Pienaar E.1, Visagie S.1, Hendry J.2
1Stellenbosch University, Human Rehabilitation Studies, Cape Town, South Africa, 2Western Cape Rehab Centre, Cape Town, South Africa
Background: Several studies have shown that a transfemoral amputation compared to transtibial has more physical demands, shows less frequent prosthetic use and decreased prosthetic mobility. Within the Western Cape's Public Health Sector, criteria for approval of a transfemoral prosthesis has been set according to predisposing factors for good post prosthetic mobility. A person has to meet the criteria and is guided by the pre-prosthetic rehabilitation service. Once prosthesis received, however, limited rehabilitation services are available and little is known about prosthetic use and mobility.
Purpose: To determine prosthetic use, prosthetic mobility and access to post prosthetic rehabilitation of people with unilateral transfemoral amputation in the Western Cape Public Sector.
Methods: The study follows a quantitative, descriptive study design. The study population included all adults who received their first prosthesis from the Orthotic and Prosthetic Centre between 1 June 2011 and 31 December 2014. Data were collected through telephone interviews. An adapted version of the Prosthetic Profile of the Amputee (PPA) was completed. The questionnaire included; use frequency of a prosthesis, prosthetic mobility across different terrains, the need for additional mobility aids, post prosthetic rehabilitation and demographic characteristics. Descriptive statistics were calculated through value of ranges, averages and percentages.
Results: 43 questionnaires were completed. The majority of study participants are men (79%), older than 50 (77%). Vascular conditions (47%) followed by diabetes (23%) are the primary causes of amputations. Thirty five participants (81%) uses their prosthesis at least once per week, of which twenty (average age of 53) uses the prosthesis 5 days and more per week, and sixteen (average age of 57.5) uses their prosthesis 3 days and less per week. The majority of prosthetic users, twenty six (74%), has the ability to walk indoors without assistive devices. On outdoor uneven terrain, twenty six needs either one (26%) or two elbow crutches (48%). Twenty four (69%) participants are limited to less than 500 steps at a time which challenges community ambulation, where two participants expressed that they can walk in the community to ability of at least 1 000 steps at a time. Eighteen (42%) from the study population received post prosthetic rehabilitation (varies from one session to inpatient rehabilitation) where thirty three (77%) feels that post prosthetic physiotherapy sessions either were or would have been beneficial to their mobility.
Conclusion(s): The high vascular cause of amputation is comparable to international studies. The majority (81%) of the study participants used their prosthetic leg although limitations were experienced in prosthetic mobility (poor walking distance, the use of assisted devices outdoors) and in access to post prosthetic rehabilitation.
Implications: The results can provide insight to therapists and prosthetists who are involved in the rehabilitation services rendered to persons with unilateral transfemoral amputations within Western Cape Department of Health; to better educate them and their patients about realistic outcomes of prosthetic mobility and use. It also highlights the limited post prosthetic services available.
Funding acknowledgements: Study is self funded, however acknowledgements to Department of Health and Western Cape Rehab Center for finances towards Masters degree.
Topic: Disability & rehabilitation
Ethics approval: This study was approved by the Health Research Ethics Committee of Stellenbosch University (S14/10/215)
All authors, affiliations and abstracts have been published as submitted.
