Amputation/prosthetic foot or leg

Amputees have enormous demands when it comes to the properties of shoes. Even at the beginning of rehabilitation, having the right shoes has a significant impact on the individual’s later gait pattern. The kyBoot stands out from all of the other shoe models on the market thanks to its air-cushion sole. If the amputee struggles to roll over the ankle in normal shoes, this completely disappears with the kybun shoe. The soft, springy soles absorb impact on all surfaces and enable the prosthetic foot to gently use the rollover motion. This saves a lot of energy and relieves stress on the residual limb. As a result, the hips and back are also relieved, which often leads to increased quality of life. Click here if you are an amputee who wears a prosthesis and would like to get quick and thorough advice from an expert.

Definition

Amputation is the removal of a body extremity. An amputation above the ankle would be described as a major amputation. The term minor amputation denotes amputations below the ankle region (i.e. up to and including the Chopart amputation). Border zone amputation is a collective term used in German-speaking countries to refer to the combination of a minor amputation at the border to vital tissue, necrosectomy or debridement.

Causes

Most planned limb amputations are necessary as a consequence of arterial occlusion (peripheral arterial occlusive disease). The indication is usually established in stage IV, when extensive tissue necrosis or infected gangrene with pending sepsis develops and vascular surgery measures are not an option or have been exhausted. In exceptional cases the indication is also established in stage III when existing chronic pain cannot be managed and the patient’s quality of life is so restricted that the amputation is the ‘lesser evil’. The amputation level depends on the quality of circulation, which is determined by means of angiography, and the most effective prosthetic fitting option.

Diabetic gangrene is the second most common indication (see diabetes mellitus). In contrast to arterial occlusive disease, the aim here is to carry out what’s known as a ‘border zone amputation’. This means amputating at the most distal location possible, right in the area that is only just still healthy. These are therefore often amputations of the toes, the forefoot (amputation/disarticulation in the Chopart or Lisfranc joint) or the hindfoot (Pirogoff amputation). This approach, which used to be frowned upon and called ‘salami slicing’, has become widely accepted since the 1990s because of improvements in wound management, systemic antibiotic treatment and diabetes control. Nevertheless, many transtibial (lower leg) or transfemoral (thigh) amputations still have to be performed ‘ultima ratio’ as the final option.

Amputations due to accident injuries are rare compared to the first two indications.

Malignant tumours very rarely require a limb to be amputated. Usually these are bone or soft tissue tumours (sarcomas).
There has been a significant increase in amputations in recent years due to MRSA bacteria.

Possible consequences

  • Phantom sensations
  • Phantom pain
  • Postoperative pain
  • Residual limb pain
  • Neuroma pain
  • Wound healing problems, both superficial and deep
  • Deep wound infection
  • Residual limb necrosis
  • Residual limb oedema
  • Contractures
  • Skin diseases on the residual limb
  • Anxiety and depression

Conventional therapy

Aftercare following an amputation primarily covers three areas:
  • Prosthetic fitting
  • Administration of medications
  • Physiotherapy
  • Walking rehabilitation
Alternative forms of treatment such as acupuncture or mirror box therapy are used with great success as well.

The kybun principle of operation – being proactive

The kybun shoe offers a unique walking experience for customers with prosthetic legs:
  • Learning the physiological gait after an amputation is much easier with the kybun shoe thanks to the soft, springy soles, as the kybun shoe does not require the typical heel impact of other shoes and enables the wearer to feel contact with the ground.
  • This relieves the strain on the stump in the prosthetic.
  • The prosthesis holds better, i.e. it is not pushed away from the residual limb as much.
  • The soft, elastic sole compensates for surface irregularities.
  • The toes rarely get caught on the ground in the kybun shoe so you stumble much less often.
  • You can tread forward confidently on the prosthesis with an easy rollover.
  • Balance while standing and walking is significantly improved.
  • The legs no longer feel so heavy after walking.
  • You can walk more confidently, more relaxed and save more energy than in conventional shoes. Your gait is also improved.
  • Getting up from a chair or the toilet etc. or getting out of the car is much easier than with other shoes. We also shouldn’t forget the safety factor. The kybun shoe has a far wider stepping surface, which reduces the risk of slipping.
  • The kybun shoe is extremely slip-resistant on all dry and wet surfaces, even in snowy conditions and on wet stone floors.

Initial reactions

Specific initial reactions when wearing prosthetic legs You may find the first steps you take in the kybun shoe somewhat irritating. This is particularly true for customers who previously always wore hard shoes. This will only have a negligible effect for beginners learning how to walk again. Experience has shown that the body gets used to this within a short period of time. Be patient, it’ll be worth it. Click here for the general initial reactions experienced by kybun mat and kybun shoe beginners: Initial reactions

kybun exercises

For information about the special kybun Schuh exercises or the basic kybun mat exercises, please click here: kybun exercises

Application tips

  • Take small steps in your kybun shoes at first.
  • Be sure to maintain an upright body posture without cramping up!
  • Keep your gaze forward while keeping the shoulders loose.
  • We recommend a kybun shoe model with a weaker trampoline effect (Comfort or SlimFit sole). These models have a somewhat wider sole in the area of the midfoot, providing added stability.
    Seek advice from your local kybun expert.
  • Try to consciously perceive the feeling of the roll-off phases. Venture out onto different surfaces. You will subconsciously gain more confidence when walking.
    After a while, you will hardly pay any attention to your steps, which will allow you to relax when walking.
  • If a sole with a weaker trampoline effect is too unstable for you, we recommend the kybun mat. You can choose the thickness you are comfortable with (the thicker, the less stable, the more intensive the training). You can also hold on to a fixed object.
  • Precise movements are essential, especially if you suffer from joint pain or osteoarthritis. Pay attention to exact movements and be sure to take a break in case of fatigue or weakness. Lateral/medial rolling of the ankle joint on the soft, elastic material has to be corrected so that the load is applied to the leg with proper axial alignment and so that strain on the back is kept to a minimum. Read more under ‘Lateral/medial rolling of the ankle joint’.
  • Take your time! The kybun shoe and the kybun mat are intensive ‘training devices’ and pose a major challenge for the body. It may take a few months before you can walk in the kybun shoe or stand on the kybun mat for several hours in a row. The duration of use is highly individual and depends on numerous factors. It also varies from day to day. Listen to your body and accept your personal limits.
  • Contact a kybun dealer you trust if you have further questions, feel unstable or if there is no alleviation of pain when using the kybun shoe even though you are following the tips.

Opinions/customer testimonials

I had both my legs amputated at the thigh 25 years ago, and two years ago I had the latest high-tech prosthetics fitted. I’d hoped to be able to finally walk better with them but sadly this wasn’t the case and I was left disappointed. Despite the modern technology, which cost me €90,000, I still couldn’t walk on cobblestones.  But then I found the kybun shoes online. At first I was unsure about the soft sole of the kybun shoes but I discovered a completely new feeling after walking just a few steps. I felt like I could feel every millimetre of the ground. It was incredible that the prosthetic foot unexpectedly began to work and the kybun shoes perfected the entire roll-off phase of the foot. Getting up from a chair or out of the car has also proven to be much easier. I don’t slip on wet surfaces or snow anymore thanks to the kybun shoes.  I already have four pairs of kybun shoes now and cobblestones are no longer a problem! Jürgen Zeller is now a freelance consultant for kybun AG in southern Germany, acting as an expert adviser to other affected individuals. For more information, visit us at www.prothesen-tuning.de.

Jürgen Zeller from Freiburg im Breisgau, Germany
Wearing the kybun shoe makes it feel a lot more natural to walk with a prosthetic. It’s gentler on my back, too. It’s especially easier for me to walk down stairs when I’m wearing the kybun shoe. Mr Zeller provided us with fantastic advice – he did an excellent job of answering all of my questions. I would definitely order these shoes again, anytime.
Norbert Strittmatter from the Wutach Valley, Germany

I’ve been wearing kybun shoes for a couple of weeks now and I am so impressed by these shoes! I wear them both indoors and outdoors. Seven years after my amputation, I have finally found a shoe that comes close to restoring the quality of life I had before. They are lightweight shoes and you don’t feel them on your feet, so it’s like walking barefoot. My back is more relaxed and is no longer painful. The anti-slip sole also makes them really secure. Sure, the price isn’t exactly enticing. But what’s important is that the shoe makes a positive difference, so it’s worth spending a bit more.

Maria Klein from Germany
I too discovered the awesome kybun shoes – after years of searching for good shoes. I found them through Mr Jürgen Zeller. In 2009 I underwent a knee disarticulation on my right leg. Since then, I’ve been doing lots of sports, and I have to say that the kybun shoe has been a real ASSET to my (Genium) prosthesis!
Udo Wiedenhöft from Germany
Fantastic stuff! How did I find out about the kybun shoe? Jürgen posted a link to his page in our Facebook group. It made me curious. Why? My left leg is amputated above the knee and my right ankle is damaged, so I am regularly in pain. I wondered whether these shoes could mitigate the problem. We started an e-mail conversation and Jürgen immediately offered to provide me with a pair of test shoes. After 14 days, I was won over and I ordered a pair. What was it that convinced me? It’s like walking on a cloud. In my Salo shoes, every stride feels stiff like a goose step. By contrast, the kybun shoes soften my steps and the foot rollover is very comfortable. They also make it easier to climb stairs step-over-step. My footsteps are quieter – now I can sneak up on people! Walking on pavements also feels much better. So those are my first impressions after a couple of weeks of wearing the shoes. Sure, they aren’t exactly cheap. But the shoes are making a positive difference. Which is why I am convinced that buying them was a good decision. I would recommend these kybun shoes wholeheartedly. Thank you so much, Jürgen! Your tremendous commitment will ensure that lots more people will find out about the kybun shoe and will hopefully be inspired to try wearing these shoes.
Oliver Decker from Germany
My experiences with kybun shoes have been overwhelmingly positive. Shortly after my amputation, I met Jürgen Zeller at an appointment with my orthopaedic technician. It was through Jürgen that I received my first pair of kybun shoes. My right leg was also experiencing adverse effects from the accident, so I was thrilled with the kybun shoes from the very beginning. I have tried all sorts of expensive sports shoes, but none of them have come anywhere close to equalling the kybun shoes! kybun shoes soften the heel impact and make me feel secure. I can walk for a long time without my leg hurting and without the sole of my remaining foot getting sore. And with kybun shoe, I don’t need to worry about slipping when it’s damp or wet underfoot. With all other types of shoe, after a very short time my remaining foot starts hurting and the sole of my foot gets sore. With other shoes, I also feel much less secure when walking. I don’t find the kybun shoes to be unstable at all. These shoes help me in all kinds of situations and make me feel secure. Perhaps to begin with, it might feel slightly strange because you have to compensate a little. But I quickly noticed that these shoes help me to walk. I think that kybun shoes are the perfect footwear, especially for people who are starting to learn to walk with a prosthesis, because they help so much with walking.
Susanne Michel from Germany