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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.
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.
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.
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 therepist 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, balnce 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 threrapists are experienced at treating patients with amputation conditions. Our dedicated therapists have advance knowledge and are experienced at providing prosthetic training.