Be the Expert that You Are

The number of activities for individuals suffering from limb loss has exploded. Compared to the amputee patient of years past, today we have patients who inquire regularly about swimming, jogging, cycling, and even more challenging activities such as skiing, kick boxing, or rock climbing. Yet how do we advocate for these types of lifestyle choices for our patients? The answer is simple. Be the experts that we are. In other words, don't shy away from encouraging your patients toward the next level of physical activity. Rather, become the motivator, organize the resources, and educate the referral stream as to how you can assist the individual in enjoying an ever-expanding lifestyle. This care begins early in the rehabilitation process when you educate the surgeon and the physiatrist about technology, components, and socket design. High-end prostheses are often considered for the advanced athlete, and yet most moderately active amputees also can benefit from higher-performing feet, impact-absorbing interfaces, and intimately fitting sockets. Share this information with the patient and his or her family as well. This provides an excellent opportunity to educate, inspire, and offer hope during a time of loss and change. Concurrently, involve both physical and occupational therapists to assess the patient's range of motion, strength, and mobility. Targeting these key functions early on will assist the patient during initial gait training, when pain, balance, and endurance issues can be detrimental to progress. Likewise, implementing core training early provides a strong trunk for enhanced upper- and lower-limb function. New amputees cannot always rely on proprioceptive feedback to help them balance and ambulate. They may utilize visual or vestibular cues to walk effectively, so good trunk strength can reduce the likelihood of gait deviations. Exercises like sitting on a dynamic disc or doing ball bridges and rhythmic stabilization with the physical therapist work well for this training. Immediately after surgery, the patient should begin a cardiovascular program since all amputees require an increase in energy expenditure for simple ambulation. While these efforts progress, the prosthetist should be evaluating the strength of the extremities, single-limb balance, overall coordination, and cognitive status. These early predictors of a patient's success can be addressed both clinically and through family involvement to ensure rehabilitative momentum is maintained. Now, fast forward past the fitting of the initial and first definitive prosthesis. You have regularly updated your physicians, and the patient has progressed through therapy. In addition, you have gained your patient's and his or her family's trust as a clinician and advocate. All along, the patient should be coached to continually set new and realistic goals. Help the amputee choose activities that relieve stress, are fun to do, and are obtainable. Be a resource for local organizations that sponsor training or events. Connect your patients with national groups such as the Amputee Coalition, Disabled Sports USA (DS/USA), and others to assist your efforts. Similarly, trial fit components that can augment your patient's ability, and don't shy away from experimenting. Numerous distributors and manufacturers offer loaner components and trial periods. Take advantage of these programs, and allow your patient to test devices. To maintain costs, test sockets pulled from Orfitrans® offer an economical method to fit sockets as they exhibit high-impact resistance. Document the results that you help your patient achieve, such as improved self-selected walking speeds, increased wear time, and the mastering of new activities. Include video footage of your patient's performance in the updates that you send to your referral sources. Then, when the patient is ready for the next level, documentation and patient knowledge will already exist to further his or her success. Joseph Sadowski, CPO, works for the U.S. Department of Veterans Affairs (VA) in the Center for the Intrepid (CFI) patient care program, which helps active duty soldiers transition to veteran status once they retire.

Be the Expert that You Are

Face to Face: Robert Dodson, CPO, LPO

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O&P JOBS

Certified Orthotist (CO)

Prosthetic Orthotic Technician

Multiple CPO and CPed Openings @ UNC Health

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Related posts:

Face to Face: Robert Dodson, CPO, LPO

Nerve-Cell-Support Design Could Give Amputees Better Control over Prosthetic Limbs

Nerve-Cell-Support Design Could Give Amputees Better Control over Prosthetic Limbs

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O&P JOBS

Certified Orthotist (CO)

Prosthetic Orthotic Technician

Multiple CPO and CPed Openings @ UNC Health

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