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Woman with prosthetic leg is sitting
Vivir con una amputación de pierna

Rehabilitación y prótesis de pierna

El cuidado del muñón, el manejo y el entrenamiento para caminar con la prótesis de pierna: tras la amputación, un equipo interdisciplinario le preparará para la vida diaria con una prótesis.

El cuidado del muñón, el manejo y el entrenamiento para caminar con la prótesis de pierna: tras la amputación, un equipo interdisciplinario le preparará para la vida diaria con una prótesis.

Summary

Rehabilitation after the leg amputation

Once the residual limb wound has healed, the rehabilitation phase as such begins a few weeks after the operation. In most cases, inpatient or outpatient rehabilitation will take up to six months. Ideally, you have chosen a specialist centre that specialises in the rehabilitation of amputees. Information on how to find the right rehabilitation facility is available here (please link to the rehabilitation facilities page in the after the amputation section).

During rehabilitation at a centre, you are cared for by a team of doctors, wound managers, physiotherapists, occupational therapists and sports scientists. The therapy programme is adapted to your state of health and strength resources. You will usually have a daily physiotherapy session with gait training, and treatment sessions for occupational therapy, balneo physiotherapy (baths, massages, electrotherapy, etc.) and sports therapy. Distributed over the day with regular breaks, the treatment will take between three and four hours, with half-hour therapy sessions as a rule. The goal is for you to get back to your usual everyday life as quickly as possible. It’s important to understand that your active participation has a crucial effect on the rehabilitation results. This may also involve questioning and modifying your previous lifestyle. Your doctor or a psychologist can support you here as well. Likewise, you shouldn’t hesitate to get counselling from a psychologist or family counsellor.

Gait training

Gait training with a leg prosthesis

The goal of rehabilitation is to optimally prepare you for life with your prosthesis. First, this includes regaining your strength, endurance and coordination through targeted physiotherapy. In addition, special gait training teaches you how to use your prosthesis.

The basic functioning of the knee joint also plays a major role in gait training for transfemoral amputees. For this reason, the training and education programme will ideally be tailored to the prosthetic components you are using. The programme should be aimed at relearning everyday motion sequences and explaining the functionality of your prosthesis to you.

Learn more about what gait training for leg amputees entails here.

Colocación y retiro correcto de la prótesis

Colocarse y retirarse por sí mismo la prótesis de forma correcta: esto es lo primero que debe practicar para caminar con una prótesis. Dado el caso, sus allegados pueden ayudarle en un primer momento. También es un ejercicio que debe integrarse en la rehabilitación. El objetivo, sin embargo, es que con algo de práctica sea capaz de hacerlo sin ayuda. Según el tipo de prótesis y las particularidades de su muñón, existen diferentes métodos para colocar una prótesis. Su terapeuta o su técnico ortopédico le mostrarán cuál es el método indicado para usted.

Prosthetic user Günther putting on the Kenevo

Sitting down and standing up with a prosthesis

Once you know how to correctly put on the prosthesis and take it off, sitting down and standing up are the next everyday actions you will learn. Users with a transfemoral amputation who are treated with a knee joint that supports sitting down can put weight on both legs while sitting down. The Prosedo, Kenevo, C-Leg® 4, Genium and Genium X3 from Ottobock offer this function, for example. This results in significant relief for the sound side, which helps prevent premature problems from excessive strain. Users with a transtibial amputation should also put the same amount of weight on both legs when sitting down and standing up for the same reason.

Prosthetic user Robert with Kenevo is sitting down

Walking on level surfaces

Once you are confident in using the prosthesis in general, actual gait training can begin. The focus now is on improving balance and coordination, sufficient weight bearing on the prosthesis side and straightening the pelvis and upper body. Your therapist also continues to work on strengthening your muscles, because strong muscles are essential for a stable body posture while walking.

First you learn how to shift your body weight and stand on one leg between parallel bars. Don’t support all your weight with your arms and sound leg; use your prosthesis, too. As soon as you can walk between parallel bars, you start the first exercises without support. The first objective is to gradually reduce the use of any walking aids you may require initially. This is achieved through a combination of a proper walking technique and strengthening your torso muscles. All gait exercises are monitored by your therapist to ensure that no gait deviations creep in. At first, the therapist is always by your side, offering help. However, you will gradually learn to do without this over time.

Once you have mastered walking on level ground, you will also practise walking on various other surfaces.

Prosthetic user during gait training indoor

Walking safely on stairs and ramps

You will always encounter obstacles in daily life, such as curbs, stairs in your home or a ramp leading up to the garage. Walking safely on stairs and ramps is a constant part of your daily life and is practised with you during gait training. The individual components of your prosthesis determine which walking technique is right for you.

Prosthetic user during gait training outdoor

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Residual limb care

Residual limb care

In the hospital, the nursing staff and doctors took care of your residual limb by cleaning the wound and changing the bandages or dressings. In the rehabilitation phase, you are shown how to care for your residual limb, the scar and also your sound leg yourself. Note that regular and intensive care are essential so you can wear your prosthesis without problems. There are special care products for your residual limb that you can use. Over time, you will develop a daily care routine that will be a natural part of your everyday life.

Exchange between prosthetic users

Daily care of the residual limb and prosthesis

During the rehabilitation phase, you will be shown how to properly care for your residual limb. To prevent the skin from becoming rough and scaly, you should wash the residual limb with water and mild soap in the morning and evening (e.g. Derma Clean). Then dry the skin thoroughly or carefully dab it dry and apply a cream. Derma Repair and Derma Prevent are two products from Ottobock developed especially to care for residual limbs and highly stressed skin. Derma Prevent, for example, helps prevent chafing by covering the skin like a protective film, keeping it soft and supple. Derma Prevent is usually used in combination with the liner and is therefore applied directly before putting on the prosthesis. Derma Repair alleviates the consequences of heavily stressed skin and protects it against damaging external influences. Derma Repair is generally applied in the evening after taking off the prosthesis. Note that putting on a prosthesis in the morning immediately after washing is often more difficult than usual, since warm water causes the skin on the residual limb to swell slightly.

In addition to caring for your residual limb, the prosthesis should also be cleaned daily. Your O&P professional will be happy to advise you. Wipe the inner socket of the prosthesis with a damp cloth to remove perspiration and skin particles. A clean contact surface to the skin helps prevent skin irritation. If you wear a liner, please care for it daily as well according to the instructions for use.

Help for residual limb problems

If wrinkles or drawn-in scars have formed on the residual limb, these require especially intensive care in order to prevent infections. Your rehabilitation team can provide you with advice. While caring for your residual limb, also look for skin injuries, pressure points and blisters. These may require medical treatment. A mirror can help you examine the back of your residual limb. Regularly massaging and gently stretching the scar is another important element of residual limb care and desensitising the sensitive skin on the residual limb.

Prosthetic user is reading in a book

Caring for the sound leg

After the amputation, your residual limb won’t be able to support a lot of weight. This automatically puts greater strain on the sound leg. However, it’s very important that it is healthy and intact so you can regain your mobility.

If you have circulatory disorders, regularly examine your sound leg for minor injuries as well. They could become dangerous in the event of an infection and should therefore be treated immediately by a doctor. Many affected individuals visit a trained pedicurist for foot care, such as having their toenails trimmed. Comfortable shoes with a good fit reduce the strain on your sound leg. Insoles may also be recommended. In addition to footwear, your choice of socks is important: Socks should be made of wool or cotton so they absorb perspiration well. If the cuff is too tight, it can disrupt blood circulation. Socks have to fit without wrinkles and should be worn only for one day. Otherwise, perspiration causes salt deposits to form that chafe the skin and can lead to infections. If you have circulatory disorders, it’s also important not to transfer to a wheelchair while barefoot. You shouldn’t stand or walk barefoot either the risk of injury is too high. And when you are in bed, you can put a padded support under the heel and ankle of your sound leg in order to prevent pressure points.

Prosthetic user with Genium X3 is standing
Preguntas frecuentes

Preguntas frecuentes

La pérdida de una o de varias extremidades confronta a las personas afectadas con numerosas cuestiones. Aquí encontrará respuesta a algunas de las preguntas más frecuentes.

Si no encontrara aquí la respuesta a la pregunta que le ocupa, diríjase a su técnico ortopédico, su terapeuta o su médico. Su equipo de rehabilitación es quien mejor puede valorar su situación personal y asesorarle de forma competente.