Diabetes brings complications. Wounds or cuts on the foot of a diabetic might not heal quickly, if at all, leaving some people dealing with infection. In cases where infection in a foot sore or wound refuses to heal and sepsis or infection carried through the bloodstream throughout the body is a possibility, an amputation of the injured foot might be recommended.
Amputation
If you're a diabetic facing a foot amputation, you can decide, along with your doctor, what type of amputation is necessary to save your leg or life. Your doctor will ultimately make the decision whether to perform an above-the-knee or a below-the-knee amputation. The type of amputation, and your overall health condition, age, prognosis and goals, will determine post-surgical rehabilitation needs.
Post-Surgial Rehab
After your diabetic foot amputation surgical procedure, your physical therapist will encourage you to move your limbs and torso as soon as possible to encourage blood flow and prevent stiffening. Your amputated limb can be placed in a range of motion device to promote hip flexion and extension. Such passive exercises also decrease muscle weakness and encourage circulation throughout your body and the injured limb.
Therapy
Your therapist works with you to restore optimal mobility and movement following your surgery. Goals will be to encourage you to bear weight on a prosthesis, and to learn to walk, turn and balance following your diabetic foot amputation. To start, you might be directed to perform lying down or sitting limb extensions. You can also perform hip adductions while seated or lying down by placing a pillow between your knees and pressing them together. Your therapist will cater your therapy treatment plan to your condition, your current state of mobility and your desire to undergo rehabilitation.
Gait Training
While getting used to a prosthetic, which is worn only a short time to start, you might require the use of a cane or walker to help you get around. Your therapist will exercise your legs in passive range of motion exercises such as hip and knee flexion and extension exercises. As you grow stronger, you'll be directed to perform such exercises on your own. During gait training, you will learn how to walk short, then longer distances with your prosthesis in place, using parallel grab bars, a cane or a walker for balance and stability. Gradually, you'll regain confidence and strength and won't require such aids.
References
- Vascular.co.nz: Amputation and Amputation Surgery
- The Amputees Guide to the Amputation and Recovery Process; Richard A. Sherman, D.E. Casey Jones; 1995
- Medscape News Today: Care of the Elderly Patient With Lower Extremity Amputation: Stages of Care
- Amputee Rehab: Below Knee Amputee (BKA) Exercises
- Better Limbs: Gait Training
