Amputation Physiotherapy Rehabilitation

Amputation is the removal of a body extremity by surgery or due to trauma. Losing a can be an overwhelming experience for anyone to go through. It requires a combined professional approach to help you adjust to living without your limb. Physiotherapists play a key role during the rehabilitation of individuals who have had an amputation.

 Amputation Physiotherapy

There can be several reasons why someone would become an amputee; however, the two main categories are:

• Trauma –when the limb is badly damaged in an accident and either the blood supply or the structure of the limb cannot be saved
• Vascular disease - if it is serious it may result in a loss of blood supply to the limb after previous medical management, which can lead to an amputation

Less common causes for amputation include, tumours, infection, as a pain control method or due to congenital reasons.

Pre-operation Physiotherapy

Prior to non-emergency amputation a physiotherapist can provide:

• Pre-operation exercises to maintain current muscle strength and range of movement
• Education on what to expect post-surgery regarding rehabilitation

Post-operation Physiotherapy

A physiotherapist can provide several interventions to assist with post-operation rehabilitation. Treatments may include:

• Massage to relieve pain, promote the healing process and relieve tension in muscles surrounding the stump or the opposite limb where problems can arise due to over-use caused by compensation.
• Acupuncture and electrical stimulation can be used to treat phantom limb pain and phantom sensation.
• Exercises to minimise stiffness in other joints and work towards strengthening whilst the patient remains on bed-rest.

The physiotherapist will carry out an initial assessment including pre-amputation lifestyle, expectations and medical limitations. Assessments and treatments will always take in to account the level of amputation, social environment, physical (healing of the stump) and psychological healing (emotional and cognitive). The physiotherapist will then devise a treatment plan in agreement with the patient to achieve maximum independence safely within the patient’s limitations.

Rehabilitation in Hospital

During your hospital stay a physiotherapist will teach you some exercises to perform in bed and they will also teach you transfers which would include getting in and out of bed, into a wheelchair and on and off the toilet.

Whilst Still in Hospital

You will continue with an exercise program to strengthen the muscles around your stump and maintain strength in all other limbs. Here they would also begin to work on gait, providing any appropriate walking aids, if required.

Rehabilitation Following Hospital Discharge

You may be discharged from hospital as early as two weeks post-operation. It is important to continue with your exercise program.

Although all physiotherapy treatment plans will be individualised, in general, physiotherapy intervention programs would include:

• Amputee strengthening program which could including a variety of exercises:
  • Isometric
  • Isotonic
  • Isokinetic
  • Manual
  • Active upper and lower limb extremity strengthening
• Functional exercises for the upper and lower limbs
• Pre-gait training exercises
• Weight bearing and balance exercises
• Pelvic and trunk exercises
• Gait training
• Injury prevention and management strategies

If appropriate you will also be assessed for an artificial limb (prosthesis). If a prosthesis is deemed appropriate the physiotherapist will educate you in donning (put on your prosthesis) and doffing (taking off your prosthesis).

Summary

Physiotherapy plays a major role in the rehabilitation of individuals following amputation.