Lesson 1Residual limb examination: skin integrity, scars, neuroma signs, swelling, limb volume variability and measurement techniquesThis lesson centres on inspecting the residual limb, stressing skin checks, scar flexibility, neuroma indicators, swelling patterns, volume changes in the limb, and reliable measurement methods to ensure safe pressure application, proper socket fitting, and sustained tissue health over time.
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 mobility tests for transtibial prosthesis users, covering timed up-and-go, six-minute walk test, stair handling, and rising from sitting, with advice on preparation, safety measures, result analysis, and recording improvements throughout 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 lesson clarifies testing for balance and body position sense, including clinical methods like Berg Balance Scale components, standing on one leg, and stability limits, along with device-assisted options, to measure fall dangers and direct specific balance exercises.
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 gathering a targeted history for transtibial prosthesis users, including operation details, prior prosthetic experiences, pain descriptions, routine activities, involvement aims, and emotional-social elements affecting recovery success and commitment.
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 examines joint movement range and muscle lengthening tests for transtibial amputees, focusing on hip, knee, and calf muscle lengths, risks of shortening, testing postures, and effects on walking patterns 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 lesson tackles evaluating support devices and settings, covering cane or walker suitability, home and job requirements, local ground conditions, and travel needs to promote secure movement and practical recovery planning in Zimbabwean 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 addresses detailed visual checks with and without the prosthesis, emphasising overall stance, pelvis positioning, limb lengths, muscle tightenings, spine shapes, and adjustment patterns impacting comfort, walking efficiency, and joint wellbeing 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 lesson specifies strength testing methods for vital muscles, such as hip side and back muscles, knee straighteners, core supports, and the opposite limb, employing hands-on tests and strength meters to inform exercise recommendations.
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 offers a systematic walking analysis structure, using checklists for stance and swing balance, step sizes, stance durations, and foot lift, connecting usual walking issues to possible prosthetic or body causes and priority treatments.
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 details checks unique to prosthetics, such as socket fitting evaluation, suspension operation, pressure patterns, alignment signs, foot reactions, and sock or liner adjustments for volume control, to separate device problems from body limitations in assessments.
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
