Amputee rehabilitation aims to return to normal life with the use of prosthesis for people who have lost limbs such as hands, arms, feet and legs. The remaining part of the limb after amputation is called the stump. A prosthesis that will replace the lost limb after surgery is used by choosing a prosthesis that will replace it in terms of appearance and function.
Loss of a limb can have lasting effects on the person’s body image, self-care, self-esteem and movement. The rehabilitation process starts from the acute period immediately after the surgery. If there is a planned (elective) amputation, the process also includes the pre-operative period. The rehabilitation program intensifies as the person’s general health improves.
Causes of Amputation
While 1-4% of amputations are congenital limb deficiency, the remaining majority occur due to trauma, tumor surgery, vascular disease, and diabetes. The reasons vary according to the amputation site and age. While trauma is the leading cause of arm and hand amputations with a rate of 75%, the most common causes of foot and leg amputations are diabetes and peripheral vascular disease. Traumatic causes are more common in young and middle age. Chronic diseases are the main cause in the elderly. In childhood, amputations due to cancer are more common.
Some factors that affect the success of amputee rehabilitation:
- Level and type of amputation
- Type and degree of disability
- General health status of the person
- family support
The aim of rehabilitation is to bring the amputee to their maximum functional capacity in individual and social life. For this, rehabilitation goals are determined in line with the needs of the patient, together with the patient and his family. Different health professionals such as physical therapy and rehabilitation doctor, orthopedics and traumatology doctor, physiotherapist, rehabilitation nurse, orthosis-prosthetic technician, psychologist, diabetist, social worker perform the rehabilitation as a team. The active participation of the patient is fundamental to the success of the program.
Amputee Rehabilitation Program Topics
- Treatments for wound healing and stump care
- Activities to ensure independence in daily living activities
- Exercises to increase muscle strength, endurance and coordination
- Wearing and using the prosthesis
- Dealing with post-operative and phantom pain
- Psychological support during the period of getting used to the new body image
- Using assistive devices
- Nutritional support that accelerates healing
- Professional counseling
- Evaluation and adaptation of the home and work environment in terms of accessibility, safety and functionality
- Patient and family education
Amputee Rehabilitation Stages
- Pre-operative (pre-operative): The general condition of the body is evaluated, the patient is educated. The level of surgical amputation is determined. The prosthesis to be used after the surgery is planned.
- Amputation surgery: stump length, remodeling of muscle, soft tissue and skin, post-operative dressing and dressing.
- Acute post-operative period: Wound healing, pain control, movement of the trunk and joints close to the trunk, emotional and psychological support.
- Pre-prosthetic period: stump maintenance, shaping, shrinking, increasing muscle strength.
- Prosthesis prescribing: Prescribing and manufacturing prosthesis. A temporary prosthesis is used until the stump takes its final shape.
- Prosthesis training: Exercises for wearing and using the prosthesis.
- Integration into society: Ensuring integration into family and community life.
- Vocational rehabilitation: Planning and training for a return to work, productive life. Changes to the old job may be necessary.
- Follow-up period: Long-term follow-up and support for prosthetic life.