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 size changes, and standard measure methods to aid safe loading, socket fitting choices, and lasting tissue health in resource-limited settings.
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 checks, with tips on setup, safety, understanding results, and noting changes during recovery in community-based care.
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, one-leg stand, and Stability Limits, plus optional machine measures, to measure fall danger and guide aimed balance training for daily safety.
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 operation details, prosthetic use, pain types, daily tasks, taking part goals, and mind-social aspects that shape recovery results and sticking to treatment.
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 checks key for transtibial amputees, stressing hip, knee, and calf muscle length, tightening risk, test positions, and effects on walking and prosthetic setup in African contexts.
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 aids and surroundings, including cane or walker fit, home and work needs, community ground, and travel requirements, to ensure safe movement and real recovery planning in Uganda's varied landscapes.
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 check with and without prosthesis, focusing on overall posture, pelvis setup, limb length, tightenings, spine curves, and body fixes that may affect comfort, walking ease, 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 power check methods for main groups, including hip side and back muscles, knee straighteners, core holders, and the other limb, using hand tests and machines to guide exercise plans for balanced strength.
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 planned walking study frame, using watch lists for stand and swing balance, step size, stand time, and foot lift, linking common off-patterns to possible prosthetic or body causes and treatment needs.
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-only checks, including socket fit, suspension work, pressure spread, alignment signs, foot action, and sock or liner handling, to tell prosthetic problems from body limits during checks in busy clinics.
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
