Pre-prosthetic training for a medically complex below knee amputee in a subacute setting: A Case Study
Type of Presentation
Event
Location
Hall of Governors
Start Date
4-7-2017 4:00 PM
End Date
4-7-2017 6:00 PM
Abstract
There are many reasons that a person may experience a lower extremity amputation. In fact, according to the Centers for Disease Control and Prevention, more than five hundred Americans lose their limb each day.1 Oftentimes physical therapists play a crucial role in determining the rehabilitation setting that these individuals will go to after their acute rehabilitation phase is complete. Research supports that dysvascular amputees have a better chance of positive outcomes when discharged to an inpatient rehabilitation setting as compared to a skilled nursing facility.2-3 For this particular case, a fifty-eight year old Caucasian female, JS, presented to a skilled nursing facility to the subacute rehabilitation floor following hospitalization due to intractable right lower extremity pain with active cellulitis and non-healing wounds which resulted in a right below knee amputation. Her hospital stay was complicated with acute respiratory failure and bradyarrhythmias and a ST elevated myocardial infarction which required a Boston scientific duel chamber pacemaker placement.
JS presented to physical therapy six weeks after her original hospital admission. This case study provides an example of a rehabilitation program used for pre-prosthetic training of a medically complex patient on the subacute unit of a skilled nursing facility. It is imperative that physical therapists in any setting understand the importance of strength training, balance, trunk stability, transfer training, and safety education prior to the amputee receiving a lower extremity prosthetic device. Choosing a discharge destination is an important decision when determining post-acute rehabilitation plans, but there is a significant gap in the research regarding the utilization of a subacute rehabilitation setting. Intensive rehabilitation for patients who have had a lower extremity amputation may significantly alter their future functional status and options when receiving a prosthetic device which is why understanding the foundation of each rehabilitation setting options is so imperative.
Pre-prosthetic training for a medically complex below knee amputee in a subacute setting: A Case Study
Hall of Governors
There are many reasons that a person may experience a lower extremity amputation. In fact, according to the Centers for Disease Control and Prevention, more than five hundred Americans lose their limb each day.1 Oftentimes physical therapists play a crucial role in determining the rehabilitation setting that these individuals will go to after their acute rehabilitation phase is complete. Research supports that dysvascular amputees have a better chance of positive outcomes when discharged to an inpatient rehabilitation setting as compared to a skilled nursing facility.2-3 For this particular case, a fifty-eight year old Caucasian female, JS, presented to a skilled nursing facility to the subacute rehabilitation floor following hospitalization due to intractable right lower extremity pain with active cellulitis and non-healing wounds which resulted in a right below knee amputation. Her hospital stay was complicated with acute respiratory failure and bradyarrhythmias and a ST elevated myocardial infarction which required a Boston scientific duel chamber pacemaker placement.
JS presented to physical therapy six weeks after her original hospital admission. This case study provides an example of a rehabilitation program used for pre-prosthetic training of a medically complex patient on the subacute unit of a skilled nursing facility. It is imperative that physical therapists in any setting understand the importance of strength training, balance, trunk stability, transfer training, and safety education prior to the amputee receiving a lower extremity prosthetic device. Choosing a discharge destination is an important decision when determining post-acute rehabilitation plans, but there is a significant gap in the research regarding the utilization of a subacute rehabilitation setting. Intensive rehabilitation for patients who have had a lower extremity amputation may significantly alter their future functional status and options when receiving a prosthetic device which is why understanding the foundation of each rehabilitation setting options is so imperative.