Lifelong Activity & Exercise After Amputation

By Brandon Smith, PT, DPT – Board-Certified Geriatric Clinical Specialist & Certified Exercise Expert for Aging Adults

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We have all heard about the need to stay healthy, especially as you age in the presence of chronic disease. Many individuals aim to work as long as they are able, or maintain quality relationships and their independence. Yet, according to the Healthy People 2010 report, 56% of adults with disabilities do not engage in any leisure-time physical activity compared to 36% among adults without disabilities. Furthermore, studies suggest that physical activity after amputation often decreases despite the deleterious effects on overall functioning. Once you have finished your therapy, how can you ‘buck the trend’ and remain active?

Despite the common idea that you must avoid disease and disability to age well, studies suggest that the absence of disease and disability is not the most important factor in successful aging. In other words, individuals are indeed able to age optimally despite their disability. So what activities are important to age successfully? According to the World Health Organization’s 2020 Guidelines on Physical Activity and Sedentary Behavior, an individual should aim for the following:

  • 150-300 minutes of moderate intensity and 75-150 minutes of vigorous intensity physical activity per week
  • No longer necessary to exercise in bouts of 10 minutes or more
  • All older adults should emphasize functional balance and strength training activity to enhance function and prevent falls for 3+ days per week
  • Sedentary behavior should be limited

Evaluating Your Current Physical Activity Routine & Planning for the Future

I want you to consider what activities you already complete within a normal week. Moreover, what activities do you enjoy now or in the past? How can you add more activity to your daily routine? You should aim to decrease the amount of time spent sedentary, carry out more physical activity, or better yet a combination of both. Importantly, gradually increasing the amount and intensity of physical activity is an excellent way to manage the typical aches and pains that may come from new activity. As noted, it is vitally important for older adults to focus on function to improve their balance and strength and combat age-related decline that often results in falls or injury.

 

With that being said, what counts as physical activity? Typically these are tasks that you have to do anyway, such as household chores, walking into the store, or yard work. Even things that don’t feel like exercise count, whether it be gardening, playing with your grandchildren, or dancing. However, in order to make it count, one must monitor the intensity of the activity, as oftentimes daily tasks may not be intense enough. This can be done through technology such as a wrist-based heart rate monitor. You can also use an RPE scale, or rate of perceived exertion, aiming for a 4-6 or 7-8 out of 10. Alternatively, you can use a ‘talk test.’ If you are able to easily have a conversation during the activity, yet still are breathing fairly hard, this counts of moderate intensity. Vigorous-intensity on the other hand only allows you to say a few words prior to taking a breath mid-conversation.

Now let us acknowledge the ‘elephant in the room’ of how difficult it is to navigate the various obstacles to increasing your physical activity, or starting and maintaining an exercise program, once discharged from therapy. Oftentimes there are concerns with self-efficacy, financial barriers, and knowledge gaps that can seem insurmountable. Perhaps your prosthetic device doesn’t fit, or you have yet to even obtain your device or may never do so. With that being said, it is important to have support. Whether this is from your prosthetist, therapist, or your peer mentor, having someone to work with you when the going gets tough is key. Research has shown that setting up a ‘buddy system’ with like-minded peers and locating accessible facilities in your community can facilitate long-term activity.

Amputee & Adaptive Exercise Training Resources in Virginia

  • Move Your Way
    • An individualized online planner to set goals, choose activities you enjoy, and get tips on how to stay motivated. You can print out a plan to track on a weekly basis
  • Program to a Healthier You!
    • Specifically targeted to assist those with mobility limitations in making healthy choices to improve their activity level
    • Includes the ‘How I Walk’ campaign aimed at reframing walking as an inclusive activity to include those who primarily use a wheelchair
  • National Limb Loss Resource Center by the Amputee Coalition
    • An extremely comprehensive collection of articles, videos, and other media on how to undergo greater amounts of activity and live a healthy life after amputation
    • Certified Peer Mentorship
  • Sportable
  • Sheltering Arms Fitness & Therapy Services

           Ultimately, physical activity has been proven time and time again to improve an individual’s quality and longevity in a wide variety of ways. It can lower your blood pressure, help you sleep more easily, and boost your mood. It can even reduce phantom limb pain and sensations. In turn, I encourage you to discover the power of exercise in your day to day and connect it to your goals in life. Remember – you have the Power to Overcome!

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