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

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== Pre- and post-fitting rehab cycle for patients with a LL-amputation  ==
== Pre- and post-fitting rehab cycle for patients with a LL-amputation<ref name="WHO">World Health Organisation (WHO). The rehabilitation of people with amputations. 2004. http://www.posna.org/news/amputations.pdf (accessed 14 May 2014)</ref> ==


The following 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.  
The following 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.  

Revision as of 18:16, 14 May 2014

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[1][edit | edit source]

The following 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[2]; bandaging

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

(3) training with mobility aids; 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 of mobility aids & 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[3]: hygiene, skin care, automassage; continue like in (4)

(6) roundup of previous sessions

 D Fitting

Post-fitting rehabilitation[4]

 6

(1) static exercises; handling prosthesis (put-on/off); taking care of prosthesis & stump[3]

(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.

  1. World Health Organisation (WHO). The rehabilitation of people with amputations. 2004. http://www.posna.org/news/amputations.pdf (accessed 14 May 2014)
  2. Demey Didier. PT Training Manual - Physiotherapy for patients with lower limb amputation. Handicap International, 2010.
  3. 3.0 3.1 State of Queensland (Queensland Health). Disease fact sheet: Caring for your stump. http://www.health.qld.gov.au/qals/docs/stump_care.pdf (accessed 14 May 2014)
  4. International Committee of the Red Cross et al. Exercises for lower limb amputees, gait training. http://www.icrc.org/eng/assets/files/other/icrc_002_0936.pdf (accessed 14 May 2014)