Physical Therapy Management Involving Strength and Gait Training for a Non-Traumatic Pediatric Amputee: A Case Report

Background: Pediatric non-traumatic amputations are under-represented in the literature, especially secondary to various disease processes. Rehabilitation following a below-the-knee (BKA) amputation for a child involves prosthetic gait training as well as addressing other factors based on the patient’s presentation. Case Description: This case study involves treatment for a fourteen-year-old patient with a BKA due to congenital tibia bowing as a result of neurofibromatosis. Both the patient and family’s goal was to normalize the gait pattern of the child with the prosthesis. The treatment was spread across nine sessions for approximately one month. Evidence Based Treatment: Treatment involved gait training using a Biodex treadmill and aboveground walking techniques. Additionally, due to patient specific factors, strength training was also implemented in order to normalize the gait pattern with the prosthesis. There was a focus on quadriceps, hip, and core strengthening. Outcomes: The patient had a 51.89% increase in his six-minute walk test distance. Also, an increase in strength was evident based on a more normalized gait pattern at the end of the encounter. Discussion: Recently, prosthesis design and fitting has greatly improved, especially to make the pediatric patient normal functioning. Following the fitting of the prosthesis, physical therapy is vital in order to normalize gait impairments. Additionally, there is a need for individualized treatments, as well as patient-family centered approaches when treating pediatric patients. The disease state, its implications, and the goals of the family contribute to the emphasis in therapy.