COMMON CAUSES OF LOWER LIMB AMPUTATION IN A RURAL COMMUNITY IN SOUTH AFRICA

Background: Persons with disabilities who reside in rural areas experience challenges accessing and utilising health services and rehabilitation. Due to the high prevalence of diabetes mellitus in rural regions, the risk of having a lower-limb amputation is increasing. Comprehensive rehabilitation is vital to mitigate the negative impact that a lower-limb amputation has on a person. Objective: To explore the barriers and facilitators to accessing rehabilitation experienced by persons with lower-limb amputations in a rural setting. Study Design: A qualitative descriptive approach was used to collect and analyse data. Methods: Data were collected from 11 conveniently sampled participants from three sub-district hospitals in the rural iLembe district, Kwa-Zulu Natal, South Africa. Data were collected using semi-structured interviews to explore the barriers and facilitators perceived by persons with lower-limb amputations in a rural region. Results: The three main barriers identified in this study were environmental factors, financial constraints and impairments. These barriers negatively impacted the participant’s utilisation of rehabilitation. The two main facilitators identified were environmental facilitators and personal factors which aided participant’s utilisation of rehabilitation. Conclusion: Access to rehabilitation was mainly hindered by the challenges utilising transport to the hospital, while self-motivation to improve was the strongest facilitator to utilising rehabilitation. Clinical relevance Rehabilitation is essential in preparation for prosthetic fitting. If a person cannot access rehabilitation services, they will remain dependent on caregivers. Highlighting the challenges to utilisation of rehabilitation in rural areas can assist to reduce these barriers and improve the functional status of persons with lower-limb amputations.

Download Full-text

Participation restrictions and vocational rehabilitation needs experienced by persons with a unilateral lower limb amputation in the Western Cape, South Africa

African Journal of Disability ◽

10.4102/ajod.v8i0.456 ◽

2019 ◽

Vol 8 ◽

Author(s):

Tak Wing Yu ◽

Liezel Ennion

Keyword(s):

South Africa ◽

Vocational Rehabilitation ◽

Lower Limb ◽

Lower Limb Amputation ◽

World Health ◽

Limb Amputation ◽

Western Cape ◽

Participation Restrictions ◽

Health Organization ◽

Rehabilitation Needs

Background: Vocational rehabilitation (VR) aims to rehabilitate a person with an amputation back into actively participating in society. Even though lower limb amputation (LLA) surgery is commonly performed in South Africa (SA), little research has been published on the participation restrictions experienced by and vocational needs of persons with LLA in the Western Cape (WC).Objectives: The aim of this study was to determine and explore the participation restrictions and VR needs of persons with a unilateral LLA in the WC.Method: A mixed-methods approach and a sequential exploratory design were utilised to collect data from 50 persons with an LLA. Participants were conveniently sampled within the Cape Metropole region of the WC, SA. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) tool was used to collect the quantitative data, and telephonic interviews were conducted for qualitative data collection.Results: A third (28%) of participants in this study were unemployed, and only 14% (n = 7) of the participants owned or used a prosthesis. In addition, 50% of the participants either had a disability grant or were on pension. The participation restrictions identified were mainly related to mobility where 74% (n = 37) of participants had extreme difficulty with mobility in general, 92% (n = 46) struggled with walking distances longer than 1 km and 80% (n = 40) had extreme difficulty in completing household tasks quickly. The main VR needs identified in this study were the inadequate rehabilitation services that target ambulation (standing and walking) to facilitate employment.Conclusion: Persons with a unilateral LLA still experience significant difficulties in mobility 3 months post-amputation, which negatively affects their participation in society and vocational activities.

Download Full-text

Metric Charcteristics of Sit-to-stand Tests in Patients After Lower-limb Amputation

Case Medical Research ◽

10.31525/ct1-nct04293237 ◽

2020 ◽

Author(s):

Keyword(s):

Lower Limb ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Sit To Stand

Download Full-text

Prostheses and orthoses. Factors to be considered when specifying a prosthesis for a person who has had a lower limb amputation

10.3403/30178636 ◽

2009 ◽

Keyword(s):

Lower Limb ◽

Lower Limb Amputation ◽

Limb Amputation

Download Full-text

Prostheses and orthoses. Factors to be included when describing physical activity of a person who has had a lower limb amputation(s) or who has a deficiency of a lower limb segment(s) present at birth

10.3403/30178633u ◽

2015 ◽

Keyword(s):

Physical Activity ◽

Lower Limb ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Limb Segment

Download Full-text

Prostheses and orthoses. Factors to be included when describing physical activity of a person who has had a lower limb amputation(s) or who has a deficiency of a lower limb segment(s) present at birth

10.3403/30178633 ◽

2009 ◽

Keyword(s):

Physical Activity ◽

Lower Limb ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Limb Segment

Download Full-text

P90 PERCEIVE: PrEdiction of Risk and Communication of outcome following major lower limb amputation - a collaboratIVE study

BJS Open ◽

10.1093/bjsopen/zrab032.089 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

Author(s):

B Gwilym ◽

C Waldron ◽

E Thomas-Jones ◽

P Pallmann ◽

R Preece ◽

...

Keyword(s):

Risk Prediction ◽

Lower Limb ◽

Health Care Professionals ◽

Healthcare Professionals ◽

Demographic Data ◽

Collaborative Study ◽

Lower Limb Amputation ◽

Research Network ◽

Limb Amputation ◽

Prediction Tools

Abstract Introduction Major Lower Limb Amputation (MLLA) is a life changing event with significant morbidity and mortality. Inaccurate risk prediction can lead to poor decision making, resulting in delay to definitive surgery, or undertaking amputation when not in the patient’s best interest. We aim to answer: In adult patients undergoing MLLA for chronic limb threatening ischaemia or diabetes, how accurately do health care professionals prospectively predict outcomes after MLLA, and how does this compare to existing prediction tools? Methods A multicentre prospective observational cohort study is being delivered through the Vascular and Endovascular Research Network. Dissemination was via an existing network of contacts and social media. Consecutive data will be collected for seven months from site launch date, including demographic data and pre-operative outcome predictions from surgeons, anaesthetists, and allied healthcare professionals. Follow-up data will comprise 30-day (mortality, morbidity, MLLA revision, surgical site infection, and blood transfusion) and 1-year (mortality, MLLA revision and ambulation). The accuracy of surgeons’ predictions will be evaluated and compared to pre-existing risk prediction scoring tools. Results PERCEIVE launched on 01/10/2020 with 23 centres (16 UK, 7 international) registered to collect data. 50 other centres (27 UK, 23 international) have expressed interest/are pursuing local audit/ethical approval. We aim to collect data on clinicians estimate of outcomes for over 500 patients. Discussion This study will utilise a trainee research network to provide data on the accuracy of healthcare professionals’ predictions of outcomes following MLLA and compare this to the utility of existing prediction tools in this patient cohort.

Download Full-text