Category: New Amputees

What support is available to amputees?

Whether its practical advice for new amputees, finding an amputee support group to connect with, or navigating the funding system, access to quality services and support networks is paramount for amputees. You can find a list below of amputee associations and amputee support groups that provide relevant information for new amputees and ongoing support throughout your life as an amputee. Here you can find prosthetic advice, peer support, health resources, funding information, prosthetic service information and more!

Amputee Support Groups/Associations

• Amputees NSW – A non-for-profit amputee association, recognised by NSW Health, that provides a comprehensive range of support services for all people affected by amputation and limb differences. Amputees NSW provides support for individuals, families, schools, allied health professionals, government agencies, interstate support groups and the broader community.
• Limbs4Life – The peak body for amputees in Australia with the vision of providing information and support to amputees and their families, while promoting an inclusive community so that no person is going through limb loss alone.
• Limbs4Kids – A national program that supports parents of children born with limb deficiencies and children or adolescents who undergo an amputation early in life.
• National Disability Insurance Scheme (NDIS) – The NDIS is an independent Australian Government statutory body that funds costs associated with disability and providing the necessary ongoing support for Australians who acquire a permanent disability before the age of 65.
• EnableNSW – A state-wide service of HealthShareNSW that provides assistive technology and related services to people in NSW with specific, short term or ongoing health needs to assist them to live safely at home.

APC Prosthetics is a certified registered NDIS provider.

For more information regarding Prosthetics please head to our resources section found here.

Allied health multidisciplinary teams are important to ensure that you are provided with a holistic treatment plan. APC are proud to participate and present training days and seminars to educate our allied health peers.

Physiotherapy

If you are an amputee, you will have likely received physiotherapy during the rehabilitation stages as a part of your hospital stay. However, physiotherapy should not be seen as a service only accessed in the early years. It is important as an amputee or someone with limb difference to maintain good muscle strength, flexibility, and stability. This will ensure that your ability to use your prosthesis continues well into your later years. Working regularly with a physio throughout your life as a prosthetic user can act as a reminder to engage the muscles you may not be using as much as you should be, or to help you kick some bad gait habits you may have developed.

Physiotherapy is currently available onsite at APC ‘s Alexandria and Northmead offices to assist amputees in varying stages of their prosthetic usage:

• Gait re-education from initial fitting of the first prosthesis through to advanced functioning (e.g., return to recreational activities, running, gym programs).
• Upgrading/teaching the use of a new prosthetic prescription.
• A program for the use of micro-processor knee joints.

Physiotherapy at APC Prosthetics is provided by Cathy Howells, a registered physiotherapist with a special interest in amputee rehabilitation and over 30 years’ experience working exclusively with amputees. All our sites can help put you in touch with physiotherapists in your area who have experience working with prosthetic limb users.

Exercise Physiology

Exercise Physiologists (EPs) sometimes get mixed up with physiotherapists. Where physios often manipulate the tissue, using an active hands-on method with massage along with prescribing targeted movements to improve a problem area, EPs offer ‘hands-off’ programs. Exercise physiologists are great for amputees and prosthetic users for prevention, ongoing targeted training, or if you have a sport or recreational activity you would like to learn to get back to or start doing since being an amputee. EPs develop person-centred exercise interventions that can be targeted for pain management, disability, chronic conditions, and injury. Feedback from our clients who use the services of EPs report that they move and walk better than they ever have before. Some have said that through the exercise interventions prescribed by their EP, they need to use less energy to walk and that has meant that it is easier to use their prosthesis and access the community (AKA live their life!).

Occupational Therapy

Occupational Therapists (OTs) can help you learn how to use your prosthesis (especially Upper Limb) for specific tasks and training, along with recommending any modifications that need to be made to your home or car.

You may need a consultation with a trained OT in the process of getting your license for the first time after amputation.

OTs are essential in the process of applying for funding for upper extremity (UX) prosthetics. An OT will need to be present in your NDIS (National Disability Insurance Scheme) Assistive Technology (AT) Assessment alongside your prosthetist. They will aid in performing and interpreting clinical outcome measures (COMs) which are functional tests demonstrating levels of ability and need.

Medical Services

The team at APC Prosthetics work closely with your rehabilitation specialist to ensure you receive the best treatment outcomes based on your health, healing and any other medical conditions that may affect your prosthetic use. Due to the long history of APC attending many amputee clinics for over 20 years, we have solid communication and a multidisciplinary team approach that leads to the quality service you will receive. We regularly consult with your other specialists as needed, for example, dermatologists, who can assist you with any skin conditions or concerns. If you see a new specialist or receive a new medication, it is a good idea to inform your Prosthetist as treatments may affect the fit or outcome of your prosthesis.

Funding for Allied Health Support Services

How you access a physiotherapist and other allied health services depends on your funding.

• ENABLE:
  • A referral from your GP will be required, you can get 5 free PT visits per year if you are on a care plan. We can assist by writing a referral to back up your need for this support service.
• NDIS:
  • Talk to your planner at your next plan review to ensure there is sufficient funding available for the number of visits you require for the length of plan. Your prosthetic AT Assessment and request will advocate for any additional services deemed necessary for you to succeed with your prosthesis and goals.
• INSURANCE: This will be negotiated with your case manager.
• PRIVATE: There is always the option to go directly to a PT etc if covered by private health insurance or by paying directly. Your prosthetist can write a letter of referral/handover to communicate with your chosen provider in order to best help you succeed.

Mental Health Support Services

Losing a limb can be a very emotional experience for you and those in your support group including friends or family. It is important you and those around you speak about how you are feeling with the appropriate support groups and services. Speak to your GP about how you can access the right mental health support for you.

There are also support services available through state and national amputee support groups.

Other Support Services:

Your prosthetist can help put you in touch with peer support groups that are run both on a state and national level. You will also find brochures in every APC branch or you can read our resource on Amputee/Limb Difference support groups here.

Support Services:

• LIMBS4LIFE:
  • Limbs4Life is a charity that provides peer support options, amputee resources and wellbeing information. They also provide independent support to help you navigate disability and health-care system. They also offer social events and activities for amputees of all ages.
• AMPUTEES NSW:
  • Amputees NSW is a volunteer based community organisation that provides support to anyone affected by limb difference. They aim to improve access to quality programmes, and news of upcoming events.

New Amputees Treatment

The amputation of a limb is a life changing experience, and the requirements of each client are different and will change throughout their life. Whether you or a loved one has undergone a lower limb (leg) amputation or an upper limb (arm) amputation and are new amputees, we are here to support you and help you reach your goals.

APC Prosthetics has a strong support system to assist clients in challenging situations and you can be sure that you or your loved one is in good hands with APC. Our philosophy is to work with new amputees to comprehensively assess their needs, establish their requirements and then deliver the most appropriate solutions.

All of our clients’ needs are unique, so our experienced prosthetists work closely with multidisciplinary health professionals to establish a customised treatment solution. The team includes Medical Specialists, Physiotherapists, Occupational Therapists, and other health professionals. You can read more information about allied health support services here.

Prosthetic Treatment Pathway – What happens after a leg amputation?

If you have had a transtibial amputation (below knee) you will typically have been fit with some form of compressive & protective device, known as a removable rigid dressing (RRD) immediately after surgery. This hard, plaster cast acts as a crash helmet for your residual limb (or stump), helps with healing and controlling swelling. Depending on the hospital you are in, you may meet your prosthetist at this stage, but typically our first meeting with you comes in the lead up to making your first limb. In the weeks leading to casting, if you are either a below knee amputee or above knee amputee, we will fit you with a stump shrinker (a compressive stocking) to help you get some of the fluid and swelling dissipated. This aids in forming an appropriate shape of your residual limb ready for wearing a prosthetic socket.

Initial Prosthetic Treatment – Interim Prosthesis

The first phase of the prosthetic rehabilitation for new amputees is the provision of an interim prosthesis. This generally occurs approximately 6 weeks after leg amputation when the suture wounds have sufficiently healed. The aims of the interim prosthesis are to establish early mobility and commence gait re-education as early as possible. But how does it get paid for? Don’t worry, in Australia you don’t have to pay for your prosthetic management out of pocket.

FUNDING: All new amputees in NSW regardless of age, except for those covered by insurance claims, have their first prosthesis for rehabilitation funded through Enable (the state-based funder for interim prosthetic limbs and those over 65). After a comprehensive assessment with your prosthetist and the rehabilitation team, the rehabilitation specialist issues a prescription to ENABLE for the interim prosthesis. If your funding is through Insurance, then your prosthetist will send the funding request through to your case manager.

Once we have approval, the prosthetist will then take a plaster cast of the residual limb, which is called a plaster negative. The plaster negative is then used to make a replica of the residual limb, which is modified to achieve a comfortable socket. The socket is then moulded over the plaster model. You can read more about how the prosthesis is made here.

Various liner materials are used to act as a cushion between the socket and the residual limb, absorbing and dissipating shock, shear and torque forces that occur during walking and standing on the prosthesis.

Next, the prosthetic components such as the prosthetic foot or prosthetic knee are connected to the socket and the client then returns for their first prosthetic fitting. During this process one of our highly skilled prosthetists assesses the socket-fit and analyses gait to determine optimal alignment. The correct alignment of the prosthesis is essential to ensure maximum comfort and function.

You can expect regular modification to this first prosthesis, as the residual limb undergoes significant changes in shape and volume during the first months. It’s important to continue to work with your physio team for ongoing gait training, muscle strengthening and stretching for optimal outcomes. After approximately 3 to 4 months or when the limb has stabilised, the prosthetic interim socket will be replaced with the first definitive socket .

Ongoing Prosthetic Management – Definitive Prosthesis:

FUNDING : For your first definitive prosthesis, the prescription process is repeated (there are some different steps dependent on your funder). If you are deemed to have completed rehabilitation, are under 65, and not covered by insurance, you will need to apply to the NDIS to continue your prosthetic funding. This can be a lengthy process, requiring a lot of paperwork. Check out our resources on the NDIS and speak to your prosthetist as they will need to complete some of the application as your treatment provider. Your prosthetist will perform an Assistive Technology (AT) Assessment and send the request to fund your prosthetic prescription to the NDIS.

When funding is approved, the prosthetist will take a new cast of your residual limb and the manufacturing and optimising process begins again. This time there will first be a diagnostic or check socket. This prosthesis is trialled for several days-weeks. It’s important you trial the check socket in as many real-life scenarios as possible in order to give your prosthetist quality feedback on the suitability of the fit and function. After the successful completion of the trial period, the prosthesis is cosmetically finished, to deliver a pleasing aesthetic result. The materials used to manufacture the definitive socket include fibreglass, carbon fibre or specially designed plastics. Utilising the latest manufacturing technologies and high-tech materials ensures a durable and extremely light socket .

As the shape and volume of the residual limb will change over time, it is very important that the client sees their prosthetist on a regular basis (every 3 to 6 months), to ensure the socket is still fitting properly, and for the maintenance of the componentry. Sometimes it is necessary for the prosthetist to make adjustments to the prosthesis to compensate for any changes. However, if the changes are too significant, a new socket (socket replacement) might be required.

You will probably require more frequent socket replacements in the earlier years of your life as a prosthetic user and these will reduce in frequency over time. The other main reason for requiring a socket replacement, or replacement of prosthetic componentry is wear and tear. Over the years, the components may degrade or rust or get scratched up from you returning to your everyday life and meeting your goals!

If you are about to undergo amputation or have recently, and have any questions, feel free to reach out to us! We have all the information needed for new amputees.