Screening of patients for first time prostheses after amputation of lower limbs

Abstract

In the world's developed countries, demographic changes, such as aging societies and increased numbers of diabetes patients, have led to an increase in amputations (11), and it is believed that as society ages, the number of people who are older than 65 will face as much as two times more amputations [3]. Of great importance after the amputation of a lower limb is the selection and adaptation of prostheses that allow patients to move around, thus achieving rehabilitation goals much more quickly [5]. A 20090-study of the rehabilitation of people with lower limb amputations in Latvia found that among 183 patients, 50% use their prostheses actively for more than 6 hours a day, 30% did not use them at all or used them for less than 3 hours a day, and 20% used them for 3-6 hours a day. The study included 173 patients with lower limb amputations who were evaluated in 2012 in relation with whether primary prosthesis should be provided. Of 173 patients who were evaluated, only 109 received a decision on primary prostheses, while in 51 cases the process was delayed for 1–3 months, in 12 cases, it was decided that prostheses would not be purposeful. More than 25% of those who followed the recommended treatment and rehabilitation programme to prepare the amputation stump, reduced contracture and enhanced physical working abilities were declared to be appropriate for further prostheses. This indicates serious shortcomings in medical treatments during the early post-amputation period.