From injury to independence: The role of pre-prosthetic physiotherapy

When an individual suffers life-changing injury resulting in limb loss, the pathway to a successful recovery depends on early access to a structured prosthetic rehabilitation programme. A key part of this includes pre-prosthetic physiotherapy or “prehabilitation”.

Prehabilitation: Setting the foundation for success

Pre-prosthetic physiotherapy is designed to:

• Optimise readiness for prosthetic fitting.
• Strengthen core and lower limb musculature to aid gait re-education.
• Improve cardiovascular fitness to reduce fatigue during prosthetic training.
• Build balance and proprioception to facilitate early mobility.
• Prevents contractures.
• Ultimately maximise functional outcomes of the first prostheses.

Early physiotherapy input is essential to support wound healing, scar management, oedema reduction, residual limb shaping, range of motion and strengthening.

Planning rehabilitation after amputation

Following our client’s accident, he suffered a fractured right femur and crushed left leg resulting in below knee amputation.

Four months after his accident, he was assessed by Dorset Orthopaedic, one of the UK’s leading providers of prosthetics and multidisciplinary rehabilitation.

Dorset Orthopaedic recommended the following:

1. 6-12 sessions of pre-prosthetic physiotherapy.
2. Prosthetic casting and fitting.
3. 20 days of intensive physiotherapy.
4. A microprocessor foot trial - trialling three microprocessor feet to assess the most suitable for everyday use and activities which align with the client’s goals.

Prior to the accident, our client led a highly active lifestyle which included running, gym training, football, swimming, and golf, often across variable terrains. He had an active physical job.

Progression through Prehabilitation

Our client was motivated to get back to an active lifestyle. He commenced his weekly pre-prosthetic physiotherapy sessions five months after injury. In between sessions he attended the gym three times a week to help get him physically fit and ready for his first prosthetic fitting.

His first prosthetic casting was seven months after his accident once his wounds had fully healed. He had his first prosthetic fitting a week later, where he demonstrated rapid adaptation and progress.

Thanks to his prehabilitation, he was able to achieve stable, confident ambulation within a significantly reduced timeframe compared to typical trajectories.

It was wonderful to see him adapt from being wheelchair bound to being able to walk up and down the parallel bars, the corridors and the ramps at Dorset Orthopaedic’s clinic.

The video compiled by our client’s partner on the day of his first prosthetic fitting is a reflection not only of his determination and focus but also the benefit of structured prosthetic programme including pre-prosthetic physiotherapy which ensured he was ready to progress to being more mobile, active and independent.

The key outcomes of Prehabilitation

• Independent mobility restored quickly and confidently after a prolonged period of immobility.
• Reduced risk of secondary complications (falls, deconditioning, contractures).
• Faster return to daily activities improving overall quality of life and independence.

After his first fitting, he underwent 8 intensive days at Dorset Orthopaedic with the prosthetist and physiotherapist.

Dorset Orthopaedic recommended physiotherapy in between intensive days with a physiotherapist more local to him to help progress to the next phase of his prosthetic rehabilitation the microprocessor foot trial. He has now trialled the feet and is ready to move on to the next stage of his rehabilitation journey.

The role of the claims process

This case highlights the value of the personal injury process and securing access to a structured programme of prosthetic rehabilitation. Interim payments ensured timely referral to Dorset Orthopaedic, where the client benefited from integrated prosthetic and physiotherapy support leading up to his first fitting and beyond.

Without this funding, delays in rehabilitation could have led to a poorer long-term physical and psychological outcome, greater reliance on care, and higher overall costs. Instead, early intervention has maximised his recovery potential and supported long-term independence.

Conclusion

This case demonstrates that:

• Prehabilitation prior to prosthetic fitting is critical in optimising physical and functional outcomes.
• Specialist centres such as Dorset Orthopaedic provide the expertise needed for complex rehabilitation following amputation.
• Early access to rehabilitation, enabled by the claims process, delivers both human and economic benefits by reducing complications and accelerating independence.

It is clear that securing early rehabilitation is an essential component of achieving the best possible outcomes for clients following life-changing injury.