Prosthesis only the tip of the iceberg

For HEINRICH GRIMSEHL rehabilitation is much more than simply fitting a patient for a prosthesis. He shares his thoughts

What is a rehabilitation protocol and why is it so important? This is better explained by an example. Let’s say for example your leg was amputated below the knee, the wound healed nicely and you now consider acquiring yourself a prosthesis. The path that the prosthetist will follow to put you back on your feet is called his rehabilitation or treatment protocol.

To cone your stump for a week (with a stretch bandage), casting and manufacturing a finished final prosthesis, thereafter sending you on your merry way with a pair of crutches, is not what I would call a complete rehabilitation protocol.

Experienced prosthetists know that your stump will change rapidly for a few months and that an adjustable test socket phase of several months could be the difference between a successful fitting and a troublesome prosthesis.

Diagram by Össur

Furthermore, proper gait training and exercises with a physiotherapist to identify weaknesses and gait deviations are key to your future success. You might suffer mental challenges or excessive weight gain or loss. Your prosthetist should be able to identify these obstacles in your rehabilitation path and refer you to the appropriate discipline within his rehabilitation circle for further treatment.

To summarise, how do you know that you will receive appropriate treatment by a group of experienced professionals?

First, you should enquire from the prosthetist what his rehabilitation protocol entails. Find out what time frames are involved and what outcome measures does he expect from you during this process. Most important, ask who the other team players (other disciplines) are in his rehabilitation team, and how they are integrated.

This information should be available at the drop of a hat. The diagram above shows a possible rehabilitation circle or multidisciplinary team that should form the basis of your rehabilitation process.

A strong rehabilitation team could mean the difference between you rehabilitating to your full potential or stagnating and regressing instead.

ContributorHeinrich Grimsehl is a prosthetist in private practice and a member of the South African Orthotic and Prosthetic Association (SAOPA). email:


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