The Prosthetic Physiotherapy Team
The Prosthetic Physiotherapy Team work together to provide specialist physiotherapy treatment, rehabilitation, support and advice for patients who have had an amputation.
Our services
We are based at the Specialist Rehabilitation and Mobility Centre at the Cumberland Infirmary, Carlisle. We provide specialist outpatient physiotherapy services for amputees in North Cumbria as well as early rehabilitation while you are an inpatient following your amputation in the Cumberland Infirmary.
Amputees living outside of Carlisle may receive their regular weekly outpatient rehabilitation from other local hospitals. Most commonly these are West Cumberland, Penrith, Workington, Brampton and Maryport Hospitals, while continuing to be reviewed by the specialist staff at Carlisle. This is to ensure that you receive the most appropriate care at the hospital closest to your home while also continuing to receive specialist input from the SRMC.
Physiotherapy BEFORE an Artificial Limb
We provide assessment and rehabilitation services for patients who want to be assessed for an artificial limb. This involves:
- Strengthening exercises and stretches
- Transfer practise
- Balance work
- Pain control using stump massage, Graded Motor Imagery, Mirror therapy and other therapies.
- Walking practice with an early walking aid.
An artificial limb is not appropriate for everyone. We use early walking aids to assess if a patient is safe to use an artificial limb:
Patients who have had an amputation below the knee will use a PPAM Aid (Pneumatic Post Amputation Mobility Aid)
Patients who have had an amputation above the knee will use either a PPAM aid or a Femurette.
Once you are fit enough you will be invited to attend the physio gym in the DSC regularly while you remain an inpatient at the Cumberland Infirmary.
Above and Below Knee Amputation
A stump compression sock (a firm elastic garment) will be fitted by your ward physiotherapist after 5 days if the swelling needs reduced further. In physiotherapy sessions you will learn how to massage and moisturise your stump and the scar.
How do I move around?
Falling is a risk after an amputation. To minimise this and protect the remaining foot we advise that you use a wheelchair to become as independent as possible.
What if I can’t use a prosthesis?
Some people who have an amputation may not be suitable for a prosthesis. There is a dramatic increase in the energy required to use a prosthesis especially when the amputation has had to be above the knee. Pre-existing medical conditions may also limit your return to walking.
This will be discussed with you and if possible a trial with an early walking aid will be undertaken at your local hospital and then reassessed at the DSC. If you are not suitable for a prosthesis at this time, you can still learn to be very independent.
Physiotherapy – with your first artificial limb
Patients who are fitted with an artificial limb will need to attend regular outpatient physiotherapy to learn how to walk with their prosthesis. This rehabilitation process takes commitment, time, energy and motivation.
All patients will start to practice their walking in the parallel bars under the supervision of trained staff.
When patients can walk safely using the bars, they then learn to use a walking aid – usually a frame, crutches or sticks. All patients will need a walking aid to begin with.
- An essential area of rehabilitation is also how to get up from the floor.
- Ongoing advice and treatment for phantom pain (see separate leaflet)
We will help you to learn how to put your limb on and off safely. Starting to practise wearing it at home for short periods of time initially. We will help you learn when/if you need to wear socks to ensure a good fit as your stump changes shape over the first year to 18 months.
Once a good walking pattern is achieved and patients are safe using a walking aid, the artificial limb can be used at home. The length of time this process takes can vary - on average from three to six months. This depends on each individual and their type of amputation. An above knee prosthesis generally involves a much longer rehabilitation process.
Physiotherapy for established limb-wearers
Once patients are used to walking with their artificial limb, they could need further physiotherapy. This may be for:
- Progressing from using a walking aid
- Balance/mobility issues
- Improving function and independence
- Falls
- After changing the type of artificial limb they are provided with.
- For assessment with a different type of artificial limb
- Pain
Our aim is to provide specialist, high quality and professional physiotherapy services for patients who have had an amputation. We work closely with a range of healthcare professionals to promote health education and independence, and to help people maximise their short and long-term potential.
If you have any questions please contact us:
Specialist Rehabilitation and Mobility Centre
Cumberland Infirmary
Carlisle
Tel: 01228 814783
Mon to Fri 08.30 – 16:40
Confidentiality
‘The Trust’s vision is to keep your information safe in our hands.’ We promise to use your information fairly and legally, and in-line with local and national policies. You have a right to understand how your information is used and you can request a copy of the information we hold about you at any time.
For further information on confidentiality contact the Information Governance Team:
Information.Governance@ncic.nhs.uk | 01228 603961
Feedback
We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:
pals@ncic.nhs.uk | 01228 814008 or 01946 523818
If you would like to raise a complaint regarding your care, please contact the Complaints Department:
complaints@ncic.nhs.uk | 01228 936302