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Prosthetic Training

Lower Limb Amputation
As would be expected, one’s mobility is directly affected after a lower limb amputation. Through the rehabilitative process, most individuals regain meaningful mobility with the use of a prosthetic limb. Many go on to participate in recreational or competitive sports and may even try new activities, such as adaptive skiing, sailing or rock climbing. Inherent to the success of these activities is healthy balance.
Maintaining balance is essential for carrying out activities for daily living, such as washing and dressing, getting in and out of the car, and walking up stairs. Difficulty in controlling one’s balance may not only affect the ability to carry out these activities but may also increase the risk of falling. People with balance problems often become inactive due to fear of falling. Unfortunately, inactivity often makes balance problems worse.

Balance is a complex process involving multiple systems in the body, including sensory receptors (eyes, inner ear and proprioceptors in the muscle tendons and joints), muscle strength and joint flexibility, as well as the nervous system, which processes and coordinates the sensory input and muscle response. Balance requires the ability to maintain the body’s center of gravity within the base of support. Those who have undergone a lower limb amputation are faced with the challenge of adjusting to a new center of gravity, as well as an altered base of support. They also experience the loss of sensory input that would naturally come from receptors in the skin, joints and muscle tendons of the amputated limb. In addition, many amputations are due to vascular causes (poor circulation), which may also effect the sensation of the “sound” limb, compounding the challenge of maintaining one’s balance.

Balance not only requires well-functioning bodily systems, but also takes into account the environment in which one is moving and the activity or task one is attempting to perform from standing still to playing tennis. For example, walking on a perfectly smooth sidewalk is much easier than walking through the woods where the ground is uneven. Reaching overhead to retrieve an object off the shelf is more difficult than retrieving it at waist level or chest height.

At the Center for Balance, Mobility and Wellness, we understand the complex nature of balance and we particularly understand how balance is affected in individuals with lower limb amputations. At the CBMW, you will receive a comprehensive initial evaluation, which will allow us to obtain baseline measures by which we can measure improvement, risk for falls and safety with a variety of activities. The evaluation includes, but is not limited to the following:

  • Current and past medical history
  • Patient’s goals and objectives for therapy
  • Joint ROM and strength 
  • Objective measures of balance in quiet standing and with movement
  • Measures of walking speed and distance
  • Activities Confidence Scale

The results of the evaluation are used to create a customized therapy program to work toward the patient’s goals. Therapy programs consist of progressive strengthening, stretching, balance activities, as well as walking—all of which are aimed at gradually increasing the individual’s confidence with their prosthesis. Our center is uniquely equipped with an overhead track and harness system, allowing the patient to perform activities that challenge balance without compromising safety. We attempt to simulate as many real-world activities as possible. As the individual’s balance and confidence improves, the harness is gradually removed.

We work closely with your prosthetist to ensure the prosthesis fits well to provide optimal performance.