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Certified Prosthetist - CP(c)

Certified Prosthetists are highly trained clinicians specializing in amputee management. They are subject matter experts in the design and manufacture of prosthetic devices and in the clinical processes associated with creating a good fit and function.

 

When a patient is deemed a good candidate for a prosthesis they are referred to a Certified Prosthetist. The Prosthetist assesses the patient, discusses their goals and preferences, then incorporates this information into a prosthetic treatment plan.  Prosthetists are key members of the patient care team from post-surgical care to the fitting of the definitive prosthesis. They help coordinate residuum shaping and volume management and work closely with Physiotherapists in the early stages of patient mobility. Prosthetists manage the long term care of the residual limb and the prosthetic device as part of a patient’s multidisciplinary care team.

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Physiatrist - MD

Physiatrists are doctors of physical medicine and rehabilitation. This five year medical specialty focuses restoring function and independence for patients with conditions affecting the brain, nervous system, and/or musculoskeletal system. Many Physiatrists specialize in one type of functional impairment, for example Amputee Care.

 

An Amputee Physiatrist can provide pre-amputation counselling and will follow a patient’s progress post-amputation for pain management, skin monitoring, and improving functional independence. Physiatrists are experts in coordinating rehabilitation care and typically work as part of a multidisciplinary team.  If Physiatry care is needed, a family physician or surgeon can make a referral.

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Physiotherapist PT

A Physiotherapist is a rehabilitation specialist who helps patients restore, maintain, or improve their strength, function, and movement. Using their specialized knowledge of bio-mechanics, they assess, diagnose, and treat muscular and functional symptoms of illness, injury, or disability. They use a combination of hands-on manipulation, exercise therapy, electrotherapy (the use of electrical current to speed recovery), mechanical manipulation (e.g. traction) and other means to help patients with mobility, strength, flexibility, injury rehabilitation, and injury prevention.

 

In amputee care, a Physiotherapist works closely with a Physiatrist and Prosthetist to determine whether an amputee is a good candidate for a prosthesis. Adjusting to an amputation requires patients receive good education and support in adapting to their new condition. A Physiotherapist helps educate the patient in preparation for the use of their prosthesis through strength and endurance training, fall prevention training, and transfer techniques. Once a patient receives their device, Physiotherapists collaborate with Prosthetists to train the patient in how to use the device, improve balance and gait when applicable, and gain the specific mobility and function. Further support is offered to patients and their families to help transition from hospital to home and community as an amputee, including recommending or prescribing mobility equipment or gait aids as necessary.

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Occupational Therapist OT

Occupational Therapists (OTs) are rehabilitation specialists who focus on mobility, self-care, and activities of daily living, work, or leisure. Their goal is to help patients resume or maintain a current level of participation in a variety of activities; everything from wheelchair transfers to basic housekeeping to job-specific tasks. OTs are an integral part of a larger rehabilitation plan, concentrating on helping patients get back to the activities that are important to them.

 

When it comes to amputee care, OTs target their patient’s return to functional independence. For an amputee this could mean something as basic as transfers for toileting, showering, or getting in and out of bed. This could also mean learning to complete more complex tasks with the use of a prosthesis. OTs assist in patient education by: referring to community resources, home making services, transportation services, and health information. An example of this would be helping patients access their local Community Care Access Centre for a home safety assessment.

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Certified Orthotist - CO(c)

Certified Orthotists are healthcare providers who have specialized in the design and fabrication of custom orthotic bracing (orthoses).  A patient may need an orthotic brace for any part of their body that has been affected by illness or injury causing muscle or skeletal changes. This can include a range of conditions from scoliosis to foot paralysis or from cerebral palsy to other neuromuscular deficits.  Certified Orthotists focus treatment plans on restoring mobility and preventing progression of impairment through orthotic bracing.

 

In amputee care, Certified Orthotists work to support muscles and joints in the remaining limb from over-use following an amputation.  A Certified Orthotist is uniquely qualified to provide a patient with orthotic devices for everything from head to toe.

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Certified Pedorthist - C.Ped(C)

Certified Pedorthists are experts in providing foot orthoses and orthopaedic footwear. These professionals are trained in manufacturing and fitting custom shoes, shoe modifications, and shoe inserts. Foot care is extremely important for many individuals with limb loss. For those missing part of their foot or toes, a Certified Pedorthist may provide a custom orthosis to help take some of the stress off of the remaining part of the foot. For individuals missing their entire foot or more of their leg, Certified Pedorthists will focus on maintaining the health of the remaining foot on the other "healthy" side. Many amputees also have health conditions such as diabetes, which impedes the sense of touch in their feet. Certified Pedorthists help to limit the risk posed by tissue breakdown by providing appropriate footwear and adequate support to the foot. 

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Nursing - RN/RPN

Registered Nurses (RN) and Registered Practical Nurses (RPN) provide first-hand patient care. They advocate for their patients and work closely with physicians, surgeons, and other healthcare providers. They perform physical assessments and monitoring including: vital signs, blood glucose testing, pain management, and wound care.

 

Amputees require specialized care while recovering from their surgery.  RNs and RPNs working in amputee care have the additional skills and knowledge needed to help patients recover from what can be a traumatic surgery. This includes wound care, pain management, and education for the patient and their families. As front line care providers, RNs and RPNs are often the first source of information and support.

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Social Worker - MSW

Social workers are trained and regulated professionals that provide an extensive range of practical and therapeutic support to individuals and their families/caregivers as they manage challenging life circumstances.  In the context of amputee care, social workers provide counselling support in many areas including emotional coping and adjustment to life post amputation, grief management, dealing with changes in body image, coping with interpersonal relationship issues, and managing other life stressors. 

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Social workers also assist individuals with managing a wide range of practical concerns including accessing income assistance for those in financial need, acquiring funding for mobility aids and prosthetic devices, and linking to housing support. Some outpatient programs offer a social worker facilitated Amputee Peer Support Group which allows individuals to give and receive support to one another through their shared experiences.

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Surgeon - MD

In Canada both Orthopaedic and Vascular surgeons are specialists in limb amputation and preservation. Depending on the hospital setting and patient, either or both surgical services may be involved. An amputee surgeon determines the suitable level of amputation and provides post-operative care. 

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