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N. Akhtar1, F.K. Patwary2
1International Committee of the Red Cross (ICRC), Physical Rehabiltiation Program (PRP), Dhaka, Bangladesh, 2Jahangir Nagar University, Information & Technology, Dhaka, Bangladesh
Background: Community integration is considered as an ultimate goal of rehabilitation for individuals after amputation which is depends on the proper rehabilitation program. However, it has been reported that even after attaining satisfactory functional independence, reintegration to home and community activities and social roles remains the most challenging part of rehabilitation. Evidence showed that together with recreation and community mobility, lower limb amputation patients also experiences poor success in employment.
Purpose: To identify the current situation in community integration after prosthetic rehabilitation to make change in the current rehabilitation system or policy of the physical rehabilitation center.
Methods: A quantitative descriptive design was implemented. 202 participants who received rehabilitation, after a major lower limb amputation at the CRP-Bangladesh which is the key physical rehabilitation center of the International Committee of the Red Cross (ICRC). Samples were identified by the stratified random sampling technique. A questionnaire was developed to collect the demographic information and data on International Classification of Function (ICF) domains (mobility, self-care, domestic life, community participation and productive activities) using a Likert scale by phone interview.
Results: Study found that among the participants 89.3% were male and 14.2% were female. 57.3% participants had trans-tibial and 42.3% trans-femoral amputation. The mean age of participants was 35.62 years and 44.9% were unemployed. trauma was the main cause of amputation for 71.4% of the cohort. 543.37 days were the mean of gap between amputation and 1st prosthesis where in average the participants got 26.99 days prosthetic training at CRP. Among the participants 39.8% were irregular in prosthetic use and used their prosthesis an average of 6.98 hours per day. 63.1% complained about complications due to the prosthesis; with pain as the main complaint for 27.6% participants. The most challenging area for participants was walking for a long time (53%), going up and down stairs without handrails (52%), lifting object (46.4%) and participating in religious activities (67.9%) where participants faced moderate to severe difficulties. Author tried to determine impact of level of amputation on the community integration using Mann-Whitney U test and in all domains, it showed significant difference (P<0. 00) between the performance of the trans-tibial and the trans-femoral groups.
Conclusion(s): Study results indicated that for the current study sample the community integration level is not up-to mark as they faced mild to severe difficulties in domains of community integration. Other shortcomings which were identified that is absent of community follow up system present in current prosthetic program so it is also needed to include in the rehabilitation program.
Implications: The author’s main interest was to find out the difficulties in various activities in rural area where the majority of the population live. This study will help to gather more information about challenging areas faced by person with amputation, so that the content of current rehabilitation programs can be improved, and amputee patients can be optimally prepared for the post rehabilitation period. The study recommended to CRP to take steps to plan for follow up services after returning to community.
Funding, acknowledgements: The work was self-funded.
Keywords: Major lower limb amputation, prosthetic rehabilitation, community integration
Topic: Community based rehabilitation
Did this work require ethics approval? Yes
Institution: Bnagladesh Health Professions Institute
Committee: Institutional Review Board
Ethics number: CRP/BHPI/IRB/4/17/124
All authors, affiliations and abstracts have been published as submitted.
