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A comparison of traditional prosthetic training versus proprioceptive neuromuscular facilitation resistive gait training with trans-femoral amputees

Reports in the rehabilitation literature suggest that patients with trans-femoral amputation ambulate well after suitable prosthetic treatment. The effects of exercise protocols on function, however, have not been documented in this population. This study was conducted to compare the outcome of traditional and proprioceptive neuromuscular facilitation (PNF) techniques on weight bearing and gait. Fifty unilateral trans-femoral amputees who were attending for their first prosthesis, participated in this study. Amputees were randomly assigned into groups receiving the traditional training or PNF. Traditional treatment was consisted of weight-shifting, balancing, stool-stepping and gait exercises. In the other group the same activities were given by PNF. Amputees were trained 30 minutes daily, for a total of 10 treatments. Pre- and post-training assessment included weight bearing measurements by using two bathroom scales and time-distance characteristics of gait from footprints. A statistically significant difference was found in all parameters within the groups due to pre- and post-training evaluation data (p<0.05), but more obvious improvement was observed in the group who received PNF (p<0.05). The results of the study suggest that the prosthetic training based on proprioceptive feedback was more effective to improve weight bearing and gait when compared with a traditional programme.

Comparison of the effects of patellar tendon bearing and total surface bearing sockets on prosthetic fitting and rehabilitation

Patellar tendon bearing (PTB) and total surface bearing (TSB) sockets have been used respectively in the prosthetic treatment of 20 trans-tibial amputees to investigate the effectiveness of both sockets on prosthetic fitting and rehabilitation. Data analysis showed that prostheses with TSB sockets were lighter than the prostheses with PTB sockets and better suspension was obtained from TSB prosthetic socket (p<0.05). It was also found that weight acceptance on the amputated side advanced to a more normal value with TSB prostheses (p<0.05). There was a statistically significant difference between the two socket types in walking and in other ambulation activities except sitting and standing up from a chair, in favour of the TSB socket (p<0.05). Consequently, due to the outcome of this study it can be said that TSB prosthetic sockets can be used effectively in the rehabilitation of trans-tibial amputees.

Do Yoga and Aerobic Exercise Training Have Impact on Functional Capacity, Fatigue, Peripheral Muscle Strength, and Quality of Life in Breast Cancer Survivors?

Aim. The aim of the study was to compare the effects of aerobic exercise training and yoga on the functional capacity, peripheral muscle strength, quality of life (QOL), and fatigue in breast cancer survivors. Material and methods. A total of 52 patients with a diagnosis of breast cancer were included in the study. The patients were randomly assigned to 2 groups: aerobic exercise (n = 28) and yoga added to aerobic exercise (n = 24). Both groups participated in submaximal exercise 30 minutes/d, 3 d/wk for 6 weeks. The second group participated in a 1-hour yoga program in addition to aerobic exercise training. Functional capacity was assessed by the 6-Minute Walk Test (6MWT). Peripheral muscle strength was evaluated with a hand-held dynamometer. The fatigue severity level was assessed with the Fatigue Severity Scale (FSS). The QOL was determined by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire. Results. There were statistically significant increases in peripheral muscle strength, the 6MWT distance, and the perception of QOL in both groups (P < .05). Additionally, the group with aerobic exercise and yoga showed marked improvement compared with the aerobic exercise group in fatigue perception (P < .05). Conclusion. According to the data from this study, aerobic exercise training and yoga improved the functional capacity and QOL of breast cancer patients. Aerobic exercise programs can be supported by body mind techniques, such as yoga, in the rehabilitation of cancer patients for improving functional recovery and psychosocial wellness.

Risk Factors, Frequency, and Causes of Falling in Geriatric Persons Who Has Had a Limb Removed by Amputation

Purpose This study was planned to investigate falls, their frequency, reasons, and consequences in the older patient with lower limb amputations. Methods Twenty-five patients with lower limb amputations were included in the study. A questionnaire for falling was applied. Functional levels of these patients were determined according to the Medicare Functional Level System. Results The falling questionnaire revealed that except for 5 patients with amputations, the subjects had experienced an incident of falling once or more than once. The common reasons for falls turned out to be losing balance, stumbling on the prosthesis, and colliding with someone. Conclusions It was concluded that performing comprehensive evaluations in which falling histories were assessed before planning rehabilitation programs enriched the rehabilitation programs by suggesting different types of activities.

Effectiveness of prosthetic rehabilitation of children with limb deficiencies present at birth

This study was performed to investigate the efficacy of prosthetic rehabilitation in children with congenital malformations, also to determine whether there were any factors related to family history and pregnancy which could have affected the formation of such deficiencies. Twenty-five (25) limb deficient children were provided with prostheses and received rehabilitation. A detailed family and pregnancy history was researched through the records. The ability of performing activities of daily living was scored on a four point scale. Thirteen (13) lower and 12 upper limb deficient children with a mean age of 4.88±2.52 years were included in the study. Ten (10) children had longitudinal and 15 transverse deficiencies. Traditional marriages amongst close cousins were observed in 31%. Five (5) mothers used medications, 2 received radiodiagnostic tests and 2 had bleedings during pregnancy. Some 84.7% of the lower limb group became independent walkers without requiring walking aids while 15.3% of them required Canadian crutches for independent ambulation. A total of 61.5% of these children actively participated in recreation with peers. In the upper limb group 41.6% were completely independent in self-care, feeding and hand skills; 33.3% showed independence with self-help devices while 25% tended to use the prostheses for assistive purposes. Participation in recreational activities was 58.2%. The authors results have shown that the children gained a functional activity level although the prostheses were provided in a late period. It can be concluded that success in rehabilitating these children is a true challenge.

The effect of physiotherapy approaches on the pain patterns of amputees for Buerger's disease

AbstractThis study was carried out on 34 lower limb amputees in order to investigate the effect of three different physiotherapy approaches on pain patterns of amputees for Buergers disease. Amputees were divided into three groups. Connective tissue manipulation (CTM) and interferential therapy (IT) were applied to the first and second groups combined with an exercise programme and prosthetic training. The third group followed only the exercise programme and prosthetic training. Amputees underwent pain assessments before and after the treatment including intensity, quality and localisation of pain. Significant differences were found between pre- and post-treatment pain values of all groups (p < 0.05) but especially in the groups treated by CTM and IT.

Comparison of the Effects of Complex Decongestive Physiotherapy and Conventional Bandaging on Edema of Geriatric Amputees: A Pilot Study

Objective: The aim of this study is to compare the effects of complex decongestive physiotherapy (CDP) and conventional bandaging (CB) on the postamputation edema of geriatric transtibial amputees. Material and Methods: Eleven geriatric transtibial amputees were included in the study. Randomized controlled study started on the first postoperative day with the amputees who are appropriate for CB and CDP. Before and after application, all the participants underwent circumferential assessments both amputated and intact side in each session. The period between the first session and the last session (transition to permanent prostheses) were recorded in days. The hospitalization period of the cases were also recorded. Results: There was not any significant difference between the groups when the duration of stay at the hospital was evaluated (P > 0.05). The period of transition to permanent prostheses was found to be shorter in CDP group (P < 0.05). When the first and last session values of both groups were analyzed, significant differences were determined (P < 0.05). The difference between the last circumferential measurements of the stump was observed to be more obvious in the CDP group than in the CB group (P < 0.05). Conclusion: To conclude, it can be postulated that CDP could be preferred in the treatment of postamputation stump edema to shape the stump effectively, which is the basic cardinal requirement of prosthetic fitting after surgery.

The Prosthetic Rehabilitation of a Patient With Hip Disarticulation as a Result of Klippel–Trenaunay–Weber Syndrome: Case Report

ABSTRACT There are various reasons for an amputation. Sometimes a systemic disease as chicken pox or a neurological disease such as spina bifida and sometimes a rare neurocutaneous disease such as Klippel–Trenaunay–Weber (KTW) syndrome can cause amputation. This article presents the prosthetic rehabilitation of a 16-year-old boy with KTW syndrome. In our examination, we observed that there were no wounds at the distal part of the residual limb; however, we found eczema in some regions. The patient had no phantom pain/feeling or any limitation concerning the sound side joint ranges; however, hamstring and gastrosoleus muscle groups were short, abductors and adductors were weak, and upper limb gross muscle strength was good. Sensory evaluation of the residual limb revealed hyperesthesia on the anterior distal part of the residual limb. The physiotherapy-rehabilitation program consisted of stretching and strengthening exercises, residual limb dynamic and isometric exercises to prepare the amputee for gait, as well as balancing and weightbearing exercises. As the program continued, the measurements for the prosthesis were taken. The amputee was able to walk with his prosthesis without bilateral crutches at the end of 2 weeks. The patient was evaluated with a gait trainer, footprint, Nottingham Health Profile, and the Medicare Classification Functional Level system before and after the rehabilitation program. It can be said that physiotherapy-rehabilitation approaches and prosthetic training were important facilitators for regaining independence.