Havyarimana E1, Fiasse J2, Van Geel C3, Lippolis G3
1Center Haguruka, Physiotherapy Unit, Bujumbura, Burundi, 2Humanity and Inclusion (Formerly Handicap International), Readaptation, Bujumbura, Burundi, 3Humanity and Inclusion, Readaptation, Bruxelles, Belgium
Background: In 2016, following the political crisis in Burundi, Handicap International (HI) has set up a functional unit, the center Haguruka in Bujumbura. The center supports mostly patients with trauma. The amputee patients are referred to the St Kizito institute for prostheses. Regarding upper limb amputee's patients, there is very few options to fit them at present in Burundi
Purpose: Presentation of a double proximal humeral amputee, Charles, 30years old, followed at the functional unit in an interdisciplinary approach in order to be fit with technical functional aids and followed also at a psychological and social level
Methods: Research action in order to provide the optimal function of the patient. Admitted in the center, we tried to fit him with prostheses in resin. Due to the heavy weight of prosthesis, it did not helped him to improve his autonomy and psycho-social well-being. The team including an orthopedic technician, an occupational therapist, a physiotherapist, a psychologist and a social worker focused on the manufacture of technical aids in polypropylene with fixations for essential Daily Living Activities (DLA) tools. The MIF scale adapted by HI was used for the evaluation of the functional abilities and the HI scale of the psychological distress was also used
Results: The MIF score at the beginning without the prostheses was 54/100. At the discharge, it reached 75. The functional technical aids enabled, through an interdisciplinary approach, in a work between the occupational therapist, the physiotherapist and the orthopedic technician an improvement of the functional ability in the DLA: It enabled the patient to eat, drink, and brushing teeth
The aid consist of a body jacket at the thorax level and hard sockets for the left and right stump which enable fixation of different tools. With the functional rehabilitation process and the intervention of the psychologist, he has reached an improvement of 69% in the psychological distress scale. Every caregiver has participated to this evolution, keeping the user at the center of the decision making process. The occupational therapist and social worker carried out also adaptations at home and restoration of family links
Conclusion(s): Our positive results show the importance for the rehabilitation professionals not to focus rehabilitation process on the upper limb prosthesis esthetic, which is often the first request of the user due to the lack of acceptance of the amputation, but to look for a solution that improve the management of DLA as Weiss and al also mentioned. On the other hand, this type of patient needs a long term follow up as in this case the user without a close monitoring after few months at home has gone to the street. A more global and long term inclusion is needed for him to have an income generating activity and make a better use of his technical aids
Implications: In the context of Burundi or other countries without prosthetist /Orthothist (category I), this achievement is a model to be reproduced for the assistance of double upper limb amputee's patients and for upper limb amputees in general.
Keywords: Interdisciplinary team, Occupational therapy, Upperlimb adapted prosthetic device
Funding acknowledgements: Humanity&Inclusion is supporting the project in Bujumbara and the presenter (coauthor) ) to participate to the congress
Purpose: Presentation of a double proximal humeral amputee, Charles, 30years old, followed at the functional unit in an interdisciplinary approach in order to be fit with technical functional aids and followed also at a psychological and social level
Methods: Research action in order to provide the optimal function of the patient. Admitted in the center, we tried to fit him with prostheses in resin. Due to the heavy weight of prosthesis, it did not helped him to improve his autonomy and psycho-social well-being. The team including an orthopedic technician, an occupational therapist, a physiotherapist, a psychologist and a social worker focused on the manufacture of technical aids in polypropylene with fixations for essential Daily Living Activities (DLA) tools. The MIF scale adapted by HI was used for the evaluation of the functional abilities and the HI scale of the psychological distress was also used
Results: The MIF score at the beginning without the prostheses was 54/100. At the discharge, it reached 75. The functional technical aids enabled, through an interdisciplinary approach, in a work between the occupational therapist, the physiotherapist and the orthopedic technician an improvement of the functional ability in the DLA: It enabled the patient to eat, drink, and brushing teeth
The aid consist of a body jacket at the thorax level and hard sockets for the left and right stump which enable fixation of different tools. With the functional rehabilitation process and the intervention of the psychologist, he has reached an improvement of 69% in the psychological distress scale. Every caregiver has participated to this evolution, keeping the user at the center of the decision making process. The occupational therapist and social worker carried out also adaptations at home and restoration of family links
Conclusion(s): Our positive results show the importance for the rehabilitation professionals not to focus rehabilitation process on the upper limb prosthesis esthetic, which is often the first request of the user due to the lack of acceptance of the amputation, but to look for a solution that improve the management of DLA as Weiss and al also mentioned. On the other hand, this type of patient needs a long term follow up as in this case the user without a close monitoring after few months at home has gone to the street. A more global and long term inclusion is needed for him to have an income generating activity and make a better use of his technical aids
Implications: In the context of Burundi or other countries without prosthetist /Orthothist (category I), this achievement is a model to be reproduced for the assistance of double upper limb amputee's patients and for upper limb amputees in general.
Keywords: Interdisciplinary team, Occupational therapy, Upperlimb adapted prosthetic device
Funding acknowledgements: Humanity&Inclusion is supporting the project in Bujumbara and the presenter (coauthor) ) to participate to the congress
Topic: Disability & rehabilitation; Occupational health & ergonomics; Orthopaedics
Ethics approval required: No
Institution: Handicap&Incluision Burundi
Ethics committee: Handicap&Inclusion Bruxelles
Reason not required: This presentation describes innovative ways in which established method have been adapted to meet changing needs in practice.However a standard consent form translate in Kirundi has been used. This form explains the purpose and request authorisation for the use of images
All authors, affiliations and abstracts have been published as submitted.
