By Javier J. Ibarra, DPT, OCS, COMT, CSCS

Amputation is the surgical removal of a limb or part of a limb. Reasons for amputations can vary from trauma to diabetes to frostbite. According to Johns Hopkins,[1], there are roughly 2 million people in the U.S. living with amputations and another 28 million at risk of amputation. In the U.S., 82% of amputations are due to vascular disease.

The impact of amputation on a person’s life can be significant, both mentally and physically. Research has shown that adults who undergo amputation participate in far less physical activity throughout the day than adults without amputation. According to one study, adults that have undergone amputation of a lower limb average about 2500-4000 steps per day, far lower than the recommended goal for people with disabilities (at least 5500)[2]. Such sedentary behavior increases the risk for a multitude of health issues as well as overall mortality.[3].  Therefore, it is crucial to remain active after ambulation to improve quality of life and overall independence and maintain health and prevent chronic disease.

Physical therapists are a vital part of the rehabilitation team during the amputation process.

Physical therapists are movement experts that can help optimize the rehabilitation plan to maximize overall function and physical activity after amputation. This may start before the amputation is even performed. The physical therapist performs a physical evaluation to measure muscle strength, range of motion, and overall mobility and may even consult with the surgeon about where to perform the amputation.

Immediately after surgery, the physical therapist will train the patient on how to function without a limb, including transfer training and other exercises to maintain range of motion and strength. As the wounds from surgery heal, the physical therapist may begin training the patient. Recommendations may include walking aids and input from the rehab team regarding what type of prosthetic may be best. Then, once a prosthetic has been decided on and made, the physical therapist's role shifts to training the patient in the prosthetic, including putting it on, taking it off, gait training, balance, and strength training.

Physical therapists play a crucial role in treating the patient undergoing amputation. From the pre-operative evaluation to prosthetic training, the physical therapist is there every step of the way to ensure optimal recovery and a return to maximal physical activity and health. Have additional questions? Give us a call at (702) 840-1222. Or, schedule a free 15-consultation here

[1] https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/amputation#:~:text=Diseases%2C%20such%20as%20blood%20vessel,tumors%20from%20bones%20and%20muscles. Accessed 4/21/21.

[2] Desveaux L, Goldstein RS, Mathur S, Hassan A, Devlin M, Pauley T, Brooks D. Physical Activity in Adults with Diabetes Following Prosthetic Rehabilitation. Can J Diabetes. 2016 Aug;40(4):336-41. doi: 10.1016/j.jcjd.2016.02.003. Epub 2016 Apr 1. PMID: 27052673.

[3] Paxton RJ, Murray AM, Stevens-Lapsley JE, Sherk KA, Christiansen CL. Physical activity, ambulation, and comorbidities in people with diabetes and lower-limb amputation. J Rehabil Res Dev. 2016;53(6):1069-1078. doi: 10.1682/JRRD.2015.08.0161. PMID: 28355032; PMCID: PMC5474964.