It is important to understand the role the rehab team plays in your recovery. The team consists of your surgeon or family physician, your physical therapists, your prosthetist, yourself and family. Not every amputee has this team of professionals assisting them, but we encourage you to try to establish one.
Your physician or surgeon will be instrumental in prescribing your prosthesis, providing all referrals and for Rehabilitation Therapies, and providing proper and necessary documentation for insurance purposes. In most cases your surgeon will continue follow-up care as you engage and complete initial Physical Therapy prosthetic gait training, the process of learning to use your prosthesis. Your physician will follow up with you routinely to make sure you are progressing according to your prosthetic rehabilitation treatment plan and at times will need to prescribe adjustments or supplies for your prosthesis.
A prosthetists is a person who measures, designs, fabricates, fits, or services a prosthesis as prescribed by a physician. Your prosthetist will help determine what type of prosthesis would be appropriate for you based on your activity level, health status, hobbies and occupation. We provide all services related to the prosthesis and supplies needed to make it fit well and function properly. It is relationship that can last many years, as a prosthesis is a tool that periodically needs to be adjusted and replaced.
Physical Therapists are instrumental in teaching a new amputee how to walk with their prosthesis. Prosthetic Gait Training is a type of physical therapy that helps people improve their ability to stand and walk with a prosthesis. Following receipt of your prosthesis, Physical Therapy can be provided by home health care professionals or at an out-patient rehabilitation facility. Prosthetic and rehabilitation patients usually receive physical therapy three times weekly in order to obtain independent while resuming normal daily activities. While working with both your prosthetist and Physical Therapist you will learn how to care for your prosthesis and what’s involved in maintaining it on a daily basis. ETPOC is a strong proponent of Physical Therapy and believe it to be one of the key factors affecting successful use of a prosthesis.
The more you know about the rehabilitation process and prosthetics, the more successful you will be with your new prosthesis.

One of the most difficult problems facing a new amputee is edema, or swelling of the residual limb. The care you give your residual limb initially will directly affect your success with your new prosthesis. Upon healing your prosthetist will take a measurement of your residual limb and fit you with a prosthetic shrinker. While a typical amputation heals within 6 weeks after surgery allowing the use of a shrinker, some patients with severe circulatory compromise or uncontrolled diabetes may experience a delay.

The shrinker is used to reduce edema (swelling) of the residual limb in preparation for casting, impressions, and measurements necessary to manufacture your prosthesis. Shrinker use prior to casting typically spans a three to four week period in which you will be fit with several smaller shrinkers as you experience reduced limb edema. Use of a prosthetic shrinker will continue after receipt of your prosthesis in order to maintain volume stability and allow a more accurate fit of your prosthesis.. This is especially important for dialysis patients and those experiencing fluctuations in residual limb volume. You will use your shrinker 24 hours a day, except when exercising, bathing, or while using your prosthesis.

Proper hygiene is essential. Wash your limb thoroughly with soap and water every day, unless your doctor has instructed you otherwise. Sometime, people have sensitive or painful spots on their residual limb or along the suture line. Deep tissue message following healing of your residual limb is often recommended in order to reduce sensitivity or "desensitize" problem areas. Improving tolerance to touch or slight pressure helps decrease limb sensitivity and sometimes reduces the feelings of itching, pain or "Phantom Limb Sensation or Pain" which refers to sensations radiating from the missing limb.

Physical therapy to regain strength and agility is an important step in your preparation to use your new prosthesis. You may have had some therapy while you were in the hospital, and chances are your doctor will want you to continue with it, both now and after you receive your new prosthesis. The strength you develop now will help you to walk as normally as possible in the future. Your doctor, prosthetist and physical therapist will work together, or independently, to evaluate when you are ready to be cast for your prosthesis.

ETPOC will work with you, your physician and/or physical therapist to design a prosthesis that is right for you. Prosthetic recommendations are based on the progress made in Physical Therapy and your K Level as determined by a your doctor, physical therapist, and prosthetist. The standardized AmPro (amputee mobility predictor) is a test administered by a physical therapist used to determine your K Level (current and potential activity level). The score obtained on the AmPro helps determine optimal component selection and design of your prosthesis. Our goal is to fabricate a custom prosthesis as close to your natural limb as possible in appearance and function. We use high strength, lightweight materials which will be designed to match your leg in size, shape, and even skin tone. Your prosthetic foot will be responsive enough to provide motion for a natural-looking gait.

An appointment for casting will be scheduled after it has been determined that the volume and size of your residual limb has stabilized. Our prosthetist and technicians will use a cast of your residual limb to make a temporary diagnostic test socket utilized to determine the fit and alignment of the prototype system.

Your prosthetist will spend a lot of time working with you during the test socket fitting to make sure your prosthesis is adjusted perfectly to your needs and comfort. The alignment fitting will take into account every aspect of your prosthesis’ fit and function. A lot of attention will be focused on the socket shape because it needs to spread out the pressures on your residual limb evenly and comfortably when you walk on it. The alignment is important to make sure your knee and hip are straight when you stand and walk, and the height of the prosthesis is not too tall or short. Following successful test socket fitting you will receive your initial prosthesis within a one week period. Following receipt of your initial prosthesis you will commence Physical Therapy prosthetic gait training while continuing rehabilitation.

When the prosthesis is finished, a final delivery appointment will be scheduled. It is common for this final fitting to occur in the office however, this can take place at rehabilitation facilities or the patient’s home. The prosthesis will be evaluated one final time for comfort and alignment.

It is important that you learn to walk properly with your new prosthesis from the day you receive it. Your physical therapist will work with you and make recommendations regarding any additional support you may need to walk your best – such as a walker, crutches, or a cane. With your therapist’s help, you will soon be accomplishing many of your daily activities. We will be counting on you to call us whenever you have any questions about the fit, alignment, or general performance of your prosthesis. We are members of your team, and want to help you do your best now and in the future.

Most new amputees experience atrophy and shrinking of the residual limb. This is perfectly natural, but it does affect the fit of your prosthesis. Adjustments to the fit of your prosthesis are made by using prosthetic socks of varying ply and thicknesses. Throughout rehabilitation and continued use of a prosthesis ETPOC will schedule you for regular follow-up visits in order to monitor the fit and function of your prosthesis. While wearing a prosthesis new amputees go through many changes in the size and shape of their residual limb during the two year period following surgery. It is very important that you attend scheduled appointments allowing our staff to assess these changes and inspect the use of prosthetic socks used to adjust the fit of your socket.

Our staff will always be upfront and honest with you regarding your insurance coverage and your financial responsibility. If you are uninsured, and in most cases want to return to work, ETPOC will assist you in seeking funding sources available for prosthetic services.