Rehabilitation after Amputation

Amputation is the loss of a limb usually from injury, disease or surgery. In the United States 82% of amputations are due to vascular disease, 22% trauma and the remaining 8% are split between congenital and cancer reasons. About 1.9 million people in the United States are living with the loss of a lower limb or an upper limb and require rehabilitation in order to resume normal daily activities. (1)

The goal of rehabilitation is to allow the individual to return to his near-normal activities as is possible. The prognosis for rehabilitation often relies on the condition of the individual prior to the trauma or surgical removal of the limb. In other words, if the individual was over 70 or was generally sedentary and inactive their ability to regain a significantly active lifestyle following the amputation will be severely limited.

Rehabilitation begins directly after surgery during the acute phase of treatment. In the initial few days after the surgery the patient will be taught how to care for their stump and some of the precautions which must be used in order to decrease the risk of any muscle tightening or contractures at the joints immediately above the amputation.

The success of the rehabilitation will depend upon the level and type of the amputation performed as well as any resulting impairments and disabilities and family support. It is important to recognize that each patient requires positive reinforcement to help improve their self-esteem and promote independence. Any rehabilitation program will be designed to meet the individual needs of the patient and actively involve the family.

In the days immediately following the amputation a pre-permanent prosthetic will be fashioned using either a soft sleeve or a plaster of Paris cup to hold the stump. These are used because the amputated limb generally experiences swelling, edema, which makes manufacturing a permanent prosthetic out of the question. This initial prosthetic will allow the patient to be up on their feet and regain their ability to stand.

Amputation rehabilitation programs will also include training for family and patient to improve wound healing as well as stump care once the wounds have healed. They will also teach activities to improve the individuals motor skills and restore them to maximum independence. Exercises are taught that will promote muscle strength, endurance and control and patients will be brought back to physical therapy in order to be fitted for their permanent prosthetic.

Rehabilitation will also address pain management in both the postoperative phase and in dealing with phantom pain. Phantom pain is a sensation of pain that occurs below low level of the amputation and may be caused by the severing of the nerves during the removal of the limb. Emotional support will be given to individuals to help them through the grieving process and through the readjustments to a new body image.

Many patients receive nutritional counseling to help promote healing and overall health as well as vocational counseling to is this them in either finding new employment or adjusting their physical skills to their previous place of employment. Rehabilitation will also help the family and individual adapt their home environment to make performing daily living activities safe and accessible.

The rehabilitation process for individuals who experience an amputation can be challenging but with the care and concern of family and rehabilitation specialists they are often able to resume their daily and recreational activities.

(1) National Limb Loss Information Center: Fact Sheet