Limb ischemia is a complication of peripheral artery disease (PAD)which can lead to amputation. Amputation occurs in approximately 3-4% of PAD patients. In Indonesia, post-amputation patients are only hospitalized for the acute phase and the post-amputation rehabilitation programs must be done as an outpatient. This could be a barrier to the continuity of rehabilitation programs. A solution is the application of home-based rehabilitation programs. A 57-year-old female was referred from the Cardiothoracic Surgery Outpatient Clinic post-amputation with bilateral below-knees and partial-hands amputation after being diagnosed with PAD. On initial examination, all her elbows, wrists, thumbs, hips, and knees showed weakness. The patient received neuromuscular electrical stimulations (NMES) as well as a home-based rehabilitation programs. On the second examination, after considering the data from the clinical finding and supporting examination, the patient received bilateral below-knee prostheses and bilateral functional partial-hand prostheses, created using 3D printing technology with polylactic acid material. After a few months, she was able to do most of her activities of daily living (ADLs) independently, work as a shopkeeper in her store, and feel more confident interacting with others. A comprehensive rehabilitation programs, patient adherence to exercise, and caregiver support are critical to improving functional capacity and the quality of life in a patient with bilateral below-knee and bilateral partial-hand amputation caused by PAD.

Background: People with obesity tend to have balance disturbance and a higher fall risk than those with normal BMI. The Weight-bearing Exercise for Better Balance (WEBB) is an exercise program that could improve balance in the elderly population, but no study implementing the WEBB program on obese subjects. This study aims to analyze the effects of the telerehabilitation WEBB program on dynamic balance in obese subjects, measured by Maximized Reach Distance (%MAXD) and a composite score of the Modified Star Excursion Balance Test (mSEBT). Methods: Ten male participants aged 18-30 were recruited. Participants underwent the WEBB program 3 times a week for 8 weeks in their own homes under the supervision of the researchers. The intensity of the exercise was increased every 2 weeks. For the analysis, %MAXD and composite score mSEBT were used to assess the dynamic balance before and after the WEBB program. Results: There was a significant increase (p < 0.05) in %MAXD of both sides and all directions. The mSEBT composite score of both sides also significantly increased (p < 0.05). All the statistical results showed large effect sizes. Conclusion: The WEBB program through telerehabilitation is proven to significantly improve dynamic balance, as indicated by an increase in %MAXD and mSEBT composite scores in obese subjects.

Limb ischemia is a complication of peripheral artery disease (PAD)which can lead to amputation. Amputation occurs in approximately 3-4% of PAD patients. In Indonesia, post-amputation patients are only hospitalized for the acute phase and the post-amputation rehabilitation programs must be done as an outpatient. This could be a barrier to the continuity of rehabilitation programs. A solution is the application of home-based rehabilitation programs. A 57-year-old female was referred from the Cardiothoracic Surgery Outpatient Clinic post-amputation with bilateral below-knees and partial-hands amputation after being diagnosed with PAD. On initial examination, all her elbows, wrists, thumbs, hips, and knees showed weakness. The patient received neuromuscular electrical stimulations (NMES) as well as a home-based rehabilitation programs. On the second examination, after considering the data from the clinical finding and supporting examination, the patient received bilateral below-knee prostheses and bilateral functional partial-hand prostheses, created using 3D printing technology with polylactic acid material. After a few months, she was able to do most of her activities of daily living (ADLs) independently, work as a shopkeeper in her store, and feel more confident interacting with others. A comprehensive rehabilitation programs, patient adherence to exercise, and caregiver support are critical to improving functional capacity and the quality of life in a patient with bilateral below-knee and bilateral partial-hand amputation caused by PAD.