Abstract:
::Background: Government and non-governmental hospitals and organizations are
distributing massive rehabilitation programs all over the Sri Lanka to rehabilitate the
people with amputation. Nevertheless, there is no proper pathway to measure the
effectiveness of those programs in terms of participation in daily life after
rehabilitation. Therefore this study was conducted to find out functional outcomes of
patients with unilateral lower limb amputation who engaged in rehabilitation and to
explore impact of socio-demographics, amputation status, medical, and rehabilitation
guidance on functional outcomes.
Methods: 48 unilateral lower limb amputees participated and were measured for
functional outcomes using Locomotor Capabilities Index (LCI), Amputee Mobility
Predictor with Prosthesis (AMPPRO), Six Minute Walk Test, VO2max and
Spirometry. Self-constructed questionnaire and qualitative interview was carried out
to determine the socio-demographics, amputation status, medical, and rehabilitation
process.
Results: Around 65% belongs to K3 and K4 level in AMPPRO classification and 96%
of individuals have ability to perform basic daily activities without assistive devices,
this reduced to 83% when engaged in advanced activities based on LCI. We found
that 31% have a restrictive pattern of respiratory functions based on spirometry test,
and 48% showed an unsatisfactory level of cardiovascular endurance based on
VO2max. The level of amputation, years since amputation, time gap between
amputation and admission for rehabilitation, prostheis usage and prosthetic usage
satisfaction, and mobility hours per day significantly impact (p<0.005 at 95% CI) on
physical functioning. 6MWD scores significantly change (p<0.005 at 95% CI) in
respect to AMPPRO K level, gender, age and level of amputation. Individuals with
K4 level have significantly higher 6MWD and VO2max values. From qualitative
analysis appeared that government hospitals mainly focus on basic care after the
amputation surgery but not on further advices or rehabilitation guidance.
Rehabilitation services mainly focus on basic independence in daily life and basic
walking training but not on long term survival, distance walking and cardiorespiratory
endurance. Hence, this study recommending to arrange awareness programs to raise
the awareness of the society about rehabilitation services and to medical and
rehabilitation professionals in Sri Lanka to arrange their post-surgical and
rehabilitation programs in an effective way, and government and responsible
authorities to take further steps to fill-up gaps in rehabilitation services.
Key words: Unilateral lower limb amputation, Rehabilitation, Physical functioning,
cardiorespiratory functions, basic care and rehabilitation guidance
Description:
A thesis is submitted to the SSARC Regional Interprofessional Master’s Program in Rehabilitation Science of Centre for the Rehabilitation of the Paralysed (CRP) in conformity with the requirements for the Degree of M.Sc. in Rehabilitation Science, Bangladesh Health Professions Institute, Faculty of Medicine, the University of Dhaka, Bangladesh: