EVIDENCE-BASED PHYSIOTHERAPY IN THE TREATMENT OF PATIENTS WITH LOWER LIMB AMPUTATION - HUNGARIAN EXPERIENCES

M. Horvath¹, D. Körömi¹, K. Kiss-Szabó¹, Á. Mayer¹

¹Semmelweis University, Physiotherapy, Budapest, Hungary

Background: Internationally several guidelines have already been prepared regarding the care and physiotherapy program of amputee patients, which contain treatment elements supported by evidence. There is currently no valid directive on the subject in Hungary.

Purpose: The study focused on reviewing the outcome measures and treatment methods physiotherapists use for patients with amputation. Our goal is to explore evidence-based physiotherapy procedures for patients who have undergone lower limb amputation, and to examine the knowledge of Hungarian physiotherapists about EBP.

Methods: A survey among Hungarian physiotherapists using an anonym questionnaire compiled based on a survey certified for Brazilian records and a Canadian survey on the rehabilitation of amputees. The part of the questionnaire assessing general professional knowledge and the use of evidence-based therapies was completed by 94 physiotherapists, and 42 physiotherapists answered the questions related to the rehabilitation of amputees. The SOFA 1.4.6 program was used as a data analysis method to detect statistical correlations, and the Chi-square test was used to detect correlations and differences between variables. Mann-Whitney U test was used. The significance level was set at p <0.05

Results: Physiotherapists know the concept of EBP, however, their inadequate knowledge of the English language limits their accurate understanding of foreign literature, which makes it difficult to critically evaluate the knowledge from the sources. The ability to read and interpret literature is influenced by language skills and higher education. The BACPAR (British Association of Chartered Physiotherapists in Amputee Rehabilitation) guideline includes everything that the Hungarian protocol does, however, it describes the individual tasks in a more diverse and detailed manner, and the rehabilitation starts even before the operation. Half of the physiotherapists are not familiar with the previous professional protocol issued by the former Ministry of Health dealing with the care of amputees, nor with foreign guidelines. Despite this, they mostly use the techniques recommended in the materials just mentioned.

Conclusions: The physiotherapy activities mentioned by Hungarian physiotherapists, such as stump shaping, improving circulation, muscle strengthening, contracture relief, balance development and gait training, all have different level of evidence, which can also be found in the BACPAR guidelines. Based on the international literature, foreign toolkits are more colourful and advanced, thus the course and time of rehabilitation differs slightly from Hungarian practice, but they work with similar procedures as Hungarian physiotherapists.

Implications: Adaptation of international guideline on physiotherapy of amputee patient to Hungarian conditions.

Funding acknowledgements: No funding for this research

Keywords:
Lower limb amputation
Evidence based therapy
Guideline

Topics:
Disability & rehabilitation
Professional issues
Musculoskeletal: lower limb

Did this work require ethics approval? No

Reason: Ethics is not necessary by the law in this case, because not any examination or intervention were performed on a patient.