When it comes to adjusting to living with an amputation there are many decisions to make based on the unique skills of each person. These unique physical, psychological and environmental skills will help to inform the different choices each person will make to live a comfortable and meaningful life. One of these factors is whether they will wear a prosthesis. Not all amputees will wear a prosthesis. In a 2011 national survey of Australian amputees, Limbs 4 Life found that 7 percent of amputees don’t wear a prosthesis, and in another Australian hospital study this number was closer to 20 percent
People living with lower limb loss use a wide variety of mobility devices to get around at home and in the community. These can include (but are not limited to) skateboards, crutches, wheelchairs, motorised scooters, saddle-chairs with wheels, handcycles – pretty much anything that suits their needs and their level of activity. The most common though, are wheelchairs and crutches.
Wheelchairs are constructed from a variety of materials, and with the help of occupational therapists and manufacturers can be measured and customised for your specific needs. You will require a certain style of wheelchair that can manoeuvre around your home and can get you out into the community. Some people have a chair for home, and a separate one to get them out and about. Your wheelchair may be a manual chair that can easily fit into a car, or it may be a motorised wheelchair that enables you to visit friends, go to the shops or travel on a train for example. Long-term wheelchair use reduces physical activity levels, but the benefits include providing basic mobility that supports independence.
Crutches are another way to support your mobility. They are easily accessible from a chemist or mobility supply shop and can be improved by a vast array of accessories that enhance their comfort. There are specially engineered and lightweight options from around the world that might be worth investing in, if you are a long-term user. When using crutches, the risks include falling on slippery surfaces and the possible development of joint problems. The benefits of crutches are that they increase a person’s physical activity which supports muscle and cardiovascular health, and they provide a freedom of access to many environments. Crutches require a level of strength, balance, and fitness to use, and while some people can use them daily, others prefer to use them only for specific activities or for added support. It is important to be aware of any muscular or joint pain and to seek support from a healthcare professional.
Looking after the health of your remaining foot/leg is important. If you use a wheelchair, it is helpful to be aware of the circulation through your leg and remaining foot. Check regularly for the shape and colour of your foot and notice if there is any pain. Your health care provider will be able to give you simple exercises and stretches to keep the circulation flowing to keep your remaining leg and foot healthy. If you are a below knee amputee your wheelchair should be fitted with a stump rest to avoid hanging your stump over the edge of the wheelchair. Stump rests also provide an amount of protection to your residual limb.
If you are using crutches, you will be placing extra weight on your remaining foot. To maintain the strength of your bones and muscles, a podiatrist can create supportive innersoles to evenly redistribute the weight as you walk, reducing any pain and ensuring the longevity of your foot. Footwear that provides protection and stability are vital with some amputees using their funding streams to enable them to use a specific non-slip or orthopaedic shoe. Persistence or luck might connect you with an amputee foot buddy to share unused shoes with!
Skirts and dresses are an obvious choice for some lower limb amputees, but for all of us who wear pants – what do we do with the leftover leg? Again, this is a personal choice with many choosing to knot, tuck or sew up the loose pant-leg of their trousers. Depending on the length of stump, others have their trousers or shorts professionally trimmed.
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