As part of a rehabilitation necessary for walking skills are taught; these include exercises Konditions- and equilibrium improvement for stretching the hip and knee, and extremities as well as for the strengthening of all exercises are intended to facilitate the patient to become accustomed to the prosthesis. Because going to amputation below the knee means an increase in energy consumption by 10-40% and an increase of 60-100% by amputation above the knee, is endurance training useful. Once the patients are clinically stable, should begin rehabilitation in order to prevent secondary complications. Elderly patients should as soon as possible begin to practice standing use of the bar and to train their balance.

Before an amputation, the physician describes the patient’s extensive postoperative rehabilitation program that will be connected to the operation. Psychological counseling is usually displayed. The rehabilitation team and the patient decide if a prosthesis (limbs prosthetics) or a wheelchair is needed. As part of a rehabilitation necessary for walking skills are taught; these include exercises Konditions- and equilibrium improvement for stretching the hip and knee, and extremities as well as for the strengthening of all exercises are intended to facilitate the patient to become accustomed to the prosthesis. Because going to amputation below the knee means an increase in energy consumption by 10-40% and an increase of 60-100% by amputation above the knee, is endurance training useful. Once the patients are clinically stable, should begin rehabilitation in order to prevent secondary complications. Elderly patients should as soon as possible begin to practice standing use of the bar and to train their balance. Quickly, flexion contractures of the hip or knee can develop complicate the adjustment and the use of a prosthesis; Contractures can be prevented by custom built by occupational therapists extension supports. Physiotherapists teach the patient how the stump is to maintain and as the earliest signs of skin necrosis can be detected. Care of the stump and prosthesis Treatment of the stump favors the natural shrinkage process which must use before using a prosthesis. After only a few days of treatment, the die can be shrunk. A special stump bandage or elastic bandages, worn over 24 hours can help to reduce the stump and prevent edema. The special bandage is easy to apply, but elastic bandages may be preferred because they can control the amount and location of the pressure better. However, the application of elastic bandages skill required, and they must be wrapped again once they are loose. Early walking with a temporary prosthesis has many advantages: It allows the amputee to be active, it accelerates the shrinkage of the stump It prevents flexion contractures It reduces phantom pain, the prosthesis shaft (the inner frame or skeleton of the prosthesis) should the stump tightly surround-possible modern computer-aided design and manufacturing processes. Various temporary prostheses are different shafts available. Patients with a temporary prosthesis can start walking exercises on parallel bars and to proceed to walk with crutches or a cane until the permanent prosthesis is made. The permanent prosthesis should be light and be tailored to the needs and safety requirements of the patient. If the prosthesis is made before the stump has shrunk, a further adjustment may be required. Therefore, the production of a permanent prosthesis usually is delayed by a few weeks, until the contraction ends. For most elderly patients with an amputation below the knee prosthesis out of the question that supports the patellar tendon and has a stiff heel, and a foot with an air-cushioned sole to the heel, and a suprapatellar cuff. If patients do not have special needs, the prosthesis is not connected below the knee with a corset or waist belt, as the prosthesis is usually very heavy and bulky. more knee designs are available for patients with amputations above the knee, depending on their skills and activities. Some newer technologies are microprocessor-controlled knee and ankle joints that allow patients to adjust the movement of their needs. Care of the stump and prosthesis The patient must learn to take care of their stumps. As a leg prosthesis is intended only for walking, patients should remove them before going to bed. Before going to bed the stump should be thoroughly inspected (using a mirror, if the patient carries out the control itself), washed with mild soap and warm water and are then dusted with talcum powder. Patients should address the following potential problems: Dry skin: lanolin or Vaseline can be applied to the stump. Excessive sweating: A perfume-free deodorant can help. Inflamed skin: The cause of irritation must be removed immediately, and talcum powder or a low-dose corticosteroid cream should be applied. Torn skin: The prosthesis should not be worn until the wound has healed. The stump sock should be changed daily, and the interior of the prosthesis should be cleaned with mild soap. Standard prostheses are water repellent neither waterproof nor. Therefore, they should, even if only part of the prosthesis is wet, immediately and thoroughly dried, but heat should not be applied. For patients who prefer to swim or shower with a prosthesis, a waterproof prosthesis can be made. Complications stump pain is the most common complaint. Common causes include: A poorly adapted prosthesis socket: This cause is the most common. Neuroma: A Amputationsneurom can usually be palpated. A daily ultrasound treatment over 5-10 sessions is most effective here. Additionally, corticosteroid injections or analgesics are used in the neuroma or the surrounding tissue, further cryotherapy, and a continuous, solid bandaging of the stump. Surgical resection often does not yield satisfactory results. Spur formation at the amputated end of the bone: Spurs can be diagnosed by scanning and X-ray images. In a spur surgical resection is the only effective treatment. By some fresh amputees a phantom sensation is specified, a painless exercise of the amputated limb with possible additional tingling paraesthesia. This feeling can last for several months or years, but usually disappears without treatment. Often feel patient only a part of the missing limb, often the foot, which is the last phantom sensation that disappears. Phantom feelings are not harmful, but patients often try without thinking to stand on both feet and then fall. This happens especially at night, when they want to wake up and go to the bathroom. Phantom pain is less common and can be pronounced and difficult to control. By some experts is argued that this particularly occurs when a painful condition existed before the amputation or pain were intra- and postoperatively treated inadequately. Various treatment methods are considered effective for. B. Simultaneous exercise with the amputated limb and the contralateral stump massage, tapping of the stump with the fingers, the use of mechanical aids, such as a vibrator, further ultrasound. Drugs such. B. gabapentin can also help. Skin damage most likely to occur when the prosthesis presses and rubs on the skin and moisture between stump and prosthesis stem accumulates. Skin damage can be sure that the prosthesis must be reset the first indication. The first sign of skin damage is a redness, then cuts, blisters and sores may develop, the prosthesis is often painful or it is impossible to wear them for long periods. Infections can also develop. Several measures can help prevent skin damage or delay: A well-fitting prosthetic socket Maintaining a stable body weight (even small weight changes can also change seat) A healthy diet and drink plenty of water (to keep the body weight and maintain healthy skin) in patients with diabetes: monitoring and control of blood sugar level (to prevent disease and so as to obtain the blood flow in the skin) For patients with an amputation of the lower limbs: an upright posture (for example, by wearing shoes the same level.) but even with a good adjustment problems may occur. The stump changes in shape and size throughout the day depending on activity, diet and weather. So there are times when the prosthesis fits well and times when it fits less well. In response to these ongoing changes, patients can adjust the fit by wearing thicker or thinner socks or insert a padding. But even with these precautions, the die can be changed enough to cause skin damage. If signs of skin damage are there, a doctor or therapist should be consulted immediately. If possible, the prosthesis should not be worn for a while.

Health Life Media Team

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