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

Original Editor - Cornelia Barth

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

Pre- and post-fitting rehab cycle for patients with a LL-amputation

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.

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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
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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 <span class="Apple-tab-span" style="white-space:pre" />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

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