National Center on Physical Activity and Disability
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I recently visited a web site at www.ncpad.org, run by the University of Illinois, with a great deal of information about adapted exercise. Although I find the pastel font on a black background difficult to read, there are a number of resources that might be useful to P&O patients.
For example, there is a bibliography of references and resources for specific disabilities. I took a look through the "amputee" citations, and recognized most of them as good sources for information on sports and recreation for this population. This site also offers PowerPoint slide shows on related topics, a newsletter, chat group, and a wealth of other resources. I was chagrined to learn from one slide show that the totally unrealistic "$1500 lifetime coverage cap" we saw HMOs apply to P&O care a few years ago is now being applied to outpatient rehabilitation services as well.
Given the advances in materials, socket designs, and components for prosthetic rehabilitation in the past decade, I am increasingly convinced that one of the most major barriers to greater mobility for many of our patients is their lack of fitness. How many times have you done everything humanly possible to make the prosthesis stable, lightweight, and responsive only to discover that the amputee's hip muscles are so weak that they fatigue after 20 steps and the gait becomes increasingly erratic after that?
Traditional gait training is helpful in teaching people how to walk again, but the evidence is mounting about the value of strength and fitness conditioning to improve walking efficiency, and that properly adapted conditioning can help even the frail, elderly individual. Walking with less effort is equally important for our orthotic patients, and proper cardiovascular and strength training can be helpful to these populations too. This web site is a good place for the clinician to learn more about the benefits that increased physical activity can offer.
