Getting Up Off of the Floor: Floor to Stand Transfer for Bilateral Amputees- Prosthetic Training:Ep9

Key strategies & steps for floor-to-stand transfer (bilateral prosthetic users)

Practice the “safe way down” first (rehearse at home)

• Start on a low, stable surface (e.g., sofa or mattress/mat table).
• Begin facing the direction you’ll move.
• Bring the close leg back slightly and keep weight through the hands, then slide down onto knees.
• Continue to the “full wipeout” positions on the floor:
  • down onto knees/hands-and-knees
  • then onto back
  • then back to hands-and-knees (power position)

When you’ve fallen: don’t rush—stabilize first

• Pause to let your heart rate/blood pressure settle.
• If others are around, use clear communication:
  • ask them to stop yanking/pulling
  • tell them you’ll signal if you need help

Do a quick equipment check before attempting to rise

From a sitting/starting position, look at both prosthetic feet:

• ensure they’re facing upward/straight
• if not, reset/don correctly before standing

If something is broken, you may need major assistance (a wheelchair may be required).

Use a “position of power” to build stability

• Move into all-fours (hands and knees)—described as the power position.
• This position can help you:
  • crawl to safety / a higher surface
  • stabilize when standing is difficult

Blood pressure management technique

• After being flat/down, get your head up into a sitting/leaning position to equalize and reduce dizziness/pressure.

Two main ways to stand up (depending on available support)

Option A: Use the sofa to reduce lifting demand (easier for weaker patients)

• Get close to the support at an angle.
• Put hips up on the sofa slightly, then roll to reach a seated position.
• Finish with a sit-to-stand transfer:
  • you didn’t fully lift off the floor; the surface helps

Option B: Stand up in open space (harder; requires more energy)

• From the power position, straighten/lock out one prosthetic for a stable base.
• Shift weight toward the locked-out side.
• Bring the other side in and press up tall.
• Key emphasis: don’t bounce off balance—control the transition.

Core mechanics repeated throughout (to reduce fall risk)

• Lock out a prosthesis for stability before fully rising.
• When standing, be as stiff and stable as possible during assistance.
• Assistance cue:
  • keep close and stable,
  • but don’t yank the patient—
  • assistance should reduce the chance of re-falling while the patient re-centers.

Down to the floor for bilateral above-knee vs below-knee amputations

• Bilateral above-knee: hamstrings not connected (may aid descent mechanics)
• Below-knee focus: similar “power position” approach, with extra suspension concerns

Below-knee prosthesis suspension warning (high risk area)

• If kneeling causes the front wall to press into the suspension interface, it can damage materials—especially with:
  • sleeve suspension
  • elevated vacuum
• If vacuum is lost:
  • expect less control
  • possible pistoning/slip
• Be prepared to rise using the same technique, but with heightened awareness that stability may be reduced.

Self-care / safety communication tips (for both patient and bystanders)

Tell bystanders explicitly:

• “Please stop—don’t yank/pull. I have a technique.”
• “Please stand near me; I’ll let you know if I need help.”

Presenters / sources

• David Lawrence (presenter)
• Robert (demonstration participant/patient)
• Carol (demonstration participant/patient)
• Mission Gait (source/series: “prosthetic interventions” on YouTube)