Ahmed A.1, Ali G.2
1ICRC Rehabilitation Center in Erbil, Female Physiotherapy Dept., Erbil, Iraq, 2ICRC Rehabilitation Center in Erbil, Head of Prosthetic and Orthotic Dept., Erbil, Iraq
Background: In a country such as Iraq, which has endured sustained conflict since 2003, lower limb amputation is a common result of this bloody conflict. Of the lower limb amputees TT level is the most prevalent. After a review of some studies and from working experience, the balance and weight bearing rehabilitation stage was deemed to be an important part of effective prosthetic rehabilitation.
Purpose: 1- Specify the causes which could have an effect on the increased number of rehabilitation sessions of the TT amputee.
2- For TT amputees who were fitted for the first time, identify the most relevant factors effecting the number of balance training sessions required.
2- For TT amputees who were fitted for the first time, identify the most relevant factors effecting the number of balance training sessions required.
Methods: The participant were 22 patients, whom are using their prosthesis for the first time. Two main categories cause of amputation were identified- diabetic and traumatic. In our rehabilitation centre as in others, pre-prosthetic rehabilitation sessions for TT amputees includes weight bearing and balance training. This continues until the patient is stable and comfortable when using his prosthesis with out any upper limb support and can balance himself on a balance board before starting to walk. For these patients we studied relevant factors as:
Patient age,
Patient B.M.I.
Stump length,
Muscle strength,
Number of rehabilitation sessions required, ( each lasting one hour).
Results: The 22 patients who were first time prosthesis users, were grouped according to the cause of amputation into two groups:
1-The first group (N=12) were amputated for diabetic reasons, had an average age of 61 yrs., stump length was an average of 14cm. Knee and hip flexion and extension muscle power graded 4/5. Six of these total 12 patients were considered to be obese according to their BMI, This diabetic group of patients needed an average of 14 sessions to acquire acceptable levels of balance.
2- The second group (N=10) patients were traumatic amputees, average age 26 years, average stump length were 14.5cm. Knee and hip flexion and extension muscle power were graded as 4/5. Only three of them were considered over weight according to their BMI. This group of patients needed 9.5 sessions to acquire acceptable levels of balance.
Conclusion(s): As can be seen in the results, higher number of balance sessions are needed in diabetic patients as compared to those amputated for traumatic reasons. Age and weight have a significant effect on determining balance acquisition in diabetic patients, despite having grade 4 muscle strength according to the Oxford scale.
Implications: The implications here are that Diabetic patients on average require more balance training sessions and therefore take longer to rehabilitate to rehabilitate overall. With growing levels of obesity, and hence DM, this needs to be taken into account when planning rehabilitation.
Funding acknowledgements: No funding was accredited or needed.
Topic: Disability & rehabilitation
Ethics approval: The only ethic system we have is the pt. acceptance.
All authors, affiliations and abstracts have been published as submitted.
