Abstract:
Below knee amputation is a big operation with far-reaching effects on
the physical, psychological and social life of the patient. The most common reasons for
an amputation are vascular disease, diabetes complications and traumatic injuries. In
worldwide epidemiological research amputation rates scored highly with wide
differences according to the country and access of medical service. For instance, one
rate of 22.5 cases/100 000 per year was reported in Canada, with predomination in
males over the age group of 65 years. The rate of amputation among American Indians
is also three times the U.S. average. The use of procedures is extremely variable in
European and Asian countries, with the highest rates being found for UK and the lowest
for Japan. In the United States, hospitalization rates for non-traumatic amputation of a
lower extremity decreased by over 50% from 1988 to 2008. In Germany and Italy also,
prevalence of amputations among the elderly patients with complicated diabetes or
PAD is very high. Objective: To review the scientific research regarding physical
therapy of individuals with lower limb amputation. Materials and methods. A literature
search was performed in the Scopus, PubMed and Google Scholar databases with
search terms related to rehabilitation after LLA. Different dimensions of
postamputation rehabilitation – physical, psychosocial, and emotional recovery – are
useful for patients to start prior to surgery. Early physiotherapy, choice of prosthesis
and psychological therapy are important in the rehabilitation process. End, virtual
rehabilitation electrostimulation, mirror therapy and hydrotherapy have been
demonstrated effective particularly in various stages of treatment. In the elderly,
multidisciplinary treatment in conjunction with the individualization of loads and
recovery phases with a slow progression can enhance success. It has been demonstrated that even patients older than 80 years can achieve functional recovery by appropriate
treatment. Already 3 months post-rehabilitation there are signs of positive quality of
life development, particularly with sustenance support. Early rehabilitation cuts annual
mortality by 30% and increases the likelihood of successful prosthetic adaptation.
Current guidelines are towards the use of biomechanical analysis, psychological
counselling and incorporating nurses in patient daily care. Therefore, the rehabilitation
of a patient with lower extremity amputation requires holistic management program
with an early onset program, multidisciplinary involvement and customized programs.
In this way not only functional capacities are recovered, but also quality of life and
social integration can be enhanced in these patients.
