PP06 - Week One

Introduction

In week one we are going to cover some basic topics that will prepare the groundwork for the next five weeks of the course.

You can see the online version of the week one email here.

In the video below Aicha Benyaich from the ICRC and Rachael Lowe introduce the topics of the week (Note - watching this video is optional).

Objectives for this week

At the end of this week you should be able to:

  1. Identify key elements of the rehabilitation treatment and prosthetic training across all phases of the rehabilitation process in a holistic approach.
  2. Define the role of the physiotherapist within the multidisciplinary/interdisciplinary environment during the phases of amputee rehabilitation and the steps included in each phase.
  3. Understand the major causes and pathologies leading to amputation.
  4. Understand the impact of the level of amputation on rehabilitation potential and on subsequent functional mobility.
  5. Understand the basic principles of biomechanics related to prosthetic alignment.

Essentials for the course

Before starting with the course topics please make sure that you have completed the pre-course activities, in particular:

  1. Sign up to the Discussion Forum so that you can contribute to the discussion.
  2. Complete the pre-course competency tool.

Topic 1: Overview of amputee rehabilitation

First let's take a look at an overview of the phases of rehabilitation for the individual with an amputation.

  1. Read the Physiopedia page Amputee Rehabilitation

Topic 2: Multidisciplinary/interdisciplinary team and the role of the physiotherapist

It is important to understand the holistic approach to rehabilitation following amputation and the role of the physiotherapist within the multidisciplinary/interdisciplinary environment.

  1. Read an overview of the Multidisciplinary/interdisciplinary management of the amputee in Physiopedia
  2. In the Engstrom text book:
    • Read about the roles of team members on pages 51-55
    • Read about some of the tools that may be used by the team to improve the overall quality of care on pages 596 -597
  3. Optional - listen to Kak Srood from the ICRC discuss the importance of interdisciplinary teamwork in the amputee rehabilitation centre in Northern Iraq (Note - the video and sound quality of this video call was poor)

Topic 3: Pathology leading to amputation

An understanding of the major causes of amputation will help you to appreciate how the process of rehabilitation may be influenced by the causative condition.

  1. Read about Pathology leading to amputation in Physiopedia
  2. In the Engstrom text book:
    • Read pages about causes of amputation on pages 21-24
    • Read about conditions predisposing to amputation on pages 39-45
    • Read how multi-pathology and complex cases can influence rehabilitation potential on pages 552-560

Topic 4: Principles of amputation

Principles of amputation include the rationale behind amputation surgery, the different levels of amputation and the effect of amputation on subsequent mobility and function.

  1. Read an overview of principles of amputation on Physiopedia.
  2. In the Engstrom text book:
    • Read about prosthetic considerations of the various levels of amputation, including those with presenting pathology, on pages 190-192
    • Read about hip and hindquarter levels on amputation on pages 299-300
    • Read about trans-femoral level of amputation on page 320
    • Read about knee disarticulation on pages 353-354
    • Read about trans-tibial level of amputation on 363-364
    • Read foot amputations on pages 394-400
    • Read about bilateral lower limb amputations on pages 408-409
  3. Lets finish off this topic by reading the section on general prosthetic knowledge, principles of amputation and causes of amputation from the ICRC PGA Manual page 11-15

Topic 5: Biomechanics

The aim of this topic is to review biomechanical principles and apply these to prosthetic rehabilitation in the lower limb amputee.

  1. Read the Physiopedia page Biomechanics in prosthetic rehabilitation

Quiz

You are not assessed on this quiz, it is designed as a learning experience and for you to test your knowledge on the topics this week.

Have a go at the quiz for week one

Case Study

Watch this video:


Find out more about Tesfa

Discussion 

Go to the Discussion Forum and add responses for the three discussion activities below. Please post your discussions as a comment in the relevant discussion thread that will be set up for you.

  1. If you are already working with amputees, what are the most common causes and types of amputations you meet in your working environment and are there any unique factors that influence the outcomes of rehabilitation where you work? If you do not currently work with amputees, explore the posts of your colleagues and feel free to ask questions.
  2. Tell us something about your team working environment.  How does your team work in relation to the concepts of multidisciplinary and interdisciplinary teamwork. What is your role and responsibility as a physiotherapist in this environment and how do you interact with the other team members, particularly when they are from other disciplines?
  3. In relation to the case presentation (video) what were/are some of the psychological and social impacts of amputation for Tesfahun, Joseeph and Akoussiwa.  How would this affect their treatment plan and functional goals.

Optional: Explore other resources

The following resources are optional for you to read/view but will further expand your knowledge on this week's topics:

ICRC-PGA-manual.png

Prosthetic Gait Analysis for Physiotherapists

This is the course textbook from ICRC which will be available to all participants of the course.

Access the book here

Alternatively you might be interested in having your own copy of the book.

Download your own FREE copy here

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Therapy for Amputees

This course textbook has kindly been provided by Elsevier and will be available to all participants of the course for FREE for the duration of the course. Please bear in mind that this book is fairly old so use it critically in addition to all the other resources that we will point you at.

Access the book here

Alternatively you might be interested in having your own copy of the book.

Buy with 20% discount from your local online Elsevier store (not available in all regions)

Buy PDF version for £4.99 direct from Physiopedia