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Amputation

What is amputation?

Amputation is the complete removal of an injured or deformed body part. An amputation may be the result of a traumatic injury or may be the result of a planned operation.

For most people, just hearing the word “amputation” stirs up feelings of anxiety and fear. Yet limb loss is not uncommon: Each year in America, more than 150,000 people face this life-changing experience. The most frequent causes are vascular disease, diabetes and cancer; about 70 percent of these patients are older adults. Traumatic limb injury is also a cause of amputation and usually occurs because of motor vehicle accidents, on-the-job and recreational injuries and military service in war zones.

Congenital limb deficiencies

Of every 100,000 births in the United States, about 26 people are born with partial or malformed limbs, many of which lead to amputations.

Limb loss rehabilitation

For those who have lost a limb, rehabilitation depends on the combined efforts of many people. At Regions Rehab Institute, you will be part of a team that includes your key family members and/or friends, a Physical Medicine and Rehabilitation physician, a physical therapist, an occupational therapist, a psychologist and a prosthetist. While it is true that most of the effort is up to you, the expertise and guidance of each person on your support team is critical.

During this early stage of recovery, the physical and occupational therapist will help you with basic but important needs such as getting positioned in the bed, transferring from bed to chair and back, balancing while standing and using crutches, a wheelchair or an upper extremity assistive device. While you are in the hospital and after your release, therapy will consist of dynamic exercises to condition and strengthen the residual limb. Your therapist will teach you specific exercises that flex and tone the muscles in the hip, back, abdomen and knee or the upper back, shoulder, upper arm and elbow.

Physical therapy for the long term

Physical therapy is not just for new amputees and new prosthetic users. For optimum mobility, you should be evaluated by a physical therapist every year or two throughout your life. They can pinpoint problems that if left untreated, will result in back problems or pain in other areas of the body.

New lower extremity users

When lower extremity users begin to wear a temporary/preparatory prosthesis, the focus shifts to standing exercises that are aimed at reorienting the center of gravity. Weight- shifting exercises between parallel bars help you learn to displace your center of gravity forward, backward and sideways. These exercises carefully move you toward bearing weight on the prosthesis and will prepare you for the weight shifting that accompanies walking. Instruction in putting on and taking off your prosthesis will also be part of physical/occupational therapy.

Actual gait training consists of many specific exercises and careful analysis by the physical therapist and prosthetist. Your physical therapist will do a lot of hands-on positioning and resistive techniques as you begin walking. For the best results, we recommend that the therapist and prosthetist continue to work together throughout your gait training. Minor adjustments in the prosthesis can sometimes enable you to make real improvements in your gait. The physical/ occupational therapist will also work with you on strengthening exercises and on specific daily living activities such as dressing, using the bathroom, standing up and sitting down, carrying objects, getting in and out of a car, driving and ambulating in the community

Its very important to care for and monitor your residual limb throughout the rehabilitation process. Ignoring even minor scratches or abrasions can lead to pain, infection and serious delays. Your therapist and prosthetist will help you learn the rules of hygiene as they apply to your prosthesis and residual limb. This includes daily cleaning of the socket, assistance with determining the best ply of prosthetic sock and managing perspiration in the residual area.

New upper extremity users

Early physical/occupational therapy for the upper extremity focuses on maintaining or increasing the mobility of the joints. In some cases, strengthening exercises will also be important.

Another focus of early upper extremity therapy is learning to use the sound hand for daily activities such as eating, grooming, using the bathroom, picking up objects and writing. The therapist can also offer guidance in using your teeth to help with some tasks.

When upper extremity users begin to wear a temporary prosthesis, the therapists and the prosthetist are involved in the training process. The first goal is to help you learn how to put on and take off the prosthesis. It is key to your success as an upper extremity user to be able to independently, accurately and quickly don and doff the prosthesis. From here, therapy will focus on learning to control the terminal device, wrist unit or elbow unit. How training proceeds depends largely on whether the prosthesis is body-powered or externally powered.

Its very important to care for and monitor your residual limb throughout the rehabilitation process. Ignoring even minor scratches or abrasions can lead to pain, infection and serious delays. Your therapist and prosthetist will help you learn the rules of hygiene as they apply to your prosthesis and residual limb. This includes daily cleaning of the socket, assistance with determining the best ply of prosthetic sock and managing perspiration in the residual area.

Location & contact information

Regions Hospital Rehabilitation Institute

640 Jackson Street
St. Paul, MN 55101
Phone: 651-254-2071
Fax: 651-254-0910