FACTORS

Factors Realistic Expectations Resources

 

AGE: Usually the younger you are, the easier it is to adjust to a prosthesis and learn how to walk. Agility and balance come easier with youth, however most people in reasonably good shape are able to make this transition to varying degrees, no matter what age.
"I am 62. I don't use any assist if the surface is smooth and level, but like a cane if I am getting onto uneven ground or going down steps.  I used a cane for the first 4 years, then decided one day that I didn't need it most of the time and it took only a couple of days for me to feel comfortable without it."   Archie (HP since 1983)

WEIGHT: Perhaps one of the most limiting factors in walking is being overweight. Since our sockets must fit tightly around the hip, abdomen and waist, an excess of fat will make it much more difficult to get a comfortable socket fit. Carrying excess weight puts stress on the remaining joints and will make it much more difficult to get around with crutches as well, even if prosthetic use is not chosen.

Neither is it good to be underweight or too thin, since there should be some degree of padding between your bones and the socket for comfort. Some of you may have undergone chemotherapy and radiation therapy resulting in weight loss. It’s best to wait until you’ve achieved a reasonable, normal weight before being fitted for a socket. Most importantly, fluctuations in weight are to be avoided once a socket is fitted. Avoid fad diets, as they will not work over the long haul. Make a commitment to a sensible diet and a reasonable weight which you’ll be able to maintain relatively easily.

STAMINA: It takes a great deal of stamina to walk with a hip or hemi prosthetic. A frequently quoted statistic is that it takes 100-200% more energy to walk with our prosthetics than a normal person. If you really want to walk, it is mandatory to maintain a good overall level of physical fitness. Relying partly or even solely on crutch walking also takes a lot of energy, therefore to regain an active life again you simply must become as fit as possible. How we do this is discussed in another area of this site, Physical Fitness.

After a major injury, surgery, cancer, chemotherapy or radiation it may take several months to regain your strength. Don’t set yourself up for failure, take your time to recuperate, and don’t push yourself too much too soon. Some of you may have other medical conditions such as heart, vascular, or lung disease which will impact your fitness level and energy expenditure. Be sure to check with your Doctor before starting any fitness routine or trying a prosthesis. It may be wise to so some tests such as a stress test to assess your tolerance to use of a prosthetic or starting an exercise program.

BONY SUPPORT: Our bones provide the structural support to our bodies and are the key to weight bearing, fitting a prosthesis, and therefore walking. The more bones that remain after surgery the better, however, we HD’s and HP’s have proven we CAN and DO WALK, even without this boney support.

Hip-disarticulations who have been left with their entire pelvis intact generally will walk easier and better than hemipelvectomies. We hemi’s support our weight with the soft tissues that remain. Sometimes only part of the pelvis is removed, called a partial or semi hemi., which puts you somewhere in the middle. Occasionally more radical surgery must be done such as removing parts of the vertebrae (back bones), sacrum and coccyx (tail bone). This will make it more difficult to walk, but not impossible. Lastly, some HD’s have been left with a small portion of the hip joint or femur remaining, not enough to activate a prosthesis but just enough to make it more difficult to fit a socket. Sometimes these are called a high AK. In this situation, functionally you are an HD, and although this makes it more difficult to fit, it is possible, especially with the new softer socket materials.

Ask your surgeon for copies of your operative report and have a set of post operative X-rays taken, from mid chest to upper thigh in the standing position, both AP and Lateral views, showing exactly what boney structures remain. Keep a copy of these and know yourself what anatomical structures you have left. This information will be very helpful to your prosthetist when it comes to fitting a socket, and may serve as an indication of future problems with scoliosis.

Keep your remaining bones, especially the sound leg, as strong as possible by weight bearing exercises, weight lifting, a sensible low fat, high calcium diet, don’t smoke and watch your alcohol consumption. Post menopausal women should check with their Gynecologist to discuss and understand the option of hormonal replacement therapy and assess their personal risk for osteoporosis.

MOTIVATION: We are all unique and possess certain inborn talents and abilities. Some people are born with an inherent sense of balance or athletic skills and for those lucky few it is usually easier to learn to walk with a prosthesis. However, no matter what your physical strengths are, motivation is perhaps the most important factor of all. Only YOU will decide how you will function for the rest of your life. It’s your decision. It may be harder for some than others, but never let another individual (even a professional) set limitations on your abilities or discourage you before you learn the facts. You’ll never know what you can do unless you try. Walking doesn’t just happen, no matter how motivated you are, unless you are willing to invest the time and effort needed to learn any new skill. It isn’t easy and does not happen overnight. Adjusting to walking with a prosthesis requires time, patience, practice, and commitment. This motivation can only come from within.

"Don't limit your choices.  Personally, I feel everyone should have a prosthesis when and if you choose...If only for cosmetic reasons, to attend the occasional wedding or social event, it's worth having a leg"  Colin (HP, occasional prosthetic user)

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This site is non-profit, voluntary and privately produced. The information presented is solely the personal opinions of the author, and is in no way to be construed or accepted as medical advice. It is highly recommended you consult with your professional health care providers for guidance.

HP/HD HELP
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Santa Ana, CA 92799
E-Mail: christina@hphdhelp.org


This site last updated on 10/6/2009