Training methods for amputees of leg prostheses
For the amputee of the lower leg, the muscle strength of the flexor and extensor of the knee joint, especially the extensor (quadriceps femoris), should be strengthened to make the amputee stride forcefully after wearing the prosthesis leg. Because of the trend of abduction, the amputees should start to do soft passive motion (mainly extension and adduction) at the early stage. Six days after the operation, the patients began to extend the hip actively; two weeks after the operation, if the residual limb healed well, the patients began to take the initiative to receive the training. In addition, it is very important to strengthen the extensor muscle (brachial major muscle) of the hip joint, because it can control the stability of the knee joint.
When wearing a prosthetic leg to walk with the ground, the greater the force of hip joint extension, the more stable the knee joint of the prosthetic leg is, and it is not easy for the knee to suddenly bend (beat the soft leg) and fall. In addition, the lateral stability of hip abductor has a great impact on the training. When the hip joint is disconnected, because the hip joint and its surrounding muscles lose their function, the prosthesis is is mainly driven by the waist and pelvis after the installation of the prosthesis. Therefore, in order to strengthen the activity ability of the waist and pelvis and expand the activity range of the pelvis and lumbar spine, the exercise of the abdominal back muscle and the iliopsoas muscle should be carried out.
Some basic methods for limb amputees to carry out residual limb training are as follows:
(1) Trunk muscle training
Because of the significant decrease of trunk muscle strength after long-term bed rest and in the elderly patients, it is very important to enhance trunk muscle strength in order to obtain the walking endurance of the prosthesis and maintain a good gait. It should be based on the training of abdominal and back muscles, supplemented by the trunk's rotation, lateral movement and pelvis lifting. Generally speaking, after two weeks of training, its abdominal muscles can be up to 50 times of sit ups.
(2) Training of healthy side legs
This training is very important for improving walking and balance.
Healthy leg standing training: after lower limb amputation, the pelvis of the residual side mostly inclines downward, resulting in scoliosis, and the prosthesis side is always longer when the prosthesis is is initially installed. For this reason, it is necessary to do standing training in front of the mirror, mainly focusing on correcting the posture and aiming at keeping standing for 10 minutes without support.
Continuous one legged jump: for patients with one side of lower limb amputation, one legged jump is often encountered in daily life (such as going to the toilet at night). However, after long-term bed rest after amputation, many patients are difficult to perform one legged jump. Furthermore, it is very important to enhance the muscle strength of the healthy leg and obtain the balance and stability of the support of the healthy leg. In training, in order to avoid monotony and dullness, if volleyball, table tennis and other ball games are used, the effect will be better.
Knee flexion and extension in standing position: This is a very useful training for stability and posture change when walking up and down steps. The goal is to be able to flex and extend the knee joint at least 10-15 times in a row. It's hard to do without support at the beginning, but after about three weeks of training, - you can do it 30-70 times. You can also take the thigh half bow, each time for a few seconds, as an auxiliary training.