Transfem Pros

8/4/2019 Transfem Pros

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TRANFEMORALPROSTHETICS

A PATIENT CARE

MANUAL FOR THE

NEW AMPUTEE

This booklet was created for informational

purposes only. The information contained

herein should only be used for reference

material and is not intended to replace the

advice of your healthcare provider(s). You

should always consult with your physician or

healthcare provider concerning any medical

issues and before beginning any treatment

regiment.


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TABLE OF CONTENTS

INTRODUCTION...1

COMMONLY USED TERMINOLOGY...2

COMMONLY USED ACRONYMS6

BASIC ANATOMY......7

STATISTICS.........8

HEALING RATES..9

MEETING YOUR PROSTHETIST....10

POST OPERATIVE CARE.11

IPOP PROSTHESES..11

SHRINKERS....13DESENSITIZATION....14

POSITIONING....14

PHANTOM LIMB SENSATION..16

PHANTOM LIMB PAIN.16

EXERCISE...16

TEMPORARY PROSTHESIS...17

PROSTHETIC PROCESS..18

CHECK SOCKET FITTING.21

TEMPORARY PROSTHETIC FITTING...22

PROSTHETIC FOLLOW UP..24

SOCK MANAGEMENT24

HYGIENE..26

PHYSICAL THERAPY..26

DEFINITIVE PROSTHESIS..28

PROSTHETIC PROCESS..28

PROSTHETIC HYGIENE....30

EXERCISE...31ASSISTIVE DEVICES..31

AMPUTEE ATHLETIC RESOURCES..33

RESOURCES FOR THE AMPUTEE.....35

REFERENCES..36


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1

INTRODUCTION

An amputation can be both physically and emotionally

challenging for anyone. It is important to understand

that many new amputees function very well and

pursue the same active lifestyle as prior to limb loss.

This booklet aims to provide you with answers to

many of the questions that arise before and after an

amputation. When speaking with your healthcareprovider, it is important to know which questions to

ask and have an idea of what to expect. Many

questions will arise throughout the rehabilitation

process. This booklet will answers to some of them

and give you resources to get further information.

Having the answers to commonly asked questions

readily available will help you prepare for the stepsand procedures that will occur before, during, and

after your amputation. This information can assist

you in your return to the things you need and

hopefully enjoy participating in.

This booklet also provides many other resources that

you may find useful in your recovery. There are many

organizations that offer a variety of assistance thatrange from driving devices to sports related

activities. This booklet attempts to turn your

disability into a possibility by sharing the collective

rehabilitative experiences of others with you.

2

Commonly used

terminology

Abduction a movement which brings the limb closer

to the midline of the body

Adduction a movement which positions the limb

further away from the body

Alignment the spatial relationship between the

prosthetic socket and the prosthetic foot

Anterior towards the front of the body

Check Socket a temporary socket made of

transparent plastic that is used by the prosthetist to

diagnose the fit of the socket

Contracture tightening of the muscles, tendons, or

ligaments that prevents normal movement of a jointCosmesis the outer covering of a prosthesis,

aesthetics

Definitive Prosthesis a replacement for a missing

limb after all post-surgical swelling has subsided

Disarticulation amputation through a joint (i.e.

ankle, knee, hip)

Donning and Doffing the process of putting on and

taking off a prosthesis

Dorsiflexion pointing the toe or foot upwards

Edema swelling of the tissues

Eversion to turn outward


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Exoskeletal a prosthesis that is hollow on the inside

and has a rigid outer coveringExtension a position of increasing the joint angle,

straightening out

Flexion a position of decreasing the joint angle,

bending

Gait Training learning, usually from a physical

therapist, how to walk safely and properly with a

prosthesis

Immediate Post Operative Prosthesis an artificial

limb that is applied in the operating room after the

amputation has occurred

Inversion to turn inward

Lateral away from the midline of the body, to the

sideLiners a sleeve or covering of the residual limb that

is used for suspension, cushioning and protection

Medial towards the midline of the body

Myodesis a process during an amputation where the

muscles are attached to bone

Myoplasty a process during an amputation where

the muscles are attached to opposing muscles

Neuroma a nerve ending that is cut during an

amputation that can ball up. Neuromas are usually

extremely sensitive and painful

4

Occupational Therapist a person trained in gaining

greater independence for patients throughrehabilitation and relearning how to perform

activities of daily living efficiently and safely

Occupational Therapy evaluation and training

performed by a licensed occupational therapist which

focuses on maximizing the activities of daily living

Pedorthotist a trained healthcare practitioner who

specialized in orthopedic footwear and foot orthosesPhantom Limb Pain pain that appears to come from

an area below where the amputation occurred

Phantom Limb Sensation the feeling that an

amputated limb is still attached to the body

Plantar Flexion pointing the toe or foot downwards

Physical Therapist a person trained in therehabilitation process of patients who have limited or

lost functions of mobility

Physical Therapy evaluation and training performed

by a licensed physical therapist which focuses on

exercise, reducing pain and regaining mobility

Posterior towards the back of the body

Prosthesis an artificial body part

Prosthetics the profession of evaluating,

fabricating, fitting and adjusting an artificial limb

Prosthetist - a trained healthcare practitioner who

evaluates, fabricates, fits and adjust prosthetic

devices


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Pylon a structure that is used to connect the

prosthetic socket to the prosthetic ankle/footcomplex

Residual Limb the portion of a limb that remains

after amputation

Shrinker a prosthetic sock created of elastic

material that is used in reducing swelling of the

residual limb

Socket the part of the prosthesis that fits aroundand protects the residual limb; usually made of

thermoplastic, laminated, or carbon composite

material

Socks a sock that is fabricated to fit the residual

limb. It is used to manage the loss of volume in the

residual limb throughout the day

Sound Side Limb the non-amputated or non-affected limb

Symes amputation through the ankle joint that still

maintains the fatty heel pad for cushioning

Temporary Prosthesis a prosthesis that is

fabricated soon after amputation. This prosthesis is

used until post-surgical swelling has subsided.

Transfemoral amputation that occurs at a level

above the knee joint but below the hip joint

Transtibial amputation that occurs at a level below

the knee joint but above the ankle joint

6

Commonly used

acronyms

ABC American Board for Certification

ACA Amputee Coalition of America

AKA Above Knee Amputation

AP Anterior-Posterior

BKA Below Knee AmputationCP Certified Prosthetist

CPed Certified Pedorthotist

CPO Certified Prosthetist-Orthotist

OT Occupational Therapy/Therapist

PT Physical Therapy/Therapist

PTB Patellar Tendon Bearing

TF Transfemoral

TT Transtibial

SACH Solid Ankle Cushioned Heel


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Basic anatomy

Femur Thigh boneGreater Trochanter Upper, prominent part of the

femur

Ischiopubic Ramus Flat, sharp bone that connects

the Ischial Tuberosity to the front of the pelvis.

Ischial Tuberosity Lower and back part of pelvis.

The bone you sit on.

Pelvis Bony structure located at the base of the

spine

Pelvis

Femur Ischial

Tuberosity

Greater

Trochanter

Ischiopubic

Ramus

8

Statistics

It is important for you to know that you are not alone

in your rehabilitation process as a new amputee. The

number of people living with an amputation is rising in

the United States, particularly as a result of diabetic

and dysvascular conditions.

In the United States, there are approximately 1.9million people living with limb loss. It is estimated

that one out of every 200 people in the U.S. has had

an amputation.6

Loss of a limb can occur for a number of reasons.

With regard to amputation of a lower limb, the most

common causes of amputation include dysvascular

complications (possibly resulting from diabetes),

trauma, cancer and congenital limb deficiency.

Amputation Statistics by Cause from the National Limb Loss

Information Center, 2006


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Healing rates after

amputation

The recovery rate after amputation is different for

each person. There are no two surgeries or people

that experience the same healing times and rates.

Following surgery, you will not return to your room

until about four hours after you wake up. When you

awake, many people say that they feel as though theyhave not had the amputation because they have the

sensation that the limb is still attached.

On your residual limb, there will likely be a drainage

tube to remove the excess fluids following your

amputation. This tube usually remains in place for 24

hours following the surgery. The surgical dressings

are typically changed within 48 hours followingsurgery. Your physician may alter these times to suit

your unique needs.

Within 7-10 days, most patients are able to go home.

Two to three weeks post-operatively your physician

will remove the staples. During the healing period,

which lasts anywhere from three to twelve weeks,

the suture line will close and heal.

When the suture line has healed, fitting for a

temporary prosthesis may begin. Again, the time

frames mentioned in this portion of the booklet are

typical. Some people may experience shorter time

frames, while others may experience complications

that lengthen them.

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Meeting your

prosthetist

Choosing a prosthetist is an important step in your

rehabilitation process. You will develop a life long

relationship with your prosthetist and will be seeing

them often for the care of your residual limb and

prosthesis.

When choosing a prosthetist, you should meet with

several different practitioners in your local area to

determine who you feel most comfortable with. Your

prosthetist should be open to your needs and listen

to what you have to say. A list of ABC Certified

practitioners can be found at http://www.abcop.org

When you meet with your prosthetist for the first

time, you should be prepared to ask any questions

that you may have about the prosthetic process.Consider making a list of questions to bring to your

appointment to ensure that all of the questions that

all of your questions are answered. Without a list, the

experience may be overwhelming causing you to

forget important questions.


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Post operative

prosthetic care

After the amputation there are several ways of

dressing the residual limb. The most common way of

dressing the limb is with the use of simple gauze

dressings. This is typically done in the operative room

by your physician immediately following surgery.

These dressings will then be changed periodically.

Ipop prosthesis

There are more aggressive approaches to post

operative care that may include the use of a rigid

dressing or what is termed an Immediate Post-

Operative Prosthesis or IPOP. An IPOP is an

immediate postoperative prosthesis that is used as anearly form of prosthetic intervention.

The benefit of being fit with an IPOP prosthesis is

early ambulation if allowed by your physician. An IPOP

prosthesis is also said to help with phantom limb

sensation, because you can see that there is a leg, or

in this sense, a prosthesis attached.

IPOP prostheses also protect the residual limb frombeing injured. Many times, a patient will wake up in

the middle of the night to use the restroom, and

forget that their limb has been amputated. When

they get out of bed and try to stand on both limbs,

they fall down and re-injure the surgery site.

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An IPOP prosthesis will protect the end of the

residual limb should this occur. There are many

different types of postoperative care and your

physician will help you choose which the best is for

you.

Photo from Flo-Tech. O&P Industries, Inc.Accessed 2May2007 online at:

http://www.1800flo-tech.com/products.html

Flo-Tech Brand IPOP prosthesis.This IPOP has all of the same basic

components of a typical prosthesis

(socket, knee and foot).Socket

Knee

Foot


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Prosthetic shrinkers

At some point after your surgery, your healthcare

providers will discuss several things with you including

the use of shrinkers, desensitization, positioning,

contracture prevention, exercise, phantom sensation

and phantom pain.

To manage post-operative edema, you may be

prescribed a shrinker or ace wrap as a means ofcompression therapy.

Shrinkers are elastic garments that are simply pulled

on or wrapped around the limb. They are typicallyused when the suture line is reasonably healed. Until

that time, an ace wrap may be used. Both methods

help to expel excess fluid that remains inside the

limb. This helps to prepare you to wear a prosthesis

by providing an appropriate limb shape.

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Desensitization

Desensitization is important to prepare your residual

limb for the forces that will soon be applied with a

prosthesis.

The most common and easiest way to desensitize the

limb is to gently massage the entire area several

times a day; this will decrease the skins sensitivity.

There are several different techniques, you shouldspeak with your physical therapist about which one is

best for you.

positioning

Positioning is extremely vital to help prevent

contractures that can cause problems when fitting aprosthesis.

If you are going to be sitting in a wheelchair you

should always sit up straight, keep equal weight on

both hips and try not to slouch. Avoiding any

prolonged periods of sitting is best if possible.

If you sit with your hips bent (flexed) for a long

period of time, the limb may develop a contractureand prolong the necessary therapy. This will

negatively effect your rehabilitation. Contractures

can cause you to be uncomfortable in your prosthesis

and/or effect how well you are able to walk. If a

severe enough contracture occurs, this will limit your

prosthetic options and candidacy.


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Proper positioning can be achieved with the use of a

pillow while lying face down in bed. If you are lying on

your back, avoid placing any pillows under your limb.

One simple position that can greatly increase

flexibility is to lay on your stomach and stretch the

limb backward.

When lying in bed remember to keep your legs

together and try to avoid any type of rotation.

Keeping these strategies in mind can help prevent

unwanted contractures.

Left: Person sitting in a wheelchaircould be at risk of developing a hipflexion contracture. Below: personlying on the stomach (prone) to

stretch the hip flexors. Consult

your healthcare provider.

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Phantom limb

sensation

Almost every amputee experiences the sensation that

the amputated limb is still present.1 These feeling can

occur due to a variety of factors including pressure

or even weather changes. These sensations may

disappear quickly or in some cases can remain for

quite sometime. Phantom sensations are different for

everyone and should not present any problems toprosthetic fittings.

Phantom limb pain

In addition to phantom sensations, some people

experience various types of phantom pain in the

amputated limb.

1

The causes of these phantom pains remain unknown

but there are treatments available to help manage

symptoms. If you experience phantom pain you should

contact your physician or nurse so that they can

recommend the appropriate treatment.

exercise

After an amputation it is common to feel weak and

unsteady. This is why it is important to begin

stretching and exercise as soon as you are able.

There are many different types of exercises; some

can be done while lying in bed, some standing, some


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sitting, and more. At times, home exercise is

important and at other times you may need to visit

your physical therapy clinic. Your physical therapist

will be able to explain and demonstrate these and/or

other exercises that are appropriate and beneficial

for you.

Temporary Prosthesis

This section will attempt to guide you through the

process of receiving a temporary prosthesis. A

temporary prosthesis is fit about four to twelve

weeks after surgery, depending on how well and

quickly the suture line heals. The temporary

prosthesis is your first prosthesis. It will help you(r):

1. get accustomed to putting on and takingoff (donning and doffing) a prosthesis2. skin get accustomed to the new pressures

and forces of prosthetic use

3. learn to walk on a prosthesis

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4. helps you to learn to manage the socksyou need to wear as your residual limb

volume changes.

In order to accomplish these things, the way this

first prosthesis is designed and looks will quite likely

be different from your future prostheses.

Prosthetic process

Upon successful healing and control of edema, your

physician will most likely prescribe a temporary

prosthesis for you. It is very important to inform the

practitioner of any goals and aspirations you have.

With your goals in mind, the process of prosthetic

selection can begin.

As a part of your first visit to the prosthetist, your

residual limb will be evaluated for any scarring,redness, blisters, or any other problems that might

effect the fit and function of a prosthesis.

Your prosthetist will then go over the different

options for prosthetic interfaces. Depending on your

needs, you and your prosthetist will choose which is

best for you.

The most common types of prosthetic interfaces

include pelite, flexible plastic and gel liners. Each has

pros and cons that must be considered.

Flexible plastic is a common choice in prosthetic

design interfaces. There are many types of plastics


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available. Flexible plastics are moisture proof, will

not compress and provide the ability to make

numerous alterations to the fit of the prosthesis.

They are very durable but do not offer the same

amount of cushioning that gel liners do.

Probably the most common type of interface is the

gel liner. These liners are worn directly against the

skin to provide cushioning while still allowing the

ability for socket adjustments. It is important tounderstand that because the liner is worn directly

against the skin they must be washed on a daily basis

and allowed to dry thoroughly before reapplying.

There are many different types of gel liners available

and your prosthetist will work with you to choose the

best one for you.

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After the socket design and interface choices are

made, the prosthetist will take a series of

measurements from your residual limb that will be

used in the fabrication process.

Your prosthetist will then take an impression of the

limb using plaster wrap. It is from this impression

that your prosthetic socket will be fabricated. This

visit with the prosthetist usually takes about one

hour. Following the visit, your prosthetist will

schedule an appointment for you to be seen back in

the office for a check socket fitting in about one

week.


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Check socket fitting

When you return to see your prosthetist for the

check socket fitting, you should bring a pair of shoes

with you. This visit will last about one hour.

The check socket is typically made of a clear plastic

that allows the practitioner to view the pressures

exerted on the residual limb prior to fabrication of

your temporary prosthesis.

During this visit, the prosthetist will allow you to

stand in the prosthetic check socket.

After adjustments are made to the socket to

alleviate pressure points, your prosthetists will ask

you to walk in the parallel bars to dynamically align

the prosthesis.

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Your practitioner will work with you to make any

necessary adjustments to the socket for a better fit

and to optimize how you walk.

Following this visit, the practitioner will fabricate the

temporary prosthesis. This process normally takes

about a week from the check socket fitting.

Temporary Prosthetic

socket fitting

A temporary prosthetic socket is usually fabricated

out of thermoplastic. The thermoplastic is used for

its high adjustability to accommodate the changes in

volume of your residual limb. It is commonly worn for

3-6 months. During this time period, you will have

several follow up visits with your prosthetist to


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evaluate and adjust the fit of your prosthesis. The

need for adjustability is crucial and therefore the

temporary prosthesis may not look like a natural leg.2

During this visit, your prosthetist will again have you

walk in the parallel bars and make any necessary

alignment changes to optimize how you walk. Once all

the adjustments have been made and you and your

prosthetist are satisfied with the fit and function of

the prosthesis, you will most likely be able to takethe prosthesis home with you.

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Prosthetic Follow up

After you receive your temporary prosthesis, your

prosthetist will provide you with follow up

appointments. It is imperative that you maintain

these appointments and follow any instructions given

to you by your prosthetist. Some of your obligations

in between appointments will be sock management,

hygiene, skin assessment, and exercises.

Follow up appointments are usually made once a week

after receiving your temporary prosthesis. These

appointments allow your prosthetist to monitor any

changes in your residual limb, and proactively manage

any issues that may arise.

After the first two months, the follow up

appointments are less stringent, and are usually on anas needed basis determined by you and your

prosthetist.

Sock management

While wearing your prosthesis it is common to

experience a loss of volume in the limb throughoutthe day. This is commonly referred to as sock

management or volume management.

As your residual limb loses volume, the space between

your residual limb and prosthesis will become greater

and must be filled. Your prosthetist will provide you


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with several socks, of various thickness, that will fill

in this space.

Sock ply is determined by the thickness of the sock.

The sock ply can visually be determined by either a

number on the sock or the color of the sock stitching.

The lower the sock ply, the thinner the sock. It will

be your job to determine when socks are required and

what size will best fill in the gap. It takes some time

to get proficient with this. Be sure to talk with theprosthetist and physical therapist when you have

questions. You will be taught how to manage your sock

wear. This skill will be frequently reviewed because it

is important in maintaining the fit and function of the

prosthesis and health of your residual limb.

Left: multiple plies of socks (6 ply, 5 ply, 3 ply and 1 ply

socks). Also shown are socks made of specialized materials(silver threads in this case). Right: Person wearing socks in a

transfemoral prosthesis due to volume loss.

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Prosthetic hygiene

You should wash your residual limb on a daily basis to

help prevent the accumulation of bacteria or

development of cysts or pimples. Simply wash your

residual limb with warm water and a mild soap. The

soap should be fragrance free to prevent any skin

irritation. A good soap to start with is the same

brand you use to wash the rest of your body with. If

this does not work for you, consult your physician or adermatologist for other recommendations. Always be

sure to rinse thoroughly and remove any residual soap

from your limb.

When drying, try to pat with a towel rather than

rubbing the limb. While this action is soothing to

some peoples limbs, it is irritating to others.

During this process you should check your skin for

any abnormalities such as redness, blisters or

anything that is otherwise abnormal to you. Any signs

of prolonged redness or soreness should be reported

to your healthcare provider right away. Early

identification of problems tends to result in less

complications. If something does not appear to be

normal, always ask a professional.

Physical therapy

Often times your physician will decide whether your

physical therapy should be on an inpatient or

outpatient basis.


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Your physical therapist will work with you on safety

and gait training (walking) with your new prosthesis.

Gait training is a process in which the physical

therapist teaches you how to walk safely and

efficiently with your prosthesis with either an

assistive device or without assistance.

Your therapist will train you on gait patterns as well

as how to navigate stairs and any other every day

challenges that may occur. You will be introduced tomany different exercises that may be accomplished

at the therapists office and/or at home.

A physical therapist will begin with certain exercises

to help strengthen the muscles needed for

ambulation. Some strength training exercises may be

able to be performed at home with the use of

TheraBand, a rubberized and resistive material.

Left: Physical Therapist assisting person learning to walk

with a transfemoral prosthesis. Right: Person with

transfemoral amputation, performing strengthening exercise

with an elastic, resistive band.

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It is important that you follow the regiment given to

you by the therapist. The exercises and training you

get in physical therapy will help you improve strength,

balance and efficiency for walking with your new

prosthesis.

Definitive prosthesis

Receiving your definitive prosthesis is a similar

process to when you were given your temporaryprosthesis.

Your prosthetist will take several measurements and

an impression of your residual limb in preparation for

a check socket. The process for fabricating the

check socket normally takes about a week.

Once your check socket is ready you will see theprosthetist again so that adjustments can be made to

the fit and alignment of the check socket in

preparation for the definitive socket.

In about a weeks time your prosthetist will have a

definitive socket fabricated. The visit to fit the

definitive socket typically takes about one hour. Theprosthesis is dynamically aligned for optimal

performance.


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The definitive socket may be fabricated of alaminated carbon or other composite materials.

Definitive sockets may also be made of

thermoplastics as well. Once all adjustments have

been made, you will be able to take the definitive

prosthesis home with you. You will be given a follow up

appointment in about one week. At this time, if the

prosthesis is functioning well and no changes have to

be made, a cosmetic covering may be considered ifyou wish.

Cosmetic covering may be made of a soft foam or a

rigid foam. It gives the prosthesis a natural

appearance, typically matching the previous shape.

The outer coloring/tone is typically incorporated into

a nylon or a rubberized prosthetic skin that is applied

30

over the cosmetic cover. The prosthesis can typically

be finished to match your sound side.

You will be given follow up appointments which will

allow your prosthetist to assess your progress and

make adjustments as needed.

Prosthetic hygiene

During the time between follow up appointments withyour prosthetist, it is imperative that you maintain a

high quality of personal hygiene.

Any part of the prosthesis that is in direct contact

with your skin should be washed daily and all residual

soap needs to be removed. This includes but is not

limited to: washing your liners (if you have one),

washing shrinkers that you may be using and washingany socks that are used to maintain proper fit inside

the prosthesis.

It is also very important to wash your residual limb

everyday to prevent skin irritations, infections,

and/or other complications. Proper hygiene

instruction will be given to you by your prosthetist.

As always, ask is something seems unclear.

exercise

Now that you have your definitive prosthesis you may

be a candidate for new types of exercises and


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activities. This is an important time to reintroduce

your goals and desires to be sure that your therapist

and other providers are working with you to best

accomplish them.

Simple standing and seating exercises can greatly

increase your stamina and make your road to recovery

much quicker. If you feel that you can accomplish

more than you are given, do not hesitate to ask your

therapist and prosthetist what other types ofexercises and activities are safe for you.

Assistive devices

Throughout your rehabilitation process, you may be

prescribed different assistive devices to help you

transfer, walk, and exercise.

In the early stages following your amputation your

therapist will begin training you to utilize various

assistive devices to aid in walking. Some of the most

commonly used devices may include the use of a

wheelchair, walkers or crutches or a cane

.

It is common to start off with one device before you

receive your temporary prosthesis. After receiving

the temporary prosthesis, you may switch to

something else. The situation is highly variable

between different people. Your healthcare providers

will discuss this with you. Similarly, you are

encouraged to ask questions if you are unsure about

32

which device is best for you, how to use it, and how

long you will use it.

Many people express a desire to walk without the use

of any assistive device and many people with an

amputation are able to accomplish this. Again, be sure

to talk with your healthcare provider about what is

realistic for you.

Assistive devices are not only used for walking. Somespecific activities such as driving require them as

well. If your amputation involves the right side there

are devices available that switch the pedals of your

car to allow driving with the left foot. In the back of

this booklet there are several organizations that

offer assistance in obtaining these devices.


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Amputee athletic

resources

Living with an amputation does not mean that you

cannot live the active lifestyle that you once had.

Below is a list of amputee athletic resources that you

may find helpful.

Activeamp.org

Activeamp.org is an online connection for amputeeswith active lifestyles. This resource has many links to

sports related amputee associations. Please visit

their website at http://www.activeamp.org/ for more

information.

Disabled Sports USA

Disabled Sports USA is a national nonprofit,

501(c)(3), organization established in 1967 bydisabled Vietnam veterans to serve the war injured.

DS/USA now offers nationwide sports rehabilitation

programs to anyone with a permanent disability.

Activities include winter skiing, water sports, summer

and winter competitions, fitness and special sports

events.3 For more information you can visit their

website at http://www.dsusa.org/

Extremity Games

The O&P Extremity Games is an extreme amateur

sporting competition for individuals living with limb

loss or limb difference. The O&P Extremity Games

allows participants to demonstrate skill, persistence

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and passion while competing for cash and other

prizes.8 For more information, contact Beth Geno at

586.354.2260 or visit their website athttp://www.extremitygames.com/

National Amputee Golf Association

The National Amputee Golf Association was

incorporated in 1954. At that time, NAGA was

comprised of a small group of amputee golfers who

played friendly games that quickly developed intoregional tournament play in various cities across the

United States. Today, NAGA has over 2500 members

worldwide.5 For more information, please visit their

website at http://www.nagagolf.org


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Amputee resources

The following is a list of online resources for new

amputees. These websites have valuable information

for every situation imaginable!

American Coalition of America

http://www.amputee-coalition.org/

Amputee Information Exchange

www.amp-info.org

Amputee Information Network

www.amp-info.net

Barr Foundation

http://www.oandp.com/resources/organizations/barr

Diabetes Resource Center

www.diabetesresource.comFord Mobility Program

www.fordmobilitymotoring.com

Life Center at the Rehab Institute of Chicago

http://lifecenter.rehabchicago.org

National Center on Physical Activity and Disability

www.ncpad.org

National Limb Loss Information Center

http://www.amputee-coalition.org/nllic

For additional amputee related websites, please visit

http://hometown.aol.com/alegnomore/amputee/alpha

beticalamputeelinks.htm

36

references

1. American Academy of Orthotists andProsthetists. For the New Amputee. (1991). pp 6-

7.

2. American Academy of Orthotists andProsthetists. Patient Care Booklet for Below

Knee Amputees. (1998). pp 8-9

3. Disabled Sports USA. Improving the Lives ofthose with Disabilities. (2005). Retrieved on

March 2, 2007 from http://www.dsusa.org/

4. Muilenberg AL, Wildon AB. A Manual for BelowKnee Amputees. (1996). Retrieved on March 17,

2007 from

http://www.oandp.com/resources/patientinfo/manuals/bkindex.htm

5. National Amputee Golf Association. What isNAGA?. (January 3, 2007). Retrieved on March

28, 2007 from http://www.nagagolf.org/

6. National Limb Loss Information Center.Amputation Statistics by Cause. (2005).

Retrieved on March 14, 2007 from

http://www.amputee-

coalition.org/fact_sheets/amp_stats_cause.html


21/21

37

7. National Limb Loss Information Center. FacingSurgery. (nd). Retrieved on March 28, 2007 from

http://www.abcamputee.com/facingsurgery.pdf

8. O&P Extremity Games. Never Say Never NeverSay Cant. (2006). Retrieved on March 17, 2007

from http://www.extremitygames.com/event/

9. University of Utah Health Sciences. PhysicalMedicine and Rehabilitation. (2001). Retrieved onMarch 14, 2007 from

http://healthcare.utah.edu/healthinfo/adult/Reh

ab/amput.htm

38

This Informational Pamphlet was made possible by

the contributions of the following:

Department of Education

Rehabilitation Services Administration

Award #H235J050020Demonstration Project on Prosthetics and Orthotics

St. Petersburg College

College of Orthotics and Prosthetics

University of South FloridaCollege of Medicine- School of Physical Therapy &

Rehabilitation Sciences

College of Engineering-Mechanical Engineering Department

Chris Lemonis, CPO(c)Amy Mountain, CPO(c)

M. Jason Highsmith, PT, DPT, CP, FAAOP

Samuel Phillips, PhD, CP, FAAOP

Scott Sanford, MEd, CO

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