Standing Balance and Control for Amputees - Prosthetic Training: Episode 12

Instructional video for lower limb amputees on standing motor control, including: initial standing positional awareness, weight shifts, step-taps.

0:23 - Terminology, Preparation
3:46 - Finding Center (Centering the Center of Mass)
5:52 - Weight Shift Control
10:15 - Stance Control (Single Limb Support, Step Taps)
12:38 - Bilateral Amputee Considerations
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This is the twelfth episode of our Prosthetic Training video series which covers the spectrum of amputee rehabilitation from immediately post-amputation through running with a prosthesis. They are intended for clinicians and patients and are a great resource for rehabilitation professionals working with lower limb amputees.

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If you have questions relating to this topic or notice other questions similar to yours, check out our You Asked Series, where we answer patient questions in short digestible videos.

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Instructor: David Lawrence, MSPT, AT-Ret
David is an internationally renowned rehabilitation professional and educator. In addition to treating patients, he delivers courses in the USA and abroad on knee, hip and foot pathologies, rehabilitation following limb amputation, and disabled sports and recreation. He is founder of The Gait Center, a walking focused physical therapy clinic located in Richmond, VA, USA, as well as the founder and Chief Executive Officer for Mission Gait.

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Social Media:

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Video production by Will Riddick, PT, DPT for Mission Gait.

[stacieklueber]

This is an excellent video! I’m a DPT Pittsburgh PA. I have my first AKA with microprocessor knee. I’m so glad you covered these topics bc it will help him tremendously

[hsjasmap]

walking is a series of controlled falls - i like this expression

[leglessjoe]

I am a newly above knee amputee and these videos are great and this therapist is awesome.

[nastyVtwin]

Your videos are awesome! I'm a three year amputee and am a k-level 4 but I am still learning quite a bit of the finer points of using a prosthetic leg. From your gait videos, I have learned how to be more efficient in my walking and I am following your running video to get better at moving fast!

[adewunmifalilat]

Thanks for the tutorial it's very helpful, am an above the knee amputee and a beginner, i believe it will help me greatly

[brendagoosen]

I will receive my above knee prosthesis on the 17th of March and I am so glad for this information and exercises that you show here. I will follow your instructions everyday, because you give me hope to walk normal again. Thank you for these videos .

[SherryReed-tv]

Excellent. RAKA, wish I had your lessons 5 yrs ago when amputated. PT did not really help me progress. Have learned on my own and find I need to correct some movements. Thank you.

[heikeb.]

Thank you for sharing your knowledge with us, I have started to walk so much better since watching your instructions. I am a bilateral below knee amputee and a diabetic.

[davidcause]

FANTASTIC TIPS!!! Thank you for your great content.

[joshnelson]

I just want to make sure that I understand what you said: "if you feel like you are 50/50, then your weight is too heavy on the prosthetic side." Isn't it really that your weight is too heavy on the sound limb, as what feels like normal distribution to them is really more weight distribution on the limb they have relied on without the prosthetic?
Around 4:30 in the video.
Thanks!

[AtmaS]

Very good theory and information for amputees. I learned a lot of basics from the video. Thank you.

[jamesaritchie]

I'm sixty-nine, have problems with dizziness, and don't have great balance, but I walked the length of the building where I got my new leg without aid the first time I put it on. If someone like me can do this then why can't most people?

I did get my new leg just five weeks after the surgery, but I was in bed for a month before the surgery and two weeks after.

Honestly, I blame the walker for the long delay most people have, and so does my prosthetist. I never used a walker except to go to the restroom in the hospital. I got my new leg just one week after getting out of the hospital and since I never used a walker for any length of time at all, and never with my prosthetic leg, I never developed a new center, a new balance point. I am now just fifty-one days from amputation day, and I walk fiver hundred plus yards every day. The only reason I can't walk farther than this is because of exhaustion. not at all in good shape, and have poor circulation, neuropathy, and Venus insufficiency in my "good" let.

This much I know for certain. It is a terrible idea to hop when using a walking. This will throw off your center faster than anything else. Either pivot the foot to get where you want to go, or lift it as little as possible and slide it. But do NOT hop.

I started my prosthetic use by taking a can, but I almost never let the can touch the floor/sidewalk. It was for emergency use only. I think this should also apply when using a walking with a new prosthetic leg. Stand fully erect, do not lean on the walker for support, and if possible, just push the walker ahead with your fingertips. Being fully erect is vital, and not using the walker for balance is equally important, if you don't want months to go by before you can walk normally again.

The short of it is that if you want to learn how to walk normally on a new leg then you have to actually walk normally on that leg from the beginning. A good prosthetist should have your temporary prosthesis to you no more than two weeks after your stup is healed enough to take it. I was healed in four weeks, not bad for an old type 1 diabetic, and had my leg a week later.

You don't learn to walk by using a walker, and certainly not by using crutches. You learn to walk by walking, and you learn to find a center mass by never losing it in the first place.

[JamesTrout-fiub]

I am a amputee right lower leg that has had two different types of prosthetic leg one was a pun lick style it worked for some time but I switched to a suction socket I like it way vetter

[rashidamather]

Your videos are very interesting but we have additional challenges I have an 82yr vascular dementia patient with the left amputated below-the-knee, no prosthetic as this stage please can you tell me how do I help him to be able to stand with the aid of a walker just to be able to feel that the right leg is still there and get him some balance, we are in South Africa Johannesburg 😉

[GoBucks]

Very good instructor although I don’t know that I would have the patience for some of his lengthy instruction methods haha 😆😂

[natalyapitts]

Dear Doctor,
I found your videos for the purpose to help my brother, who lost his leg in Ukraine. He got his prosthetic, but he cannot have rehabilitation in the facility because of the war . I am wondering if we can hope for lessons with you online? I would be very grateful if you answer to our desperate need. Sincerely,
Natalya

[cedrichunter]

I'm an above knee amputee and I'm trying to transition into free hand walking from a hemi-walker or cane. I'm having difficulty though. What do you suggest?

[timothyrogers]

Very interesting and useful video. My question is when using a step up block, with my prosthetic in unlocked position, meaning it will bend with any weight put on it. So will locking or tightening my buttocks and groin muscle keep that leg from bending. I have not walked without the aide of crutches or walker. I do use my tredmill and it has hand rails to hang onto. I’ve only fallen once. The prosthetic buckled and really nothing I could do. I was hanging on too but still hit the deck. No injuries. Thank you.

[sicilyny]

3yrs an amp..and my brain is still confused. No balance...I get really frustrated at my lack of balance.
Shouldn't I have my brain trained by now??
I am diabetic...does that matter??

[ariela]

Unfortunately, I also haven't had a leg for two months now