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<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><ref name="Manual TT">Muilenburg &amp;amp;amp; Wilson. A Manual for Below-Knee (Trans-Tibial) Amputees, 1996. http://www.oandp.com/resources/patientinfo/manuals/bkindex.htm (accessed 14 May 2014)</ref><ref name="Manual TF">Muilenburg &amp; Wilson. A Manual for Above-Knee (Trans-Femoral) Amputees, 1996. http://www.oandp.com/resources/patientinfo/manuals/akindex.htm (accessed 14 May 2014)</ref> == | == 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><ref name="Manual TT">Muilenburg &amp;amp;amp;amp; Wilson. A Manual for Below-Knee (Trans-Tibial) Amputees, 1996. http://www.oandp.com/resources/patientinfo/manuals/bkindex.htm (accessed 14 May 2014)</ref><ref name="Manual TF">Muilenburg &amp;amp; Wilson. A Manual for Above-Knee (Trans-Femoral) Amputees, 1996. http://www.oandp.com/resources/patientinfo/manuals/akindex.htm (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. | ||
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| Up to 6 | | Up to 6 | ||
| | | | ||
(1) assessment<ref name="Demey D">Demey Didier. PT Training Manual - Physiotherapy for patients with lower limb amputation. Handicap International, 2010.</ref>; bandaging | (1) assessment<ref name="AMP">Gailey RS et al. The Amputee Mobility Predictor: an instrument to assess determinants of the | ||
lower-limb amputee ability to ambulate. Arch Phys Med Rehabil 2002;83:613-27.</ref><ref name="Demey D">Demey Didier. PT Training Manual - Physiotherapy for patients with lower limb amputation. Handicap International, 2010.</ref>; bandaging | |||
(2) donation of mobility aids & training; bandaging (pt education); positioning & mobilization stump; scar treatment; transfers | (2) donation of mobility aids & training; bandaging (pt education); positioning & mobilization stump; scar treatment; transfers | ||
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(5) taking care of the stump: hygiene, skin care, automassage | (5) taking care of the stump: hygiene, skin care, automassage | ||
(6) roundup of previous sessions | (6) roundup of previous sessions, re-assessment | ||
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(5) taking care of the stump<ref name="State of Queensland">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)</ref>: hygiene, skin care, automassage; continue like in (4) | (5) taking care of the stump<ref name="State of Queensland">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)</ref>: hygiene, skin care, automassage; continue like in (4) | ||
(6) roundup of previous sessions | (6) roundup of previous sessions, re-assessment | ||
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(5) like (4); start sports activity | (5) like (4); start sports activity | ||
(6) roundup of previous sessions | (6) roundup of previous sessions, re-assessment | ||
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This list of treatment contents and activities is linked to specific references | |||
== <span style="line-height: 1.5em;">References</span> == | == <span style="line-height: 1.5em;">References</span> == | ||
Revision as of 11:53, 16 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][2][3][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[4][5]; 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, re-assessment |
|
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[6]: hygiene, skin care, automassage; continue like in (4) (6) roundup of previous sessions, re-assessment |
|
D Fitting Post-fitting rehabilitation[7] |
6 |
(1) static exercises; handling prosthesis (put-on/off); taking care of prosthesis & stump[6] (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, re-assessment |
This list of treatment contents and activities is linked to specific references
References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ World Health Organisation (WHO). The rehabilitation of people with amputations, 2004. http://www.posna.org/news/amputations.pdf (accessed 14 May 2014)
- ↑ Muilenburg &amp;amp;amp; Wilson. A Manual for Below-Knee (Trans-Tibial) Amputees, 1996. http://www.oandp.com/resources/patientinfo/manuals/bkindex.htm (accessed 14 May 2014)
- ↑ Muilenburg &amp; Wilson. A Manual for Above-Knee (Trans-Femoral) Amputees, 1996. http://www.oandp.com/resources/patientinfo/manuals/akindex.htm (accessed 14 May 2014)
- ↑ Gailey RS et al. The Amputee Mobility Predictor: an instrument to assess determinants of the lower-limb amputee ability to ambulate. Arch Phys Med Rehabil 2002;83:613-27.
- ↑ Demey Didier. PT Training Manual - Physiotherapy for patients with lower limb amputation. Handicap International, 2010.
- ↑ 6.0 6.1 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)
- ↑ 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)
