Therapy Benefits
For Lower Limb Considerations - A below the knee amputee will need anywhere from 8-12 individualized physical therapy sessions to become safe with their prosthesis in their community.
An above the knee amputee will need between 12-20 individualized physical therapy sessions to become proficient with their prosthesis.
A bilateral amputee (missing both limbs) will require 24-48 sessions depending on the level of their amputations.
For Upper Limb Considerations - A patient will need pre-prosthetic therapy and prosthetic therapy after their amputation. Pre-prosthetic therapy focuses on independence with self-care, and addresses wound healing and scars.
Prosthetic therapy will teach the patient how to use their prosthesis and integrate it into all areas of function. Often, the patient will need adaptive equipment to assist in tasks. Rehabilitation often takes longer than lower limb to return the patient to all areas of their desired activities of daily living (ADLs).
The cost for a one full hour physical therapy and/or occupational consult is between $130.00 and $200.00
Here are the benefits...
A course of physical therapy treatment consists of first evaluating the patient's musculoskeletal system including range of motion of all joints, gross motor strength testing, balance and coordination assessment, fit of prosthesis, evaluation of skin integrity, home assessment/modification, discussing patient goals as it relates to their home and work environment and quality of life.
Along with therapy, perhaps the most important aspect of treatment is patient education regarding recovery from limb loss. During PT treatment, the amputee will be receiving information regarding skin health/care, liner/prosthetic management, safety during gait and functional activities and chronic injury prevention.
During the course of treatment, the physical therapist will treat the amputee for all strength, range of motion, and balance deficits. This includes rigorous therapeutic exercise, balance and proprioceptive training and specialized gait training. As the treatment progresses, the physical therapist will incorporate functional activities including ambulating on different surfaces including ramps, curbs and stairs and will customize treatment according to the requirements the patient may have upon returning to work/hobbies.
Robert Gailey states: "Despite the prevalence of lower limb amputation (LLA), only a small percentage of people with LLA actually receive physical therapy post amputation and are rehabilitated to their full potential level of function. People with unilateral TTA who received Evidence-Based Amputee Rehabilitation program demonstrated significant improvement in functional mobility, with most participants (66.7%) improved at least 1 K-level (58.3%) (Functioning level) and greater than the minimal detectable change (66.7%)."(1)
Robert S. Gailey, PhD, PT (Professor) has been at the University of Miami Miller School of Medicine, Department of Physical Therapy for 30 years. He also has a joint appointment as a Health Science Researcher with Miami Veterans Affairs Medical Center and is the Director of the Functional Outcomes Research & Evaluation Center. His doctorate in prosthetics and orthotics was received from the University of Strathclyde in Glasgow, Scotland where he developed the Amputee Mobility Predictor an objective measure of amputee function and most recently developed the Comprehensive High-Activity Mobility Predictor. He has authored over 50 publications and has continued research efforts directed toward: amputee rehabilitation, the biomechanics and metabolic cost of prosthetic gait, functional assessment and athletic pursuits of the amputee as well as other athletes with disabilities across the life span.
References:
1. Robert Gailey Ignacio Gaunaurd, Michele Raya, Neva Kirk-Sanchez, Luz M Prieto-Sanchez, Kathryn Roach. Effectiveness of an Evidence-Based Amputee Rehabilitation Program: A Pilot Randomized Controlled Trial. Physical Therapy Magazine Volume 100, issue 5, May 2020 https://academic.oup.com/ptj/article/100/5/773/5707560