Individuals with bilateral lower-limb (LL) amputations require more energy when using bilateral prostheses compared with those who have unilateral LL amputations. A short prosthesis is often used to determine whether someone will be functional using a more advanced prosthesis long term.
This case report describes physical therapy interventions for a 72-year-old male subject in subacute rehabilitation after a bilateral transfemoral amputation secondary to peripheral artery disease (PAD). At initial examination, the patient was dependent for all transfers and unable to sit unsupported.
The interventions were done in three phases. Phase 1 focused on trunk strengthening, postural control, sitting and standing balance, and standing tolerance using short prostheses on a tilt table. Phase 2 progressed to dynamic standing activities using a tilt table and LiteGait with the goal to increase standing tolerance. Phase 3 focused on transfers and gait with assistance from the LiteGait and a platform walker.
After 8 weeks of rehabilitation, the patient achieved all short-term goals (STGs) and made 75% progress toward meeting his long-term goals. His Functional Balance Grades Scale (FBGS) score increased from poor to fair, whereas his Functional Independence Measure (FIM) scores for transfers and ambulation increased from 3 to 4 and 0 to 1, respectively.
There is limited information in the literature on progressing exercise programs in individuals with bilateral transfemoral amputation. Physical therapists may wish to consider the interventions described in this case report when designing programs for individuals with bilateral transfemoral amputation.