BOOK
Amputee Rehabilitation, An Issue of Physical Medicine and Rehabilitation Clinics of North America, E-Book
(2014)
Additional Information
Book Details
Abstract
This issue of Physical Medicine and Rehabilitation Clinics of North America is devoted to "Amputee Rehabilitation." Editor Robert Meier, III, MD is the Medical Director of the Amputee Services of America and has assembled the top experts to review this important topic. Articles in this issue include: Principles of Contemporary Amputee Rehabilitation; Etiology and Demographics of Amputation; Surgical Techniques for Ideal Outcomes; Pre-prosthetic Care; Prosthetic Choices for Leg and Arm Amputees; Devising the Prosthetic Prescription and Typical Examples; Prosthetic Training; Complications Following an Amputation; Outcomes Measurement; Gait Evaluation for the Leg Amputee; Innovative Techniques and Future Options; Emotional Adaptation to Limb Loss; Pain Management for the Amputee; and Amputation Classification and Functional Outcomes.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Amputee Rehabilitation | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| Contents | vii | ||
| Physical Medicine & Rehabilitation Clinics Of North America\r | xi | ||
| Foreword\r | xiii | ||
| Preface | xv | ||
| Dedication | xix | ||
| Epidemiology of Limb Loss | 1 | ||
| Key points | 1 | ||
| Dysvascular | 2 | ||
| Diabetes | 3 | ||
| PAD | 4 | ||
| Reamputation rates | 5 | ||
| Trauma | 5 | ||
| Cancer | 6 | ||
| Congenital deficiency | 6 | ||
| Summary | 7 | ||
| References | 7 | ||
| Impact of Limb Loss in the United States | 9 | ||
| Key points | 9 | ||
| Traumatic limb loss | 10 | ||
| Nontraumatic limb loss | 11 | ||
| Peripheral Arterial Disease | 11 | ||
| Diabetes | 12 | ||
| Obesity | 13 | ||
| Limb loss and “the obesity paradox” | 13 | ||
| Weight gain after limb loss | 14 | ||
| Health disparity | 14 | ||
| African American Individuals | 15 | ||
| Native Americans | 15 | ||
| The Importance of Focused Education | 16 | ||
| Preventable limb loss | 16 | ||
| “Usual care” in the United States | 18 | ||
| Adjustment after limb loss | 19 | ||
| The prosthetist and prosthetic industry | 21 | ||
| Fair insurance coverage and national advocacy | 22 | ||
| Amputee medical home | 23 | ||
| Acknowledgments | 25 | ||
| References | 26 | ||
| Principles of Contemporary Amputation Rehabilitation in the United States, 2013 | 29 | ||
| Key points | 29 | ||
| Principles of amputation rehabilitation for the civilian with limb loss | 29 | ||
| Principles of amputation rehabilitation for the veteran with limb loss | 31 | ||
| Multidisciplinary approach | 32 | ||
| References | 33 | ||
| Amputation Surgery | 35 | ||
| Key points | 35 | ||
| Introduction and philosophy of amputation surgery | 35 | ||
| Stump revision | 37 | ||
| Controversial levels of amputation | 37 | ||
| Targeted Muscle Reinnervation | 41 | ||
| Osseous Integration (Direct Skeletal Attachment) | 41 | ||
| Bone Lengthening and Soft-Tissue Coverage | 41 | ||
| References | 43 | ||
| Selected readings | 43 | ||
| Pain Issues and Treatment of the Person with an Amputation | 45 | ||
| Key points | 45 | ||
| Residual limb pain | 46 | ||
| Phantom limb pain | 49 | ||
| Generalized treatment modalities that should always be used | 49 | ||
| Residual limb evaluation for pain | 49 | ||
| Medications | 50 | ||
| Therapeutic modalities | 50 | ||
| Miscellaneous pain treatment modalities | 50 | ||
| Psychologic factors that influence the pain experience | 51 | ||
| Invasive techniques for pain treatment | 51 | ||
| Use of a pain treatment algorithm for the person with an amputation with problematic pain | 51 | ||
| References | 52 | ||
| Emotional Adaptation to Limb Loss | 53 | ||
| Key points | 53 | ||
| Changes imposed by amputation | 53 | ||
| Changes in Body Image | 54 | ||
| Changes in Functional Abilities | 54 | ||
| Changes in Finances | 54 | ||
| Changes in Comfort | 55 | ||
| Emotional reactions to limb loss | 55 | ||
| Shock and Disbelief | 57 | ||
| Denial | 57 | ||
| Anger | 58 | ||
| Depression | 58 | ||
| Anxiety | 59 | ||
| Guilt | 60 | ||
| Bargaining | 60 | ||
| Yearning | 60 | ||
| Acceptance | 61 | ||
| Coping strategies | 61 | ||
| Relaxation Training | 62 | ||
| Exercise | 63 | ||
| Balanced Diet | 63 | ||
| Support from Others | 63 | ||
| Acceptance | 64 | ||
| Identifying Negative Self-Talk | 64 | ||
| Pacing | 65 | ||
| Other Helpful Interventions | 65 | ||
| Differences in emotional healing | 65 | ||
| Gender | 65 | ||
| Cultural/Religious Considerations | 66 | ||
| Age | 66 | ||
| Education | 66 | ||
| Family and Support System Availability | 67 | ||
| Prior Lifestyle and Level of Functioning | 67 | ||
| Prior Life Catastrophes | 67 | ||
| Hallmarks of unsuccessful emotional outcomes or maladaptation | 67 | ||
| Pain, Pain, and More Pain | 67 | ||
| Anger Outbursts | 68 | ||
| Alcohol and Drugs | 68 | ||
| Negative Outlook on Life | 68 | ||
| Lack of Acceptance | 68 | ||
| Poor Sleep Pattern | 69 | ||
| Changes in Appetite and Weight Gain | 69 | ||
| Not Being Able to Return to Work | 69 | ||
| Lack of Integration into the Community | 70 | ||
| Hallmarks of successful emotional outcomes and/or positive adaptation to amputation | 70 | ||
| Objective Measurements | 70 | ||
| Subjective Measurements | 70 | ||
| Communication | 70 | ||
| Return to activities | 70 | ||
| The Road to Successful Adaptation | 71 | ||
| References | 71 | ||
| Further readings | 72 | ||
| Amputee Rehabilitation and Preprosthetic Care | 75 | ||
| Key points | 75 | ||
| Occupational therapy intervention for preprosthetic training in the lower extremity amputee | 75 | ||
| General Evaluation | 75 | ||
| Evaluation of Activities of Daily Living | 76 | ||
| Evaluation for Driving | 76 | ||
| Occupational Therapy Treatment of Lower Extremity Amputees | 76 | ||
| Activities of daily living | 76 | ||
| Therapeutic exercise | 76 | ||
| Preprosthetic care for the UE amputee | 76 | ||
| Preoperative Care | 76 | ||
| Evaluation | 76 | ||
| Treatment | 77 | ||
| Team Collaboration | 77 | ||
| Postoperative care | 77 | ||
| Preprosthetic training for the UE amputee | 77 | ||
| Shaping and Shrinking | 77 | ||
| Posture Training | 78 | ||
| Desensitization | 78 | ||
| Scar Management | 78 | ||
| ROM | 78 | ||
| Pain Management | 79 | ||
| Strengthening of UEs | 79 | ||
| Conditioning and Endurance Training | 79 | ||
| ADL | 80 | ||
| Myoelectric Site Testing/Training | 80 | ||
| Preprosthetic Training for Bilateral Upper Extremity Amputees | 81 | ||
| Bathing | 81 | ||
| Toileting | 81 | ||
| Dressing | 82 | ||
| Grooming | 82 | ||
| Eating | 82 | ||
| Food Preparation | 83 | ||
| Home Modifications | 83 | ||
| Occupational Therapy’s Role in Prosthetic Prescription | 83 | ||
| Physical therapy preprosthetic rehabilitation of lower extremity and UE amputees | 83 | ||
| References | 90 | ||
| Prosthetic Choices for People with Leg and Arm Amputations | 93 | ||
| Key points | 93 | ||
| Introduction | 93 | ||
| Sockets, liners, and suspension systems | 94 | ||
| Atmospheric Suspension, Anatomic Suspension, and Osseointegration | 95 | ||
| Lower limb prosthetics | 97 | ||
| Prosthetic Foot and Ankle Mechanisms | 97 | ||
| Primary Foot Selection Considerations | 97 | ||
| The Prosthetic Foot Keel | 98 | ||
| The Prosthetic Foot Heel | 98 | ||
| Aesthetics of Prosthetic Feet and Shoes | 99 | ||
| Prosthetic Ankles and Shanks | 99 | ||
| Prosthetic Knees | 100 | ||
| Knee Axis Configurations | 100 | ||
| Fluid Dampening Versus Constant Friction | 100 | ||
| Four Additional Knee Features | 101 | ||
| Microprocessor Control of Prosthetic Knees | 102 | ||
| Transverse Rotators: an Important Component for People with Transfemoral Amputations | 103 | ||
| Prosthetic Hip Joints | 103 | ||
| Summary of Options for People with Lower Limb Amputations | 104 | ||
| Upper limb prosthetics | 104 | ||
| Functional Aesthetic Prostheses | 105 | ||
| Activity-Specific Prostheses | 106 | ||
| Strategies for Control of Upper Limb Prosthetics | 106 | ||
| Options for Thumb, Finger, and Partial Hand Amputations | 107 | ||
| Options for Upper Limb Amputations at the Wrist and Proximal | 107 | ||
| Terminal devices | 107 | ||
| Voluntary opening versus voluntary closing | 108 | ||
| Hands, split hooks, and prehensors | 108 | ||
| Wrists | 110 | ||
| Elbows | 112 | ||
| Shoulders | 112 | ||
| Options for People with Bilateral Upper Limb Amputations | 113 | ||
| Choosing to go without | 113 | ||
| Summary | 113 | ||
| References | 114 | ||
| Devising the Prosthetic Prescription and Typical Examples | 117 | ||
| Key points | 117 | ||
| Statistical snapshot | 117 | ||
| Contraindications | 118 | ||
| Levels of involvement | 119 | ||
| Consultation, managing expectations | 120 | ||
| Balancing function and form | 121 | ||
| Lower limb | 121 | ||
| Upper limb | 121 | ||
| Types of Upper Limb Prostheses | 122 | ||
| Body powered | 122 | ||
| External powered | 122 | ||
| Functional aesthetic (passive) | 123 | ||
| Utilitarian/activity specific | 123 | ||
| Overuse Syndrome or Repetitive Stress Injury | 123 | ||
| Physical and occupational therapy | 123 | ||
| Congenital and acquired | 124 | ||
| Socket design, liners, and suspension | 124 | ||
| Economics and reimbursement | 125 | ||
| Sample prescriptions | 128 | ||
| Sample Transtibial Prescription | 128 | ||
| Sample Transfemoral Prescription | 131 | ||
| Sample Transradial Prescription | 131 | ||
| Sample Transhumeral Prescription | 131 | ||
| References | 131 | ||
| Prosthetic Training | 133 | ||
| Key points | 133 | ||
| Introduction | 133 | ||
| Types of prostheses: an OT’s perspective | 134 | ||
| Working closely with the CP and prosthetic component manufacturer | 134 | ||
| Goals and time frames | 134 | ||
| Occupational therapy initial assessment | 136 | ||
| Prosthetic delivery overview: an OT’s perspective | 137 | ||
| What to look for before training begins | 137 | ||
| Virtual evaluation and training | 139 | ||
| Training depends on type of prosthesis | 141 | ||
| Three stages of upper limb prosthetic training | 142 | ||
| Electrically powered component selection and programing: how it affects training | 142 | ||
| Community reintegration and other referrals | 147 | ||
| Multi-limb loss | 147 | ||
| Outcome measures from the OT’s perspective | 149 | ||
| Resources | 150 | ||
| Technology: what is new? | 150 | ||
| Summary | 150 | ||
| References | 151 | ||
| Gait Analysis in Lower-Limb Amputation and Prosthetic Rehabilitation | 153 | ||
| Key points | 153 | ||
| Normal locomotion | 154 | ||
| Gait analysis | 155 | ||
| Kinematics | 156 | ||
| Temporal and Spatial Descriptive Measures | 156 | ||
| Clinical gait analysis in people with amputations | 156 | ||
| Gait Abnormalities in People with Transtibial Amputations | 160 | ||
| Leg length discrepancies | 160 | ||
| Transfemoral prosthetic gait deviations | 161 | ||
| Stance-Phase Problems | 161 | ||
| Summary | 166 | ||
| References | 166 | ||
| Complications Following an Amputation | 169 | ||
| Key points | 169 | ||
| Introduction | 169 | ||
| Musculoskeletal complications | 170 | ||
| Dermatologic considerations | 171 | ||
| Pain | 173 | ||
| Psychiatric considerations | 175 | ||
| Summary | 176 | ||
| References | 176 | ||
| Outcome Instruments for Prosthetics | 179 | ||
| Key points | 179 | ||
| Introduction: nature of the problem | 179 | ||
| Review methods | 180 | ||
| Search results | 181 | ||
| Lower limb amputation–specific functional instruments | 181 | ||
| Prosthesis Evaluation Questionnaire—Mobility Scale (PEQ-MS and PEQ-MS 12/5) | 181 | ||
| Locomotor Capabilities Index (LCI, LCI-5, LCI10-4) | 188 | ||
| Amputee Mobility Predictor (AMP, AMPPRO, and AMPnoPro) | 188 | ||
| L-Test of Functional Mobility (L-Test) | 188 | ||
| Orthotics and Prosthetics Users’ Survey Lower Extremity Functional Status (OPUS-LEFS) | 189 | ||
| Generic lower limb functional instruments | 189 | ||
| Timed Up and Go (TUG) | 189 | ||
| Berg Balance Scale (BBS) | 190 | ||
| Activities-Specific Balance Confidence Scale (ABC Scale) | 190 | ||
| Patient-Specific Functional Scale (PSFS) | 190 | ||
| Timed Walking Tests (2MWT, 6MWT) | 190 | ||
| Distance Walking Tests (10mWT) | 191 | ||
| Upper limb amputation–specific functional instruments | 191 | ||
| Assessment of Capacity for Myoelectric Control (ACMC) | 191 | ||
| Orthotics and Prosthetics Users’ Survey Upper Extremity Functional Status (OPUS-UEFS) | 191 | ||
| Activities Measure for Upper Limb Amputees (AM-ULA) | 192 | ||
| Box and Blocks Test (BBT) | 192 | ||
| Jebsen-Taylor Test of Hand Function (JTHF) | 193 | ||
| Lower limb amputation–specific health-related quality of life | 193 | ||
| Socket Comfort Score (SCS) | 193 | ||
| Trinity Amputation and Prosthesis Experience Scales—Revised (TAPES-R) | 193 | ||
| Orthotics and Prosthetics Users’ Survey Health-Related Quality of Life (OPUS-HRQOL) | 194 | ||
| Generic health-related quality of life instruments | 194 | ||
| Patient-Reported Outcomes Measurement Information System (PROMIS) | 194 | ||
| Amputation-specific health-related quality of life instruments | 195 | ||
| Amputation-specific patient satisfaction instruments | 195 | ||
| Orthotics and Prosthetics Users’ Survey Satisfaction with Device and Services | 195 | ||
| Controversies and future considerations | 196 | ||
| Summary | 196 | ||
| Acknowledgments | 196 | ||
| References | 196 | ||
| Ideal Functional Outcomes for Amputation Levels | 199 | ||
| Key points | 199 | ||
| Levels of amputation | 199 | ||
| Upper Extremity | 199 | ||
| Lower Extremity | 199 | ||
| Bilateral Amputees | 199 | ||
| Rehabilitation team | 200 | ||
| Prosthetic candidacy | 200 | ||
| Physical therapy | 203 | ||
| Occupational therapy | 203 | ||
| Psychological therapy | 204 | ||
| Vocational rehabilitation | 204 | ||
| Ideal outcomes of upper extremity amputation | 205 | ||
| Ideal outcomes of lower extremity amputation | 206 | ||
| Measurable functional outcomes | 207 | ||
| Summary | 207 | ||
| References | 207 | ||
| Appendix 1 | 209 | ||
| A Quote for the Conclusion of the Text | 213 | ||
| Index | 215 |