Possible Exercises For Above
Physical Fitness For Sports Participation And/or Competition:
In amputees who would like to advance their fitness levels and enter a competition, depending on the level of the competition, they may benefit from a sports coach to specifically train them for performance. At all levels, the value of a prosthetist in helping to decide if and when to progress to a sports prosthesis is helpful.
Strength And Conditioning Specialist
The importance of a strength and conditioning specialist is to develop optimal conditioining for the specific sport or recreational activity. The physical demands of sport include aspects like strength, power, stability, balance and endurance and therefore an intensive individualised conditioning programme is recommended for high level participation.
Again, the ideal scenario is for the physiotherapist, coach, strength and conditioning specialist and prosthetist to work closely together.
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Return To Recreational And Sports Activities
If you are active or have a favorite sport you may also want to consult with a recreational physical therapist, who can help you choose appropriate adaptive recreation equipment. Depending on your personal goals and preferred leisure activities, the recreational physical therapist can help you return to sports such as golf, hiking, running, swimming, or cycling. A prosthetist can help you choose the best prosthetic device for taking part in these types of activities. You also may gain valuable advice from other individuals with amputations your physical therapist can help you find support groups for people with amputations in your area.
University Of Oklahoma Home Exercise Program For People With Lower Limb Amputations
These exercises are appropriate for persons with amputations either above or below the knee. Remove your prosthesis to do these exercises. Your prosthesis is designed for walking. Exercising with it might put too much pressure on parts of your leg and even cause skin breakdown.
Lying on your stomach for 30 minutes twice a day will keep the muscles in front of your thigh from getting tight. While lying this way, you can exercise your leg by lifting it backwards. You can also strengthen your back muscles by lifting your head, or raising your arms. Check with your therapist before you do these exercises to make sure they won’t cause other problems.
You can pad a stool or phone book with a towel or pillow and then do leg exercises which make you lift and control your body weight. This picture shows how you can strengthen the muscles on the back of your hip by “bridging” with the amputated limb. You can also bridge with the non-amputated limb.
You can also turn to the side of the amputated limb, and “bridge” using muscles on the side of your hip. If done correctly, this exercise is an excellent way to learn how to control the prosthesis. However, you have to lie on your side without rolling, and keep your leg in a straight line with your upper body. If you let your leg come forward or let your pelvis and hips roll backward, you will be using the wrong muscles and developing bad habits for walking.
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Physical Therapy Guide To Below
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Transtibial amputation, or below-knee amputation, is a surgical procedure performed to fully remove a lower limb that has been damaged due to trauma, congenital defect, or disease. Transtibial amputation comprises 23% of all lower-limb amputations. Amputation is possible in any age group, but the prevalence is highest among people aged 65 years and older.
Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.
The Ideal High Level Rehabilitation Team
The ideal high level rehabilitation team around the amputee athlete should include the physiotherapist, the prosthetist, the coach and in more elite athletes the strength and conditioning specialist. In a study done at Walter Reed with combat veterans with limb loss, it was found that the patients saw their rehabilitation team as “motivating and supportive coaches” physically and emotionally and that routine interaction with all team members promoted self-confidence and self-advocacy.
The roles often overlap and the team is most effective when decisions are made in collaboration with each other and with the athlete. In broad terms though, the roles could be described as follows:
Assessment
Basic assessment should have taken place including details of the stump, medical history, medication, level of function etc. . If this basic assessment has not been done, it should be done at the start of any programme.
Yellow flags should be assessed like home circumstances, emotional state and an assessment of expectations from the athlete.
Formulation of an individual problem list and plan:
The information gleaned from the assessment will allow one to develop a problem list specific to that individual and thereafter a goal-directed plan to deal with those problems
Basic strength and conditioning:
Core stability:
Gait training, including running gait:
Return to sport, or Begin sport assessment:
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Who Qualifies For High Level Rehabilitation
Although this usually refers to competitive or elite athletes, any amputee who has reached the level of function where they are able to ambulate effectively with a good gait pattern should be encouraged to develop further improvements to allow for participation in at least fast walking, but possibly jogging or running. Cognisance of considerations for high level athletes should also be borne in mind but are not as important in the participation-only population group .
Once participation progresses to competition, rehabilitation/training should be more intense and outcome-focussed. The remainder of this article will focus on individuals who have reached the level of competition, including elite athletes.
Ready To #moveforward With Our Below
Any lower-extremity amputation involves a pretty extensive rehabilitation process, which means it will require work on your part. However, returning to a fulfilling lifestyle is far from impossible, especially when you have a reliable team and support system on your side.
This same rule applies to upper-extremity amputees and lower-extremity amputees recovering from above-knee amputations as well, with the latter category facing an extremely similar array of challenges that they must topple as they #MoveForward. As such, we recommend checking out the exercise tips associated with those above-knee amputees as theres a lot of overlap amongst all lower-extremity routines!
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Do The Appropriate Level With Amputee Exercises
Before you begin exercising, you need to start at your appropriate level. Its the same whether you have all four limbs or not. You need to recognize your abilities and obstacles to prevent injury.
You also want to make sure you do enough, so your program is effective. You need to begin your workout to get the right level of challenge, which means you may have to adapt some of these exercises.
You should consult with your doctor or a top prosthetics and orthodontics clinic to make sure you find the right exercise program for you.
Specific Risks For High Level Amputee Athletes
Mechanical Overload: One of the greatest risks for lower limb amputees is overload. Overload due to compensatory mechanisms and putting the body in a non-optimal biomechanical position due to the prosthesis. Our observation is that the hamstring muscle in the intact limb is particularly vulnerable to injury. Research has shown that the load absorption in the knee joint of the intact leg is also increased load during ordinary activities of daily living. This should be considered in the design of conditioning programmes as well as for recovery purposes.
Physiological overload: Due to the higher energy demand and less muscle mass available to generate forces in the limb, physiologically the athlete might need longer recovery times. This is highly dependant on the level of the amputation.
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Can This Injury Or Condition Be Prevented
As many as 60% of vascular amputations may be preventable. The leading causes of transtibial amputation are complications from diabetes, such as peripheral vascular disease , open wounds, and infection. Prevention and management of diabetes and lower-extremity circulation problems can greatly reduce the risk of developing conditions that lead to the need for lower-extremity amputation. Make sure that you protect your feet by wearing adequate and appropriate footwear. It is also important to examine your lower extremities and feet daily for signs of skin problems, such as redness or discoloration, swelling, blisters, scratches, or open wounds. It is important to promptly consult your primary health care provider, should you notice a problem. Prevention of infection is an extremely important way to prevent transtibial amputation.
It is also important to stop smoking. Smoking cigarettes can significantly interfere with and delay the healing of limbs affected by any of the lower-limb problems mentioned here. Smokers with a previous amputation have a 25 times greater risk of reamputation than nonsmokers.
Exercises To Do If You Have Had A Below
Knee extension
Lie on your back with your leg bent and your stump straight. Straighten the knee on the stump side as much as possible by pushing down into the bed and tightening the muscles on top of the thigh.
Hold for 5 seconds. Repeat 10 times.
Straight-leg raises
Lie on your back with your sound leg bent and your altered limb straight. Straighten the knee on your residual limb as much as possible, then raise your leg off the bed.
Hold for 5 seconds. Repeat 10 times.
Bridging
Bend your sound leg and lift your bottom up. You may need a support under your altered limb to begin with. Try and keep your hips level.
Hold position at the top for 5 seconds then lower
Repeat 10 times
Raised knee extensions
Lie on your back with a firm roll under your knees. Straighten each knee, one at a time.
Hold for 5 seconds.Repeat 10 times
Hip abduction
Lying on your side, keep your hips level with your upper body. Lift your altered limb upwards and slowly lower.
Hold for 5 seconds. Repeat with sound leg.
Hip extension
Lie on your front.
Hold the limb elevated for 10 seconds, lower slowly. For below-knee amputees keep the knee straight through the movement.
Hold for 5 seconds.Repeat 10 times
Knee extensions
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Amputee Balance Exercises For Below
Following a below-knee amputation, your balance will never be quite the same and thats okay. It simply means youll need to retrain your brain to accommodate your new situation and all that will take some practice. Your balance system is very complex, and in little or no time, it can be compromised if it is not being used. The good news is that your balancing muscle memory can be restored quickly with the right training and activities. Of course, like with any other recovery-related exercises, all balance training should be cleared by your physician or PT before starting.
With that said, you can help your brain adjust to your new normal by practicing very simple activities, such as:
- Standing as much as during your daily activities such as brushing your teeth, washing, doing the dishes, or even just loading the dishwasher.
- Reaching out for objects while sitting, kneeling down, or standing with even pressure placed on your prosthesis for as long as possible.
- Performing mini squats where you remain standing with even pressure on both feet and your knee bent just a little bit. While doing this, attempt to turn from side to side as many times as possible. Try this first without your prosthesis , then again with your prosthesis.
Also, being able to balance on your prosthesis with the full weight of your body is essential if youre aiming to walk smoothly and confidently again. To help you accomplish this, you can:
Exercises For Below Knee Amputees
Please note, this page is printable by selecting the normal print options on your computer.
Quad set Put your hands behind you for support. Keeping your stump straight, bend your other leg. Keep your legs close together. Straighten the knee on your stump as much as possible and press the back of your knee down into the surface underneath, tightening the muscles on top of the thigh. Hold for ____ seconds, and then relax. Repeat ___ times.
Lie flat on your stomach with your arms folded under your head. Keep both legs straight and close together. Lift your stump off the bed just enough to clear the surface. Be sure to keep your stomach flat on the bed. Return to the starting position and relax. Repeat ____times.
Lie flat on your stomach with your arms folded under your head. Keep your legs straight and close together. Bend the knee of your stump, slowly bringing it back to towards your buttocks. Slowly return to the starting position and relax. Repeat____times.
Lie on your side with your affected limb on top. Bend your bottom leg to give you more support. Lift your stump towards the ceiling. Be sure to keep your knee straight. Hold for ____ secs. Return to the starting position and relax. Repeat ____ times.
Lie on your back & bend both knees up. Squeeze your buttocks and lift your bottom off the bed. Hold for ___ seconds, then relax.Repeat this ___ times.
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Home Exercises For Lower Extremity Amputees
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Video taken from the channel: Gewigsverlies Dietilies
Video taken from the channel: Nebraska Methodist Health System
Video taken from the channel: Mission Gait
Shows a wide range of exercises for individuals with limb loss..NCHPAD is the nations premier center in promoting the health and wellness of people with disability. To view more resources and services which can benefit all ages and populations, connect with us:Website: http://www.nchpad.org.
Video taken from the channel: University Hospital Southampton
Video taken from the channel: Bodyweight Muscle
List of related literature:
Rehabilitation Without A Prosthesis For A Below Knee Amputation
- Balance and co-ordination techniques to refine motor skills.
- Learning how to complete everyday transfers in and out of bed, using stairs and getting up from the floor etc.
- A strengthening program which will assist you in carrying out your day to day activities.
- Wheelchair skills and practice with walking aids.
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Programmes To Address These Considerations
Strength development: The same principles of strength development apply for IWAs as for ABBLs. The sport or activity chosen should determine the most important movements to train. Due to the human bodys ability to compensate and adapt, the movements should be clearly evaluated for compensatory mechanisms. The type of prosthesis selected is important. Only when a movement is done in a biomechanically efficient manner, should the load be increased. Electively certain movements may be performed without a prosthesis amputations) such as plyometric jumping. Training load can be increased by either making the movement more complex, increasing the resistance, increasing time to fatigue or increasing the speed of movement.
Stabilisation: Core stability and hip joint stability is crucial in amputees. Programmes should address static stability and also dynamic stability. Frequently static stability is excellent but dynamic control and stability is poor due to the lack of movement in the prosthesis. When the athlete performs competitive movements, the control should be advanced and with a large endurance base. Upper body compensatory mechanisms to address postural adaptations should also be monitored.
Flexibility: Both sides, the amputated side as well as the non-amputated side should have good flexibility. Range of movement flexibility of the joint closest to the amputation should be maintained.
FITT Principle
What Kind Of Physical Therapist Do I Need
All physical therapists are prepared through education and experience to treat below-knee amputation conditions. However, you may want to consider:
- A physical therapist who is experienced in treating people with rehabilitation and amputation conditions. Some physical therapists have a practice with a focus on rehabilitation and prosthetic training for extremity amputation.
You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.
General tips when you’re looking for a physical therapist :
- Get recommendations from family, friends, or other health care providers.
- When you contact a physical therapy clinic for an appointment, ask about the physical therapists’ experience in helping people who have a below-knee amputation.
- Be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms worse
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