Lesson 1Residual limb examination: skin integrity, scars, neuroma signs, swelling, limb volume variability and measurement techniquesThis part centres on checking the residual limb, stressing skin checks, scar movement, neuroma signs, swelling, volume changes, and standard measures to aid safe loading, socket fit, and long-term tissue care.
Skin color, integrity, and breakdown riskScar location, adherence, and mobility testsPalpation for neuroma and nerve tendernessEdema patterns and soft tissue consistencyCircumference and length measurement methodsMonitoring limb volume changes over timeLesson 2Functional mobility testing: timed up-and-go (TUG), 6-minute walk test, stair assessment, sit-to-stand measuresThis part describes mobility tests for transtibial users, covering TUG, 6-minute walk, stair handling, and sit-to-stand, with tips on setup, safety, reading results, and noting changes in rehab.
Timed Up and Go test setup and scoringSix-Minute Walk Test proceduresStair ascent and descent performanceSit-to-stand and transfer assessmentsUse of assistive devices during testsLesson 3Balance and proprioception testing: clinical tests (Berg Balance Scale items, single-leg stance, Limits of Stability) and instrumented measuresThis part explains balance and body sense tests, including Berg items, one-leg stand, and Stability Limits, plus tool-based measures, to gauge fall risk and direct balance training.
Static standing balance observationsBerg Balance Scale item selectionSingle-leg stance and tandem stance testsLimits of Stability and weight shiftingInstrumented balance and sway measuresLesson 4Structured history-taking: surgical history, prosthetic history, pain characteristics, activity goals, and psychosocial factorsThis part shows how to gather focused history for transtibial users, covering surgery details, prosthetic use, pain types, daily activities, goals, and mind factors affecting rehab success and follow-through.
Key surgical details and amputation etiologyPrevious prosthetic use and device changesPain type, intensity, triggers, and patternsActivity level, vocational and sport goalsPsychosocial context, mood, and supportLesson 5Joint range of motion and muscle length testing relevant to transtibial amputees (hip, knee, ankle/gastroc-soleus length)This part reviews joint movement and muscle length tests for transtibial amputees, stressing hip, knee, and calf length, shortening risks, test positions, and effects on walking and prosthetic setup.
Hip flexion, extension, and rotation rangeKnee flexion and extension measurementGastrocnemius–soleus length assessmentStandardized goniometry positioningImpact of contractures on gait and fitLesson 6Assistive device and environmental assessment: cane/walker use, workplace demands, uneven terrain challengesThis part tackles checking aids and settings, including cane/walker fit, home and work needs, community paths, and transport, to ensure safe movement and practical rehab planning.
Cane and walker selection and fittingHome layout, hazards, and accessibilityWorkplace physical demands and tasksCommunity terrain and outdoor challengesTransportation and public transit accessLesson 7Observation and static postural assessment with prosthesis on and off (pelvic alignment, limb length, contractures)This part covers step-by-step visual checks with and without prosthesis, focusing on overall posture, pelvis alignment, limb length, shortenings, spine curves, and adjustments affecting comfort, walking efficiency, and joint health long-term.
Posture with prosthesis donned and doffedPelvic tilt, obliquity, and rotation checksApparent and true limb length comparisonDetection of hip and knee flexion contracturesSpinal alignment and compensatory posturesLesson 8Muscle strength testing protocols for hip abductors/extensors, knee extensors, core and contralateral limbThis part details strength test methods for main muscles, including hip side and back muscles, knee straighteners, core stability, and opposite limb, using hand tests and machines to guide exercises.
Hip abductor strength testing methodsHip extensor and gluteal strength checksKnee extensor and quadriceps assessmentCore stability and trunk strength testsContralateral limb strength comparisonLesson 9Gait analysis framework: observational checklist (stance/swing symmetry, step length, stance time, foot clearance), identifying prosthetic-related deviationsThis part offers a structured walking analysis frame, using checklists for stance/swing balance, step length, stance time, and foot lift, linking common issues to prosthetic or body causes and treatment focus.
Standardized observational gait checklistStance phase symmetry and stabilitySwing phase, foot clearance, and timingStep length and cadence comparisonsCommon transtibial gait deviationsLinking deviations to likely prosthetic causesLesson 10Prosthetic-specific checks: socket fit assessment, suspension performance, pressure mapping basics, alignment cues, prosthetic foot response, socks/liner fit and volume managementThis part details prosthesis checks, including socket fit, suspension work, pressure spread, alignment signs, foot action, and sock/liner handling, to separate device problems from body issues in assessment.
Static and dynamic socket fit assessmentSuspension system function and pistoningPressure-sensitive and tolerant area reviewVisual and functional alignment indicatorsFoot rollover, heel response, and stabilitySock ply, liner fit, and volume strategies
