Physical therapy and gait training are very important pieces to recovering from a lower limb amputation. Proper gait training is an essential component to regaining independence. Working together with your physician, therapist and prosthetist you learn training techniques, while also making sure the prosthesis fits properly.
Fit
The first step in training with a prosthesis is working with your prosthetist to ensure the device fits properly. After the amputation and throughout the rehabilitative process, the residual limb continues to mature and change in both shape and size. These changes require adjustments to be made to the socket, the portion of the prosthesis that fits over your limb, to ensure it is fitting properly and the prosthesis is secure. These adjustments should only be made by your prosthetist; an improperly fitted device should not be worn.
Gait
Learning to walk with a prosthesis can be challenging and the fundamentals of gait, or walking, can vary by level of amputation. Above-knee amputees must learn to use both a knee and ankle joint, whereas below knee amputees need only learn to use the ankle joint. Learning to walk with a prosthesis usually takes three to nine months in order to increase strength, flexibility and confidence.
Weight
Maintaining a constant body weight is an important part of being a prosthetic wearer. In order to maintain an appropriate fit of the prosthetic socket, fluctuations in weight should be kept to a minimum. The residual limb can take up to three years to shrink and enter into its mature shape and size. Additionally, limiting intake of sweet and salty foods in order to limit water retention helps maintain the fit of the prosthesis.
Therapy and Exercise
Physical therapy and gait training is done by trained therapists and prosthetists. Exercises involve strengthening and regaining your center of gravity, weight shifting and specific exercises to help with standing, sitting and community ambulation. Hip exercises are primarily used with above-knee amputees are done to strengthen the legs and pelvis. Weight shifting exercises are done using parallel bars. Early therapy is usually provided by the prosthetist during the prosthetic fitting process and physical therapists provide ongoing gait training.
