Long term rehabilitation
As an amputee rehabilitation becomes a part of life going forward. There are different possibilities to maintain and perhaps even improve the health status after the therapy and care. On the one hand, it plays an essential and important role to exchange information about one's problems, sometimes very specifically with regard to amputation. For this purpose, there are local exchange platforms such as self-help groups, where patients meet and describe their experiences in dealing with an amputation. Another important aspect, which is often neglected, but represents a very stressful condition for the amputee, is phantom pain - there are further exercises to reduce this pain. Furthermore, gait deviations can creep in after prolonged walking which, however, requires on the one hand targeted training and correct adjustment of the prosthesis. On the other hand, on-going training and a permanent gait training helps to prevent gait deviations and secondary diseases.
Information platforms for amputees:
The exchange with other affected persons is very important for amputees and can contribute to a better understanding of the condition and how to deal with it. Joining a self-help group can help to exchange information with other amputees, gain information and participate in joint activities as well as events. In a direct exchange questions can be clarified, new interests can arise and possibly even new friendships can be made.
A large, international self-help group is the International Confederation of Amputee Associations (IC2A), which provides tips and tricks for freshly operated patients, information on sports activities with amputation and materials on differences in prostheses.
Among other reasons, deviations in walking can have an influence on muscular and skeletal structures. A secondary disease, which in this context can be caused by incorrect and excessive stress, is for example arthrosis.
While the therapist observes and analyzes the amputee's gait, the therapist should be able to recognize and evaluate gait deviations in consultation and cooperation with the certified Prosthetist/Orthotist. The reasons are multifactorial and may be: muscle weakness or shortening, fear, or lack of balance. Also incorrect prosthestic alignment may be the reason for gait deviations.
Self-help measures for patients and complementary therapy against stump pain
Phantom limb pain
When pain comes from a part of the body that is no longer present, such as after an amputation, we speak of phantom pain. A lot of patients suffer from this neurological disorder after an amputation. The brain still receives signals from the nerves that were previously responsible for this part of the body and this leads to pain. This pain can be burning, stinging or electrifying, and occurs especially at night and massively disturbs sleep.
A lot of amputees experience phantom sensations: This is also referred to as sensations in the part of the body that no longer exists, which are not painful, but are usually very unpleasant. Patients experience sensations of heat or cold, pressure or itching in the separated part of the body, even movements are sometimes felt.
The causes for phantom limb pain could be neuromas. This neuromas - or in other words scars on the severed nerves (neurinomas) can trigger phantom pain.
Painless awareness of amputated limb
|Phantom limb pain|
Pain caused in central nervous system
- Wearing the prosthesis & gait training
- Mirror therapy / Visual feedback
- Aluminum foil or special liner
- Electrical therapy (TENS= transcutaneus electrical nerve stimulation)
- Pre-surgery: local anesthesia of the limb to remove a neuroma
- Desensitivity training
- Post-operative skin and scar treatment
- Stress Management
Psychological impact after amputation
The loss of a limb e.g. after a trauma can also have psychological consequences. Affected persons may need additional support in coping with the loss of a limb. Talking to your doctor and other health care professionals is important as it would ensure that the appropriate care is provided.
As mentioned above amputees may need additional help, because it could be a devastating and frightening experience. Adjusting to life after an amputation can be challenging, but many people enjoy a good quality of life once they have managed to adapt and to talk about their problems and experience with other amputees.