Semra Topuz

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.

Reliability and construct validity of the Turkish version of the Trinity Amputation and Prosthetic Experience Scales (TAPES) in lower limb amputees

Background: In Turkey there is no amputee-specific instrument to measure health-related quality of life in lower limb amputees. Objectives: To evaluate the validity and reliability of a Turkish version of the Trinity Amputation and Prosthesis Experience Scales (TAPES). Study design: Outcome study to determine test–retest reliability and construct validity of the adapted Turkish version of the TAPES. Methods: After translation/retranslation of the TAPES, the Turkish version of the TAPES was applied to 47 amputees. A quality of life evaluation (Nottingham Health Profile), a satisfaction evaluation (Satisfaction with Prosthesis), and a functional assessment tool (Amputee Mobility Predictor) were also performed and analysed. Results: On the basis of retesting, the Turkish version of the TAPES was observed to be reliable. The first domain of the Turkish version, which includes psychosocial adjustment, activity restriction and satisfaction with the prosthesis, was found to be valid. However, the validity of the second domain could not be analysed. Conclusions: The Turkish version of the multidimensional TAPES survey is valid and reliable in Turkish unilateral lower limb amputees and may be used in clinical situations to assess the needs of amputees. Clinical relevance The Turkish version of the TAPES quality-of-life measurement tool for amputees is a valid instrument for assessing the effectiveness of rehabilitation and clinical applications.

Evaluation of functionality in acquired and congenital upper extremity child amputees

OBJECTIVE The aim of this study was to evaluate the functional level of children with congenital and acquired upper limb loss after a rehabilitation program. METHODS This study included a total of 40 children, aged 8 to 17 years with upper limb loss. Children were divided into two groups; congenital amputees (n=20) and acquired amputees (n=20). The children underwent prosthetic fitting, prosthetic training and rehabilitation. The Child Amputee Prosthetics Project - Functional Status Inventory (CAPP-FSI) and Prosthetic Upper Extremity Functional Index (PUFI) were used at the initial visit to the prosthetic unit without prosthesis, 3 weeks after the prosthetic training and 6 months after discharge with and without prosthesis. The results with and without the prosthesis were compared between the acquired and congenital amputee groups. RESULTS There were significant differences in all tests performed at the baseline, at the 3rd week, and at the 6th month without prosthesis and at the 3rd week and at the 6th month with prosthesis (p<0.05). The congenital group received higher scores in the CAPP-FSI and PUFI at the baseline, at the 3rd week and at the 6th month (p<0.05). Patients in the congenital group used their prostheses for 8 hours a day and the acquired group for 4 to 8 hours. CONCLUSION Daily prosthesis usage time and the childs experience with the prosthesis during daily activities are the determining factors for the functional level in upper limb child amputees. Functionality may improve based on these factors.

Effects of Complex Decongestive Physiotherapy on an Older Female Patient With Psoriasis-Related Primary Lymphedema

In this study the effectiveness of complex decongestive physiotherapy (CDP) in a patient with psoriasis-related primary lymphedema is reported. We describe a case of 61-year-old woman with bilateral lower extremity primary lymphedema diagnosed with lymphoscintigraphy. She had lymphedema for 5 years and lymphedema of the left extremity was more severe than that of the right. The CDP program was applied once a day 5 days a week for 7 weeks and continued as a home program after 7 weeks. Assessments were performed before, right after, and 1 month after the treatment. After the CDP program, we detected a significant decrease in the volume of the lower extremities, especially on the left side. Furthermore, complaints related to lymphedema, such as discomfort and feeling of tension and heaviness on the lymphedema area, and limitation in functional activities, improved with this program. Active and passive range of motions of the knee and ankle improved in the affected side. At 1-month-follow up, the volume of extremities further decreased and other improvements maintained at the level after treatment. CDP can be an effective treatment method in psoriasis-related primary lymphedema but further studies, especially of larger sample size, are needed.

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.

Do mobility and life setting affect falling and fear of falling in elderly people

The aim of this study is to determine the differences between falling and mobility among elderly people in different settings. This investigation included 41 elderly people living in a retirement village and 45 elderly people in community dwellings. Subjects were assessed in terms of mobility and activities of daily living, falling, and fear of falling. There were significant differences between groups in terms of age, mobility, and activities of daily living (P < .05); however, there were no remarkable differences between falling and fear of falling (P > .05). This study shows that along with several factors, such as mobility, the life style of elderly people, which is shaped by their living conditions, has an impact on falling.

Evaluation Of Gait Symmetry In Amputees Who Use Below Knee Prosthesis With Dynamic Foot

Purpose: To assess inter limb symmetry while walking in unilateral transtibial amputees which use dynamic foot. Method: Gait velocity, cadence, step length, stance percentages and ambulation index results of amputees (n=20) were recorded. Comparison was made with control group. (n=21) Results: Gait velocity, cadence and ambulation index results were greater for control group. Cases had longer stance time on their intact limb than amputated side. Stance time difference between limbs were higher for amputee group than control group. Conclusion: Amputees had higher stance percentage on their intact limb than sound limb with regard to healthy people.

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.