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PATIENT INSTRUCTIONS IN FORWARD WALKING

Above-Knee Amputee

RlSING FROM A CHAIR

1.

Place normal foot in back


of the prosthetic foot.

2.

Bend body forward

3.

With hip and knee


extension, force the
body out of the chair
using the prosthesis
for balance.

4.

Rise to a standing
position by extending
the sound knee.

PATIENT INSTRUCTIONS IN FORWARD WALKING


Above-Knee Amputee

SITTING DOWN IN A CHAIR

1.

Approach chair as
offered.

2.

Transfer weight to
the nonnalleg.

3.

Pivot on the ball of


the normal foot, and
bring the prosthetic
foot around into
position for sitting.

4.

Break the prosthetic


knee slightly.

5.

Lower self into chair


with the normal leg,
maintaining trunk
flexion.

A.

WEIGHT SHIFfJNG

1.

Stand between the parallel bars.

2.

Shift weight laterally from the normal leg to the prosthesis.

3.

The shift in weight is accomplished by movement of the hips rather than the
shoulders, and the weight is thrown alternately over the lateral border of each shoe.

4.

The shoulders and the pelvis remain level.

A.

WEIGHT SlllFTING

5.
6.

Do n.Qtbend the nmmal knee.


Do nm allow balance to occur by trunk: movement which may cause lateral bending
of the trunk on the prosthetic side.

B.

C.

ALTERNATE KNEE BENDING


1.

Stand between the parallel bars.

2.

Alternately bend the nonnal and the prosthetic knees just enough to raise the heel
from the floor. This teaches the amputee how to break the prosthetic knee.

3.

Reciprocally flex and extend the knees, starting with the sound knee.

PRELIMINARY INS1RUCTION FOR FORWARD WALKING


Exercise#l
a.
b.
c.

d.
e.

Stand between parallel bars.


Stand with weight on the
prosthesis.
Keeping the prosthesis
"planted" on that spot,
rhythmically step forward and
back with the normal leg.
Put full weight on the nonnal
leg at the beginning and end of
each step.
The normal foot should pass
close to the prosthetic foot in
order to facilitate lxxiy weight
shift over the prosthesis.
CAUTION: Warn amputee about
knee instability when sound leg is
posterior to prosthetic leg.

'

C.

PRELIM1NARY INS1RUCTION FOR FORWARD WALKING (Con'd.)

Exercise#2
a.
b.
c.
d.
e.

Stand between parallel bars


Stand with weight on normal leg.
Break the prosthetic knee.
Keeping th~ normal leg "planted",
step forward and back with the
prosthetic leg.
Place full weight on the prosthetic
at the end of the forward and
backward step. Keep the knees
in full extension by pressing back
with the residual limb, particularly
when the prosthetic leg is forward.

Exercise #3
a.
b.
c.
d.
e.
f.

Stand between parallel bars.


Keeping the prosthetic foot in place,
step forward and back three times
with the normal leg.
On the third step, step forward with
the prosthesis.
Keeping the normal foot "planted",
step forward :and back three times
with the prosthesis.
On the third step, complete the step
by coming forward with the normal
foot.
Repeat the sequence.

FORWARD WALKING WITillN Tiffi PARALLEL BARS

D.

1.

Step off with the sound foot.

2.
3.

Shift the weight forward over the


sound leg.
Flex the residual limb allowing the
prosthetic knee to flex and the shin
to follow through into extension.

D.

FORWARD WALKING WI1HIN THE PARALLEL BARS (Coned)

4.

Place the prosthetic heel ahead of


the toe of the 1normal foot. Heel
contact is made at the time the
prosthetic kn~ goes into full
extension.

5.

On heel contact, press back with the


residual limb against the posterior
wall of the socket. This will
maintain the knee in full extension
and overcome instability.
Simultaneously shift weight to
the prosthesis.

E.

SIDE STEPPING ON NORMAL LIMB

\j.

1.

2.

Balance on prosthesis; socket


should be in adduction.
Swing the normal leg into
abduction

5.

3.

4.

Shift weight to the normal leg.


Adduct the prosthesis and place
the prosthetic foot next to the
normal foot

Repeat the sequence.

F.

SIDE STEPPING ON PROSTHESIS

1.
2.

3.

Balance on the normal limb.


Swing the prosthesis into
abduction.

4.

5.

Shift weight to the prosthesis,


making sure socket is in
adduction.
Adduct the normal leg and place
the foot next to the prosthetic foot.

Repeat the sequence.

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