Page 74 - Virtual Vascular Volume 7

Below Knee Amputation View from above

Major amputation (e.g. below knee amputation or above knee amputation)
is physically and psychologically traumatic to the patient and the family.

Rehabilitation after major amputation is essential if the patient is to have

full ambulation and to lead an independent life afterwards.

Ideally, before the amputation, the physiotherapist should prescribe
exercises for preoperative conditioning, explain the procedure to the

distressed patient, and educate the patient about future prospects.

Peri-operative pain control is important to enable early exercise and Liner over the stump

mobilization. Physiotherapy should begin as soon as possible after surgery

when the wound is stable. Initially, the physiotherapist will review the
patient at the bedside, and later in the gymnasium. Exercises include

stretching and straightening of the hip/ knee joints to prevent contractures,

and strengthening of arm muscles. Later to learn to roll in bed, sit on the
side of the bed, and transfer safely from bed to chair. View from the side

When the patient is more stable, he/ she should learn to move about in a
wheelchair, and stand and walk with an assistive device such as the

Pneumatic Post-Amputation Mobility Aid (PPAM Aid) or prosthesis.

Whilst wearing the prosthesis, the stump should be well protect. First is to

put a liner on the stump, and then to make sure it is stable using an
integrated seal ring, before placing the stump in the socket.

Occupation therapy and home visits are also important prior to discharge
from hospital.

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