Lesson 1Residual limb examination: skin integrity, scars, neuroma signs, swelling, limb volume variability and measurement techniquesThis part focuses on checking the residual limb, stressing skin check, scar movement, neuroma signs, swelling, limb volume changes, and standard measure ways to support safe loading, socket fit choices, and long-term tissue health in local 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 outlines function mobility tests for transtibial users, including TUG, 6-minute walk, stair handling, and sit-to-stand measures, with advice on setup, safety, understanding, and noting changes during recovery.
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 testing, covering clinic tools like Berg items, single-leg stand, and Limits of Stability, plus optional machine measures, to measure fall risk and guide aimed 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 explains how to gather a focused history for transtibial prosthesis users, covering surgery details, prosthetic use, pain types, daily activities, participation aims, and mind-social aspects that affect recovery results and sticking to plan.
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 range and muscle length testing for transtibial amputees, stressing hip, knee, and calf muscle length, shortening risk, testing positions, and effects on walking and prosthetic alignment.
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 addresses checking assistive tools and surroundings, including cane or walker fit, home and work needs, community ground, and travel needs, to ensure safe movement and real recovery planning in rural areas.
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 systematic visual check with and without prosthesis, focusing on overall posture, pelvic alignment, limb length, shortenings, spine curves, and adjustment strategies that may affect comfort, walking efficiency, and long-term joint health.
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 muscle strength testing ways for key groups, including hip side and back muscles, knee straighteners, core stabilizers, and the other limb, using hand testing and machines to guide exercise plans.
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 presents a structured walking analysis frame, using observation lists for stance and swing, step length, stance time, and foot clearance, and links common changes to possible prosthetic or body causes and treatment priorities.
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 prosthetic-specific checks, including socket fit, suspension work, pressure spread, alignment signs, foot behavior, and sock or liner management, to tell prosthetic problems from body issues during check.
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
