Table 2.

Level 2 device-specific physical therapy protocol.

Protocol		Description	Criteria for advancement to level 3
Level 2 (sessions 3 and 4)
	Evaluation	Reassessment as needed	N/Aa
	Strengthening	Progression to sitting, quadruped, planks, standing, and transitions	Independent in HEPb
	Stretching	Primarily used for cooldown at completion of each session	Independent in HEP
	Education	Description of HEP and purpose of each exercise	Verbalizes understanding of each exercise
	Gait training	Improving step length symmetry (eg, verbal cueing to increase step length on nonprosthesis side) and improving rollover on prosthesis side (eg, resistive gait training with TheraBand)	Ability to trigger power in prosthetic foot during gait >50% of steps and increased gait symmetry with verbal cueing for step length as determined through observational gait analysis
	Mobility training	Transfers (eg, stand-to-sit), and ramp negotiation	Able to maintain midline center of mass with stand-to-sit transfer
	Neuromuscular reeducation	Intact limb mobility (eg, rolling ball under intact limb) to promote weight shifting, static single limb balance training on prosthesis side with minimally necessary upper limb support and stepping exercises (eg, step touches 15-20 cm step in parallel bars and step touches to a cone in the parallel bars)	Independent in HEP
	HEP	Includes therapeutic exercises outlined in level 2	Independent in HEP

^aN/A: not applicable.

^bHEP: home exercise program.