The primary goal of physiotherapy after amputation is to maximize the patient's functional capabilities at home and within the community. This involves a tailored program designed to address physical, emotional, and social aspects of recovery . Stages of Physiotherapy After Amputation Physiotherapy for amputees is typically divided into several key stages, 1. Pre-Operative Phase • Assess the patient's overall health, medical history, and functional needs • Educate the patient on post-operative care, including wound care, pain control, and early exercises . • Prescribe exercises to improve strength and flexibility of the hip and knee, especially for lower limb amputations . • Teach the patient how to use assistive devices like walkers or crutches, preparing them for immediate post-operative mobility. • Address psychological and emotional needs, helping patients prepare mentally for the surgery and its aftermath . 2. Post-Operative Phase (Immediate Healing) This stage focuses on initial healing, pain management, and preventing complications, early mobility, prevention of contractures, edema reductions, phantom limb pain and sensation management. 3. Pre-Prosthetic Phase Once the surgical wound has healed and swelling has significantly reduced, this phase prepares the residual limb for prosthetic use . Physiotherapy focuses on: • Strengthening exercises: Targeted exercises build muscle strength around the residual limb, which is essential for prosthetic control . Core muscle strengthening is also emphasized for overall stability • Desensitization exercises: These help the residual limb become more tolerant to touch and pressure, improving comfort with a prosthesis . • Weight-bearing training: Gradually increasing weight-bearing on the residual limb prepares it for the demands of prosthetic use . • Skin care and hygiene education: Patients learn how to care for their residual limb to prevent skin breakdown and infection, which is critical for comfortable prosthetic wear . • Prosthetic prescription: The physical therapist collaborates with a prosthetist to determine the most appropriate type of prosthesis based on the patient's needs, lifestyle, and goals. 4. Prosthetic Training Phase This is a significant phase where the patient learns to use their new prosthetic limb effectively . Physiotherapy includes: • Prosthetic fitting and adjustment • Gait training • Functional training: Developing skills for daily tasks such as dressing, bathing, and meal preparation while using the prosthesis. • Prosthetic component training • Increasing wear time. • Advanced gait training: 5. Return to Function and Community Reintegration This final phase aims to help the individual fully reintegrate into their life and community . Physiotherapy supports this by: • Vocational rehabilitation: Assisting with job training, employment placement, and workplace accommodations if the patient wishes to return to work • Social activities and hobbies: Encouraging participation in recreational activities and hobbies to build confidence and improve quality of life . • Adaptive equipment training: Teaching the use of specialized tools or home modifications to enhance independence • Ongoing support and education: Providing resources for support groups and continued advocacy . Challenges and Technology in Physiotherapy Physiotherapy addresses common challenges faced by amputees, including physical pain (post-operative, phantom, and residual limb pain), emotional distress, body image concerns, and initial functional limitations. The specific challenges can vary depending on the level of amputation; for instance, upper limb amputees may struggle with fine motor skills, while lower limb amputees focus on balance and coordination .