Training methods of amputees with unilateral thigh prosthesis

(1) Wearing artificial limbs

① Let the amputee of one side thigh sit on the chair (or stand), and put talcum powder on the stump.

② Wrap the stump with a smooth cloth, bread the front part to the groin, wrap the back part to the ischian structure, and pay attention to the cloth without wrinkles.

③ Put the stump into the receiving cavity, pull the cloth out of the valve hole, and insert the stump firmly in the receiving cavity. At this time, the patient takes a standing position, the knee joint remains extended, the dummy foot is placed about 20cm in front of the healthy foot, the amputee side hand is used to press the upper part of the receiving cavity to avoid knee flexion, and the healthy side hand is used to pull out the guide cloth. When pulling out the cloth, pay attention to the feeling of the skin of the disabled limb, understand which part is not pulled enough, so as to avoid the twisted part of the disabled limb; if the cloth is pulled out while bending the healthy side leg, let the disabled limb If there is slight piston movement between it and the receiving cavity, it is easier to completely introduce the residual limb into the receiving cavity. At the same time, we should pay attention to the position of the stump in the receiving cavity, and the angle of the adductor longus tendon in the front of the stump should be located in the front of the receiving cavity.

④ After drawing the cloth, properly adjust the tension of the skin of the stump around the upper edge of the receiving cavity, and then install the valve.

(2) Balance training of standing position for unilateral thigh amputee

After the amputee first installed the prosthesis, he immediately wanted to walk. In fact, the most effective shortcut is to step by step through functional training, obtain walking stability, and cultivate self-confidence. The importance of this basic training is to cultivate the habit feeling of the stump to the prosthesis, to obtain the balance feeling when the weight is moved to the prosthesis, and to correctly grasp the state of each stage in the walking cycle, so as to form a good gait habit from the beginning of walking practice.

The balance training of standing position should be carried out in parallel bars or by using horizontal wood walls or general walls.

① Stand 80cm in front of the horizontal timber wall (wall), with the upper body inclined to the horizontal timber wall. At this time, we must rely on the hip extensor to prevent knee bending.

•  Back to the wall, stand 50cm away from the wall, lean back against the wall.

③ Alternating walking training: after finishing the above ① and ② training, we will do walking training in parallel bars. Pay attention to the stride length of healthy limbs not to be small, the waist should be straight, and the residual limbs should be placed in front. Moreover, in the supporting phase of the prosthesis, the pelvis should move horizontally above the prosthesis; if the pelvis can be kept horizontal, the upper body will not incline to the prosthesis side. Therefore, the walking width should be minimized.

During the practice of changing direction, the patient can be instructed to rotate the prosthesis toes with the weight behind them at 180 degrees. In addition, you can rotate your heels as an axis.

(5) Walking training outside parallel bars: in this period, the main purpose is to further improve the walking ability and experience the control skills needed for a smoother gait. When one leg amputation, walking with crutches and other supports is the main cause of poor gait. Therefore, except for the elderly, the rest must be trained without any support. The training methods include turning with toes, restoring various kinds of balance training, pelvic lifting, knee flexion and extension, etc.

③ Standing in the parallel bar, do the training of pitching and catching without support. When the trainer (PT) throws the ball, the aim should be to make the patient's upper body lean forward, backward, left and right.

④ Hit the ball on the floor and turn.

(3) Balance training in parallel bars: standing position training as shown in the figure. Carry out the following training successively: ① transfer the body weight to the prosthesis side; ② alternately bend the knee; ③ step on the foot before and after; ④ move laterally.

During training, pay attention not to bow your head, look straight ahead with your eyes, shoulders flat and waist straight. At first, hold the bar with both hands, and then gradually relax the hands holding the bar.

(4) Walking training in parallel bars: keep about 10cm between feet.

① The main point of this training is to experience the feeling of flexing the residual limb to make the leg of the prosthesis swing out and extend the knee joint.

——Take a step back to make the prosthesis bear weight;

——When the toes of the prosthesis touch the ground, the weight of the prosthesis is moved to the side of the healthy limb;

——Step out the prosthesis forward and make its heel fall in front of the toes of the healthy limb;

——In order to keep the knee joint in the extension position, the arm muscles should be used to prevent the knee from bending suddenly.

② Step training of healthy limb: the key point of this training is to extend the hip joint of the disabled limb by stepping out of the healthy limb and master the feeling when the prosthesis kicks back.

——Step back the healthy limb to make it fully load-bearing;

——Move the weight to the prosthesis side, straighten up and step out of the healthy limb, and try to make the step distance larger;

——Lift the heel of the prosthesis to make the toe bear weight and bend the knee joint.

③ Alternating walking training: after finishing the above ① and ② training, we will do walking training in parallel bars. Pay attention to the stride length of healthy limbs not to be small, the waist should be straight, and the residual limbs should be placed in front. Moreover, in the supporting phase of the prosthesis, the pelvis should move horizontally above the prosthesis; if the pelvis can be kept horizontal, the upper body will not incline to the prosthesis side. Therefore, the walking width should be minimized.

During the practice of changing direction, the patient can be instructed to rotate the prosthesis toes with the weight behind them at 180 degrees. In addition, you can rotate your heels as an axis.

(5) Walking training outside parallel bars: in this period, the main purpose is to further improve the walking ability and experience the control skills needed for a smoother gait. When one leg amputation, walking with crutches and other supports is the main cause of poor gait. Therefore, except for the elderly, the rest