Amputations

Why Physical Activity is Important to People with an Amputation

While amputation can be a complicated medical process impacting millions of people worldwide, this does not prevent many people from pursuing a healthy and active lifestyle. Research shows that exercise not only improves overall health and reduces the impact of secondary conditions such as cardiovascular disease, high blood pressure and obesity among individuals with an amputation, but it enhances their quality of life through heightening their ability to perform everyday activities.

The benefits that an individual who has undergone an amputation can gain from physical activity will largely depend on their starting point, and the degree of effort which they are willing to put into an exercise program. The choice of physical activity should be matched with the individual’s interests, needs and abilities. The individual will move and participate in their own way. The types of equipment which may assist a person with an amputation to participate in physical activity may include a manual, sport or power wheelchair, a cane, crutches, walker, brace, orthotics, or prosthetics.

Each and every individual should have the opportunity to get actively involved in community programs, fitness and health initiatives. The role of physical activity providers in creating a welcoming and safe environment to accommodate a person with an amputation cannot be understated.

Physical Activity Tips and Modifications for People with an Amputation

When working with an individual who has an amputation, consider the following:

Create a welcoming environment – customer service focus;
Reminder: privacy/disclosure policies ensure individuals share information at their discretion and comfort;
Think safety first;
Encourage the individual to consult with a medical professional prior to starting a physical activity program;
An individual’s limited mobility could have been the result of an accident, injury or progressive condition – be patient and supportive;
Consult with resource agencies with expertise in areas of inclusive physical activity – training or professional development materials may be beneficial;
Ensure staff and volunteers receive adequate training to be able to deliver quality customer service, gain equipment knowledge/use and learn about available resources – on/off-site;
Avoid slippery surfaces and raised obstructions;
Create space for easy movement and participation;
Provide a facility without barriers to participation, thus creating access to the venue, equipment or activity (this could include: accessible parking spaces, ramp access or flat access to the front door, remove obstacles in hallways – signage, garbage/recycling bins, automatic or wide frame doorways to enter/exit).

Teaching and Communication Techniques

Ask the individual what their needs and interests are – do not assume that the individual needs or would like help;
Focus on what the individual can do rather than what they cannot;
Offer assistance and support as required or when asked;
Reminder – do not touch an individual or their assistive device or service animal without their consent;
When leading activities outdoors, ensure participants wear sun screen protective clothing, sunglasses and a hat because certain medications may make a person more susceptible to sun burn;
Allocate additional staff or volunteers to the area where the participant will be taking part in an activity, where possible;
As with every individual, other considerations should be discussed (i.e. pain, fatigue and the individual’s expectations).

Physical Activity Tips and Modifications

Match the individual with activities which meet their interests, needs and abilities. Some individuals may be able to train or race competitively on the track while for others, a slow walk may be enough;
Develop activities at the level of the individual, focusing on aerobic training of 4 to 7 times a week for 30 to 60 minutes, general weight training of 2-3 days per week focusing on repetitions of 8 lifts, and flexibility performed at the end of each workout to help maintain range of motion;
Make it interesting – exercise and everyday activities, such as gardening or walking a dog, can easily go together;
Make it fun – having fun and socializing are important benefits to physical activity experienced by people who are active;
If available, provide adapted equipment.

More Information About Amputation

What is an Amputation?

Amputations can occur through a congenital condition, or they may take place through a traumatic injury to an individual’s limbs (hand(s), arm(s), foot/feet or leg(s)). An amputation may be minor, involving fingers or toes or a small part of a hand or foot. A major amputation can involve the removal of all or part of the hand or foot, a leg, or an arm.

Amputations are often carried out through a surgical procedure, by which all or part of a limb or extremity is removed. Today these procedures are highly specialized and as technology progresses, prosthetics continue to advance.

Impact of an Amputation

For each person, the impact of amputation will vary depending on whether the amputation was congenital vs. acquired, the type, and the circumstances through which it was sustained. Physical activity can go a long way towards enhancing the health and outlook of a person who has undergone an amputation. These individuals have more to lose from being sedentary.

Some of the common factors associated with an amputation, which exercise can help to alleviate include:

A negative emotional response due to losing a body part;
Risk of weight gain or poor health which could make the individual more susceptible to contracting secondary health conditions;
Re-establishment of body awareness and adapting to the loss of function following an amputation;
Dealing with chronic pain, such as the sensation of pain which some individuals experience even after an amputation – this is referred to as Phantom Pain;
Altered sense of body image;
Risk of depression or other psychological problems. Around 30% of people with limb loss experience depression and/or anxiety.

Useful Information about Amputation

An estimated 227,000 Canadians have an amputation of a limb or extremity;
An amputation may be congenital. Other causes may include trauma, illness such as diabetes, or infection;
Injuries which prevent an individual from using a part of their body are the leading cause of amputation;
Individuals with an amputation may undergo rehabilitation and may use prosthetic devices.

Resources

Amputee Coalition of Canada: Freedom through Sports - www.amputeecoalitioncanada.org/support-programs/freedom-through-sports/
Variety Village – www.varietyvillage.ca
Living with Amputation - www.waramps.ca/ways-we-help/living-with-amputation/
Exercise Tips for Trainers working with Amputees - www.nchpad.org/827/4217/Ex~Rx~Tips~for~Trainers~Working~with~Amputees
Active Amputees: The Road to Independence - www.muhcpatienteducation.ca/DATA/GUIDE/352_en~v~active-living-after-amputation.pdf
NHS Choices: Information about Amputation - www.nhs.uk/conditions/amputation/

Helping Canadians with Disability/Chronic Disease Get Physically Active

For Canadians with a disability, regular physical activity may be even more important than it is for the rest of the population. For a person with a disability, an active lifestyle can open doors to increased health, social inclusion and self-empowerment - doors which might otherwise remain closed. Access to physical activity can eliminate the likelihood of acquiring secondary health conditions like diabetes, high blood pressure or heart disease. Being active builds resiliency and can provide an all-important outlet for a person with a disability.

This project would not have been possible without the expertise of our partners. ALACD would like to sincerely thank these organizations for working with us to develop this resource: the Ontario Blind Sports Association, Variety Village, the National Network for Mental Health, and the Learning Disabilities Association of Canada.