Many changes have prompted the authors to revise the first edition of this text. Firstly, changes in the legislation and organization of the National Health Service in the UK have resulted in the need for a more flexible and adaptable approach towards amputee management. These changes are ongoing and span across the acute episode in the hospital setting and care in the community setting. Secondly, prosthetic and wheelchair supply and management have altered significantly following the McColl Report of 1986, allowing a more flexible service for the amputee's individual needs. Smaller companies are supplying a greater variety of prostheses: new designs and components are constantly being made available and will increase as the European Common Market and world markets expand. There is now a separation between prosthetic service companies and the manufacturers of components and hardware. there is no longer a national overview of the service as it is now provided for, either on a regional or local basis. Thirdly, training, education, quality and standards issues are now also adressed at local level. This second edition addresses some of these aspects and aims to help the clinical physiotherapist to cope with this constantly changing scene by paying attention to basic principles. It is still intended as a handbook for qualified and student physiotherapists and as such is still practically orientated.
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