Lesson 1Residual limb examination: skin integrity, scars, neuroma signs, swelling, limb volume variability and measurement techniquesThis lesson focuses on examining the residual limb, stressing skin checks, scar mobility, neuroma signs, swelling, volume changes, and measurement methods to ensure safe loading, socket fit, and tissue health in Zambian patients.
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 lesson describes functional mobility tests for transtibial users, including TUG, 6-minute walk, stairs, and sit-to-stand, with tips on setup, safety, interpretation, and tracking progress in Zambian rehab settings.
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 lesson covers balance and proprioception tests, including Berg items, single-leg stance, Limits of Stability, and optional tools, to assess fall risk and plan targeted balance training for Zambian users.
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 lesson teaches focused history-taking for transtibial users, covering surgery, prosthetic use, pain, activities, goals, and psychosocial factors affecting rehab outcomes and adherence in Zambia.
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 lesson reviews joint motion and muscle length tests for transtibial amputees, focusing on hip, knee, and calf length, contracture risks, positions, and implications for gait and alignment in Zambia.
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 lesson assesses assistive devices and environments, including cane fit, home/work demands, terrain, and transport needs, to promote safe mobility and practical rehab planning in Zambian contexts.
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 lesson covers visual assessment with/without prosthesis, focusing on posture, pelvic alignment, limb length, contractures, spine, and compensations affecting comfort, gait, and joint health in Zambia.
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 lesson details strength testing for key muscles like hip abductors, extensors, knee extensors, core, and opposite limb, using manual and dynamometry methods to guide exercises in Zambian practice.
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 lesson provides a gait analysis framework with checklists for symmetry, step length, time, clearance, linking deviations to prosthetic or physical causes and treatment in Zambian clinics.
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 lesson covers prosthetic checks like socket fit, suspension, pressure, alignment, foot response, and liner management to differentiate device issues from physical problems during assessments in Zambia.
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
