Immediate prosthesis fitting and comprehensive rehabilitation following lower limb amputation – the most important components of physiotherapy
Journal Title: Rehabilitacja Medyczna - Year 2006, Vol 10, Issue 1
Abstract
In this paper, a model of rehabilitation and immediate prosthesis fitting following lower limb amputation was presented. Advantages of amputee’s treatment in a specialised centre for comprehensive rehabilitation, beginning with the first days of hospitalisation up to the point of achievement of optimal physical fitness and independence allowing hospital discharge, were emphasised. Psychological support offered to the patients was addressed. Peculiar character of physiotherapist’s range of activity both in patients’ rehabilitation and prosthesis fitting was presented. The role of early prosthesis application was emphasised by presenting successive stages of fabrication of the temporary and then the definitive prosthesis, from taking the measure, formation of stump positive and, subsequently, of particular components of the prosthesis, up to its regulation, definitive assembly of all parts and finishing. Examples of prosthetic solutions for instrumentation of irregularly shaped stumps were described and shown. The essence of correct stump positioning for preventing contractures as well as its bandaging to combat post-operation oedema, to reduce pain, accelerate post-surgery wound healing and stump formation was denoted. Successive stages of patient’s mobilisation, assuming the erect posture and gait learning, including walking on a stairway, uneven ground and overcoming obstacles, as well as types of the performed kinesitherapeutic exercises and most frequently used physiotherapeutic procedures were distinguished. Forms of sport-recreational treatment and integration activities aiming at patient’s best possible preparation for independent life were discussed. Additionally, the spectrum of ergotherapist’s activities, including patient home visits to adjust household conditions to new patient’s needs, was presented. Finally, based on a case report of a patient in advanced age with prolonged stump healing, the whole process of immediate prosthetic fitting and comprehensive rehabilitation, starting with the day of admission to the rehabilitation centre up to the point of definitive application of the prosthesis and achievement of complete independence, was described.
Authors and Affiliations
Aneta Pirowska, Tomasz Włoch, Roman Nowobilski
Keywords
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