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10: Prosthetic gait training and deviations

DOI:

10.1891/9781617051142.0010

Authors

  • Wheaton, Michael W., MD
  • Foster, Alicia A., MS
  • Kelly, Brian M., DO

Abstract

This chapter covers both lower and upper extremity restoration and rehabilitation and serves as a handy reference for busy practitioners to support sound clinical decision-making. It begins with basic anatomy, kinesiology, and a recap of surgical decisions principles and post-operative care for amputees. It discusses common medical issues such as phantom limb sensation and pain, skin problems, and sexual and psychological considerations. The chapter reviews patient functional goals and perform a routine functional assessment to help set expectations for prosthetic use. Preprosthetic gait training should focus on flexibility, prevention of contractures, and strengthening that will aid stability and safety with gait training. Patients initially prefer a wide base of support (BOS) that provides increased stability with the prosthesis. To use the prosthesis effectively, the prosthesis must be realigned to a narrower BOS for proper alignment of the hips and pelvis and gait efficiency.