Understanding Prosthesis

When an amputee is looking to get a device that will help improve the functioning of his/her limbs, the process can become exhausting when

trying to understand what is the best option when choosing the right type of prosthetic legs. But first, what is a prosthesis? A prosthesis or

prosthetic implant is an externally applied device and product used to replace wholly or partly an absent or deficient limb

segment that assists people with physical impairments to improve their functioning and increase their potential to live quality lives.

Well, if you have gone through amputation, you understand how much this device improves the mobility functioning of the user by

protecting joints, restoring cosmesis, alleviating pain, correcting deformities, and prevents secondary impairments. In fact, most prostheses

are required for long-term use and very few are used for limited periods.

Prosthetics as commonly known, is the science and art of treating people by

the use of prostheses. It’s a specialty within the medical and health care field

concerned with the research and development, design, manufacture and its

application.

When you are going through amputation, which might have been caused by

an accident or otherwise, you need to look for a good prosthetist or orthotist.

Now, a prosthetist is a person who has completed an approved course of

education and training and is authorized by an appropriate national authority

to design, measure and fit prostheses.

They’re a good investment. Find one from a nice facility who is experienced and then develop a relationship of trust with him/her.

It’s important to feel comfortable with them since you’ll be stuck with them for a lifetime.

So remember that before you wear a prosthesis, the affected leg must be given time to heal. Most patients begin rehab with a test prosthesis

within the first three months to help with physical therapy and gait training. It can be customized for adjustments as the patient progresses.

Types of Prosthetic Legs

Exoskeletal Prosthesis:

A wood or urethane foam prosthesis with a hard plastic shell. This prosthesis is heavier and less customizable than an endoskeletal

prosthetic. But it is more durable and long-lasting.

Endoskeletal Prosthesis:

A prosthesis with an inner support pylon made of light-weight materials such as aluminum or titanium. The feet and knees can be swapped

out. This makes the endoskeletal prosthesis easily adjustable for different activities and active lifestyles.

So do you think you need to get a prosthetic leg?

If you think you do, then here are a few things you should know;

The prosthetic leg is made of lightweight, durable materials. Choosing a prosthetic leg is determined by a number of factors. You need to

decide what meets your desired preference based on your budget, environment, daily routines, appearance, among others.

In Kenya, there are few suppliers of prosthetic legs, some of which include GM Medical Kenya.

Parts of a prosthetic leg will be determined by these choices:

*The socket. This is a precise mold of your residual limb that fits snugly over the limb. It helps attach the prosthetic leg to your body.

When choosing a limb, you need to decide on your balance. That is, you must have one that gives you a balance in your twist movement,

vertical movement but just ensure they are minimal every time for safety purposes.

*The suspension system. It’s the method in which the prosthesis stays attached, whether through sleeve suction, vacuum

suspension/suction or distal locking through pin or lanyard. It can have liners. The liner is a protective cover made of a flexible, cushioning

material. Worn over your residual limb, it reduces movement and chafing between the skin and the socket.  Having a silicone liner provides

high stability and good adhesion if your limb has a lot of soft-tissue.

An example is shuttle lock suspension which means there is a pin attached to the end of the liner which inserts into a locking mechanism in

the bottom of the socket. The lock connects your socket to your prosthesis.

*Knee. There is above-knee and below-knee amputation.

When choosing the prosthetic knee that fits, you need to consider a few things such as the manufacturer. Manufacturers produce different

materials like hard plastic or metal and so you need to know which one is comfortable for your usage. Safety is also important as you need to

choose a knee that provides a good balance and prevents injuries.

Lifestyle is another factor to consider. If you’re a sportsperson, the prosthetic knee should have the load-bearing capacity, if walking for long

distances or often, they need to have knees that sustain that. Another one is hobbies, for example, if you’re a swimmer or take part in water

sports, then a knee that’s splash-proof will be needed to prevent rusting or wearing off of the material used.

*Foot. The foot is the first point of impact on your leg. It provides stability. If you take part in activities involving the movement of the feet

often, ask yourself how much flexibility in terms of twists and turns that you need on the foot. Therefore, it should be strong, as it will be

taking on huge force and torque as you walk and run. A prosthetic foot must also be small enough to fit within a foot shell, a cosmetic

covering for the prosthetic foot, and thus fit within a shoe. The challenge is the foot being light, strong, and small, and yet functional and

durable.

Selecting the right footwear.

Selecting the right footwear is dependent on the dimensions of the prosthetic feet, the grip on the shoes so that they don’t get off and other

needs that fit your lifestyle. Here are some factors to consider:

Multi-axial motion. Some are designed to mimic the ankle, which allows the foot to move in multiple planes.

Materials. The materials in a prosthetic foot differ by activity level. Wood, plastic and foam are usually found in feet designed for

individuals who have low activity levels and require stability.

Energy storage. A foot made with carbon fiber for energy storage gives you a spring in your step. The carbon fiber compresses as

you apply weight and propels you forward as your foot rolls, returning energy to your step as the spring releases.

Function. Prosthetic feet are designed to mimic a human foot at a specific activity level. For people who cannot walk, the function

is largely cosmetic.

Comfort. It has to feel good for you to meet your activity goals. Comfort allows you to be more active.

*Appearance of the prosthetic leg. The image is important as well. It

should also look good so that you walk in confidence and feel good about

yourself always because you chose a design that is appealing to you. They come

in different designs so you can find out whether a cosmetic cover can be

applied to the model you’re considering.

*Budget. Financial considerations are important when choosing prosthetic

shoes. Depending on how active a person is, the quality of footwear will vary

especially with those in sporty activities, they’ll need high-quality shoes that fit

the prosthetic feet and are durable despite the activities.

Also, the lifespan of a prosthetic component can be three to five years or even

fifteen years so proper budgeting is needed to achieve requirements at the same time save money. Whenever you need a new prosthetic leg,

start preparing to get insurance coverage for the consistent doctor visitations you will have.

Now that you have an idea on how to go about choosing the right prosthetic foot, you can start researching what fits your desired goal. There

should be a proper fit and alignment that suit the needs of the individual. It’s important to consult first, then choose the one that matches

your lifestyle.

A few more points to keep in mind:

As soon as you start learning how to use the prosthetic legs, you may undergo common issues like:

*Changing residual limb shape. This usually occurs in the first year after an amputation as the tissue settles into its more

permanent shape and may affect the fit of the socket.

*Phantom limb pain. Pain on the amputated leg could be intense enough to impact your ability to use the prosthesis.

*Excessive sweating. It can affect the fit of the prosthesis and lead to skin issues.

*Weakness in the residual limb. May make it difficult to use the prosthesis for long periods of time.

Ensure you keep in check with your physiotherapy/physical therapy. These are services to individuals to develop, maintain and restore

maximum movement and functional ability throughout the lifespan.

Remember…

When persons with any disability enjoy the benefits of people-centered care which include proper health care services and social support,

they are able to experience personal growth, well-being, participation in social activities, personal care as well as improve their quality of life.

Don't tell me you can't - Juan José Méndez Fernández

References:

https://www.who.int/disabilities/world_report/2011/chapter1.pdf

https://www.ottobock.com.au/prosthetics/lower-limb/lower-limb-overview/

https://www.amputee-coalition.org/prosthetics-types-guide/

https://en.wikipedia.org/wiki/Prosthesis

Reach out to us and share your testimonials and experiences of prosthetic legs as well.