presented by Alicia White
Treating a patient with limb loss has the potential to be intimidating to a physical therapist with no background of that patient population. With an in depth understanding of patients with amputations, the physical therapist will be better prepared to provide appropriate rehabilitation. The following lecture and supplemental materials will offer an evidence based knowledge foundation for treating patients with limb loss. Following the lecture, the physical therapist will be able to understand an appropriate approach for rehabilitation of patients with amputations.
Dr. Alicia White graduated from Baldwin-Wallace University in 2004 with a degree in athletic training. She continued her studies at the University of Miami where she earned a doctorate in physical therapy in 2007. Dr. White worked at the Center for the Intrepid in San Antonio, Texas for ten years where she treated high-level patients with amputations in the military and civilian sectors. Additionally, she taught the running course for all patients with amputations that had a desire to run while being treated at the Center for the Intrepid. She has served as an expert witness in several cases concerning the functional expectations for patients with amputations. In addition, she has taught Prosthetic Rehabilitation at the US Army Baylor Physical Therapy Program and Adaptive Sports at Texas State University. Dr. White continues her passion for teaching running as the South Texas Paralympic Track Coach and within her own practice, Evolve Prosthetic Rehabilitation. Dr. White also treats pediatric patients with amputations at the Children’s Hospital of San Antonio.
It is imperative to understand “why” your patient may be coming to you and how to appropriately address each patient. Every patient is unique, however, by understanding the common reasons for amputations, you will be better prepared to treat your patient.
Understanding the level of amputation will better help you prepare for post op precautions and expectations. Understanding surgical procedures will assist with creating an appropriate plan of care. Understanding both the level of amputation and the available surgical procedures will better help you educate the patient on their post op expectations.
Some patients will begin treatment with you prior to their amputations. They will look to you for guidance with any surgical choices they may have. It is imperative that you understand these considerations to be able to assist the patient with their concerns.
Neurological implications post amputations present their own unique and significant recovery techniques. The therapist must understand these implications, be able to explain them to the patient, and treat them accordingly.
Patients can potentially lose a limb secondary to poor wound healing. Even if that is not the case, they will have a suture line that must meet the demands of prosthetic wear without breakdown. It is imperative to be able to treat the wound and educate the patient to prevent further wounds.
Weight management and long term physical fitness will determine activity levels of this patient population for the remainder of their lives. Proper nutrition will help to maintain a healthy weight, which promotes proper socket fit, optimal energy expenditure with activity, and appropriate wound healing.
The internet provides a wealth of information for patients with amputations, but it is still imperative to help the patient understand their new diagnosis, assist them with deciphering appropriate internet information, and increase their awareness of organizations available to assist them in the community.