Stages of Prosthetic Fitting: Steps to Getting a Prosthesis

Losing a limb is a life-altering experience, but it doesn't mean the end of your active lifestyle or independence. Prosthetic devices have come a long way, offering advanced technology and personalized solutions to help you regain mobility and function.

At PrimeCare, our team specializes in custom upper-limb and lower-limb prosthetics and understands that the journey to getting a prosthesis can be both exciting and challenging. We've created this guide to help you navigate the process and learn about the different stages involved, from the initial evaluation to long-term care and maintenance.

Requirements for Prosthetic Prescription

Before you can be fitted for a prosthesis, you need to meet certain criteria to ensure a successful and comfortable experience:

• Stable residual limb: Your residual limb must be fully healed from surgery, with no open wounds or infections. It should also have a stable shape and size.
• Reduced swelling (Edema): Any significant swelling in your residual limb needs to be under control. This can be achieved through compression therapy, exercises, or other methods recommended by your doctor.
• Adequate range of motion: You should have enough flexibility and strength in your limb remnant and surrounding joints to move the prosthesis comfortably.
• Overall health: Your overall health should be stable enough to tolerate the physical demands of wearing and using a prosthesis. This may involve managing any underlying health conditions, such as diabetes or heart disease.

Important Considerations Before Getting an Artificial Limb

• Psychological readiness: Adjusting to a prosthesis requires a positive mindset and willingness to learn. It's important to be mentally prepared for the challenges and actively participate in the rehabilitation process.
• Commitment to therapy: Physical and/or occupational therapy is a crucial part of prosthetic customization. You need to be committed to attending therapy sessions regularly and practicing the skills you learn at home.
• Financial resources: Depending on your insurance coverage and the type of prosthesis you need, there may be out-of-pocket costs involved. It's important to discuss financial aspects with your doctor and insurance provider beforehand.

Your healthcare team will work closely with you to ensure you meet all the requirements before moving forward with the prosthetic fitting process. This individualized approach helps guarantee a successful fit and a positive experience with your new prosthesis.

The Prosthetic Fitting Process: Limb Deficiency Transformation

The fitting of a prosthetic device is a collaborative journey involving you, your prosthetist, and other healthcare professionals. It's a multi-step process that requires patience, commitment, and open communication to achieve the best possible outcome. Here's a comprehensive breakdown of the different stages involved:

1. Pre-Prosthetic Phase

• Initial evaluation: This first step involves a comprehensive assessment of your residual limb and overall health after the amputation surgery. Your doctor will take detailed measurements of your limb, and assess its shape, strength, range of motion, and skin condition. They will also discuss your lifestyle, activity level, and goals for using a prosthesis. This information is crucial for determining the most suitable type of prosthesis for your individual needs.
• Prosthetic prescription: Your physician or prosthetist will write a prescription for your prosthesis, outlining the specific type, components, and features required to meet your individual needs and goals. This prescription will be used to guide the fabrication.
• Pre-prosthetic training: This phase may include physical therapy to prepare your limb remnant for a prosthesis. Exercises may focus on strengthening the muscles, improving the range of motion, and reducing swelling. You will also learn about proper limb care, including hygiene and wound management, to ensure a healthy foundation for wearing a prosthesis. Your prosthetist will educate you on what to expect during the fitting, addressing any concerns or questions you may have.

2. Preparation for the Prosthesis Fitting

• Casting and molding: To create a custom-fit test prosthetic socket, a precise mold of your residual limb is created. This can be done using traditional plaster casting or modern 3D scanning technology. The resulting mold captures the unique shape and contours of your limb, ensuring a comfortable and secure fit for the socket.
• Preparatory prosthesis fabrication: A temporary, or preparatory, prosthesis is often created, utilizing the test socket. This initial prosthesis is typically simpler in design and construction compared to the final prosthesis. Its purpose is to allow you to start getting used to the sensation of wearing a prosthetic limb and begin practicing basic movements and weight-bearing activities.
• Test socket and temporary prosthesis customization: The initial prosthesis is fitted to your residual limb, and your prosthetist will carefully assess the fit and comfort. They will also provide instructions on how to put on and take off the prosthesis properly. This phase allows for fine-tuning the test socket and alignment, ensuring a proper fit before the final socket and prosthesis are made.

3. Definitive Prosthesis Fabrication

• Incorporating feedback: Based on your experience with the preparatory prosthesis and the feedback you provide, your prosthetist will make adjustments to the design and components of the final prosthesis. This ensures that the definitive prosthesis is tailored to your specific needs and preferences, optimizing comfort and cosmetic appearance.

4. Prosthesis Fitting

• Initial fit: The definitive prosthesis is fitted to your residual limb, and your prosthetist will carefully evaluate the fit, function, and overall comfort. They will make any necessary adjustments to ensure a secure and comfortable fit.
• Dynamic alignment: This involves fine-tuning the alignment of the prosthetic device to optimize your gait and movement patterns. Proper alignment is crucial for maximizing the functionality of the prosthesis and preventing pain.
• Gait training and physical therapy: For lower limb amputees who get above-the-knee prosthetics, for example, gait training is crucial to relearn how to walk with your new limb. You'll work with a physical therapist to develop proper weight distribution, balance, coordination, and walking techniques. Therapy also helps strengthen the muscles around your residual limb and improve your overall mobility.
• Training for upper limb prostheses: For upper limb prostheses, like above-the-elbow or hand prostheses, the fitting stage may also involve training on how to control and use the prosthetic hand or hook, as well as exercises to strengthen the muscles in your arm and shoulder.
• Fine-tuning: Throughout the fitting stage, your prosthetist will continue to make adjustments as needed to make sure the prosthesis works optimally and address any discomfort or issues you may encounter. This may involve modifying the socket, adjusting the alignment, or fine-tuning the control systems.

5. After the Prosthesis Fitting

• Continued therapy and rehabilitation: Even after the initial fitting, regular therapy sessions are crucial for continuing to build strength, improve coordination, and refine your skills with the prosthesis. This may involve occupational therapy or specialized training for specific activities, such as running or sports.
• Lifestyle adjustments: Adapting to a new prosthesis may involve changes to your daily routine and living environment. Your prosthetist and therapists can offer guidance and support as you make these transitions, such as recommending adaptive equipment or modifications to your home.
• Maintenance and care: Proper care of your new prosthesis is essential for its longevity. This includes cleaning the socket and components, inspecting for wear and tear, and scheduling regular checkups with your doctor for any adjustments or repairs.

The duration of the prosthesis fitting can vary depending on several factors, including the complexity of your prosthesis, the extent of your injury, and your individual healing and adaptation rate. In general, the entire process can take several weeks or even months.

Tips for Amputees Getting an Artificial Limb

A successful prosthetic fit goes beyond simply receiving the device; it involves a commitment to learning, adapting, and prioritizing your overall well-being. Our team at PrimeCare has outlined some essential tips to enhance your prosthetic journey:

1. Be patient and persistent: Adapting to a prosthesis takes time, effort, and patience. Don't be discouraged by initial challenges or setbacks. Embrace the learning process and trust that with consistent practice and perseverance, you will achieve your goals. ‍
2. Gradual progression is key: don't rush returning to your normal activities. Gradually increase your activity level and listen to your body. Pushing yourself too hard too soon can lead to setbacks.
3. Open communication: Maintain open and honest communication with your prosthetist and therapists. Share any discomfort, pain, or concerns you may have. They’re there to support you and can make adjustments or provide solutions to enhance your comfort and function.‍
4. Embrace physical therapy: Commit to your rehabilitation program. Regular physical therapy sessions will help you build strength, improve balance and coordination, and master essential skills for using your prosthesis effectively.‍
5. Prioritize skin care: Diligent skin care is vital to prevent irritation, sores, and infection. Wash your residual limb daily with mild soap and water, thoroughly dry it, and inspect it regularly for any signs of redness or breakdown. Use recommended lotions or creams to maintain healthy skin and use a clean, well-fitting prosthetic sock to cushion your limb and absorb sweat.‍
6. Pain management: It's not uncommon to experience some pain, including phantom pain, during the initial stages of prosthetic use. Discuss any pain with your doctor, as they can suggest various pain management techniques, including medication or alternative therapies like massage or acupuncture.‍
7. Stay active: Regular exercise can help strengthen your muscles, improve your balance, and enhance your overall well-being. It can also help prevent muscle atrophy and contractures, which can negatively impact your prosthetic fit. Additionally, staying active can boost your mood, reduce stress, and improve your overall sense of well-being to help pave the way for a successful prosthetic journey. Consult with your doctor or physical therapist to develop a safe and effective exercise plan tailored to your individual needs and abilities.‍
8. Sleeping with a prosthesis: Depending on your specific situation and the type of prosthesis, you may or may not be advised to sleep with it. Be sure to consult with your prosthetist for personalized guidance on the best sleeping practices for your needs.‍
9. Emotional well-being: Adjusting to a new prosthesis can be emotionally challenging. Don't hesitate to seek emotional support from friends, family, therapists, or support groups. Connecting with others who have similar experiences can be incredibly helpful during your journey.‍
10. Stay informed and engaged: Educate yourself about the latest advancements in prosthetic technology and rehabilitation techniques. By staying informed and engaged in your care, you can make the most of your prosthetic device and achieve your full potential.

Remember, the journey to successfully using a prosthesis is unique for each individual. By following these tips and working closely with your healthcare team, you can maximize your comfort and overall quality of life with your new limb.

Your Journey to a New Normal with a Prosthesis

Adapting to a prosthetic device is a personal journey, and everyone's experience is unique. With the right support, guidance, and resources, you can overcome challenges, regain independence, and thrive with your new prosthesis.

At PrimeCare, a top prosthetics company in New Mexico, we’re dedicated to guiding you through every step of the prosthetic fitting process so that you receive the best possible care and support. Since 2009, we’ve been working with New Mexico residents to help transform their confidence. Contact us today to schedule a consultation and let us help you embark on this transformative journey!