rehabilitation after prosthesis
 
rehabilitation after prosthesis

Rehabilitation: to restore to use, as through therapy and education or to restore to good condition, operation or capacity.

Following an amputation of a lower limb or upper limb individuals will require rehabilitation to return to function and to use their new prosthetic appropriately. In the last seven to 10 years technology and research has moved the use of lower and upper limb prosthetics into an entirely new generation. Where before a prosthetic was used only to mask the loss of a limb, today prostheses are able to function in a way which was only dreamt of just five years ago.

New prosthetic hands are able to rip and hold weight up to 20 kg and prosthetic feet are able to grip the ground with the toes in the same way that a natural foot can. Using these advanced technologies in order to regain function and the previous lifestyle requires rehabilitation and education.

Statistics show that the majority of individuals who require an amputation are age 65 and over and, the reasons for these amputations (diabetes, obesity and peripheral vascular disease) are increasing at horrifying rates. More than 185,000 amputations are performed annually in the United States alone with the prevalence rate being highest among individuals who are 65 and older. 18.2 million Americans have diabetes and 41 million have prediabetes, both of which can results in wounds which lead to amputation.

To make matters worse, it usually takes an older individual much longer to achieve wound healing, regains strength or move through the rehabilitation process following an amputation. We all know that it's harder to do anything when you are 70 years old versus when you are 17. Unfortunately, the older the individual the greater the impact that deconditioning will have on their ability to successfully navigate rehabilitation.
However, age is not the only factor involved. Successfully navigating rehabilitation following an amputation is also the results of the individuals desire, motivation and create surgical overall conditioning.

The key to self-sufficiency for an individual who has had an amputation is the ability to transfer themselves independently from one area to another. For instance, if they choose to use a wheelchair consistently then the ability to transfer from the wheelchair to a chair, a toilet, a bed or a car is key in their ability to maintain their independence. This is the first goal of rehabilitation. In addition to transferring from one area to another individuals must also learn a new way of achieving their previous activities of daily living skills.

These activities of daily living skills include personal hygiene, dressing themselves, eating and bathroom skills. Only when these skills are mastered and the individual will maintain their independence or return to living alone.

Rehabilitation following an amputation begins in the first several days. However, it is not rehabilitation that begins with the use of the prosthetic arm or leg but rather teaching the individual to maintain their personal space and possessions as well as work through their activities of daily living skills. Once home and living independently, individuals will not keep their prosthetic on 24 hours a day, seven days a week. This is because the stump will need time and air in order to maintain good skin health.

The degree of difficulty and rehabilitation for individuals who have a lower leg amputation is higher in those who have an above the knee amputation reverses those who suffer any loss below the knee. This is because individuals who have a below the knee amputation still have the knee joint with the strength and muscle power for stability and motion that those above the knee amputees do not.

Before any individual with an amputation at the knee or higher is fitted with a prosthesis they should learn how to transfer in and out of that independently, be able to go from sitting and standing independently using a walker and be able to walk in the parallel bars or with a walker for at least 25 feet without the prosthesis.

Although the new prosthetic legs with microprocessors have the ability to give individuals further stability while walking, they do not have the power to bring an individual from sitting to standing like a real leg does. It is for this reason that any amputee must learn how to get from sitting to standing independently as well as be able to walk using parallel bars or with a walker without the prosthetic. This only helps to improve the strength in the remaining parts of his body in order to be able to use the prosthetic much more functionally.

In the past, high technologically advanced prosthetic devices were used primarily on individuals who were the most active or who were interested in athletic competition. However, as technology improves and prices come down the use of these prosthetic devices have now been offered to other individuals who are able to control and use them appropriately.

A person with two legs makes countless adjustments to their stride every time they walk. An individual who has an amputation and uses a prosthetic device must constantly be alert to the environment in which they are walking and consider the ground situations. Walking in crowds is risky as well as walking on wet or uneven ground. The new technology available in lower limb prosthetics has been able to help individuals maintain better stability, keep from stumbling and decreases the concentration and mental energy needed in order to navigate their environment.

Navigating through the rehabilitation process for an individual who has suffered from an amputation requires not only the concerted effort of the rehabilitation team but also the input of any other medical professionals needed in order to control other underlying medical conditions. For instance, individuals who have an amputation secondary to diabetes may also suffer from peripheral vascular disease in the other leg, cardiovascular disease or may have also suffered a stroke. It is important to maintain communication between case management, physical therapy and any other medical professionals who are involved in the rehabilitation process in order to get the best successful outcome possible.

After an individual is discharged from the hospital their activity level will increase gradually over the following weeks and months. Physical therapists and occupational therapists will help direct a patients course of action both at-home and in therapy.

As new technologically advanced prosthetics continue to be manufactured in research and physical therapists continue to improve the manner in which individuals are taught to return to their previous lifestyle, it is believed that many more older individuals will be able to return to their previous activity level and also will be able to minimize any stumbles and falls which can result in further injury. It is the whole and goal of every rehabilitation specialist who works with individuals who have amputations that they continue to enjoy a fruitful life.

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rehabilitation after prosthesis

 

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