Pre-Fitting Management of the Patient with a Lower Limb Amputation: Difference between revisions
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== OVERVIEW OF THE REHABILITATION PROCESS == | == OVERVIEW OF THE REHABILITATION PROCESS == | ||
The rehabilitation process of the lower limb amputee consists of nine phases <ref name="esq">Esquenazi A. Amputation rehabilitation and prosthetic restoration: from surgery to community reintegration. Disability and Rehabilitation, 2004; 26,(14/15); 831–6.</ref> , namely: | |||
*pre-operative, | |||
*amputation surgery, | |||
*acute post-surgical, | |||
*pre-prosthetic, | |||
*prosthetic prescription, | |||
*prosthetic training, | |||
*community integration, | |||
*vocational rehabilitation and | |||
*follow up. | |||
Table 1: Phases of amputee rehabilitation: Modified from Esquenazi &Meier (1996) cited in Esquenazi (2004). | |||
{| width="70%" border="1" cellpadding="1" cellspacing="1" | |||
|- | |||
! scope="col" | Phase | |||
! scope="col" | Hallmark | |||
|- | |||
| Pre-operative | |||
| Assess body condition, patient education, surgical level discussion, postoperative prosthetic plans | |||
|- | |||
| Amputation Surgery/Reconstruction | |||
| Length, myoplastic closure, soft tissue coverage, nerve, handling, rigid dressing | |||
|- | |||
| Acute post-surgical | |||
| Wound healing, pain control, proximal body motion, emotional support | |||
|- | |||
| '''Pre-prosthetic | |||
| '''Shaping, shrinking, increase muscle strength, restore patient locus of control''' | |||
|- | |||
| Prosthetic Prescription | |||
| Team consensus on prosthetic prescription and fabrication | |||
|- | |||
| Prosthetic Training | |||
| Increase prosthetic wearing and functional utilization | |||
|- | |||
| Community Integration | |||
| Resumption of roles in family and community activities. Emotional equilibrium and healthy coping strategies. Recreational activities. | |||
|- | |||
| Vocational Rehabilitation | |||
| Assess and plan vocational activities for future. May need further education, training or job modification. | |||
|- | |||
| Follow-up | |||
| Life-long prosthetic, functional, medical assessment and emotional support | |||
|} | |||
<br> | |||
== PRE-PROSTHETIC REHABILITATION PHASE == | == PRE-PROSTHETIC REHABILITATION PHASE == |
Revision as of 16:58, 2 March 2015
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INTRODUCTION[edit | edit source]
The loss of a lower limb has severe implications for a person’s mobility, and ability to perform activities of daily living [1]. This negatively impacts on their participation and integration into society [2].The ultimate goal of rehabilitation after limb loss, is to ambulate successfully with the use of a prosthesis[3] . Prosthetic rehabilitation is a complex task that ideally requires input from a transdisciplinary rehabilitation team. However, most often physiotherapists are in charge of the physical rehabilitation process [4].
OVERVIEW OF THE REHABILITATION PROCESS[edit | edit source]
The rehabilitation process of the lower limb amputee consists of nine phases [5] , namely:
- pre-operative,
- amputation surgery,
- acute post-surgical,
- pre-prosthetic,
- prosthetic prescription,
- prosthetic training,
- community integration,
- vocational rehabilitation and
- follow up.
Table 1: Phases of amputee rehabilitation: Modified from Esquenazi &Meier (1996) cited in Esquenazi (2004).
Phase | Hallmark |
---|---|
Pre-operative | Assess body condition, patient education, surgical level discussion, postoperative prosthetic plans |
Amputation Surgery/Reconstruction | Length, myoplastic closure, soft tissue coverage, nerve, handling, rigid dressing |
Acute post-surgical | Wound healing, pain control, proximal body motion, emotional support |
Pre-prosthetic | Shaping, shrinking, increase muscle strength, restore patient locus of control |
Prosthetic Prescription | Team consensus on prosthetic prescription and fabrication |
Prosthetic Training | Increase prosthetic wearing and functional utilization |
Community Integration | Resumption of roles in family and community activities. Emotional equilibrium and healthy coping strategies. Recreational activities. |
Vocational Rehabilitation | Assess and plan vocational activities for future. May need further education, training or job modification. |
Follow-up | Life-long prosthetic, functional, medical assessment and emotional support |
PRE-PROSTHETIC REHABILITATION PHASE[edit | edit source]
Physiotherapist preparation[edit | edit source]
Assessment of the amputee (see section 6 not covered in this section)
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Patient education
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Stump management
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Exercise therapy
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Restoring locus of control
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Referral
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References
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- ↑ Dillingham TD & Pezzin LE. Rehabilitation setting and associated mortality and medical stability among persons with amputations. Archives of Physical and Medical Rehabilitation 2008; 89; 1038-1045.
- ↑ World Health Organisation (WHO). International classification of functioning disability and health (ICF). World Health Organisation 2001. Geneva.
- ↑ Lusardi MM, Postoperative and preprosthetic care. In Lusardi, MM, Jorge, M & Nielsen, CC editors. Orthotics and Prosthetics in Rehabilitation, Third Edition. Missouri: Elsevier, 2013.p. 532-594.
- ↑ Kaplan SL, Outcome measurement and management: First steps for the practicing clinician. Philadelphia, FA Davis Company, 2007.
- ↑ Esquenazi A. Amputation rehabilitation and prosthetic restoration: from surgery to community reintegration. Disability and Rehabilitation, 2004; 26,(14/15); 831–6.