Falls Advice when Using Prosthetic Limbs

As an amputee, you are at risk of falling, both when wearing your prosthesis and when you are not. This booklet aims to advise you on how to prevent falls around the home, and how to manage if you do fall.

There may be other factors which put you more at risk of falling, for instance:

Other medical problems such as arthritis, stroke or heart problems
Experiencing light-headedness, dizzy spells or low blood pressure
Poor eyesight
Taking regular medication, or more than 4 different prescribed drugs
Problems with sleeping
Poor diet
Alcohol intake
Living alone

If you are concerned about any of the above, see your doctor. You can also ask your doctor to review your prescribed medication regularly. Try to have regular eyesight tests with an optician; eye tests are free if you are over 60.

Preventing Falls At Home

Here is some general advice about how you can stay safe around the home.

Try to do regular exercise to stay supple and strong.
Never leave objects lying around, especially on the stairs and walking areas.
Keep cables tidy.
Avoid loose rugs, tack down frayed carpet edges or replace them.
Avoid poorly fitting footwear and long trailing clothing
Do not rush to answer the phone or doorbell. People who know you will be patient and wait
Minimise the need to reach high or low. Keep frequently used items at a convenient height and consider fitting a letter cage for your post, to avoid having to pick it up from the floor.
Never stand on furniture to reach things, use proper steps
Consider fitting handrails on both sides of the stairs. Avoid or minimise using the stairs if you do not feel safe
Keep stairs and living areas well lit. Consider using energy saving light bulbs which do not need changing as often as standard bulbs. If you need to get up at night, always put the light on
Get up from chairs or your bed slowly. Blood pressure falls as you change position, and this can make you feel dizzy.
Let a family member or neighbour know if you are feeling unwell.
Use correct walking aids around the home, your physiotherapist will advise you on this. If you use items of furniture to lean on, ensure that the castors/wheels are removed.
If you use walking aids, replace the ferrules (rubber bottoms) before the surface smoothes over. Ferrules are available from the physiotherapy department at the Centre.
Re-arrange furniture around your home if needed.
Keep your house warm. If you get cold this can make your joints stiff, and make you less mobile. Remember you may be entitled to financial help for heating costs such as the winter fuel allowance.
Make sure your prosthesis is fitting properly and that you attend your prosthetic review appointments for the prosthesis to be serviced and maintained.

If you do fall

First, carry out a top to toe check, and ask yourself:

Does anything hurt?
Can I move?

I should stay down

I should get up

If you decide you should stay down follow these steps as appropriate:

Attract attention

Use your phone to call for help
Use your pendant alarm
Shout or bang something

Keep Warm

Cover yourself with clothing, a towel, a tablecloth, a rug or a blanket.

Get Comfortable

Find a cushion or pillow nearby or roll up an item of clothing and place it under your head.

Keep Moving

You need to keep changing position to avoid pressure sores
Move your joints around to avoid stiffness and help circulation.
Roll away from any damp areas.

If you decide you can get up follow these steps as appropriate:

Getting up from the floor

Your physiotherapist will teach you this as part of your walking training.

Here we describe two ways of getting up – on your hands and knees and by lifting yourself backwards, and you will have been taught the best way for you, depending on your level of amputation, and the strength in your arms.

Before getting up, try and stay calm, and do not rush.
If you are lying awkwardly, try and move so that you are lying on your back with your legs out straight.
If any movement is too painful, STOP.
If you are in any pain, or doubt about moving and getting up, then follow the advice for ‘I should stay down’, and regularly perform your top to toe check.
During your fall your walking aids may have landed away from you. You may need to move across the floor on your bottom to retrieve them before getting up.

Getting up on your hands and knees

Check that you are able to get up, that you have no pain and that you can move your arms and legs normally. Move yourself close to an item of furniture which you can use to help you up. This may be your wheelchair (ensure the brakes are on) or an armchair.

Roll onto your side. Push yourself onto one
hip and bend your knees.

Push yourself up onto your hands and knees into a crawling position. If your amputation was above the knee, you can still use this
method by kneeling through the prosthetic knee. If you need to roll over to get into this
position it is best to go towards your sound leg so as not to ‘trap’ your prosthetic leg
beneath you.

Hold onto your wheelchair or armchair.

Facing the chair lift your sound leg and place
the foot flat on the floor.

Push up through your arms and your leg
to lift yourself into a standing position.

Turn yourself to sit on the chair.

Getting up by lifting yourself backwards

Taking off the arms of the wheelchair will also make holding the seat easier as you get up. Turn yourself so that your back is to the chair. You should sit about 5-6 inches in front of the chair.

Reach your hands behind you to hold the seat of the chair firmly. Bend your soundleg to firmly place your foot on the floor.

Push through your arms and your sound leg to lift yourself up onto the seat.

If the seat is too high, you may need to break the lift into two by using cushions from your settee. The method is then exactly the same.

Whichever way you use to get up from the floor make sure that you rest and check yourself over again before you try to move. Your prosthesis may have twisted or loosened during the fall, and you may need to take it off and re-adjust it. You will also be shaken and shocked from the fall, so take your time before you try to get up again. Always make sure that you tell somebody about your fall, and monitor yourself for any increase in pain or if you begin to feel unwell.

Always tell your GP or a health professional about your fall. If you have had 2 or more falls in the last 12 months and feel your ability to safely use your prosthesis has deteriorated, please inform a member of staff at the Centre. The team at the Centre can then assess you to help reduce the risk of you falling.

Also in this section

Useful Links

If you have any questions or concerns regarding the information above then please get in touch with the team at the Artificial Limb and Appliance Centre.

Artificial Limb and Appliance Centre (ALAC)
Rookwood Hospital
Fairwater Road
Llandaff
Cardiff
CF5 2YN

Reception / Appointments : 029 2031 3930
Physiotherapy Department: 029 2031 3921

Find out more on the Cardiff and Vale University Health Board website.