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Physical disabilities

Physical Disabilities may affect, either temporarily or permanently, a person's physical capacity and/ or mobility. There are many different causes but they can include inherited or genetic disorders, serious illnesses, and injuries.

Amputations

Lower

Limb

Lower-limb amputation is the removal of a part or mltiple parts of the lower limb. Though there is some discrepancy in literature regarding exact distal boundaries, it is generally accepted that "major" amputations include those which are at or above to the ankle..

 

The absence of a limb or part of a limb, lead to issues of strength, stability, balance, and joint motion.

Upper

Limb

Upper limb amputation is the removal of any part of the forearm or arm. A major limb amputation is generally considered any amputation at or above the wrist.

The loss of upper extremity usage can be caused by congenital or acquired reasons.

Because of the loss, this can lead to painful pressure points, a risk of dropping objects, loss of strength in certain parts of one’s limb.

Congenital Amputatuion

Limb deficiency

 

Individual is born wihtout a limb. Congenital amputations are classified according to the site or the level of limb absence.

 

Acquired

 Amputation

When an individual has  alimb removed by operation due to trauma, infection, diabetes and/or vascular impairment

 

Prosthesis

Is a substitute for a missing body part. The purpose of the prosthetic device is to enable the student to function with as few restrictions as possible.

 

Common Abbreviations for individuals with amputations

 

  • AK - Above or through the knee joint

  • BK - Below the knee, but through or above the ankle joint

  • AE - Above or through the elbow joint

  • BE - Below the elbow, but through or above the wrist joint

 

Consider the possibility of:

  • Increased risk of falling 

  • Decreased strength

  • Difficulty with balance and motor control

  • Pain and swelling in the area of amputation

  •  Contractures (soft-tissue tightness; will need to complete stretching exercises)

  • Limited joint motion

  • Elimination of knee power (knee disarticulation)

Consider the following with lower extremity amputations:

  • Focus on increasing balance

  • Focus on strengthening limbs to increase motor control

  • Pain and swelling in area of amputation

  • Contractures (soft-tissue tightness; will need to complete stretching exercises)

  • Focus on increasing joint motion

  • Focus on strengthening quadricep muscles for better knee power (knee disarticulation)

Consider the following with upper extremity amputations:

  • Fingers or partial hand (transphalangeal or transcarpal) - Precise dexterity (performing tasks with hands), focus on comfortable interactions for pressure points (considered for prosthetics and assistive equipment)

  • Wrist disarticulation (through the wrist joint) - Focus on strengthening grip, focus on comfortable interactions for pressure points

  • Below-elbow (transradial) - Focus on strengthening grip, focus on comfortable interactions for pressure points

  • Elbow disarticulation (through the elbow joint) - Focus on comfortable interactions for pressure points, focus on strengthening joint stability

  • Above-elbow (transhumeral) - Focus on strengthening grip, focus on comfortable interactions for pressure points

  • Shoulder disarticulation (through the shoulder joint) - Focus on comfortable interactions for pressure points, focus on strengthening joint stability

  • Interscapular Thoracic (removal of entire shoulder girdle) - Focus on joint stability, focus on
    strengthening rotator cuff

Plegias

Quadraplegia

Quadriplegia is often referred to as tetraplegia, it is paralysis below the neck.

 

All four limbs, as well as the torso, are typically affected. 

 

The degree of disability and loss of function may vary from person to person, and even from moment to moment.

Hemiplegia

Paralysis that affects an arm and a leg on the same side of the body.

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The degree of paralysis varies from person to person and may change over time.

 

Paraplegia

Paraplegia is paralysis below the waist, and usually affets both legs, the hips, and other functions, such as sexuality and elimination.

 

Refers to substantial impairment in functioning and movement, not necessarily a permanent and total paralysis.

Monoplegia

Monoplegia is the paralysis of a single area of the body, most typically one limb.

 

People with monoplegia typically retain control over the rest of their body, but cannot move or feel sensations in the affected limb.

 

Consider the following with clients:

  • Consistently communicate with the patient to see how they feel and what needs to be adjusted

  • Focus on joint stability and developing movements for power

  • Limb below the site of injury may still be sensitive

  • Focus on controlled movements, strengthening grip, and improving flexibility

Teaching Tips and Goals

  • Perform physical activity safely

  • Enable the individual to effectively use the prosthesis

  •  Introduce exercises to strengthen muscles around the stump

  • Introduce activities that will improve balance and enhance ambulation

  • Shorten the distance and/or decrease the speed of an activity for the individual (primarily for individuals with lower limb deficiencies)

  • Develop strength and flexibility of the unaffected limb

  • Develop cardiovascular endurance

  •  Provide activities in which the individual can succeed or perform equal to or better than other students

  • Supplement physical education instruction with activities that involve gross motor movement

  • Teach appropriate techniques for falling

  • Demonstrate and encourage a normal gait pattern, especially for individuals with lower limb problems

Wheelchair User/ Mobility Tips

  • Removable chairs (as opposed to booths) allow for extra space to be created

  • Step-less entry

  • Add ramps

  • Abundant space to maneuver once inside

  • Automatic doors

  • Designated accessible washroom

  • Update Restroom Signs

  • Welcome Service Animals

Consider the possibility of:

  • Increased risk of falling 

  • Decreased strength

  • Difficulty with balance and motor control

  • Pain and swelling in the area of amputation

  •  Contractures (soft-tissue tightness; will need to complete stretching exercises)

  • Limited joint motion

  • Elimination of knee power (knee disarticulation)

Medical Considerations

  • Edema (swelling) of the stump

  • Pressure sores from the prosthetic device

  • Atrophy of musculature in or around the affected limb or joint

  • Poor Circulation at the level of amputation

  • Contractures

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