Frequently Asked Questions (Artificial Limb Service)

We can arrange for you to come to an Artificial Limb Centre to talk to our prosthetists (who will make and fit your artificial limb), physiotherapists and nurses. We can also arrange for you to meet with another amputee with similar circumstances if you want to talk to someone who has been through it before.

There’s a lot you can and must do to be able to use an artificial limb and use it well. Top priorities are:

• Working through your feelings about losing a limb and deciding how to rebuild your life after amputation
• Exercising to build up the muscles needed for balance and walking
  preparing and taking care of your residual limb to attain a proper, sound shape for the artificial limb
• Learning proper body positioning and strengthening, to maintain tone and prevent contractures.

You will be advised by the therapy staff in the hospital on all of the above before you go home.

As a new amputee you have a lot to deal with. The trauma of the amputation and the impact it has on your career, relationships, finances, sexuality, and self-esteem can be difficult to handle. Getting to grips with the emotional side of things can also help you to deal with the physical barriers. Getting out of the house and participating in life is essential to your long-term health and well-being.

Limb loss is usually the result of, rather than the cause of other health problems. However, since the loss of a limb can result in decreased activity, the risk of health problems associated with a sedentary lifestyle may be increased.

Residual limb and phantom pain, as well as skin problems associated with artificial limb use are also common.

Maintaining a stable weight is extremely important so you can keep fitting into the socket of your artificial limb. Regular exercise also helps decrease the risks of other health problems.

After the amputation, there will be a time of recovery, adjustment and rehabilitation.

Everyone is different so there’s no set time span for recovery and walking again. Recovery time is often determined by amputation level, your health and fitness and also the desire to get back to normal life again.

At first your limb will be swollen. As the swelling goes down, your bones will start to show more. Also the muscles that used to move your limb will begin to reduce in size through lack of use which makes the bones seem more prominent. This is very normal and isn’t usually a problem.

The level of your amputation will determine where the pressure is taken. Any cut bones will not directly support your weight although there may be contact. Every effort is made to ensure comfort and protection of your stump.

Each artificial limb is tailor-made for you, depending on the level of your amputation, your physical ability and your needs. Most standard artificial limbs are made of component parts attached to a socket that fits over your residual limb.

The artificial limb is generally held on by the socket and also a strap, but there are other ways too. Your prosthetist will decide which method suits you best based on both the type of amputation and the type of artificial limb you have.

Most people who lose a limb can get back to normal daily activities within a few months.

How well you function depends mainly on your goals, along with a comfortable artificial limb, good follow-up care, and a can-do attitude from you as well as your team at the Artificial Limb Centre.

A prosthesis or artificial limb is an artificial replacement for a missing limb or part of a limb.

Although an artificial limb will not be as natural as your own limb, it can help you to do many things successfully if you put your energy and willpower into learning how to use it.

It’s important to work with your doctor, prosthetist and therapist. Keeping up with your team so they can design and fit your limb correctly and then train you how to use it is the key to being a successful artificial limb user.

Unfortunately most artificial arms do not look completely natural and can have a mechanical look about them. Your arm will not hang completely straight due to the suspension required. There are various movements you can make for the arm to rest in a natural position when, for example, you sit down. Basically, the more you wear the arm, the more natural your movements will become. You can also use jewellery or a watch to give a good effect.

Your arm will either be purely cosmetic or have a detachable hand which can be exchanged for a hook. The method of opening and closing a hand or hook will vary. You’ll need to discuss your needs with your prosthetist.

Your artificial limb needs to be strong enough to support your weight, so it’s as light as we can make it. It is actually much lighter than the leg that has been amputated. However, it feels heavy because it is not part of the body and is being moved by a shorter section of your remaining leg or arm.

Learning to use an artificial limb is a tough job. It takes time, great effort, strength, patience and perseverance. You will work with a therapist while learning how to handle your new artificial limb. You will need guidance on how to:

• Take care of your artificial limb
• Put on (don) and take off (doff) your artificial limb
• Walk on different surfaces, including stairs and uneven terrain
• Handle emergencies safely, including falling down and getting up again
• Perform daily activities at home, at work and driving a car
• Investigate new things you may like to try, like sports and recreational activities

Some people choose not to use an artificial limb, relying on mobility devices.

However, even when you have an artificial limb, whether you also use crutches or a wheelchair depends on several factors including level of amputation, whether you have a single or bilateral amputation, and your level of balance and strength.

Most amputees have a pair of crutches for times when their limb is off, including night time trips to the bathroom, showering, participating in certain sports, and to help if the artificial limb needs to be left off for any length of time.

If you have lost both legs, you will use a wheelchair at least some of the time. Unilateral amputees may find it helpful to use a walking stick, walking frame or crutches for balance and support in the early stages of walking or just to have a break from the artificial limbs. The best advice will come from your therapist and is based on factors such as age, balance, strength and sense of security.

Everyone is different and has different levels of tolerance. Initially you will have a structured programme designed to increase your tolerance to wearing the artificial limb. You will become more familiar with your own limits with practice.

Yes you can, but the height of the heel and sole need to be similar unless you have a foot which is able to be adjusted at home – check with your prosthetist first.

No, because the parts inside the limb will corrode. It is better to swim without wearing your artificial limb.

Certain areas of your socket will produce more pressure than other areas and your skin will tend to redden with this pressure. The redness should go away within around 20 minutes of removal of the limb. If the redness persists or is also itchy, contact your prosthetist for advice, he/she may suggest you see your GP.

Follow-up is as important as the initial fitting. You will need to make several visits to the prosthetist for adjustments, as well as training with a therapist. Between them, they can help ease pressure areas, work out any problems, and enable you to regain the skills you need to adapt to life after limb loss.

Tell your prosthetist if your new limb is uncomfortable, too loose or too tight. Ask questions about things you need or want to do. Communicate honestly about your needs. The more you tell your prosthetist and therapist, the better you will be able to succeed with your artificial limb.

Depending on your age, activity level and growth, your artificial limb can last anywhere from several months to several years.

In the early stages after limb loss, changes in the residual limb can lead to shrinking. This may lead to a need for socket changes, the addition of liners, or even a different device.

Later on, increased activity levels and the desire for additional function can mean a change in the artificial limb or some of its component parts. Once you are comfortably set-up and the limb is working as you want it, it will only need minor repairs or maintenance and can last for an average of three years.

It’s best to plan on making follow-up visits to your prosthetist as a normal part of your life. Proper fit of the socket and good alignment are the keys to making sure that your artificial limb is meeting your needs. Artificial limbs, like cars, need regular maintenance and repair to keep working well. Even small adjustments can make a big difference.

Yes, things can happen to your limb that will require repair or replacement, so it’s a good idea to contact your prosthetist if you think something’s not right and let him/her have a look at your artificial limb.

Get small problems with your artificial limb taken care of straight away. There’s no benefit to waiting until something falls apart or causes you serious skin breakdown. If you wear an artificial limb too long when it needs repairs or replacement you can do harm, not only to your residual limb, but also to other parts of your body. Strain on other muscles, especially in your back and shoulders, will affect both your posture and also the performance of the artificial limb and the energy needed to use it. Early prevention is more valuable than long-term treatment.

We will discuss your prosthetic prescription with you, and then make the decision on your artificial limb in consultation with you. This is based on your lifestyle, activity level and general health.

In most circumstances the hospital that did your amputation will send a referral for you to the Limb Centre. The Limb Centre will then make an appointment for you. Sometimes (rarely) a referral is not done and no contact is made – in this instance we accept referrals from a GP, health provider or from the amputee. Once you have made your initial appointment, further appointments can be made directly with the Artificial Limb Centre and you do not need to go through your GP.

If you are still an inpatient, the hospital will arrange transport for you either by ambulance or taxi. Once you are discharged, you will need to arrange your own transport. You can apply for travel assistance through ACC (if your amputation was the result of an accident), or through WINZ – Civilian Amputee Assistance. You may be eligible for Health New Zealand’s National Travel Assistance Scheme. This is for people who need to travel long distances or travel frequently. The Artificial Limb Centre has all the forms for you to claim back travel costs.

You will be assessed by the clinical team who are: surgeon, physiotherapist and prosthetist. They will discuss your rehabilitation plan with you and assess your healing, strength, ability and importantly what goals you have. We take a plaster cast or measurements of your stump so we can begin to make your artificial limb. All artificial limbs are custom-made for each individual.

There will be several appointments for fitting before you receive your finished limb.

If you have a discharge report from hospital please bring it with you so we can put a copy with your records.

Please make sure you are wearing comfortable clothing, if you are an above knee amputee you may like to wear shorts (we appreciate you wearing underwear with substantial cover) as we will need to work intimately.

Please bring a pair of shoes to your fitting appointments.

Depending on the site of amputation you might need an adaptive device to get driving. You will need to advise your insurance company that you are now an amputee. You might be required to undergo a driving assessment to ensure you are able to continue to drive safely. If you are concerned please consult your GP.

I Can’t Get Into My House Or Into The Toilet/Bathroom Because Of Steps.

Your house can be assessed by an Occupational Therapist. This is usually arranged by the hospital that did your amputation or by the rehabilitation facility. They will recommend any changes that need to be made. Housing Modification Services funded by Disability Support Services.

Limb loss generally refers to the absence of any part of an extremity (arm or leg) due to surgical or traumatic amputation. The term limb deficiencies means the congenital absence or malformation of limbs.

Limb loss can occur due to trauma, infection, diabetes, vascular disease, cancer and other diseases. The causes of congenital limb deficiencies are frequently unknown.

Caring for a person who has undergone an amputation will depend greatly upon his or her overall health and strength. People who are candidates for artificial limb use will make several visits to their prosthetic facility to obtain a correctly fitting limb. Physical/occupational therapy or gait training may be needed to facilitate successful use of their artificial limb and other assistive devices to regain independence. Some new amputees may also need professional assistance with emotional adjustment to limb loss. Amputees whose health does not permit artificial limb use may require more assistance with mobility and transfers.

In general, artificial limbs are free to New Zealand citizens and permanent residents. Special artificial limbs that may be needed for vocational and recreation purposes may be available under certain circumstances and can be supplied at the amputee’s own expense.

Non-residents will need to pay before receiving our services – the price varies depending on the artificial limb required – please call us for further information.

Yes, non-residents can access our prosthetic services. However, all fittings, appointments, and ongoing care must take place in New Zealand, and the patient will need to be present in the country for approximately three months during the initial treatment period.

Yes. Prosthetic services and devices are not publicly funded for individuals who are not New Zealand residents. As a result, all associated costs – including the prosthesis, rehabilitation, and ongoing maintenance – must be paid privately.

If you are not a New Zealand citizen or permanent resident, you are not eligible for publicly funded support. While you may still receive treatment, it will be on a self-funded basis, and ongoing costs will apply throughout the lifetime of the prosthesis.

Yes, we can usually assist with a prosthetic device from an early age, which will be determined by the clinical team at the Artificial Limb Centre.

Assesses the patient and casts the amputated site, then builds the limb to the individual’s requirements.

Clinically assesses each patient for their suitability, progression and current to receive a prosthetic limb.

Assesses the patient’s current physical levels of ability and provides rehabilitation services.

The Physiotherapist will examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability where possible. In addition, Physiotherapists will develop fitness and wellness oriented programmes to aid each individual to increase mobility and live an active healthy life (PTA, 2003).

The goal of the occupational therapist is to aid and enable the patient to participate in activities undertaken in everyday life.

Occupational Therapists achieve this by working with our patients to enhance their ability to engage in the occupations they desire, need, or are expected to do. This may require modification of the occupation or the surrounds/environment to better support the occupational therapy engagement (OTNZ-WNA, 2016)

Ensures that each patient’s new limb is funded and assessed accordingly; and that there is capacity for the limb to be delivered in a timely manner.