scholarly journals Gülhane lower extremity amputee rehabilitation protocol: A nationwide, 123-year experience

2020 ◽  
Vol 66 (4) ◽  
pp. 373-382
Author(s):  
Yasin Demir
Keyword(s):  
Lower Extremity ◽  
Rehabilitation Protocol ◽  
Amputee Rehabilitation

Mobility in persons with lower extremity amputations and influencing factors: Using the International Classification of Functioning, Disability and Health to quantify expert views

2018 ◽  
Vol 43 (1) ◽  
pp. 88-94 ◽  
Author(s):  
Seema Radhakrishnan ◽  
Friedbert Kohler ◽  
Christoph Gutenbrunner ◽  
Arun Jayaraman ◽  
Karin Pieber ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Frequency Analysis ◽  
Lower Limb ◽  
International Classification ◽  
Lower Limb Amputation ◽  
International Classification Of Functioning ◽  
Limb Amputation ◽  
Common Framework ◽  
Amputee Rehabilitation

Background: International Classification of Function, Health and Disability provides a common framework and universal language for rehabilitation professionals across the globe. Objectives: To identify problems in functioning and mobility relevant to persons with lower-limb amputation from an expert’s point of view and quantify these problems using the International Classification of Function, Health and Disability. Study design: Qualitative study using electronic and paper surveys. Methods: Electronic or paper survey was done across six countries targeting clinicians involved in pre- and post-amputation care. Meaningful concepts were extracted from the responses and linked to suitable second-level and where applicable third-level International Classification of Function, Health and Disability categories. Categorical frequency analysis was completed for the combined data and for each location. Results: A total of 183 experts from 6 different countries responded to the survey. A total of 2171 concepts were identified, 82% of which could be linked to a second-level International Classification of Function, Health and Disability category. The categorical frequency analysis revealed that the categories of walking, design and construction of buildings for public and private use and sensation of pain were the most frequently occurring concepts and was similar across the six countries. Conclusion: The International Classification of Function, Health and Disability can be utilised as a common framework for communication among clinicians involved in rehabilitation of persons with lower-limb amputation across the globe. The most important factors that were identified by experts in amputee rehabilitation working in different international locations were similar. Clinical relevance The challenges faced by the clinicians involved in care of persons with lower extremity amputation vary across different parts of the world. The overarching goal for the clinician irrespective of the location is to improve mobility and quality of life of their clients. The International Classification of Function, Health and Disability provides a common language between the various stakeholders in amputee rehabilitation across the globe.

scholarly journals Video games towards Rehabilitation: Video Games based Rehabilitation Approach for Upper Limb Amputee Patients (Preprint)

2019 ◽  
Author(s):  
Nasrul Anuar Razak ◽  
N.A. Hashim ◽  
H. Gholizadeh
Keyword(s):  
Video Games ◽  
Upper Limb ◽  
Computer Games ◽  
Pearson Correlation ◽  
Maximum Voluntary Contraction ◽  
Voluntary Contraction ◽  
Rehabilitation Protocol ◽  
Patient Motivation ◽  
Block Test ◽  
Amputee Rehabilitation

BACKGROUND Prepared residual muscles and induced specific brain plasticity are very important before wearing a myoelectric prosthetic hand. They can be achieved through exhausting and tedious muscle training. Conservative physiotherapeutic exercise often results in significant reduction in patient motivation. Motivation is a key factor for effective rehabilitation and is frequently used to determine rehabilitation outcome. While a few systems for upper limb amputee rehabilitation are available, playful concept in rehabilitation that usually increase patient engagement and perseverance through the use of video games is often unanalyzed in the upper limb amputee population. OBJECTIVE This study investigated whether the inclusion of video games in the upper limb amputee rehabilitation protocol could have a beneficial impact for muscle preparation before wearing myoelectric prosthesis, coordination and patient motivation. METHODS Ten participants, 5 amputee and 5 able-bodied, enrolled in ten 1-hour sessions within a 4-week rehabilitation program. In order to investigate the effect of the rehabilitation protocol used in this study, a virtual reality box and block test and electromyography assessment was performed. Maximum voluntary contraction was measured before, after, and two days after interacting with four different EMG-controlled computer games. Participants completed user evaluation survey and their motivation was assessed using the Intrinsic Motivation Inventory (IMI) questionnaire. RESULTS Muscle strength and coordination increased at the end of training for all the participants. The result of the Pearson correlation indicated that there was a significant positive association between the training period and the Box and Block Test score (r(8): 0.95, p < 0.001). The percentage of Maximum Voluntary Contraction increment value is greater before training (6.84%) and in follow up session (7.14%) but was very small (2.11%) shortly after the training was conducted. The IMI assessed showed high scores for subscales of interest, perceived competence, choice and usefulness but low values for pressure and tension. CONCLUSIONS This study demonstrates that videogames enhance motivation and adherence in upper limb amputee rehabilitation programs. The use of videogames could be seen as complementary methods for physical training in upper limb amputee rehabilitation. CLINICALTRIAL The test was approved by the Medical Research Ethics Committee (MREC) and the Ministry of Health (MOH) Malaysia, Approval ID: NMRR-16-2106-32880.

Combining Values

2002 ◽  
Vol 7 (2) ◽  
pp. 1-4, 12 ◽  
Author(s):  
Christopher R. Brigham
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Evaluation Method ◽  
Proximal Phalanx ◽  
Common Error ◽  
The Third ◽  
Whole Person ◽  
Impairment Ratings ◽  
Upper Extremity Impairment ◽  
The Individual

Abstract To account for the effects of multiple impairments, evaluating physicians must provide a summary value that combines multiple impairments so the whole person impairment is equal to or less than the sum of all the individual impairment values. A common error is to add values that should be combined and typically results in an inflated rating. The Combined Values Chart in the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition, includes instructions that guide physicians about combining impairment ratings. For example, impairment values within a region generally are combined and converted to a whole person permanent impairment before combination with the results from other regions (exceptions include certain impairments of the spine and extremities). When they combine three or more values, physicians should select and combine the two lowest values; this value is combined with the third value to yield the total value. Upper extremity impairment ratings are combined based on the principle that a second and each succeeding impairment applies not to the whole unit (eg, whole finger) but only to the part that remains (eg, proximal phalanx). Physicians who combine lower extremity impairments usually use only one evaluation method, but, if more than one method is used, the physician should use the Combined Values Chart.

Quick Reference: Chapter 3: The Musculoskeletal System and Chapter 4: The Nervous System

2000 ◽  
Vol 5 (3) ◽  
pp. 4-4
Keyword(s):  
Nervous System ◽  
Lower Extremity ◽  
Musculoskeletal System ◽  
Multistep Method ◽  
Manual Muscle Testing ◽  
Motor Deficits ◽  
Lower Extremity Weakness ◽  
Residual Symptoms ◽  
Muscle Testing ◽  
Almost All

Abstract Lesions of the peripheral nervous system (PNS), whether due to injury or illness, commonly result in residual symptoms and signs and, hence, permanent impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, divides PNS deficits into sensory and motor and includes pain in the former. This article, which regards rating sensory and motor deficits of the lower extremities, is continued from the March/April 2000 issue of The Guides Newsletter. Procedures for rating extremity neural deficits are described in Chapter 3, The Musculoskeletal System, section 3.1k for the upper extremity and sections 3.2k and 3.2l for the lower limb. Sensory deficits and dysesthesia are both disorders of sensation, but the former can be interpreted to mean diminished or absent sensation (hypesthesia or anesthesia) Dysesthesia implies abnormal sensation in the absence of a stimulus or unpleasant sensation elicited by normal touch. Sections 3.2k and 3.2d indicate that almost all partial motor loss in the lower extremity can be rated using Table 39. In addition, Section 4.4b and Table 21 indicate the multistep method used for spinal and some additional nerves and be used alternatively to rate lower extremity weakness in general. Partial motor loss in the lower extremity is rated by manual muscle testing, which is described in the AMA Guides in Section 3.2d.

Q&A: Multiple Lower Extremity Impairments and AMA Guides, Third Edition, Revised

2017 ◽  
Vol 22 (2) ◽  
pp. 15-16
Author(s):  
Christopher R. Brigham ◽  
Kathryn Mueller ◽  
Steven Demeter ◽  
Randolph Soo Hoo
Keyword(s):  
Lower Extremity

Spinal Impairment Evaluation: Fifth Edition Changes

2001 ◽  
Vol 6 (1) ◽  
pp. 1-3
Author(s):  
Robert H. Haralson
Keyword(s):  
Spinal Cord ◽  
Lower Extremity ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Spinal Cord Injuries ◽  
Clinical Findings ◽  
Fourth Edition ◽  
Treatment Results ◽  
Standard Terminology ◽  
Made In

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, was published in November 2000 and contains major changes from its predecessor. In the Fourth Edition, all musculoskeletal evaluation and rating was described in a single chapter. In the Fifth Edition, this information has been divided into three separate chapters: Upper Extremity (13), Lower Extremity (14), and Spine (15). This article discusses changes in the spine chapter. The Models for rating spinal impairment now are called Methods. The AMA Guides, Fifth Edition, has reverted to standard terminology for spinal regions in the Diagnosis-related estimates (DRE) Method, and both it and the Range of Motion (ROM) Method now reference cervical, thoracic, and lumbar. Also, the language requiring the use of the DRE, rather than the ROM Method has been strengthened. The biggest change in the DRE Method is that evaluation should include the treatment results. Unfortunately, the Fourth Edition's philosophy regarding when and how to rate impairment using the DRE Model led to a number of problems, including the same rating of all patients with radiculopathy despite some true differences in outcomes. The term differentiator was abandoned and replaced with clinical findings. Significant changes were made in evaluation of patients with spinal cord injuries, and evaluators should become familiar with these and other changes in the Fifth Edition.

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