Links and Resources //
Discover valuable resources for amputees with acccess to information from trusted sources, including the Amputee Coalition, guidance on depression, insights on recognizing skin conditions, and definitions of terminology. Empower yourself with knowledge today!
Real Life Prosthetics™ does not warrant, endorse, guarantee, or assume responsibility for the accuracy or reliability of any information offered by third-party websites linked through the site or any website or feature linked in any banner or other advertising.
Journey of an Amputee //
Please note that this information is generalized, based on optimum healing conditions, prompt responses from insurance companies and other medical providers, etc. Every situation is unique and has their own highs and lows.
PRE-PROSTHETIC CONSULTATION (ASAP)
You should contact a Prosthetist as soon as possible when amputation surgery is inevitable. Make sure to choose wisely when determining YOUR Prosthetist as this relationship should be lifelong.
Questions that you can ask when interviewing Prosthetists:
-
Where did you receive your degree in Prosthetics & Orthotics?
-
Where did you complete your residency?
-
When did you receive certification/licensure?
-
What do you consider your areas of specialization
-
Where will my device be fabricated? Onsite by your company's certified technicians or central fabrication off-site?
PHYSICAL THERAPY
PRE-PROSTHETIC REHABILITATION (ASAP)
Pre-operative rehabilitation (also called 'pre-rehabilitation') is an increasingly common strategy used in multiple patient populations to improve patients' physical and mental condition prior to surgery, thus aiming at improving the post-operative patient outcomes.
With physical therapy for above-the-knee amputation and limb-loss patients, your physical therapist helps prevent contractures and improve range of motion. Physical therapy for bilateral amputee and limb-loss patients helps overcome residual limb challenges and develop muscular strength for transfer and motion.
You should contact a physical therapist as soon as possible when amputation surgery is inevitable. Make sure to choose wisely when determining YOUR physical therapists as this relationship will help or hinder your transition back into your community as an amputee.
Questions that you can ask when interviewing physical therapists:
-
Where did you receive your degree in physical therapy?
-
Where did you rotate clinically as a physical therapy student?
-
When did you receive licensure?
-
What do you consider your areas of specialization?
-
What is your typical protocol for pre and post-prosthetic rehabilitation?
-
Do you work closely with any particular Prosthetist or prosthetic company?
AMPUTATION AND HEALING
4 - 6 WEEKS
What to expect during your hospital stay when you come home.
-
Keep your limb protected and covered while healing (staples/sutures in place.)
-
Keep your limb very clean while healing.
-
Keep your knee straight while healing (below-the-knee amputation) or keep your hip stretched out while healing (above-the-knee amputation.)
-
Ask your Prosthetist about protective devices (removable rigid dressings, post-op devices, etc.)
-
Continuing exercises learned in the hospital.
-
Moving safely at all times to prevent falls.
-
Keeping all follow-up appointments.
WHILE GOING TO PHYSICAL THERAPY...
Work with your physical therapist on desensitization techniques as hypersensitivity is normal. In addition, also work with your physical therapist on phantom limb sensation/phantom limb pain reduction as this occurs with most amputees.
Also happening in during the healing process...
COMPRESSION THERAPY (2 - 3 WEEKS)
After healing specifically when sutures have been removed. Talk with your Prosthetist about using shrinker socks for compression therapy when sutures/staples have been removed.
WHILE GOING TO PHYSICAL THERAPY...
Talk to your inpatient physical therapist about using ace bandage for compression therapy while sutures/staples are still in your residual limb.
PREPARATORY PROSTHESIS
3 - 5 MONTHS
Your preparatory prosthesis is most likely the first device that you will receive. The prosthesis has three main components (socket, pylon and foot). This device has no foam covering or skin covering because it is designed for short-term use and your Prosthetist needs access to components for quick alignment changes.
The goal with using this device is to shape your residual limb as it shrinks, improve your balance (double limb support), mobility skills, and cardiovascular efficiency in preparation for your definitive prosthesis. This prosthesis is typically used for 3 - 5 months as your residual limb shrinks in size.
DEFINITIVE PROSTHESIS
5+ MONTHS
Your definitive prosthesis is the device you receive after preparatory training. This prosthesis generally has up to five main components (socket, pylon, foot, foam covering and skin covering). This device does not require as much adjustment so the foam cover can be installed to restore leg symmetry and a skin covering installed to protect foam from mositure, mold and mildew.
The goal with using this device is to continue shaping your residual limb as it shrinks, continue improving your balance (double limb support), mobility skills, and cardiovascular efficientcy with advanced gait training. This prosthesis is provided at the 4 - 6 months mark as your residual limb matures.
One or two replacement sockets may be required within the first 24-months of being an amputee to track anatomical change. Your socket fit may become dangerous when using 10+ sock ply; excessive pistoning can result in skin trauma and breakdown.
Your Prosthetist should follow up with you routinely and determine when a new socket or prosthesis is required.
RESIDUAL LIMB SIZE STABILIZATION
24 MONTHS
Your residual limb should reach a point where it does not constantly change size on a daily basis. Life gets much better at this point, when you don't have to constantly contend with various sock ply combinations to achieve a comfortable fit. You should also reach a point where you follow-up with your Prosthetist every 6-months to make ensure that your prosthesis continues fitting/functioning optimally.
SIGNS OF DEPRESSION
Clinical depression is common in people with amputation and it is very treatable. It is important to watch for such problems as:
-
Ongoing sadness, irritability, fear or nervousness
-
Difficulty in sleeping
-
Loss of appetite
-
Loss of interest in life
-
Ongoing preoccupation with the cause amputation
-
Withdrawal and isolation
-
Use of alcohol or drugs to escape or manage your feelings
-
Difficulty following therapy recommendations.
If you notice that any of these feelings persist, talk with your physician; they should be happy to arrange a mental health consultation.
PHANTOM LIMB SENSATION
When people have an amputation, they usually have feelings in the limb that is missing. There may be tingling, a prickly sensation or a numb feeling. The missing limb may feel hot or cold. It may feel as if the toes or fingers are moving, that the limb is in a funny position or there may just be a feeling that the limb is still there. These feelings are called "phantom limb sensations." The sensations are very real; "phantom" refers to the fact that the limb is missing. The important thing to know is that phantom limb sensations are perfectly normal and almost all people with amputations experience them to some degree.
SKIN PROBLEMS
Skin problems are fairly common on the residual limbs of amputees. They may develop for a variety of reasons, including poor socket fit, incorrect alignment of the prosthesis, poor skin care or allergic reactions. Skin problems for the amputee often take on one of the following forms:
-
rashes
-
blisters
-
ulcers
-
verrucous hyperplasia
-
epidermoid cysts or infections
Controlling order when you wear a prosthesis, your leg will be enclosed much like your foot used to be. If you develop an unpleasant odor on your residual limb, much like that of a sock or shoe, you should not be alarmed. The best way to control the smell is to take good care of your skin and to keep your socket clean. If excessive perspiration is a problem, you can use a spray-on antiperspirant that does not contain a deodorant (deodorants can cause rashes in a prosthesis). If needed, a very strong antiperspirant can be prescribed by your doctor.
PHYSICAL THERAPY
Your physical therapist is another very imporant member of your rehabilitation team. They will help you learn how to use your prosthesis. Therapy may occur in an outpatient setting or in the home. Physical therapy in an outpatient clinic is recommended. This is because there is more equipment available to use, your therapist has additional help if needed, and therapists generally have more time to give to their patients in a clinic.
Physical Therapy Goals
-
learning to put on your prosthesis correctly
-
transferring in and out of wheelchair
-
transferring on and off of a toilet
-
transferring in and out of a bathtub
-
walking with a prosthesis
-
walking up and down a ramp
-
stepping over curbs
-
walking up and down stairs
-
getting off the floor.
Your therapy does not need to be limited to these basic skills. You should strive to return to as active a lifestyle as you had before your amputation. Once you have mastered the basics, discuss resuming more challenging activities with your rehabilitation team.
Support Groups
Amputee Coalition In 1986, a small group of amputee support group leaders recognized the need for an organization dedicated to the needs of people with limb loss, their families and healthcare providers. Working entirely as volunteers, they laid the foundation for what the Amputee Coalition is today, the leading national non-profit organization that empowers individuals with limb loss through education, support and advocacy.
Prosthetic FAQs for the New Amputee
Last Updated January 2021
Support //
In 1986, a small group of amputee support group leaders recognized the need for an organization dedicated to the needs of people with limb loss, their families and healthcare providers. Working entirely as volunteers, they laid the foundation for what the Amputee Coalition is today, the leading national non-profit organization that empowers individuals with limb loss through education, support and advocacy.
Certified Peer Visitor (CPV) Program
Amputee Coalition offers peer support in the form of support groups, hospital partnership programs, youth camp, and our Certified Peer Visitor program.
Find out more by going to Amputee-Coalition.org
Health Care //
University of Maryland Upper Chesapeake Health
The University of Maryland Rehabilitation Network is dedicated to providing comprehensive and compassionate rehabilitation and support to individuals who have undergone limb amputation.
ChristianaCare Center Wilmington Hospital
November 2010
Center for Rehabilitation earns special certification for amputation patients
Resources //
Ability Magazine is published bi-monthly and features a wide range of disability issues including travel.
Amp'd connects you to the limb loss/difference community directly. Whether you're looking to learn, become an advocate for others, or speak directly with your peers, Amp'd has the tools and services to help you achieve your goals.
inMotion Magazine is published bimonthly for Amputee Coalition of America members for amputees, caregivers and healthcare professionals, providing timely and comprehensive information.
Living Adaptive is the podcasting home of the adaptive community. Keep current with adaptive happenings and listen to guests that include individuals that adapt to notable adversity and thrive, supporting organizations, and personalities that are making impacts within the adaptive world. You can adapt no matter the challenge.
The National Limb Loss Information Center®
Where can you turn when you have questions about limb loss? Here at the National Limb Loss Resource Center®, we provide comprehensive information and resources free of charge. All of the information that we provide is reviewed by the Coalition’s medical/scientific advisory committee of experts in the field of limb loss so you can count on the accuracy of the information.
The O&P Edge has been the industry’s leading and most-read publication among O&P professionals since 2002.
United Amputee Services Association (UASA)
U.S. Department of Veterans Affairs - Prosthetics
VA's Rehabilitation and Prosthetic Services is responsible for the national policies and programs for medical rehabilitation, prosthetic and sensory aids services that promote the health, independence and quality of life for Veterans with disabilities.
Glossary of Terms for Orthotics and Prosthetics //
ABC Certified Orthotist or Prosthetist
An allied health professional who has completed the necessary educational requirements and passed the examination prescribed by the American Board for Certification in Orthotics and Prosthetics, Inc. (ABC).
Abduction; motion of a limb or body part away from the median plane of the body. The resulting effect can cause problems with proper gain and/or ambulation and may prolong the rehabilitation process, especially in cases of lower extremity limb loss--- adduction is its opposite.
Adaptive Equipment; devices that assist in activities or mobility (i.e., wheelchair ramps, hand bars/rails, car and home modificatins, canes, crutches, walkers and other similar devices.)
AE (above-the-elbow); a specific level of amputation also known as transhumoral.
AFO (ankle-foot orthosis); is a commonly used orthosis in patients having weakness in the ankle dorsiflexor or plantarflexor muscles due to several disorders such as stroke, cerebral palsy, spinal cord injury, and peripheral nerve injury.
AK (above-the-knee); a specific level of amputation also known as transfemoral.
Alignment; the position of the prosthetic socket in relation to the foot and knee.
Alloplastics; also Anaplastics, the discipline of restoring the body through life-like, realistic means.
Alloplastologist; also Anaplastologist, one who practices in Alloplastology.
Alloplastology; also Anaplastology, the art and science of restoring the body through life-like, realistic means.
Ambulation; the action of walking or moving. Fo r lower extremity amputees, rehabilitation is primarily concerned with ehlping the patient achieve proper gait and/or ambulation.
BE (below-the-elbow); a specific level of amputation also known as transradial.
BK (below-the-knee); a specific level of amputation also known as transtibial.
Body-Powered Prosthesis (upper extremity); a arm prosthesis powered by movement in the upper extremity portion of the body, specifically the muscles of the shoulder(s), neck and back. The motion of these movements is then captured by a harness system that generates tension in a cable, allowing a terminal device (hook or prosthetic hand) to open and close.
Check or Test Socket; a temporary socket, often transparent, made over the plaster model to aid in obtaining proper fit and function of the prosthesis.
CO; Certified Orthotist
Contracture; the tightening of muscles around a joint, restricting the range of motion and suppressing muscular balance.
Contralateral; originating in or affecting the opposite side of the body.
CP; Certified Prosthetist
CPO; Certified Prosthetist and Orthotist
Custom Fit; fitting an individual with a device that is made from an image of the individual's anatomy and fabricated according to the needs of that individual.
Disarticulation; an amputation of a limb through the joint, without cutting any bone--- performed at the hip, knee, ankle, shoulder, elbow and wrist levels.
Distal; the end of the residual limb. The end that is farthest from the central portion of the body. Distal is the opposite of proximal.
Donning and Doffing; putting on and taking off a prosthesis, respectively.
Dorsiflexion; an upward movement or extension of the foot/toes or the hand/fingers.
Endoskeletal Prosthesis; a prosthesis built to imitate the movements and functional capabilities of the human skeleton, with all parts and componentry.
Extremity; synonymous with limb, usually referring to an arm or leg.
Gait; a manner of walking that is specific to each individual.
Gait Training; part of ambulatory rehabilitation, or learning how to walk with your prothesis or prostheses.
KAFO (knee-ankle-foot orthosis); a custom-molded plastic shell with contoured metal uprights and a variety of knee joints designed to provide support and correction to the knee, ankle and foot.
Lateral; to the side, away from the median plane of the body
Liner (roll-on liner); suspension systems used to hold the prosthesis to the residual limb and to provide additional comfort and protection for the residual limb. Roll-on liners can also accommodate volumetric changes in the residual limb. These liners may be made of silicon, pelite, or gel substances.
Medial; motion of a body part toward the median plane of the body.
Microprocessor-Controlled Knee; these devices are equipped with a sensor that detects full extension of the knee and automatically adjusts the swing phase of ambulation, allowing for a more natural gait.
Myoelectrics; technology used mainly in upper extremity prosthetics to control the prosthesis via muscle contraction using electrical signals from the muscles to power the prosthesis.
Neuroma; when a nerve is severed during amputation, the nerve endings form a mass (neuroma) reminiscent of a cauliflower shape. Neuromas can be troublesome, especially when they are in places that are subject to pressure from the socket.
Orthoses; the plural of orthosis.
Orthosis; a customized appliance used to help straighten or help prevent a deformity.
Orthotics; the professional practice of providing orthopedic appliances or braces.
Orthotist; professional health practitioner who provides orthotic services.
Osseointegration; the growth action and adhesive nature of bone tissue with titanium, which allows an individual to have a prosthesis attached so as to become part of their body's own structure. The process was developed by Professor Ingvar Brånemark of Sweden in the 1960's and is commonly used in dentistry and metacarpophalangeal (MCP) joint replacement in the hand.
Pedorthic; the design, manufacture modification and fit of shoes and foot orthoses to alleviate problems caused by disease, congenital condition, overuse or injury.
Phantom Pain; painful sensations, usually moderate, that originate in the amputated portion of the limb.
Phantom Sensation; this is the feeling that the missing body part is still there. It may involve uncomfortable but not necessarily painful sensations such as burning, tingling and/or itching.
Pistoning; refers to the residual limb slipping up and down inside the prosthetic socket while walking.
Plantarflexion; when the toe/foot is pointing down, away from the median plane of the body.
Posterior; the backside of the body or part in question (i.e., posterior knee or patellar region.)
Prostheses; the plural of prosthesis.
Prosthesis; a custom-designed artificial limb or body part.
Prosthetics; the professional practice of providing artificial limbs.
Prosthetist; a professional health practitioner who designs, creates and fits artificial limbs or body parts.
Prosthosis; a custom hybrid designed prosthetic incorporating a hinged portion of an orthotic device.
Proximal; nearer to the central portion of the body. Proximal is the opposite of distal.
Range of Motion; the amount of movement a limb has in a specific direction.
Rehabilitation; the process of restoring a person who has been debilitated by a disease or injury to a normal, functional life.
Residual Limb; the portion of the arm or leg remaining after an amputation, sometimes referred to as a stump or residuum.
Range of Motion; the amoutn of movement a limb has in a specific direction.
SACH foot (solid-ankle cushion heel); the foot is made of wood with a flexible rubber shell that surrounds the wooden core. The SACH foot is usually prescribed to moderately active or less active amputees, but can be prescribed to amputees of all activity levels. SACH feet are also used in the design of foreshortened prostheses, or stubbies.
Shrinker; an elastic wrap or compression sock worn on the residual limb to reduce swelling and to help properly shape the residual limb.
Socket; the portion of the prosthesis that fits around and envelopes the residual limb and to which the prosthetic components are attached.
Stance Control Knee; these prosthetic knee joints typically offer a weight-activating friction brake that locks the knee into place during pivotal points of ambulation, offering stability and balance where needed.
Stubbies (foreshortened prostheses); stubbies are used during and sometimes after initial ambulatory. habilitation. They are customized to each individual and are usually made up of standard sockets, no articulated knee joints or shank, with modified rocker bottoms or SACH feet turned backward for balance and stability.
Suction Socket; mainly for use by AK level amputees, this socket is designed to provide suspension by means of negative pressure vacuuming. T his is achieved by forcing air out of the socket through a one-way valve when donning and using the prosthesis. In order for this type of socket to work properly, the soft tissues of the residual limb must precisely fit the contours of the socket. S uction sockets work very well for those whose residual limbs maintain a constant shape and size.
Suspension System(s); one of many suspension systems must be used in order to keep the rposthesis attached to the residual limb. Mos t of these systems are integral parts of the socket and prosthesis.
Swing Phase; this is when the prosthesis moves from full flexion to full extension. Th e term is usually used in reference to prosthetic knee units.
Symes Amputation; an amputation through the ankle joint that retains the fatty heel pad portion and is intended to provide end weight bearing.
Unilateral; an amputation that affects only one side of the body (opposite of bilateral).
UE (upper extremity); having to do with the upper part of the body. It is used in reference to amputees with arm or shoulder amputations.
WD (wrist disarticulation); an amputation through the wrist.
WHO (wrist-hand orthosis); primarily used to support weak muscles and/or immobilize or limit the motion of the wrist while allowing the fingers to move.