetic side. This increased resistance during the exercise will help give you more forward momentum. When walking, this will produce a longer and more natural stride.

5. Figure-8-walking / turns: Place rubber cups on the floor and walk in a figure of eight or make gentle turns. Concentrate on the roll-over movement of the prosthetic foot and feel how smoothly the prosthetic knee is flexing.

6. Walking with sticks: Using sticks can help improve your trunk rotation and balance as you get used to the prosthetic knee. Actively loading the prosthesis (putting your weight on to it) and generating a smooth rollover of the prosthetic foot will enhance your forward momentum.

7. Sitting down: Place the prosthetic foot slightly forward, then put your weight on your prosthetic knee and keep it there until you can gently bend it. The resistance – or braking power – you can feel helps you to sit down slowly. (The amount of resistance will depend on what kind of prosthetic knee you are fitted with. Whether you are on a microprocessor knee or a mechanical knee, be sure to first consult with your prosthetist before attempting this exercise.)

8. Walking down stairs: Hold the handrail(s) and place the rear half of the prosthetic foot on the step. Practice putting weight on the prosthetic side and gradually move the pelvis forward. By loading the prosthetic knee like this, you will produce the resistance needed to get you down to the next step smoothly.

9. Walking down a ramp or slope: Hold the handrail(s) and take short, evenly-paced steps. Loading the prosthetic knee will produce the resistance needed to walk down the ramp in a controlled way.

Exercises for below-knee amputees

Rehab Exercises BK

1. Standing: Stand upright, dividing your weight evenly between the prosthetic side and the sound side. Use a mirror for visual control.

2. Side to side: Shift your weight slowly onto your prosthetic side; it will help if you contract your gluteal muscles (muscles around your hip) and your residual limb. Next, shift your weight slowly back onto your sound side. Repeat.

3. Forwards - Backwards: Stand upright, dividing your weight evenly between the prosthetic side and the sound side. Shift your weight slowly forward and backward, controlling your balance and feeling your prosthetic forefoot when shifting forward.

4. Balancing: To make balancing more difficult, try to stand on a balance board. Be careful stepping on and off the balance board.

5. Spot-stepping: Mark three different spots on the floor, for a small step, a medium step and a large step. Actively load your weight onto the prosthetic side and take a step forward with your sound side. Focus on your balance over the prosthesis as you move forward and backward with your foot. Make sure you take a full step forward and backward.

6. Stepping up:  Shift your weight slowly onto your prosthetic side, then push your residual limb into the socket and place the sound-side foot on the step. Try to control your balance on the prosthetic side using the muscles around your knee and hip. Pay attention to the forward movement of your pelvis to keep it in line without twisting or rotating.

7. Tennis ball movements: Shift your body weight slowly onto your prosthetic side and contract your residual limb in the socket. Place a tennis ball underneath your sound-side foot. Make small circles with your sound-side foot and alternate with fast cross-movements.

8. Thera-band movements: Shift your weight onto the sound side, place the Thera-Band around your prosthetic foot and tie the other end to fixed object. Move your prosthetic foot in a slow and controlled way to the side, making sure it travels in a straight line.

9. Obstacle stepping: obstacles (plastic cups or toys) on the floor at equal distances and step over them. Raise your knee until it is in line with your hip and repeat with every step.

10. Extra exercises: Walk sideways, crossing the prosthetic foot over the sound-side foot. Other options: crossing the sound-side foot over the prosthetic foot, side steps, tightrope walking, backwards walking and big steps.