Background: Lower limb amputees face many challenges, and most of them prefer to use prosthetics for daily tasks and activities. The prosthesis is usually a combination of connected prosthetic components, and their spatial orientation is called the prosthetic alignment. Proper alignment is essential, as it substantially affects the quality and comfort of a prosthesis.   Objective: The aim of this study was to create a method that could accurately and effectively quantify the alignment of a transtibial and transfemoral prostheses using Vicon optical motion capture system.   Methods: Two experimental series were conducted. The first one was to test the repeatability of the measurement. Three analysts placed retroreflective markers on the prostheses three times, and five measurements were recorded each time. Alignment parameters were calculated in Vicon ProCalc for each measurement, and a standard error of measurement was found for each alignment parameter. The standard error of measurement was calculated from three variance components, between-analyst, within-analyst, and between-trial variability. The second experimental series was conducted to understand the relationship between alignment adjustments and the outcome parameters. The socket height, internal rotation, flexion, adduction, and translation were modified and measured. The socket translation was calculated in three coordinate systems to study how they affect the outcome.   Results: For the first experimental series, the standard error of measurement for every alignment parameter was below 3° and 6 mm. The between-analyst variability was the most prominent, and the parameters calculated in the sagittal plane were more reliable than those calculated in the frontal and transverse plane. In the second experimental series, there was a linear relationship between the modifications and the measured outcome. When a connection between two prosthetic components was changed by turning the screws one round, the average change in angle between them was 2°, and the average translation change was 4.4 mm. Of the three coordinate systems, the translation calculated in ankle coordinates was more reliable than in global coordinates and describe the translation more effectively than in socket coordinates.   Conclusion: The reliability of the measurements was considered good. The standard error of measurement was low, and the main variability resulted from differences in marker placement between the analysts. The results from the measured alignment changes were as expected. All the parameters could be effectively interpreted, and the ankle coordinates were considered advantageous in describing the socket translation.

Relative motion between residual limb and prosthetic socket is an indication of poor fit. Both the fabrication and fitting processes are highly subjective and a favorable result depends upon the technician's expertise. Although numerous methods exist to measure the relative motion, all have limitations and are not well suited for clinical use. A measurement system using optical sensors has been proposed by students at the Technische Universität Darmstadt and evaluations of a functional model have yielded promising results. In this thesis, the existing functional model is improved and expanded to use an array of sensors. A new microcontroller is selected and incorporated into the system. The software and data communication are optimized for fast, reliable performance and the system is then evaluated on a test rig to determine favorable calibration settings and quantify performance. System frequencies up to 1299 Hz are achieved. It is found that the surface microstructure has a dominant effect over short measurement distances; calibrations performed over longer distances are to be preferred. For the chosen calibration factors, the greatest relative errors over a 40 mm distance are found to be 0.90% ± 0.51% in the X direction and -4.76% ± 1.61% in the Y-direction. A systematic drift is also identified. The final system accommodates up to eight sensors and is controlled from a feature-rich MATLAB GUI. / Master of Science / In lower limb prosthetics, the amount of relative motion between the prosthesis and residual limb is considered an indicator of the quality of fit. As existing methods for measuring this motion are generally difficult to use, a simpler system is desired. The task for this master's thesis is to develop an existing functional model into a measurement system with multiple sensors and validate its performance. The first step is to upgrade the microcontroller responsible for reading the sensor data and transmitting it to the PC. The original codes for both the microcontroller and PC-side Graphical User Interface (GUI) are then examined and optimized for maximum speed. The system is expanded to accommodate multiple sensors and its performance evaluated using a test-rig. Finally, the completed system is prepared for use in a future study by creating the appropriate component housings, wiring, and software functionalities.

The ability to successfully negotiate stairs and steps is an important factor for functional independence. While work has been undertaken to understand the biomechanics of gait in lower-limb amputees, little is known about how amputees negotiate stairs and steps. This study aimed to determine the mechanics of landing in unilateral lower-limb amputees when stepping down to a new level. A secondary aim was to assess the effects of using a shank-mounted shock-absorbing device (Tele-Torsion Pylon) on the mechanics of landing. Methods Ten unilateral amputees (five transfemoral and five transtibial) and eight able-bodied controls performed single steps down to a new level (73 and 219 mm). Trials were repeated in amputees with the Tele-Torsion Pylon active and inactive. The mechanics of landing were evaluated by analysing peak limb longitudinal force, maximal limb shortening, lower extremity stiffness, and knee joint angular displacement during the initial contact period, and limb and ankle angle at the instant of ground-contact. Data were collected using a Vicon 3D motion analysis system and two force platforms. Findings Amputees landed on a straightened and near vertical limb. This limb position was maintained in transfemoral amputees, whereas in transtibial amputees knee flexion occurred. As a result lower extremity stiffness was significantly greater in transfemoral amputees compared to transtibial amputees and able-bodied controls (P < 0.001). The Tele-Torsion Pylon had little effect on the mechanics of landing in transtibial amputees, but brought about a reduction in lower extremity stiffness in transfemoral amputees (P < 0.05). Interpretation Amputees used a stepping strategy that ensured the direction of the ground reaction force vector was kept anterior of the knee joint centre. Using a Tele-Torsion Pylon may improve the mechanics of landing during downward stepping in transfemoral amputees.

Thesis (M Sport Sc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Limited data exists on a transition process of minimalist shoe running, warranting longitudinally designed studies. The primary aim of this study was thus to determine whether lower limb kinematics can be adapted, whether vertical average loading rate (VALR) can be attenuated, and whether lower limb joint moments can be altered by either novice or short-term (seven-week) minimalist shoe training. Ten experimental (EXP) habitually shod male endurance runners (age 24.10 ± 1.74; weekly training mileage 29.36 ± 8.51 km; BMI: 22.83 ± 8.55 kg/m2) volunteered to participate in a seven-week minimalist shoe transition programme. Eleven age and training matched control participants (CONT) (age 24.00 ± 2.18; weekly training mileage 24.90 ± 3.30 km; BMI: 23.78 ± 6.12) continued to run in their usual running shoes during the intervention period. All participants were provided with a pair of Vibram Fivefingers ® (VF). The VF intervention started at ~ 11% to 22% and ended at ~ 52% to 132% of the participants‘ usual shod training distance, determined by subjective lower limb comfort ratings. Lower limb biomechanics for barefoot: BF, minimalist: VF, and shod: SH were recorded with an eight-camera Vicon ® motion capture system, synchronized with a Bertec ® force plate, both prior to and after the transition programme. Twelve running trials at self-selected speeds were recorded bilaterally for each shoe condition. An inverse dynamic approach was used to calculate lower extremity joint moments. Primary parameters of interest were kinematic: step frequency (steps/min), step length (m), footstrike angles (FSA, degrees), strike index (SI,%); average vertical loading rate (VALR, BW/S) and sagittal and frontal plane peak joint moments (Nm/kg.m) of the ankle, knee and hip. At pre-testing, the results showed that for VALR, VF running was significantly higher than SH running but significantly lower than BF running (P < 0.05). Statistically significant shorter step lengths, higher step frequencies, greater plantar-flexion FSA, higher strike index, greater knee flexion FSA, and greater ankle inversion FSA were seen in BF and VF conditions compared to SH (P < 0.05). Statistically higher plantarflexion moment peak (PFM) while lower ankle dorsiflexion moment peak (DFM) and knee abduction moment peak (KAM) was found while BF and VF than SH running. The only statistically significant effect of the VF training intervention on kinematics was that of higher step frequency for the SH condition (P < 0.05), and greater inversion FSA in the BF condition. A trend was seen for the EXP group to increase VALR (P > 0.05). Ankle PFM peak significantly increased, while knee extensor moment peak (KEM) peak significantly decreased for the EXP group only (P < 0.05). Contrary to the initial hypothesis, novice or short-term VF training did not result in significantly attenuated VALR. However, alterations in joint moments suggest a shift in the distribution of external loads due to the VF training. Insufficient kinematic adaptation with VF training could be attributed to inability to sense higher VALR or due to greater perceived ratings of calf-Achilles discomfort, and may indicate that more than seven-weeks are required to transition and adapt to VF running. / AFRIKAANSE OPSOMMING: Beperkte data is beskikbaar oor die oorgangs fase van hardloop met minimalistiese skoene, langtermyn studies is dus nodig. Die primêre doel van die studie is om te bepaal of gemiddelde vertikale ladingstempo (VALR) verminder kan word en onderste-ledemaat gewrigsmomente aangepas kan word deur ‗n korttermyn oefenprogram in minimalistiese skoene. Tien experimentaal (EXP) manlike uithouvermoë hardlopers (ouderdom 24.10 ± 1.74; weeklikse oefen afstand 29.36 ± 8.51; BMI: 22.83 ± 8.55) wat gewoonlik in skoene hardloop het vrywillig ingestem om aan die sewe week minimalistiese-skoen oorgangsprogram deel te neem. Elf kontrole deelnemers wat gepas is volgens ouderdom en oefening, (ouderdom 24.00 ± 2.18; weeklikse oefening 24.90 ± 3.30 km; BMI: 23.78 ± 6.12 kg/m2) het in hulle gewone oefenskoene bly hardloop. Alle deelnemers het ‗n paar Vibram Fivefingers ®-skoene ontvang. Die VF intervensie het begin met ~ 11% tot 22% en geeinde met ~ 52% tot 132% van die deelnemers gewone afstande in SH. Biomeganiese aspekte van die onderste ledemate vir kaalvoet: BF, minimalisties: VF, en skoene: SH is deur middel van ‗n agt-kamera Vicon ® bewegingsisteem gesinkroniseer met ‗n Bertec ® kragplatform, voor en na die oorgangsprogram bepaal. Twaalf hardloop-pogings teen ‘n self-bepaalde spoed is bilateraal vir elke skoenkondisie gemeet. ‗n Omgekeerde dinamiese benadering is gebruik om die gewrigsmomente van die onderste ledemate te bepaal. Die primêre parameters van belang was kinematies: treefrekwensie, treelengte, voettrefhoeke (FSA), tree-indeks (SI); gemiddelde vertikale ladingstempo (VALR), en sagittale en frontale vlak piek gewrigsmomente van die enkel, knie en heup. By voor-toetsing, die resultate toon aan dat vir VALR, VF-hardloop betekenisvol hoër was in vergelyking met SH-hardloop, maar betekenisvol laer was in vergelyking met BF-hardloop (P < 0.05). Statisties beduidende korter tree, hoër treefrekwnesie, meer plantaarfleksie FSA, hoer ―strike index‖, meer kniefleksie FSA, en meer enkel inversie FSA is gevind in die BF en VF kondisie in vergelyking met SH (P < 0.05). Statistiese betekenisvol hoër plantaarfleksiemoment pieke (PFM), en minder enkel dorsiefleksiemoment pieke (DFM) en knie abduksiemoment pieke (KAD) was gevind by BF- en VF- hardloop in vergelyking met SH-hardloop (P < 0.05) Die enigste statistiese betekenisvolle verskil in die kinematika van die VF intervensie was ‗n hoër tree frekwensie vir die SH kondisie (P < 0.05), en groter enkel inversie FSA in die BF kondisie. Die EXP groep neig om ‗n verhoging in VALR te hê (P > 0.05). ‗n Aansienlike verhoging is gevind in piek enkel PFM, terwyl piek knie KEM statisties wesenlik verlaag het in die EXP groep (P < 0.05). In teenstelling met die oorspronklike hipotese het onmiddellike en 'n korttermyn VF oefenprogram nie 'n bekenisvolle effek op VALR vermindering nie. Sommige veranderings in gewrigsmomente suggereer dat 'n verplasing in die verspreiding van eksterne ladings plaasvind as gevolg van die VF oefening. Die onvoldoende kinematiese aanpassing kan moontlik toegeskryf word aan die onvermoë om hoër VALR waar te neem, of as gevolg van die hoër waargenome lesings in kuit-Achilles ongemak. Dit kan aandui da 'n VF oorgang proses van meer as sewe weke vereis word om aan te pas aan.

Pour comprendre et diagnostiquer les pathologies qui affectent l’organisation spatialede notre squelette, il est essentiel d’aborder ces problématiques en 3D. Le CT-Scan et l’IRMsont des modalités d’imagerie couramment utilisées en milieu clinique pour étudier en 3D notresystème musculosquelettique. La plupart de ces systèmes d’imagerie proposent une acquisitioncouchée sur laquelle les effets gravitaires ne sont pas pris en compte. Le CT-Scan est unemodalité particulièrement irradiante et l’IRM est plus spécifiquement dédiée à l’étude des tissusmous. Le système EOS permet de reconstruire en 3D les os à partir d’une paire deradiographies biplanes à faible dose d’irradiation. En plus, le système EOS propose uneacquisition en position debout, prenant en compte les effets gravitaires. Cette thèse contribue àl’amélioration des méthodes de reconstruction 3D des membres inférieurs à partir des radiosbiplanes. Dans le cadre de thèse on a proposé et évalué : 1) Une méthode de reconstruction3D des membres inférieurs s’appuyant sur des modèles paramétrés et des inférencesstatistiques. 2) Une méthode d’auto-amélioration de la reconstruction 3D des membresinférieurs en utilisant du traitement d’images local et le recalcul d’inférences statistiques. 3)Enfin, des méthodes utilisant des critères de similarité d’images et des critères morphologiquespour détecter de manière automatique le côté médial et latéral du fémur et du tibia. Le but estd’éviter l’inversion par l’opérateur de condyles fémoraux et plateaux tibiaux, affectant la valeurdes paramètres cliniques, surtout les torsions. La méthode de reconstruction proposée dans lecadre de cette thèse est intégrée dans le logiciel sterEOS® et utilisée dans une soixantained’hôpitaux au monde. Les méthodes développées dans le cadre de cette thèse ont permis deprogresser vers la reconstruction semi-automatisée, précise et robuste du membre inférieur / For a better understanding and diagnosis of the pathologies affecting the spatialorganization of our skeleton it is necessary to address them in 3D. CT-Scan and MRI areimaging modalities commonly used to study the musculoskeletal system in 3D. Moreover,patients are recorded in reclining position thus gravity effect can’t be taken into account.Furthermore, CT-Scan exposes patient to high radiation doses and MRI is used mostly tocharacterize soft tissues. With the EOS system, from a pair of low dose biplanar radiographs wecan reconstruct bones in 3D, and the radiographs are recorded in standing position thus gravityeffects are considered. This thesis contributes to the improvement of the 3D reconstructionmethods of lower limbs from biplanar radiographs. In this thesis we have proposed andevaluated: 1) A 3D reconstruction method of the lower limbs based on parametric models andstatistical inferences. 2) A method for the auto-improvement of the 3D reconstruction of thelower limbs. This method combines image processing and the recalculation of the statisticalinferences. 3) Finally, methods based on similarity measures and shape criteria were used todetect automatically the medial and lateral side of the femur and tibia. The aim of thesemethods is to avoid the inversion of the femoral and tibial condyles in biplanar radiographs.These inversions have an impact in the calculation of clinical measurements, particularly thetorsional ones. The reconstruction method proposed in this thesis is already integrated withinthe sterEOS® software, available in 60 hospitals around the world. The methods developed inthis thesis have led us to a semi-automatic, accurate and robust reconstruction of lower limbs.

This thesis deals with the current state of development of active lower limb prostheses and focuses mainly on own design of active prostheses. The introduction deals with the anatomy of lower limb and briefly describes the walk cycle. In other chapters are summarized amputation techniques in the lower limb, followed by a description of the allocation of prostheses according to the level of amputation, which were described in earlier chapters. The thesis also deals with the division of prostheses according to the patient's activity level and briefly describes the structural differences in these individual cases. Chapter describing the actual development in the field of active prostheses initiates part dealing with the detailed description of the part of the prosthesis. The following chapters deal with the design and implementation of a prototype of active transfemoral prosthesis. The penultimate chapter deals with the software description of all parts of the prosthesis. This chapter is followed by an evaluation of the achieved results.

Prosthesis treatment requires the close interaction of different actors. In fitting prostheses to patients, special attention is given to the manufacturing of the socket. The continuous development of the technologies involved in the fitting and optimization of prostheses is shown in the literature. The assessment of orthopedic technicians and their influence in the process is thus far largely unexplored. Ten orthopedic technicians were interviewed about the socket fitting process after transfemoral amputation. The research goal was to clarify the socket treatment process with regards to the German context. The results showed that the orthopedic technicians focussing on the patient during the fitting process. This study underlines the importance of interaction and empathy. Volume fluctuations are decisive within the treatment process and are interactively influenced by various factors. Furthermore, the research emphasizes the need for appropriate assistive technologies and the potential for the further development of existing systems.

Thesis (MScMedSc)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Lower limb amputations cause multiple physical, psychological, environmental and socioeconomic barriers. Individuals who have suffered a lower limb amputation require comprehensive rehabilitation to ensure social integration and economic self-sufficiency. In addition, constant monitoring and evaluation is an essential part of human service delivery programmes. However, the amputation rehabilitation programme offered at Elangeni an outpatient rehabilitation centre for clients with physical disabilities in Paarl, Western Cape, South Africa is not monitored, and has not been evaluated since its inception in 2000. Thus, the current study evolved to describe and evaluate the rehabilitation programme for persons with lower limb amputations at Elangeni. A mixed method descriptive design was implemented. All persons who received rehabilitation, after a major lower limb amputation at Elangeni, between 2000 to 2011, were included in the study population. In addition, the physiotherapist and occupational therapist that provided amputation rehabilitation at Elangeni, at the time of the study, were interviewed. Thirty participants who met the study inclusion criteria were identified. Quantitative data was collected using a researcher designed, structured demographic questionnaire, an International Classification of Function checklist based questionnaire and a participant rehabilitation folder audit form. Two interview schedules one for clients and one for therapists were used for guidance during semi structured interviews. Quantitative data was entered onto a spread sheet and analysed by a statistician using Statistica, version 8. Qualitative data was thematically analysed according to predetermined themes. No programme vision, mission or objectives could be identified for the amputation rehabilitation programme. Poor record keeping practices and a lack of statistics were found. Rehabilitation was impairment focused with no attention given to social integration. Clients who received prosthetic rehabilitation showed improved functional ability with regard to picking up objects from the floor (p = 0.031) getting up from the floor (p = 0.00069), getting out of the house (p = 0.023), going up and down stairs with a handrail (p = 0.037) and moving around in the yard (p = 0.0069), climbing stairs without a handrail (p = 0.037), going up and down a kerb (p = 0.0082) walking or propelling a wheelchair more than 1km (0.0089) and walking in inclement weather (0.017). A lack of indoor mobility training had a statistically significant negative impact on the participants’ ability to lift and carry objects (p 0.011), standing up from sitting (p = 0.042), getting around inside the house (p = 0.00023), picking up objects from the floor (p = 0.00068), getting up from the floor (p = 0.0072), getting out of the house (p = 0.0016), going up and down stairs with a handrail (p = 0.019), moving around in the yard (0.0013), going up and down stairs with-out a hand-rail (p = 0.019), getting up and down a kerb (p = 0.0022), walking or wheeling 1km or more (p = 0.0032) and using transport (p = 0.0034). Failure to address community mobility during rehabilitation had a statistically significant negative impact on all aspects of community mobility scores except doing transfers and driving. In conclusion, for the study participants, Elangeni failed to provide rehabilitation according to the social model of disability and Community Based Rehabilitation principles. It is recommended that managers, service providers, and clients re-consider the purpose of Elangeni and develop a vision and objectives for that service. In addition, management should take an active role in service monitoring and evaluation and provide guidance and mentorship to therapists. / AFRIKAANSE OPSOMMING: Onderste ledemate amputasies impak negatief op `n persoon se fisiese, sielkundige en sosiale funksionering. Individue wat ’n amputasie ondergaan het benodig omvattende rehabilitasie om sosiale integrasie en ekonomiese onafhanklikheid te verseker. Konstante monitering en evaluasie is ’n essensiële deel van rehabilitasie programme. Nietemin die amputasie rehabilitasie program wat by Elangeni aangebied word, word nie gemoniteer nie en was nog nooit geëvalueer nie. Dus het hierdie studie dit ten doel om die rehabilitasie programme vir persone met onderste ledemate amputasies by Elangeni te beskryf en te evalueer. Kwantitatiewe en kwalitatiewe navorsingsmetodes is in kombinasie gebruik in die studie. Alle persone wat rehabilitasie by Elangeni ontvang het na ’n onderste ledemaat amputasie, sowel as die terapeute wat by Elangeni werk, het die studie populasie gevorm. In totaal het 32 persone aan die studie deelgeneem. Kwantitatiewe data is met behulp van `ʼn demografiese vraelys, `ʼn ICF gebaseerde vraelys, en `ʼn leer oudit vorm ingesamel. Twee onderhoud skedules, een vir die kliënte en een vir die terapeute, is gebruik as riglyn tydens insameling van kwalitatiewe data. Kwantitatiewe data is statisties ontleed deur ʼn statistikus wat gebruik gemaak het van Statistica 8. Voorafbepaalde temas is gebruik tydens tematies ontleding van kwalitatiewe data. Geen program visie, missie of doelwitte kon geïdentifiseer word nie. Swak rekord houdings praktyke was gevind. Rehabilitasie het gefokus op die fisiese en nie op sosiale integrasie nie. Die kliënte wat prostetiese rehabilitasie ontvang het, het statisties beduidend beter gevaar ten opsigte van optel van voorwerpe van die vloer af (p = 0.031), om van die vloer af op te staan (p = 0.00069), om uit die huis uit te kom (p = 0.023), om trappe met `ʼn handreling te klim (p = 0.037), om op die erf rond te beweeg (p = 0.0069), om trappe sonder `ʼn reling te klim (p = 0.037), om by sypaadjies op en af te gaan (p = 0.0082), om meer as `ʼn kilometer te loop of met die rolstoele te ry (0.0089) en om in ongure weer te loop (0.017). `ʼn Tekort aan heropleiding van mobiliteit binne die huis het `ʼn statisties beduidende impak gehad op die vermoë om goed te dra (p 0.011), op te staan van sit af (p = 0.042), in die huis rond te beweeg (p = 0.00023), voorwerpe van die vloer af op te tel (p = 0.00068), van die vloer af op te staan (p = 0.0072), uit die huis uit te kom (p = 0.0016), trappe met `ʼn handreling te klim (p = 0.019), in die erf rond te beweeg (0.0013), trappe sonder `ʼn handreling te klim (p = 0.019), by `n sypaadjie op en af te gaan (p = 0.0022), meer as 1km te loop of met die rystoel te ry (p = 0.0032) en om vervoer te gebruik (p = 0.0034). `ʼn Gebrek aan heropleiding van gemeenskapsmobiliteit het `ʼn statisties negatiewe impak gehad op alle aspekte van gemeenskapsintegrasie behalwe die doen van oorplasings en bestuur. Rehabilitasie praktyke was nie gebaseer op die sosiale model van gestremdheid en Gemeenskap Gebaseerde Rehabilitasie beginsels nie. Dit word aanbeveel dat diens verskaffers, kliënte en bestuurders oor die fokus van rehabilitasie by Elangeni moet besin. Daar moet ʼn visie en doelwitte vir die diens ontwikkel word. Voorts moet bestuurders van distrik vlak ʼn aktiewe rol speel in die monitering en evaluasie van dienste en mentorskap aan terapeute verseker.

Title: Lower limb muscle activity during squat and technique seoi nage in judo Objectives: Goals of my work is finding activity lower muscle limb using surface electromyography in shallow squat, deep squat and seoi nage technic in judo. From the obtained results will be compared muscle activity in relative to MVC and compared timing activity of measuring muscles between deep squat and technic seoi nage right. Methods: Research component consisted of 10 subjects, 5 of fitness and 5 are active judokas. With using surface electromyography and kinematic analysis we monitored activity of measured muscles in shallow and deep squat, and seoi nage technic. The size of muscle activity was assessed in relation to MVC. Results: Evaluation of the results showed a higher involvement by m. gluteus maximus in deep squat than shallow squat. Deep squat makes higher muscles activity. Performing of seoi nage technique resulted in higher values by m. quadriceps femoris. Sequence involvement of muscles during deep squat and seoi nage techniques in selected subjects showed we a strong similarity with various techniques. Key words: Lower limb muscle,judo, electromyography, squat, seoi nage

The number of patients with diabetes mellitus has been increasing recently. The so-called diabetic leg and related amputation treatment belong to the complications of the disease. Amputation or removal of the end part of a limb obviously affects not only the physical aspect of a patient, but also the psychical, social and spiritual aspects. It is therefore vital that each nurse is able to choose from suitable techniques of communication with such patients and to provide them with sufficient support in the adaptation to a new life role. Callista Roy also dealt with this issue and developed a model named after her, which can be applied to patients adapting to a newly arisen situation, which amputation of a lower limb definitely is. Three goals were set in the thesis. The first one was to find out what kind of problems patients after amputation of a lower limb see in the individual adaptation modes according to C. Roy. Then we focused on the interventions applied by nurses to the support for the adaptation in the individual adaptation modes and to what extent nurses work with stimuli in Roy's conception. The research was based on the data collection by means of a qualitative method, the techniques of semi-structured interviews, and involved observation of patients after amputation of a lower limb and of nurses working at a standard surgery department. After the saturation of the research sample set the data was analysed and processed by means of the "pencil & paper" method. The research has shown that nurses devote particular attention to the physiologic adaptation mode and to the interdependence mode in their practice. In terms of the satisfaction of the basic physiologic needs they mostly mentioned the assistance in self-service activities, in the sphere of excretion and very often also interventions contributing to pain relief. In the self-concept group identity adaptation mode nurses mostly apply suitable communication and provision of sufficient information. In terms of the role function adaptation mode we can say that nurses search for this kind of information, but no activity supporting this mode was found among the nurses. Unlike nurses, who pay the highest attention to the satisfaction of the physiologic adaptation mode and thereto related interdependence mode, patients see shortcomings in all four adaptation modes. In the physiologic adaptation mode patients mostly pointed out problems with movement manifested themselves in the deficit of self-care. In the sphere of self-concept group identity, they mentioned the feeling of helplessness and inferiority. Nearly all patients see a problem in the dependence on the nursing staff and the disability to play the roles once played. Among the most frequent stimuli affecting a patient after lower limb amputation are pains that nurses relieve by means of analgesics prescribed by physicians, patients also often mention the approach of the staff and social interaction owing to the absence of family members. The research has shown that nurses approach patients with dignity and also respect the incoming visitors. The information obtained by this research can be used as a basis for seminars focused on this issue and lead to the improvement of the nursing care about patients with amputation of a lower limb.