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Marlis Gonzalez-Fernandez, MD, Ph.D.
Losing a limb due to accidental trauma or illness has tremendous impact on a person's body, emotions, relationships, calling, and way of life. While some other surgical procedures return the patient to health and well-being relatively quickly, the recovery period after a major amputation can be long and require hard work on the part of both the patient and the care team.
In the case of patients who are about to have an amputation, the rehabilitation process begins as far as possible before the surgical intervention. This is called a "pre-hab".
The Amputation Rehabilitation Team
Physical medicine and rehabilitation professionals can work with you to create a customized plan and prepare you for what lies ahead. Your rehabilitation team may include:
- ADoctor of Physical Medicine and Rehabilitationfocuses on restoring health and functional ability after an amputation and will create a customized treatment plan tailored to your needs.
- Aphysiotherapistworks with you on muscle strength, flexibility and coordination and trains you on how to use your prosthesis if one is part of your recovery.
- AOrthopedic technician or prosthetist, creates a custom prosthesis when one is used.
- Aoccupational therapistworks with you to maximize your independence and adjust to everyday life, with or without a prosthesis.
- ARehabilitationspsychologehelps you with grief and loss related to the removal of a limb and all related mental crises, includingPost-Traumatic Stress Disorder (PTSD).
Johns Hopkins Comprehensive Rehabilitation Program for Amputees
The support of a dedicated team of experts is essential in recovery from limb amputation. At Johns Hopkins, our physical therapists, prosthetists, prosthetists, physical and occupational therapists, rehabilitation psychologists and other specialists work together to create your customized rehabilitation plan.
Learn more about our amputee rehabilitation program
Your amputation recovery
The success of rehabilitation after an amputation depends on many factors, including:
- Your age and medical history
- Your general health, diet, fitness and lifestyle
- Which part of the body will be amputated
- The surgical approach
For example, a young, fit person who undergoes an amputation after an accident may have stronger muscles and healthier blood vessels than an older adult who has lost a limb after years of living with diabetes or peripheral artery disease. However, a sudden and unexpected amputation can take a greater toll on the person's mental health.
Smokingis a major obstacle to successful recovery. Smoking can cause postoperative complications, slower healing, and worsening of vascular disease. Rehabilitation experts strongly recommend that anyone undergoing rehabilitation after an amputation quit smoking.
Emotional recovery after amputation
An amputation can be devastating, leaving you with sadness, anger, and grief at the loss of your independence and self-image. You may also be concerned about the cost of medical care and the impact the amputation will have on your career.
You are not alone. About 41% of people who have had an amputation are at risk for anxiety (including PTSD), depression, substance use disorders, strained relationships, and reduced quality of life. It's important to remember that treating these symptoms can be very effective. Obligation to cooperate with aRehabilitationspsychologecan help your mind and emotions recover along with your body.
Self-care is especially important in the early stages of your recovery. Try to get regular sleep, stick to a routine and eat a healthy diet, and try some relaxation techniques like meditation or mindfulness. Most importantly, make sure you have a support system of trusted family and friends to share your feelings and concerns with.
Prosthetics after amputation
Not everyone who has an amputation wants or needs an artificial device to replace the lost body part. To help you make the decision, the physical medicine and rehabilitation team considers many aspects of your life and health, including which limb was amputated. Prosthetic legs can help restore mobility. Prosthetic arms can be more complex, including newer models with technology that connects to the nervous system and allows for fine motor movements.
Your age, weight, fitness level, and general pre-amputation health are important variables. An elderly patient or one with a chronic condition may already have limited mobility. Heart disease can make it difficult to endure the physical labor required to use a prosthetic leg. Children with a congenital loss of a limb or a deformity often have the stamina and energy to do very well with prostheses.
Assessment of readiness for prosthetic devices
Choosing a prosthesis is an important decision and requires a commitment. Training and ongoing maintenance and upgrades can be part of the picture. In addition to assessing your physical fitness for a prosthesis, your doctor and rehabilitation team will discuss all the pros and cons with you so you can make the best decision for your goals and lifestyle.
Is a prosthetic leg right for you?
If you've had a leg amputation and are weighing the benefits of a prosthesis, there's a lot to consider: the type of amputation, your pain level, and your mobility goals—and that's just the start. Here's what you need to know about getting a prosthetic leg.
Find out more about purchasing a prosthetic leg
Start with a prosthesis
There are different types of prostheses. If the prosthesis is a traditional prosthesis that attaches to your remaining limb with suction, you will likely receive it after your amputation site has healed, which usually takes about six weeks. If the site heals well and there are no complications, you can start using your prosthesis.
With your new hand, foot, arm or leg you will receive support in adjusting to life. The doctor specializing in physical medicine and rehab will see you regularly for at least six months. Physical therapy is an essential part of your recovery, and your program will adapt as you make gains in strength, endurance, balance, and mobility.
Patients with an arm prosthesis work closely with an occupational therapist who can optimize their motor skills and enable them to be as independent as possible in everyday life.
How prostheses are made
Unlike the artificial limbs of the past, modern prosthetics use lighter, stronger materials, and updated technologies help them work more efficiently. Depending on the type of amputation, the prosthesis may contain a joint to replace an elbow or a knee. Sometimes prostheses are intentionally kept short to allow mobility while protecting the person from injury from falls.
Designing and manufacturing prostheses is both an art and a science and requires an understanding of physics, engineering, anatomy and physiology. The prosthetist begins by removing a plaster cast of the remaining limb. This mold can help to create an artificial limb of the right size.
parts of a prosthesis
A conventional prosthesis contains the following components:
- Pylon: A rod that forms the inner core of the artificial arm or leg and is made of metal or carbon fiber
- Power outlet: Where the device attaches to the stump. The socket must be carefully fitted and adjusted so that it does not irritate tissue or put undue pressure.
- Liner: Bandages, sock-like relining, and padding can make the interface between the residual limb and the prosthesis more comfortable. If the tissue swelling goes down after the operation, these can be adjusted.
- suspension system: What keeps the prosthesis attached. A prosthesis may use straps, straps, straps, or suction cups to stay in place.
With a traditional prosthesis, you need to change the liner, cuffs, and socks at least every six months.
Regain your life after amputation
An amputation can change your life, but you don't have to face the future without help. Whether you choose to have a prosthesis or not, the Physical Medicine and Rehabilitation team will work with you to regain as much of your mobility, well-being and independence as possible.
Johns Hopkins Rehabilitation Network Symposium on Limb Loss
The Limb Loss Symposium returns virtually and is open to all18. April 2023. Registration is free. Topics to be covered during the symposium include anaplastology, late effects of prosthetic use, emerging technologies and best practices for amputee care.