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Chapter 6
PHYSICAL REHABILITATION
a. Overview
Rehabilitation after an amputation is a long process. If a leg or foot has been amputated (lower extremity amputee),
most of your training in stump care and walking will be done by Physiotherapists / Physical Therapists (called P.T.s).
These professionals have four or more years of training in helping people recover from a wide variety of debilitating
problems. They are highly skilled in helping you learn to take proper care of your stump and in learning to walk with an
artificial leg. You will be taught to take care of and wrap your residual limb (stump). You will be fitted with the artificial
limb (prosthesis) most likely to help you develop a good way of walking (gait), carry out your daily activities, return to
work, and participate in sports. If an arm or hand has been amputated (upper extremity amputee), you will probably work
with an Occupational Therapist (called an O.T.). These professionals have four or more years of training in helping people
overcome handicaps and disabilities. They are experts in such areas as teaching you to carry out all kinds of tasks with one
hand or in modifying activities to make the best use of your prosthesis.
You will probably get to go home from the hospital as soon as you can get around by yourself safely - with or without
an artificial limb. You will have to plan to return to the hospital or a local rehabilitation center very frequently for continued
training and treatment.
One vital part of rehabilitation is extra care for the remaining limbs. An intact lower limb tends to take more of your
weight at first. A remaining upper limb tends to take over much of the work done of an amputated arm or hand. The extra
stress on these limbs may be more than they can easily take so you have to give them extra care and be sure not to over use
them.
b. Extent of recovery
The extent of your recovery depends largely on your physical condition prior to amputation. If you were in good
physical shape before the amputation, you will probably recover within a few months and be able to perform most of the
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activities you did before your amputation. Many amputees who are in good physical condition play basketball, hike, hunt,
swim, WORK, and do most of the other activities their peers do.
Extent and speed of recovery depends mostly on these factors:
(1) Your age and the length of the healing process. People heal more slowly as they get older. The more complex the
amputation and its wound, the slower healing is likely to be.
(2) The extent of other medical problems associated with the amputation such as burns or diseases causing general
debilitation such as diabetes or not enough blood supply to the limb (vascular insufficiency) all of which tend to lengthen
the recovery process.
(3) Learning to use your prosthesis is hard work so your overall physical condition and health will play an important
role in how quickly you can progress.
(4) How closely you follow the instructions of your physiotherapist. This is especially true of how much you do. It is
easier to prevent problems than to cure them so don't overdo!
(5) How much you want to recover and learn to use your prosthesis. There is simply no substitute for determination. If
you do not want to work at learning these difficult tasks, you will not get very far.
(6) There are many psychological factors which can speed up or slow down your recovery. Support from family and
friends, various social and economic factors can play an important role in either speeding up or virtually stopping your
recovery.
c. Post surgical dressings
Just after surgery any or all of the following basic types of dressings for your residual limb may be used.
(1) Rigid dressing: Just after surgery many patients are fitted with a rigid dressing (cast) to assure control of swelling
and provide comfort. The end of the cast is made to take a simple training prosthesis usually called a "pylon" so training
in standing and walking can be started immediately. A typical pylon is shown in Figure Five. This cast may have to be
changed after several days or weekly because it becomes loose from the shrinkage of your residual limb. It is held on [ Pobierz całość w formacie PDF ]