Functional capacity of elderly with lower-limb amputation after prosthesis rehabilitation: a longitudinal study

Silva, Alana das Mercês; Furtado, Graziella; Santos, Isaías Pimentel dos; Silva, Cecília Barbosa da; Caldas, Larissa Rocha; Bernardes, Kionna Oliveira; Ferraz, Daniel Dominguez

doi:10.1080/17483107.2019.1684581

Cited by 28 publications

(27 citation statements)

References 29 publications

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“…Lower extremity amputation is defined as the complete loss in the transverse anatomical plane of any part of the lower limb and can be divided into major (above ankle, through knee, and up to hip amputations) and minor (foot and toes) amputations (Nather and Wong, 2013;Ang et al, 2017;Chan et al, 2019). Diabetic lower extremity amputation (DLEA) is a major surgical procedure performed in patients with diabetes and generally disruptive to patients' normal life and can have a profound and lasting impact on an individual's physical and functional capacity and quality of life (Liu et al, 2010;Holzer et al, 2014;Barg et al, 2017;Silva et al, 2019). Amputation-related physical inabilities affect patients' daily activities of living and their social roles and identities, which often leave them with a sense of dependency and powerlessness (Chini and Boemer, 2007;Sousa et al, 2009;Livingstone et al, 2011;Senra et al, 2012;Foster and Lauver, 2014;Grech and Debono, 2014;Washington and Williams, 2016).…”

Section: Introductionmentioning

confidence: 99%

“…These aspects emphasise the challenge and complexity of the rehabilitation phase of major DLEA after wound healing. Many research studies have also explored rehabilitation of patients with major amputation (Chini and Boemer, 2007;Sousa et al, 2009;Senra et al, 2012;Grech and Debono, 2014;Silva et al, 2019). Little is known about the early stages of DLEA where patients may have to grapple with potential slow-healing post-amputation wounds and cope with physical and psychosocial stress.…”

Section: Introductionmentioning

confidence: 99%

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Struggling for normality: experiences of patients with diabetic lower extremity amputations and post-amputation wounds in primary care

Zhu

Goh

Chew

et al. 2020

Prim Health Care Res Dev

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Aim: To explore the experiences of patients living with diabetic lower extremity amputation (DLEA) and its post-amputation wound in primary care. Background: DLEA, including both minor and major amputation, is a life-altering condition that brings numerous challenges to an individual’s life. Post-amputation physical wound healing is complicated and challenging because of wound dehiscence and prolonged healing times. Understanding patients’ experiences after DLEA with a post-amputation wound will enable healthcare professionals to develop interventions to assist patients in physical healing and psychosocial recovery. Methods: This study employs a qualitative design using interpretative phenomenological analysis (IPA). A purposive maximum variation sample of nine patients who had had lower extremity amputations and post-amputation wound attributed to diabetes in the previous 12 months was recruited from a primary care setting in Singapore. Semi-structured audio recorded one-to-one interviews with a duration of 45–60 min each were conducted between September 2018 and January 2019. The interviews were transcribed verbatim and analysed using IPA. Findings: The essential meaning of the phenomenon ‘the lived experiences for patients with DLEA and post-amputated wound’ can be interpreted as ‘struggling for “normality”’ which encompasses four domains of sense making: physical loss disrupted normality, emotional impact aggravated the disrupted normality, social challenges further provoked the disrupted normality, and attempt to regain normality. The study highlights the complex physical and psychosocial transition facing patients after DLEA before post-amputation wound closure. In primary care, an amputation, whether minor or major, is a life-altering experience that requires physical healing, emotional recovery, and social adaptation to regain normality. Patients living with DLEA and a post-amputation wound may benefit from an interdisciplinary team care model to assist them with physical and psychosocial adjustment and resume normality.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Struggling for normality: experiences of patients with diabetic lower extremity amputations and post-amputation wounds in primary care

Zhu

Goh

Chew

et al. 2020

Prim Health Care Res Dev

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“…Rehabilitation in geriatric amputate is always challenging (Silva et al, 2019). Bachmann et al(2010) have found that comprehensive geriatric assessment (CGA) leads to improved detection and documentation of geriatric problems.…”

Section: Discussionmentioning

confidence: 99%

“…Elderly people with a lower-limb amputation would facing a heavy burden on health resources, requiring comprehensive rehabilitation program and long-term care. The special characteristic of geriatric with lower-limb amputation, with multiple physical, psychological, cognitive, and social comorbidities, imposes unique challenges to ongoing rehabilitation care (Silva et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation of Vascular Transtibial Amputee Patients with Type 2 Diabetes Mellitus and Peripheral Artery Disease: A Case Report

Mayangsari¹,

Sulastri²

2021

IJRP

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Introduction: Most lower extremity amputations are currently caused by vascular disorders. Diabetes contributes to twothirds of all lower extremity amputations, while 6-10% of amputations are due to traumatic injury, and the remainder is due to a tumor. The role of physical medicine and rehabilitation experts is very important in providing an overview of the functional level based on the level of amputation. Case: 66 years old, female, referred from Orthopedic department with diagnosing right below-knee amputation 1 year ago, to be made a prosthesis. She underwent amputation because has an ulcer on the back of her foot that worsens and is always wet. She has diabetes mellitus type 2, diabetic nephropathy, hypertension, and peripheral artery disease that altered her condition. She already could do most of the daily activities and walk independently using a walker in a couple of months after surgery. From the physical examination, we found postural low back pain, limitation of right hip joint range of motion, peripheral polyneuropathy, decreased cardiorespiratory endurance, and less confident MFES that indicate fear of fall in geriatric. A complete geriatric assessment was done. Following the rehabilitation program for 6 months, the patient felt a more fit, full right hip range of motion was obtained. She walked more easily with her prosthesis and experienced improvements in physical function parameters Conclusion: The prosthesis was needed to decrease energy consumption during ambulation. Recommended amputation rehabilitation involves interaction between the health care team and the patient to achieve rehabilitation goals.

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“…4,[11][12][13][14] The quantitative studies measured prothesis use at different times ranging from discharge to 15 months after rehabilitation and their results varied both in terms of the quantity and quality of prosthesis use. [7][8][9][10][11][12][13][14] For instance, some studies found a declined of use 6,10 restricted functioning in mobility, 10 leisure and social role such as employment, 8, 9 and limited autonomy outdoors while others 7-8 reported increase prosthesis use overtime and higher functioning in activities of daily living. A qualitative meta-synthesis 13 of the literature reported that most studies focused on adaptation to the amputation and the prosthesis, the role of social relationships, and the impact of the prosthesis on identity.…”

mentioning

confidence: 99%

A Mixed-Methods Study on Prosthesis Use Among Older Canadians With Lower-Limb Amputations

Pousett¹,

Budzinski

Labbé

et al. 2021

Can. Prosthet. Orthot. J.

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BACKGROUND: The prevalence of lower-limb amputations (LLA) in older adults is increasing. Due to the substantial resources required for rehabilitation, there is growing interest in exploring prosthesis use as well as the factors that impact use for individuals with LLA. OBJECTIVES: To examine how older adults, those over 50 years old, with a new LLA use their prostheses following rehabilitation and to identify factors that increase or decrease prosthesis use after discharge from a rehabilitation hospital. METHODS: The StepWatch Activity Monitor, the Prosthetic Profile of the Amputee Questionnaire, and a semi-structured interview were used to measure prosthesis use and factors affecting use at 12 weeks post-discharge from a rehabilitation hospital. Descriptive statistics were calculated for the quantitative data and the qualitative interviews were analyzed using the International Classification of Functioning and Disability. RESULTS: Two user profiles emerged from the 11 participants’ use patterns. The Regular Users integrated their prosthesis into their lives, using it for various types of activities, while the Strategic Users wore their prosthesis to perform specific activities of daily and instrumental activities of daily living tasks. Body functions (e.g., pain), personal (e.g., feeling of independence), and environmental factors (e.g., home adaptations or social support) impacted prosthesis use. CONCLUSIONS: The emergence of profiles suggests variability in how older adults with LLA use their prosthesis after rehabilitation. However, the factors affecting prosthesis use were similar between the profiles. Therefore, while it is important for rehabilitation teams to consider patients’ individual needs when setting goals for prosthetic training, they must also consider common factors affecting prosthesis use. Layman's Abstract The prevalence of lower-limb amputations (LLA) in older adults is increasing. Because of the substantial resources rehabilitation demands, there is growing interest in exploring prosthesis use as well as the factors that impact use for individuals with LLA. In this study we examine how adults over the age of 50 with LLA use their prosthesis after rehabilitation. We also identify factors that increase or decrease prosthesis use after leaving a rehabilitation hospital. We used several measures to study prosthesis use. The StepWatch Activity Monitor, the Prosthetic Profile of the Amputee Questionnaire, and a semi-structured interview were all used to measure prosthesis use after 12 weeks from leaving a rehabilitation hospital. Two user profiles emerged from our data. The Regular Users integrated their prosthesis into their lives, using it for various types of activities, while the Strategic Users wore their prosthesis to perform specific ADL and IADL tasks. Body functions (e.g., pain), personal (e.g., feeling of independence), and environmental factors (e.g., home adaptations or social support) impacted prosthesis use. Our findings suggest there is variability in how older adults with LLA use their prosthesis after rehabilitation. However, the factors affecting prosthesis use were similar between the profiles. Therefore, while it is important for rehabilitation teams to consider patients’ individual needs when setting goals for prosthetic training, they must also consider common factors affecting prosthesis use. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36833/28219 How To Cite: Pousett B, Budzinski C, Labbé D, Miller WC. A mixed-methods study on prosthesis use among older Canadians with lower-limb amputations. Canadian Prosthetics & Orthotics Journal. 2021;Volume 4, Issue 1, No.10. https://doi.org/10.33137/cpoj.v4i1.36833 Corresponding Author: William C Miller,University of British Columbia, Vancouver, British Columbia (BC), Canada. E-Mail: bill.miller@ubc.caORCID: https://orcid.org/ 0000-0003-3060-0210

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Functional capacity of elderly with lower-limb amputation after prosthesis rehabilitation: a longitudinal study

Cited by 28 publications

References 29 publications

Struggling for normality: experiences of patients with diabetic lower extremity amputations and post-amputation wounds in primary care

Struggling for normality: experiences of patients with diabetic lower extremity amputations and post-amputation wounds in primary care

Rehabilitation of Vascular Transtibial Amputee Patients with Type 2 Diabetes Mellitus and Peripheral Artery Disease: A Case Report

A Mixed-Methods Study on Prosthesis Use Among Older Canadians With Lower-Limb Amputations

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