Keep on moving, the importance of exercise with amputation

Unilateral amputation causes a catastrophic disruption to the musculoskeletal system. Although prostheses are improving all the time, they still are an inadequate replacement for an anatomical limb. Nonetheless, exercise is important, to maintain as much function as possible and to continue to reap the cardio-repository response that follows from exercising.

Exercise should be carefully monitored. This can help to ensure the right amount of loading and stimulation to the remaining anatomy. Too much exercise which is asymmetrical can excessively load the sound structure, which may cause osteoarthritis, pain and injury. Too little loading can cause the structures to atrophy (diminish), which may lead to osteopenia, muscle loss and sedentary lifestyles.

Most people with an amputation can walk on any prosthesis or with crutches. Walking is a key exercise to load the musculoskeletal system, and can be achieved by most people with amputation. Monitoring the symmetry/limp of walking as load and speed increases can help to maintain it within a safe limit, which enables a biopositive response. MovementAlly's gait analysis system is a useful way to monitor this performance.

Running is likely to be better performed with a more dynamic prosthesis, such as an Energy Storing and Response (ESR)/Dynamic Elastic Response (DER) foot. This is because energy is stored in the foot in the early part of stance and it is returned to bounce the body along into swing. Finding the appropriate stiffness of prosthesis to tune-into the natural frequency of running can affect how well someone runs and how comfortable the prosthesis feels.

Balance training is also important for people with amputation, to help with stability and with recovering from a fall. Other general conditioning exercises including strength, flexibility, agility and power can be included to enable successful activity and to increase quality of lie. Research, led by Siobhán, has resulted in a validated and effective UREnabled exercise programme. This has resulted in increaseed physical activity levels, confidence and fitness for people with lower limb amputation. It is a multidimensional, staged intervention with proven results.

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