Amputee Rehabilitation

Amputee rehabilitation focuses on helping people adjust to life after losing a limb, whether through trauma, vascular disease, infection, cancer or complications of other conditions such as diabetes.

Rehabilitation aims to:

• Optimise recovery after surgery
• Support wound healing and pain management
• Build strength, balance and mobility
• Train safe use of prosthetic limbs where appropriate
• Promote independence in everyday activities
• Support emotional adjustment for patients and families

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Causes and types of amputation

Amputations may involve:

• Lower limb – toes, foot, below-knee, through-knee, above-knee, hip disarticulation
• Upper limb – fingers, hand, partial forearm, through-elbow, above-elbow, shoulder disarticulation

Common reasons include:

• Peripheral vascular disease and diabetes
• Severe trauma or crush injuries
• Infection or sepsis not responding to treatment
• Tumours involving bone or soft tissue
• Complications of previous surgery

Many patients also have other health needs, such as cardiac disease, stroke or brain injury, which make rehabilitation more complex.

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Common challenges after amputation

People recovering from amputation can experience a combination of:

• Post-operative pain and swelling
• Phantom limb pain or sensation
• Reduced balance and increased risk of falls
• Weakness and deconditioning
• Difficulty with walking, transfers and stairs
• Problems with everyday activities such as washing, dressing and using the toilet
• Skin and wound issues around the residual limb
• Emotional impact, including shock, low mood, anxiety and body image concerns

Early, coordinated rehabilitation can reduce complications and support a safer return home or to an appropriate care setting.

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Inpatient amputee rehabilitation at The Royal Buckinghamshire Hospital

Our multidisciplinary team provides tailored rehabilitation programmes for adults after amputation, including those with complex neurological or medical needs.

Multidisciplinary team (MDT)

Your rehabilitation may involve:

• Consultants in Rehabilitation Medicine
• Specialist rehabilitation doctors and nurses
• Physiotherapists
• Occupational therapists
• Prosthetists (via specialist limb centres)
• Speech and language therapists (if there are additional neurological needs)
• Neuropsychologists and clinical psychologists
• Dietitians and pharmacists
• Social workers and discharge planners

The team works with you and your family to set realistic goals and review progress regularly.

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Rehabilitation focus areas

Early post-operative management

• Positioning and limb support to protect the residual limb
• Wound care in collaboration with the surgical team
• Swelling management, compression and shaping of the residual limb
• Pain and phantom limb pain management
• Respiratory care and early mobilisation to reduce complications

Physiotherapy

Physiotherapy helps you rebuild strength, balance and mobility. This may include:

• Bed exercises and graded strengthening programmes
• Transfer training (bed, chair, toilet, car)
• Standing and balance work using parallel bars or standing frames
• Gait training with walking aids and, where appropriate, prosthetic limbs
• Fall-prevention strategies and safe mobility indoors and outdoors

Occupational therapy

Occupational therapists support independence in daily life:

• Assessment of personal care tasks (washing, dressing, toileting)
• Practising everyday activities using adaptive techniques and equipment
• Kitchen and domestic skills where appropriate
• Wheelchair and seating assessments, including pressure care
• Recommendations for home adaptations, such as grab rails, ramps or stairlifts
• Energy conservation and pacing advice

Prosthetic rehabilitation

For patients suitable for prosthetic fitting, we work closely with specialist limb centres to:

• Prepare the residual limb for prosthetic use (shape, skin care, strength)
• Support initial prosthetic assessment and fitting where this forms part of the pathway
• Provide gait training and functional practice with the prosthesis
• Educate on donning, doffing, care and safe use of the limb

Not all patients will use a prosthesis; for some, the focus is on optimal wheelchair mobility, transfers and safe use of equipment.

Psychological and emotional support

Adjusting to limb loss can be emotionally challenging. Our team can offer:

• Support with adjustment, grief and changes in body image
• Strategies for coping with pain, fatigue and anxiety
• Help with goal setting and planning for the future
• Support and education for family members and carers

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Complications we aim to prevent or manage

Without appropriate rehabilitation and monitoring, people after amputation may be at risk of:

• Falls and fractures
• Contractures and joint stiffness
• Poor wound healing or infection
• Skin breakdown and pressure ulcers
• Persistent or poorly controlled pain
• Deconditioning and reduced cardiovascular fitness
• Loss of independence in daily life

Through early intervention, structured therapy and careful nursing care, we work to reduce the likelihood of these complications.

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Who may benefit from admission?

Inpatient amputee rehabilitation at The Royal Buckinghamshire Hospital may be suitable for adults who:

• Have undergone recent limb amputation or revision surgery
• Have complex needs due to multiple injuries, neurological conditions or medical comorbidities
• Need intensive therapy to regain mobility and independence
• Require coordinated planning for prosthetic fitting and long-term equipment needs
• Have increased care needs following an acute hospital stay

We accept referrals from acute hospitals, surgeons, GPs, case managers, solicitors and insurers.

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Referrals and further information

Our goal is to support each person after limb loss to achieve the best possible function, independence and quality of life, while providing clear guidance and support for families and carers.