Physical Therapy: Post Below- Knee Amputation (Alliance Physical Therapy)

Below-knee amputation or lower–knee amputation is a surgical process conducted to

remove a limb damaged due to any injury, trauma or disease. The process of amputation

can be performed at any age, but is more prevalent among the age group of 65 years and

older.

What do we mean by Below-Knee Amputation?

Below-Knee Amputation or BKA is a surgical process to remove the damaged or diseased

limb. The main reason behind BKA (Below-Knee Amputation) is peripheral vascular disease

or poor circulation in the lower limb. Due to poor circulation; immune or healing responses

to injury limit and foot or leg ulcers may form that do not heal. These damaging ulcers may

develop infection spreading to bones. Amputation is conducted to remove these diseased

tissues and to prevent further infection.

During BKA, an orthopedic or vascular surgeon removes the diseased limb while saving as

much of healthy bone and tissue as possible. The remaining limb is then shaped up, so that

it can be used for a prosthetic leg.

How can a Physical Therapist help?

Below-knee Amputation is a very difficult and challenging phase, both emotionally and

physically. More energy and strength is required to walk with a prosthesis than normal

walking. Your physical therapist can develop an individualized exercising regime which will

not only increase your overall strength, range of motion and flexibility, but will also expedite

your recovery and reduce time between amputation and first step with a prosthesis.

Post Amputation Rehabilitation:

Physical Therapist will start your routine as soon as your condition stabilizes and doctor

clears you. Your initial treatment may include:

● Range-of motion and gentle stretching exercises

● Instructions to roll on the bed, sit on the bedside and safely moving to the chair

● Educating about the proper positioning of limb to prevent contractures

● Educating to move about in a wheel chair and to walk and stand with a supportive

device.

Preventing Contractures:

Contractures mean the development of tightness of the soft-tissues which further limits the

mobility and motion of the joint. After BKA, the most common contracture that follows is,

at the knee when it becomes flexed and it is difficult to straighten it. If these contracturers

are not dealt with, they make it difficult for you to walk properly or wear prosthesis and as

well increase the need of supportive device like a walker. Your physical therapist will help

you to:

● Maintain normal posture and range of motion at your knee and hip

● Position your limb properly and prevent developing contracture

● Maintain normal range of motion through stretching and positioning exercises.

Swelling:

Experiencing post-operative swelling is normal. Compression will be maintained by the

therapist in order to protect your residual limb and to lessen and control your swelling. The

physical therapist will accomplish compression by:

● Wrapping the limb with elastic bandages

● Making you wear elastic Shrinker sock.

This also helps to shape the limb in order to prepare it to fit it in prosthetic leg. Your

physical therapist will monitor the fit of these devices and as well educate you to use them

properly.

Managing Pain:

Your physical therapist will also help you to manage pain in several ways involving:

● TENS and electrical stimulation may be used where pain is relieved by blocking

nerve signals.

● Manual therapy; involving joint manipulation and massages may be used to

improvise circulation and joint motion.

● Stump management is instructed which includes skin care and stump sock use.

Other Management Techniques:

● Your Physical therapist will work with prosthetist in order to prescribe best fit

prosthesis for you. Initially, you will receive a temporary prosthesis while your

residual limb is healing; thereafter, it will be modified according to your need &

requirement

● Your physical therapist will help you to master using wheel chair and walking with

a supportive device like cruthes or walker.

● Therapist will educate you about using your prosthetic limb successfully and will

also make you learn how to take care of your resideual limb with regular skin and

hygiene checks, exercising and correct positioning.

● Therapist will also educate you how to put new prosthesis and take it off.

● Therapist will also help you to build up tolerance for wearing your prosthetics for

longer times while protecting skin intergrity of residual limb.

● Prosthetic training takes time and physical therapist make you learn to stand,

balance and walk with a prosthetic limb. You may progress gradually and

eventually learn to walk independently, without using any supportive device.

● Your therapist will also continue with stretching and strengthening exercises

unless you achieve your fullest potential and become able to perform the activities

you used to before amputation.

Contact Alliance Physical Therapy for thorough and agile post below knee

amputation rehabilitation. Our professional physical therapists are experienced at

treating patients with amputation conditions. Our dedicated therapists have

advance knowledge and are experienced at providing prosthetic training.

Visit us at :- http://www.alliancephysicaltherapyva.com/