scholarly journals Narratives of Recovery Over the First Year After Major Lower Limb Loss

2020 ◽  
Vol 30 (13) ◽  
pp. 2049-2063
Author(s):  
Phoebe Sanders ◽  
Ross Wadey ◽  
Melissa Day ◽  
Stacy Winter
Keyword(s):  
National Health Service ◽  
Narrative Analysis ◽  
Lower Limb ◽  
Well Being ◽  
Limb Amputation ◽  
First Year ◽  
Rehabilitation Center ◽  
Prosthetic Rehabilitation ◽  
Psychosocial Experiences ◽  
Opening Up

The objectives of this research were to extend previous research by exploring the psychosocial experiences of patients over the first year after major lower limb amputation (MLLA) and identify implications for rehabilitation practice. This research took place at a United Kingdom–based National Health Service–operated prosthetic rehabilitation center. Thirty patients were recruited who had experienced MLLA within the last year and were undertaking prosthetic rehabilitation. Data were collected through semi-structured narrative interviews, observation, and a reflexive journal and analyzed using dialogical narrative analysis. The concept of well-being was used to map patients’ recovery trajectories, and five narrative typologies were identified: accelerated decline, adaptation, illusory cure, muddling along, and projection. This article advances knowledge by opening up new possibilities for anticipating patients’ future needs through the stories they are telling in the present and provides the basis for additional resources supporting psychosocial recovery.

scholarly journals A qualitative study of the challenges of providing pre-prosthetic rehabilitation in rural South Africa

2017 ◽  
Vol 42 (2) ◽  
pp. 179-186 ◽  
Author(s):  
Liezel Ennion ◽  
Anton Johannesson
Keyword(s):  
South Africa ◽  
Lower Limb ◽  
Rural Setting ◽  
Limb Amputation ◽  
Prosthetic Rehabilitation ◽  
Rural South ◽  
Physical Strength ◽  
District Hospitals ◽  
Fitting In ◽  
Rural South Africa

Background: There is a known shortage of rehabilitation staff in rural settings and a sharp increase in the number of lower limb amputations being performed. A lack of adequate pre-prosthetic rehabilitation will result in worse physical and psychological outcomes for a person with a lower limb amputation, and they will not be eligible to be fitted with a prosthesis. Objective: To explore therapists’ experiences with providing pre-prosthetic rehabilitation in a rural setting. Study design: A qualitative descriptive approach was used to collect and analyse data. Methods: Data were collected from 17 purposively sampled therapists in five district hospitals in a rural community in South Africa. Data were collected in two rounds of focus groups to explore the challenges of providing pre-prosthetic rehabilitation in rural South Africa. Results: The main themes identified in the study were (1) a lack of government health system support, (2) poor socioeconomic circumstances of patients and (3) cultural factors that influence rehabilitation. These themes all negatively influence the therapists’ ability to follow up patients for pre-prosthetic rehabilitation after discharge from hospital. A lack of adequate pre-prosthetic rehabilitation is a substantial barrier to prosthetic fitting in rural South Africa. Patients who do not receive pre-prosthetic rehabilitation have a poorly shaped residuum or other complications such as knee or hip joint contractures which disqualifies them from being referred to prosthetic services. Conclusion: Therapists involved in this study identified the most important barriers to patients having access to prosthetic services. Clinical relevance Pre-prosthetic rehabilitation provides care of the residuum; maintenance or improvement of physical strength, joint range of motion and referral to a prosthetist. By exploring the challenges known to exist in this service, we can identify potential ways to reduce these barriers and improve the lives of those who use it.

scholarly journals Goal pursuit, goal adjustment, and affective well-being following lower limb amputation

2013 ◽  
Vol 19 (2) ◽  
pp. 409-424 ◽  
Author(s):  
Laura Coffey ◽  
Pamela Gallagher ◽  
Deirdre Desmond ◽  
Nicola Ryall
Keyword(s):  
Lower Limb ◽  
Goal Pursuit ◽  
Well Being ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Goal Adjustment

scholarly journals Dual motor disability in an outpatient rehabilitation center

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Marina Portugal Makhoul ◽  
Kelly de Jesus Santana ◽  
Uleida de Brito Lima Lopes ◽  
Nádia Baggio Barreto Rodrigues ◽  
Christina de Farias Dell’Aglio ◽  
...  
Keyword(s):  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Outpatient Rehabilitation ◽  
Time Interval ◽  
Rehabilitation Center ◽  
Motor Disability ◽  
Rehabilitation Period ◽  
Long Time ◽  
Social Demographic

Objectives: To estimate the prevalence of dual motor disability and to identify social, demographic, clinical and rehabilitation-related characteristics. Methods: Retrospective descriptive study in an outpatient rehabilitation center with individuals with dual motor disability from major lower limb amputation associated to post-stroke hemiparesis. Social demographic, clinical and rehabilitation characteristics data were collected from medical record. Results: The prevalence of dual motor disability was 5.4%. Seventy-six subjects were evaluated, 69.7% were male, with a mean age of 65.6 ± 9.3 years. Hypertension was present in 96.1% of subjects, and 25% were smokers. Over 73% of patients had had the stroke prior to amputation. Time elapsed between lesions had a median of 23 months, and sequelae were ipsilateral in 51.3% of patients. Of these, 54 patients (71%) were referred to physical therapy. The time interval between dual disability and the beginning of therapy was 28 months, with total rehabilitation time of 14.3 months. At rehabilitation completion, 36% achieved their goals but 30% were discharges consequent to lack of compliance. Conclusion: The prevalence of dual motor disability due to hemiparesis secondary to stroke and lower limb amputation in a rehabilitation center was 5.4%. Our population showed singular characteristics related to the rehabilitation process, such as a long time between the occurrence of dual disability and the beginning of rehabilitation, and long rehabilitation period.

scholarly journals Issues Faced by Prosthetists and Physiotherapists During Lower-Limb Prosthetic Rehabilitation: A Thematic Analysis

2022 ◽  
Vol 2 ◽  
Author(s):  
Shruti Turner ◽  
Athina Belsi ◽  
Alison H. McGregor
Keyword(s):  
Thematic Analysis ◽  
Lower Limb ◽  
Limb Amputation ◽  
Service Users ◽  
Prosthetic Rehabilitation ◽  
Structured Interviews ◽  
User Perspective ◽  
Prosthetic Socket ◽  
Clinician Perspectives ◽  
Insight Into

Successful prosthetic rehabilitation is essential to improve the physical and mental outcomes of people with lower-limb amputation. Evaluation of prosthetic services from a prosthesis user perspective have been published and commissioned by the national bodies, however, the perspectives of clinicians working with service users during rehabilitation have not to date been sought. We sought to determine factors impacting lower-limb prosthetic rehabilitation from a clinician's perspective to inform studies focusing on prosthetic and socket design and fitting. Six clinician (2 prosthetists, 4 physiotherapists) interviewees were self-selected from a survey exploring issues and frustrations during lower-limb prosthetic rehabilitation. Semi-structured interviews explored the impactors on and frustrations with rehabilitation and the prosthetic socket. A thematic analysis was subsequently conducted to identify themes in the responses. Five themes were identified: Service Disparity, Body Impactors, Consequences of Ill-Fit, Prosthesis Irritants, and Limitations of Practice. Each theme, though distinct, relates to the others either as a cause or consequence and should be viewed as such. Addressing the themes will have benefits beyond the issues addressed but also expand into the other themes. This study provides an insight into the clinician perspectives on lower-limb prosthetic rehabilitation, which has not been formally documented to date.

scholarly journals Physical activity guidelines and promotion: An online survey of United Kingdom’s prosthetic rehabilitation healthcare professionals

2020 ◽  
Vol 44 (4) ◽  
pp. 192-201
Author(s):  
Sarah Deans ◽  
Alison Kirk ◽  
Anthony McGarry ◽  
David Rowe
Keyword(s):  
Physical Activity ◽  
Lower Limb ◽  
Healthcare Professionals ◽  
Educational Institution ◽  
Physical Activity Promotion ◽  
Well Being ◽  
Common Source ◽  
Prosthetic Rehabilitation ◽  
Physical Activity Guidelines ◽  
Activity Promotion

Background: Healthcare professionals play a key role in supporting physical activity participation for people with lower limb absence. Objectives: The objectives of this study were to survey healthcare professionals’ views of people with lower limb absence in the United Kingdom, explore their awareness and knowledge of physical activity recommendations and investigate their current and desirable practice towards physical activity promotion. Study design: Cross-sectional study. Methods: Potential participants were identified from open-access health-related databases, educational institution databases, and the authors’ professional networks. An online 40-item questionnaire was distributed electronically and by post. Survey items were multiple choice, Likert-type scale or open-ended questions to explore the characteristics of healthcare professionals, awareness/knowledge of physical activity guidelines, current and desired practice and views on physical activity promotion. Results: In total, 106 people responded. Physiotherapists had greater awareness/knowledge of physical activity guidelines compared to prosthetists/orthotists and other respondents. Awareness/knowledge of guidelines decreased as age, experience and time since qualification increased. The most common source of knowledge was self-directed learning. Conclusion: Continuing and improving education on the content of physical activity guidelines may be helpful for healthcare professionals in promoting physical activity to those with lower limb absence. Clinical relevance This research aims to inform prosthetic rehabilitation professionals and academics about an under-researched area within physical activity for health. This knowledge could help develop interventions with the aim of improving physical activity promotion and participation, and ultimately the health and well-being of people with limb absence.

Cardiorespiratory fitness and physical strain during prosthetic rehabilitation after lower limb amputation

2019 ◽  
Vol 43 (4) ◽  
pp. 418-425
Author(s):  
Daphne Wezenberg ◽  
Rienk Dekker ◽  
Frank van Dijk ◽  
Willemijn Faber ◽  
Lucas van der Woude ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiorespiratory Fitness ◽  
Aerobic Capacity ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Prosthetic Rehabilitation ◽  
Physical Strain ◽  
Individual Level ◽  
The Individual

Background: Sufficient cardiorespiratory fitness has been regarded a prerequisite for prosthetic walking. In order to improve cardiorespiratory fitness, adequate strain ought to be placed on the system during training. Objectives: To determine cardiorespiratory fitness at the start and end of inpatient rehabilitation after lower limb amputation and determine the physical strain experienced during conventional prosthetic rehabilitation. Study design: Multicenter prospective cohort study. Methods: Cardiorespiratory fitness was assessed using a peak one-legged cycle exercise test. Physical strain was assessed during a minimum of three full rehabilitation days using heart rate recordings. Physical strain was expressed in the time per day that heart rate exceeded 40% of heart rate reserve. Results: At the start of rehabilitation, peak aerobic capacity was on average 16.9 (SD, 6.5) mL/kg/min ( n = 33). Overall, peak aerobic capacity did not improve over the course of rehabilitation ( n = 23, p = 0.464). Fifty percent of the patients experienced a physical strain level that satisfies minimum criteria for maintaining cardiorespiratory fitness (>40% heart rate reserve for 30 min/day). Conclusion: Cardiorespiratory fitness was low and did not increase during conventional prosthetic rehabilitation. On average, the physical strain during rehabilitation was insufficient to elicit potential improvements in aerobic capacity. Results stress the need for dedicated physical training modules at the individual level. Clinical relevance This study shows that clinicians ought to be aware of the relatively low cardiorespiratory fitness of people who have undergone lower limb amputation and that improvements during rehabilitation are not always obtained. Results stress the need for physical training modules in which intensity is imposed at the individual level.

People with lower limb amputation and their sexual functioning and sexual well-being

2014 ◽  
Vol 37 (3) ◽  
pp. 187-193 ◽  
Author(s):  
Jesse Elisabeth Verschuren ◽  
Jan H. Geertzen ◽  
Paul Enzlin ◽  
Pieter U. Dijkstra ◽  
Rienk Dekker
Keyword(s):  
Lower Limb ◽  
Sexual Functioning ◽  
Well Being ◽  
Lower Limb Amputation ◽  
Limb Amputation
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