Pre-Fitting Management of the Patient with a Lower Limb Amputation: Difference between revisions
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== PRE-PROSTHETIC REHABILITATION PHASE == | == PRE-PROSTHETIC REHABILITATION PHASE == | ||
The PRE-PROSTHETIC rehabilitation phase of the lower limb amputee will include six components: | |||
#Physiotherapist preparation | |||
# Assessment of the amputee (see section 6 not covered in this section) | |||
#Patient education | |||
#Stump management | |||
#Exercise therapy | |||
#Restoring locus of control | |||
#Referral<br> | |||
=== | === Physiotherapist preparation === | ||
=== | === <br>Assessment of the amputee (see section 6 not covered in this section)<br> === | ||
=== | === Patient education<br> === | ||
=== Restoring locus of control<br> === | === Stump management<br> === | ||
=== Exercise therapy <br> === | |||
=== Restoring locus of control<br> === | |||
=== Referral<br> === | === Referral<br> === |
Revision as of 17:01, 2 March 2015
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Original Editor - Liezel Wegner
Top Contributors - Sheik Abdul Khadir, Admin, Leslie Angama, Tarina van der Stockt, Lucy Aird, Kim Jackson, Tony Lowe, Simisola Ajeyalemi and Amrita Patro
INTRODUCTION[edit | edit source]
The loss of a lower limb has severe implications for a person’s mobility, and ability to perform activities of daily living [1]. This negatively impacts on their participation and integration into society [2].The ultimate goal of rehabilitation after limb loss, is to ambulate successfully with the use of a prosthesis[3] . Prosthetic rehabilitation is a complex task that ideally requires input from a transdisciplinary rehabilitation team. However, most often physiotherapists are in charge of the physical rehabilitation process [4].
OVERVIEW OF THE REHABILITATION PROCESS[edit | edit source]
The rehabilitation process of the lower limb amputee consists of nine phases [5] , namely:
- pre-operative,
- amputation surgery,
- acute post-surgical,
- pre-prosthetic,
- prosthetic prescription,
- prosthetic training,
- community integration,
- vocational rehabilitation and
- follow up.
Table 1: Phases of amputee rehabilitation: Modified from Esquenazi &Meier (1996) cited in Esquenazi (2004).
Phase | Hallmark |
---|---|
Pre-operative | Assess body condition, patient education, surgical level discussion, postoperative prosthetic plans |
Amputation Surgery/Reconstruction | Length, myoplastic closure, soft tissue coverage, nerve, handling, rigid dressing |
Acute post-surgical | Wound healing, pain control, proximal body motion, emotional support |
Pre-prosthetic | Shaping, shrinking, increase muscle strength, restore patient locus of control |
Prosthetic Prescription | Team consensus on prosthetic prescription and fabrication |
Prosthetic Training | Increase prosthetic wearing and functional utilization |
Community Integration | Resumption of roles in family and community activities. Emotional equilibrium and healthy coping strategies. Recreational activities. |
Vocational Rehabilitation | Assess and plan vocational activities for future. May need further education, training or job modification. |
Follow-up | Life-long prosthetic, functional, medical assessment and emotional support |
PRE-PROSTHETIC REHABILITATION PHASE[edit | edit source]
The PRE-PROSTHETIC rehabilitation phase of the lower limb amputee will include six components:
- Physiotherapist preparation
- Assessment of the amputee (see section 6 not covered in this section)
- Patient education
- Stump management
- Exercise therapy
- Restoring locus of control
- Referral
Physiotherapist preparation[edit | edit source]
Assessment of the amputee (see section 6 not covered in this section)
[edit | edit source]
Patient education
[edit | edit source]
Stump management
[edit | edit source]
Exercise therapy
[edit | edit source]
Restoring locus of control
[edit | edit source]
Referral
[edit | edit source]
References
[edit | edit source]
- ↑ Dillingham TD & Pezzin LE. Rehabilitation setting and associated mortality and medical stability among persons with amputations. Archives of Physical and Medical Rehabilitation 2008; 89; 1038-1045.
- ↑ World Health Organisation (WHO). International classification of functioning disability and health (ICF). World Health Organisation 2001. Geneva.
- ↑ Lusardi MM, Postoperative and preprosthetic care. In Lusardi, MM, Jorge, M & Nielsen, CC editors. Orthotics and Prosthetics in Rehabilitation, Third Edition. Missouri: Elsevier, 2013.p. 532-594.
- ↑ Kaplan SL, Outcome measurement and management: First steps for the practicing clinician. Philadelphia, FA Davis Company, 2007.
- ↑ Esquenazi A. Amputation rehabilitation and prosthetic restoration: from surgery to community reintegration. Disability and Rehabilitation, 2004; 26,(14/15); 831–6.