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[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.
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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[1][2] |
|
A No Fitting Maintenance of a good stump; Prevention of complications |
Up to 6 |
(1) assessment[3]; 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[3] |
|
B Fitting Pre-fitting rehabilitation directly after surgery |
Up to 6 |
(1) assessment[3]; 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[3]; 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[4]: hygiene, skin care, automassage; continue like in (4) (6) roundup of previous sessions, re-assessment[3] |
|
D Fitting Post-fitting rehabilitation[5] |
6 |
(1) first assessment with prosthesis[3]; static exercises; handling prosthesis (donning & doffing); taking care of prosthesis & stump[4] (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[3] |
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)
- ↑ Demey Didier. PT Training Manual - Physiotherapy for patients with lower limb amputation. Handicap International, 2010.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 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.
- ↑ 4.0 4.1 State of Queensland (Queensland Health). 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)
