Core Stability

The total weight of prosthetic componentry should fall within an individual’s body weight limits; in general, no more than 100 kg.^1,2 Weaker leg and core muscles, reduced aerobic capacity and insufficient suspension can make a prosthesis feel heavier. Learning how to monitor & adjust your fit within the prosthetic socket and regularly performing stabilization exercises can help promote an energy efficient gait pattern. The easier it is to walk, the more likely it is you’ll do more, leading to improved endurance and confidence to try new activities. 

Muscles of the hip girdle are key players of prosthetic gait. These muscles help to provide socket stability during stance, assisting with maintaining an upright position and counteracting the body’s natural forward falling during walking.³ Pelvic stability and rotation are necessary to advancing a prosthesis. For individuals with a prosthetic knee unit, these motions help unlock the knee to take a step and minimize compensations like hiking of the hip or circumduction.

Bridging Exercise

One effective technique you should try is Bridging Exercise, a tried and true stabilization technique designed to help you maintain proper positioning of your pelvis and strengthen your hip extensors. As noted, both are essentials to prosthetic gait. You don’t need any fancy equipment as you’ll be lifting your own body weight. This can be modified depending upon your level of amputation and can be performed with or without your prosthesis. If you perform without, place something sturdy under your residual limb (e.g., foam roller).  If possible, place a folded pillow between your thighs to activate supporting musculature. Set-up technique is just like with pelvic tilts (in fact, they are a huge component to bridging).

Lay on your back with your hips bent and lower extremities supported as suggested. Start with a pelvic tilt by contracting your abdominal muscles and flattening your low back. Next, push through your residual limbs and slowly raise your pelvis up doing your best to keep both sides level. Once you reach your highest potential, hold for 5 seconds by squeezing your buttocks muscles and breathing easily. Slowly lower and repeat for 2 sets of 10-15 repetitions.

Too hard? Take breaks by decreasing the number of repetitions and increasing the number of sets (e.g., 4 sets of 5 repetitions). Too easy? Try laying on the floor and putting your prosthesis/leg on the edge of a couch or exercise ball to make lifting your pelvis more challenging. For everyone, remember to breathe, go slow and focus on keeping your pelvis level.

Until next time….

References

1. Kulkarni, Jai, et al. “Bariatric Amputee.” Prosthetics & Orthotics International, vol. 39, no. 3, 2015, pp. 226–231., https://doi.org/10.1177/0309364614525186.
2. Potok, Bryan. “No Link Found Between BMI and Skin Problems in Persons With Lower-Limb Loss—New Study.” Amputee Store, Amputee Store, 20 Oct. 2021, https://amputeestore.com/blogs/amputee-life/no-link-found-between-bmi-skin-problems-in-lower-limb-amputees.
3. Wilhoite, Sydni, , et al. “Rehabilitation, Guidelines, and Exercise Prescription for Lower Limb Amputees”. Strength and Conditioning Journal, vol. 42, no. 2, April 2020, pp. 95-102. doi: 10.1519/SSC.0000000000000523