Rehabilitation Outcome of Bilateral Lower Limb Amputees
Journal Title: Stanley Medical Journal - Year 2017, Vol 4, Issue 1
Abstract
Background: Bilateral Lower limb Amputation, according to WHO-ICF not only result in anatomical loss of structure but also impacts on participation of functional activities like bipedal stance, ambulation, vocational activities that need standing and walking in order to full fill his or her role in the society, Indeed amputees suffers psychologically in terms of self esteem and body image . It also affects the Quality of life in term of stump pain, phantom limb pain and fatigue due to increased energy expenditure. This study analyse epidemiological data as well as rehabilitation outcome measures of total of 32 subjects with bilateral Lower limb amputation who sought rehabilitation service at Government Institute of Rehabilitation Medicine, Madras Medical College, Chennai. Objective: To study the Rehabilitation outcome of Bilateral lower limb Amputations of different etiology and amputation levels on subjects rehabilitated at Government Institute of Rehabilitation Medicine, K.K. Nagar, Chennai attached to Madras Medical College. Materials and Methodology: Study Design –Prospective outcome study. Study Period- 2011 to 2016. Study Population & Settings -32 Subjects with Bilateral lower limb amputation, rehabilitated at Government Institute of Rehabilitation Medicine, KK Nagar, Madras Medical College. Inclusion CriteriaSubjects with age between 18 to 70 years , Males and Females , presenting with Traumatic due to road traffic accident, train traffic accident ,Dysvascular and any other etiology that resulted in Bilateral Amputation. Exclusion criteria-Subjects with age below 18 years/age above 71 years, unilateral lower limb amputation, involvement of upper limb amputation, congenital Limb deficiency who cannot give consent and mentally retarded were excluded. Outcome measures -The following criteria had been used to assess the functional outcome of Bilateral lower limb amputee-Ambulation status (by The Amputee Single Item Mobility Measure -AMPSIMM).-Prosthetic use/ compliance by Houghton scale,-Stump Pain, Phantom Pain at 2 months and 6 months after the 2nd amputation -Psychological status (by applying 5 stages of grief /in addition item hope for coping up with disability).-Energy expenditure in terms of Physiological cost Index. Conclusion: Rehabilitation of Bilateral amputation was time consuming and needed more training to overcome additional problems like with change in COG, loss of proprioception bilaterally leading loss of balance on standing and ambulating with prosthesis and increased energy expenditure Bilateral Lower limb amputees due to trauma ambulate better than those with dysvascular etiology. Ambulation status of younger individual Bilateral amputees and those with one or more natural knee joint is better when compared to older Bilateral amputees and those with loss of both natural knee joints respectively. Higher level Bilateral Trans-femoral amputation need more time and training than lower level Bilateral Trans-tibial amputations.
Authors and Affiliations
Ramesh C, Jayakumar T, Thirunavukkarasu P, Geetha Kalpana J, Chitrarasu K
Keywords
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