Basic rehabilitation protocol in a low resource setting or conflict/disaster context: Amputation: Difference between revisions

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'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}    
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}    


= <span style="line-height: 1.5em;" />Pre- and post-fitting rehab cycle for patients with a LL-amputation =
= Pre- and post-fitting rehab cycle for patients with a LL-amputation =
</div>  
</div>  
This table is a suggestion for a relatively normal rehab cycle of patients without complications. For more complex cases additional sessions will be necessary based on case-by-case-evaluation.  
This table is a suggestion for a relatively normal rehab cycle of patients without complications. For more complex cases additional sessions will be necessary based on case-by-case-evaluation.  


___________________________________________________________________________________
___________________________________________________________________________________  


Session (1) assessment =&gt; decision:
Session (1) assessment =&gt; decision:  


''A no fitting<br>B fitting after preparation start directly after surgery<br>C fitting after preparation start with healed stump<br>D postfitting''<br>___________________________________________________________________________________
''A no fitting =&gt; go to table &amp; see A<br>B fitting after preparation start directly after surgery =&gt; go to table &amp; see B<br>C fitting after preparation start with healed stump&nbsp;=&gt; go to table &amp; see C<br>D postfitting =&gt; go to table &amp; see D''<br>___________________________________________________________________________________  


{| width="800" border="1" cellpadding="1" cellspacing="1"
{| width="600" border="1" cellpadding="1" cellspacing="1"
|-
|-
|  
|  
'''Final outcome &amp;'''
'''Final outcome&nbsp;'''


'''procedure / objectives'''
'''&amp; procedure/ objectives'''


| '''Nr of Sessions'''
| '''Nr of sessions'''
| '''Content'''
| '''Content'''
|-
|-
|  
|  
''A No fitting''
''A No Fitting''


Maintenance of a good stump;&nbsp;
Maintenance of a good stump;&nbsp;
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Prevention of complications
Prevention of complications


| up to 6
| &nbsp;Up to 6
|  
|  
(1) assessment; bandaging
(1) assessment; bandaging


(2) donation of mobility aids &amp; training; bandaging (pt education); positioning &amp; mobilization stump; scar treatment;&nbsp;
(2) donation of mobility aids &amp; training; bandaging (pt education); positioning &amp; mobilization stump; scar treatment; transfers


(3) training with mobility aid; all of (2) with focus on independence (pt education)
(3) training with mob.aid; all of (2) with focus on independence (pt education)


(4) like (3) but more independence
(4) like (3) but more independence
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|-
|-
|  
|  
''B Fitting''
Pre-fitting rehabilitation directly after surgery
| &nbsp;Up to 6
|  
|  
|
(1) assessment; bandaging<br>
 
(2) donation mobility aids and training; bandaging; positioning &amp; careful &nbsp;mobilization of stump, until wound is healed then continue with (3) &nbsp;below (after wound closure)
 
|-
|-
|  
|  
''C Fitting''<span class="Apple-tab-span" style="white-space:pre"> </span>
<span class="Apple-tab-span" style="white-space:pre" />Pre-fitting rehabilitation after wound closure <br>
| &nbsp;Up to 6
|  
|  
|
(1) assessment; bandaging
 
(2) donation mobility aids &amp; training; bandaging; positioning &amp; mobilization stump; scar treatment; desensitization; transfers
 
(3) training with mob.aid; all of (2) with focus on independence; start weightbearing on stump; strengthening (classical &amp; in function eg. football)
 
(4) like (3) but more independence
 
(5) taking care of the stump: hygiene, skin care, automassage; continue like in (4)
 
(6) roundup of previous sessions
 
|-
|-
|  
|  
''&nbsp;D Fitting''
Post-fitting rehabilitation
| &nbsp;6
|  
|  
|
(1) static exercises; handling prosthesis (put-on/off); taking care of prosthesis &amp; stump
|}
 
(2) continue with (1); weight shift in parallel bars; gait training with mob.aid
 
(3) static balance exercises; simple transfers; continue gait training
 
(4) dynamic balance exercises; advanced transfers; advanced gait training &gt; obstacle course
 
(5) like (4); start sports activity


(6) roundup of previous sessions


|}


B Fitting<br>Pre-fitting rehabilitation directly after surgery Up to 6 sessions 1 assessment; bandaging<br>2 donation mobility aids and training; bandaging; positioning &amp; careful mobilization of stump, until wound is healed then continue with 3 below (after wound closure)<br>C Fitting<br>Pre-fitting rehabilitation after wound closure Up to 6 sessions 1 assessment; bandaging<br>2 donation mobility aids &amp; training; bandaging; positioning &amp; mobilization stump; scar treatment; desensitization; transfers<br>3 training with mob.aid; all of 2 with focus on independence; start weightbearing on stump; strengthening (classical &amp; in function eg football)<br>4 like 3 but more independence<br>5 taking care of the stump: hygiene, skin care, automassage; continue like in 4<br>6 roundup of previous sessions<br>D Fitting<br>Post-fitting rehabilitation 6 sessions 1 static exercises; handling prosthesis (put-on/off); taking care of prosthesis &amp; stump <br>2 continue with 1; weight shift in parallel bars; gait training with mob.aid<br>3 static balance exercises; simple transfers; continue gait training<br>4 dynamic balance exercises; advanced transfers; advanced gait training &gt; obstacle course<br>5 like 4; start sports activity<br>6 roundup of previous sessions<br>
<br>


== <span style="line-height: 1.5em;">References</span><span style="line-height: 1.5em;" /> ==
== <span style="line-height: 1.5em;">References</span> ==


References will automatically be added here, see [[Adding References|adding references tutorial]].  
References will automatically be added here, see [[Adding References|adding references tutorial]].  


<references />
<references />

Revision as of 17:51, 13 May 2014

Original Editor - Your name will be added here if you created the original content for this page.

Top Contributors - Cornelia Barth, Admin, Laura Ritchie, Kim Jackson and Claire Knott  

Pre- and post-fitting rehab cycle for patients with a LL-amputation[edit | edit source]

This table is a suggestion for a relatively normal rehab cycle of patients without complications. For more complex cases additional sessions will be necessary based on case-by-case-evaluation.

___________________________________________________________________________________

Session (1) assessment => decision:

A no fitting => go to table & see A
B fitting after preparation start directly after surgery => go to table & see B
C fitting after preparation start with healed stump => go to table & see C
D postfitting => go to table & see D

___________________________________________________________________________________

Final outcome 

& procedure/ objectives

Nr of sessions Content

A No Fitting

Maintenance of a good stump; 

Prevention of complications

 Up to 6

(1) assessment; bandaging

(2) donation of mobility aids & training; bandaging (pt education); positioning & mobilization stump; scar treatment; transfers

(3) training with mob.aid; all of (2) with focus on independence (pt education)

(4) like (3) but more independence

(5) taking care of the stump: hygiene, skin care, automassage

(6) roundup of previous sessions

B Fitting

Pre-fitting rehabilitation directly after surgery

 Up to 6

(1) assessment; bandaging

(2) donation mobility aids and training; bandaging; positioning & careful  mobilization of stump, until wound is healed then continue with (3)  below (after wound closure)

C Fitting

Pre-fitting rehabilitation after wound closure

 Up to 6

(1) assessment; bandaging

(2) donation mobility aids & training; bandaging; positioning & mobilization stump; scar treatment; desensitization; transfers

(3) training with mob.aid; all of (2) with focus on independence; start weightbearing on stump; strengthening (classical & in function eg. football)

(4) like (3) but more independence

(5) taking care of the stump: hygiene, skin care, automassage; continue like in (4)

(6) roundup of previous sessions

 D Fitting

Post-fitting rehabilitation

 6

(1) static exercises; handling prosthesis (put-on/off); taking care of prosthesis & stump

(2) continue with (1); weight shift in parallel bars; gait training with mob.aid

(3) static balance exercises; simple transfers; continue gait training

(4) dynamic balance exercises; advanced transfers; advanced gait training > obstacle course

(5) like (4); start sports activity

(6) roundup of previous sessions


References[edit | edit source]

References will automatically be added here, see adding references tutorial.