BK Training Series

The Amputee Walking School is an outcomes-based program led by Todd
Schaffhauser and Dennie Oehler.  We offer full-day clinics, inservices,
and Amputee Walking Schools.  Our mission is to help our patients reach
life skill goals by providing a community service program that continues
training after the rehabilitation process has ended. Our amputee
walking school is in its 30th year with programs and classes are being
held throughout the country.

WALL SQUATS

One key point to remember:

• Socket should be in bench    

    alignment;

• Heel should remain on the floor

• Avoid rising up onto the toe, which

     adds tremendous pressure on the

     tibia bone (front of socket)

• ALWAYS have a chair/stool behind

    for safety before attempting this

    exercise

• Taking a step out with the

     prosthetic side onto the heel 

     allows you to get into proper

      bench alignment

• Slide down wall into 90 degree

    angle

• ALWAYS have a chair/stool 

    behind for safety before

    attempting this        

    exercise

Squats at Parallel Bars Mistakes

Sitting back is a common mistake

Leaning forward raises heel up

Correct Positioning

Heel stays on the ground

Back is straight

Arms are fully extended

You do not need to squat all the way down to feel your muscles working

Try holding for counts 2-4-6-8 seconds when down in the squat position

Partner Assisted Squats

Always have a chair behind for safety

 Each partner lowers themselves shifting  hips back and down    

 Try to prevent knees from shifting too far forward

Avoid lifting heel off the ground

 Maintain a straight trunk with a head-up position

Press the feet into the floor through the knees

Resistance Squats

Adding a TheraBand for resistance when doing Stand-Up Squats inside the Parallel Bars

Keep heels on the floor and flat footed stance 

Maintain a straight trunk with a head-up position

We use loop bands for lateral band resistance walking:

 Parallel Bars

Beginners start in Parallel Bars

Put band around legs midway through socket or up around the condyle for shorter residual limb

 Walker-spotter could stand behind in guard position

Move the walker sideways till the outer leg is mid-line with your body.

Step sideways and you should now be back centered with the walker.

Repeat to the end of your side stepping distance

Ten feet for beginners.

Advanced Lateral Walk

•Spotter uses hands as support and laterally walks

•Toes facing forward and band fully stretched

•Avoid staggered stance

•Go in both directions 10 feet for beginners

 Side stepping with a squat

Turn feet out sideways

Take side-step to stretch out the band and proceed to squat

Lateral Loop Band:  Baby Stepping 

Spotter uses hands as support and laterally walks

Keep band FULLY stretched wide with resistance and take very small steps sideways

Practicing Turns

When doing turns avoid

Spinning and

Sticking prosthesis out in front other foot with weight mostly on your heels

Imagine a CIRCLE underneath you and perform your turns inside the CIRCLE

This circle training will help keep your center of gravity underneath you

Use tape or “mark spot” or hula hoop to create circle

BKTS Stairs Ascending and Descending

Ascending

We always teach sound side ascending first

We also teach a two stair advanced ascending with both sides

Then Target >Place > Step up

First step Beginner and the Second step is Advanced

Descending

Hold on to the handrails for safety

Prosthetic side goes down first placing the rear of the foot on the step

Sound leg meets at the equal step

Try to achieve more of the forefoot to rotate over the edge of the step

This will allow a better step over step while descending

This is to teach the amputee to accept weight onto the prosthesis with the correct timing and alignment

Learn correct prosthetic foot placement on each step

Learn to trust the knee while it is flexing

An upright posture is important to ensure correct alignment & timing

BK PowerWalk

Place Thera-Band below knee joint towards end of the residual limb

More advanced place Thera-Band around ankle joint area

Spotter hold from behind as amputee walks  10ft>20ft>up to 50ft 

Progression

Add a second band on the sound side for a more aggressive workout

Parallel Bars

Walker/Forearm Crutches/Cane

No Assistive Device

Reebok Core Board Balance Training

The Core Board allows you to dial in resistance and have a wider platform

Amputee feels more stable compared to traditional wobble board

Spotter holds hands as amputee places prosthetic side on first

Spreads feet out to the sides

Begin shifting side to side

Keep knees in bent position as

you shift side to side 

Step down prosthetic side first

Holding on first with two hands  for beginners   

One hand for intermediate

No hands for advanced

Forward Stepping

• Using a NON-SLIP plyometric agility ladder we do balance, targeting and strength training
• Slowly lift prosthetic side up as high as possible and hold for 3 seconds
• Target foot placement in the next ladder box
• Bring sound leg into the same box

Lateral Stepping

• Slowly lift prosthetic side up as high as possible and hold for 3 seconds
• Target prosthetic side with a  lateral step to farthest point in the box
• Bring sound leg into the same box Return using the sound leg first

BK Cone Stepping

•Step 1

•Starting Position: Place a series of cones 18-30" apart in a straight line on a non-slip surface. Stand 6" behind the first cone with your feet hip-width apart or closer, hold onto the spotter.

• Step 2

•Walking Movement: Slowly lift prosthesis off the floor to clear the height of the cone, stabilizing your body on the stance (supporting) leg.

• Avoid any sideways tilting or swaying in your upper body and try not to move the stance (supporting) foot. Hold this position momentarily before stepping forward, pushing off your stance (supporting) leg to clear the cone.

• Step 3

•The raised leg should initiate contact over the cone with a heel strike first, followed by the mid- and fore-foot, transferring your body weight into the prosthesis. As you load onto the prosthesis, again avoid any sideways tilting or swaying in your upper body and try not to move the stance (supporting) foot. Your trailing leg needs to also clear the cone.

• Step 4 •Continue this sequence through the series of cones.

•Learn first how to perform single leg-stands on the ground and, if possible, on a foam balance pad before performing cone walks.

Exercise Variation

This exercise can be progressed in several ways:

(1) lift each leg higher off the floor to further   challenge your balance

(2) walk through the cones at a faster pace,

(3) step sideways through the cones, or

(4) step backwards through the cones.

Balance Beam Training

Heel to Toe Walking

Lateral Walking-could also add a squat

Can combine with PowerWalk exercise

Can add some OT training (catch ball or cone training)

Treadmill Training is a great activity I like to begin when it's safely possible 

Harness systems are great to utilize in the beginning.

Interval training to increase walking speeds 

Makes you take more steps in your day.

Plyometric Ladder Drills>Balance Pads>Loop Band Lunges