LAS VEGAS – The Short Leg Graduated Protocol, used to train bilateral transfemoral amputees to walk on full length legs without assistive devices, has shown positive outcomes in a study, according to Kevin Carroll, MS, CP, FAAOP, vice president of prosthetics, Hanger Prosthetics & Orthotics and Chrysta Irolla, MS, MSPO. They presented the results at the Hanger Educational Fair & National Meeting, here.
The protocol was developed to define and systemize the key elements that lead to successful prosthetic use in bilateral transfemoral amputees. The study, which is scheduled to be submitted within the month for journal publication, summarized the quantitative results from a survey of SLGP participants.
Developing and refining the SLGP has been an ongoing project for Carroll, who described the protocol as a kind of tough love program for bilateral transfemoral amputees. “We want to keep them out of the wheelchair,” Carroll said.
“There are a lot of factors that can contribute to whether they’re going to succeed or not – some of which have nothing to do with your prosthetic intervention, but all of which, as prosthetists, you have to consider,” Irolla said. She noted the main challenges these amputees face, including increased metabolic demands, altered proprioception, physical deconditioning, emotional issues, comorbidities, fear of falling, and negative previous prosthetic experience.
The protocol works in four phases: building confidence, walking on short legs, graduated increases in leg length and walking on full-length legs, including the transition to microprocessor knees.
The first phase of building confidence in bilateral transfemoral amputees is crucial because it “creates a strong foundation for them to be prepared for this very arduous training program. If their goal is not to be walking every day with their prostheses they’re going to fail,” Irolla said. This is not a program that can be completed in just a few weeks, and many weeks, if not years, of training and physical therapy may be necessary.
Irolla noted that peer to peer support, as well as support from family and friends, was invaluable to participants’ success.