When Kiera Roche does yoga with her prosthetic leg, she never knows how far to bend while doing the warrior pose. But Roche, who had her leg amputated in 2001, has seen an improvement in her balance and flexibility since she started using Fitness for Amputees, the world's first fitness app for amputees.
"I have much more confidence in my movement, particularly when negotiating sideways movement," says Roche, who lives in London. "I have a much greater trust in my prosthesis and I know when and at what point it will bend, and how much resistance I can expect when trying to do yoga lunges."
The app, designed for unilateral leg amputees, was created by Ottobock, a leading prosthetic limbs manufacturer in Germany. It was designed alongside a team of physiotherapists and occupational therapists with 16 exercise prompts; eight of which are for strength and endurance while the other eight are for coordination and balance. The brand released its latest version of the app on April 10th, with a new training module called "Stretch & Relax."
Stretching and relaxing are both underrated activities for amputees, as they help improve flexibility and prevent muscle stiffness. Amputees often suffer from muscle contractions and back pain. "I lost my right leg above the knee three years ago from a severe MRSA infection I got during knee surgery—I didn't have a choice and finally had it amputated," says Debra Cummings, a 62-year-old amputee in the US, who likened the app to a trainer who worked with her specific limitations.
While the app doesn't replace physiotherapy—the support of an actual person provides unparalleled emotional benefits for someone enduring a life change like amputation—its exercises do aim to help stabilize the upper body and the spine, leading to greater independence and mobility for those with prosthetic legs. According to the Amputee Coalition, there are more than a million annual limb amputations globally, many of them new lower extremity amputations like Cummings'. "I started using the app three weeks ago and in that short time, my balance has improved by 20 to 30 percent," she says, stressing the importance of her own autonomy.
"Amputees often develop bad posture," says Anne Debusson, the head of sales at Ottobock in Germany. "The app helps train the muscles they need to have a natural gait and good posture." Since amputees depend on a prosthesis for body weight support, asymmetries can throw balance and gait off.
"An app designed specifically for amputees is going to offer a better improvement rate because it has been designed with a specific audience in mind," says Roche, who eight years after her amputation, created a fitness organization for amputees called LimbPower. "I use the app regularly. It helps me with balance and improves the proprioception [the ability to sense stimuli within the body regarding position, motion, and balance] of my leg, knowing where it is and building trust in my prosthesis."
The app's exercises are split into two categories: ones for those while wearing their prosthetics and other for those without it, as the exercises target different muscles groups. "For some amputees," says Roche, "there are limitations of movement when wearing prosthesis, so sometimes exercises are better performed without the prosthesis on. Other exercises have a positive impact on wearing and improve the use of the prosthesis, so these exercises are more effective while wearing it."
Santosh Basnet, who runs an educational blog called Amputee Fitness, had his right arm amputated after an accident. As time passed, he noticed the muscles on the left side of his body were getting much bigger than the right side. "I started going to the gym with hope that the trainers will be able to help me, however that was pretty much a disappointment," writes Basnet on his website. "If you don't exercise and stay active, you might risk having one side of the body more developed than the other. This will exacerbate the look of the already disfigured body." Basnet says that being able to exercise effectively balanced out the look of his body considerably.
Roche has taken the exercises from the app and shared them with other amputees in LimbPower's fitness workshops. She uses those that "focus on agility, balance, coordination, strength and conditioning," she says.
The "Stretch & Relax" training module has been especially restorative for Roche. "It will help amputees with contracture [the hardening of muscles, which can deform joints], a common problem if they don't do their exercises," she says. The work goes beyond physical rehabilitation, too, Roche adds. "It supports them on a journey to a more active and inclusive life."
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