Physiotherapy following through-knee amputation.

Physiotherapeutic treatment considerations specific to the through-knee amputee are presented. Treatment is determined by the assessment findings. The physiotherapy programme includes post-operative exercises, early weight-bearing, bed to chair transfers, bandaging techniques, the counteracting of contractures and gait training. Physiotherapy is a vital part of the rehabilitation of through-knee amputees. Principles of treatment are based on normal human locomotion, the individual patient's health status, biomechanical changes and expected stump functions. The through-knee stump is generally problem free, functional and end-bearing, allowing for a high rehabilitation rate in independent ambulation. It is therefore well suited for the geriatric amputee.

Running patterns of transfemoral amputees: a clinical analysis.

The challenge of rehabilitating young, healthy transfemoral amputees may extend beyond the boundaries of teaching them to adapt to functional activities of daily living. The goal for several of these amputees is to participate and sometimes even compete in recreational activities, including running. These amputee runners require prosthetic adaptations as well as a comprehensive individualized training programme to ensure that their running is as safe and energy efficient as possible. To help amputees achieve this, clinicians must understand normal and prosthetic locomotion. This paper compares the biomechanical differences between walking and running in normal locomotion and analyses the running modes used by transfemoral amputees. The modified running mode achieved with the Terry Fox Running Prosthesis subjectively "looks" more energy efficient to the observer and "feels" more energy efficient to the user. These assumptions have yet to be confirmed or refuted by a rigorous scientific research study. An outline of the proposed physiotherapy protocol includes the familiarization, treatment, and training phases. Physiotherapists involved in amputation rehabilitation may not be commonly confronted with this level of patient expectation. It is their responsibility to give realistic guidance to these amputees so that they can safely and independently pursue their recreational running activities. This need can best be fulfilled by providing sound clinical advice which has been validated by research findings.