Table 3.

Level 3 device-specific physical therapy protocol.

Protocol		Description	Criteria for advancement
Level 3 (sessions 5 and 6)
	Evaluation	Reassessment as needed	N/Aa
	Strengthening	Review as needed	Independent in HEPb
	Stretching	To be used for cooldown at session completion	Independent in HEP
	Education	Gait training and purpose for improving symmetry	Verbalizes understanding of gait training
	Gait training	Promoting gait initiation on prosthesis side with anterior pelvic rotation (ie, manual techniques to facilitate or initiate anterior pelvic rotation while in parallel bars with progression to anterior stepping on prosthesis side), relaxed upright posture with ambulation (ie, verbal cueing to keep chest upright), and resistive gait training with TheraBand and verbal cues for increased step length with intact limb	Demonstrates ability to trigger power with at least 80% accuracy during level ground ambulation and increased gait symmetry, including upright posture, step length, and toe break as determined through observational gait analysis
	Mobility training	Ramp and stair negotiation	Hill Assessment Index score ≥6 (ie, step past more than half foot length, with assistive device)
	Neuromuscular reeducation	Four-directional resistance exercise on intact side while maintaining single limb stance on prosthesis side, static single limb balance training on prosthesis side to be progressed to noncompliant surface (eg, foam), and progression of stepping exercises to increase time in single limb stand on the prosthesis	Able to maintain single limb stance on prosthesis side with or without an assistive device for 15 seconds
	HEP	Includes therapeutic exercises in level 3	Independent in HEP

^aN/A: not applicable.

^bHEP: home exercise program.