Perceived independence and limitations in rising and sitting down after rehabilitation for a lower-limb amputation

Objective: To study perceived independence in rising and perceived limitations in rising and sitting down in persons after a lower-limb amputation and the relationship of these perceptions with personal and clinical characteristics. Design: Cross-sectional study. Subjects/patients: Persons with a lower-limb amputation wearing a prosthesis (n=172). Methods: Perceived independence in rising was assessed with the Locomotor Capabilities Index. Limitations in rising and sitting down were assessed with the Questionnaire Rising and Sitting down. Multivariate logistic and linear regression analyses, respectively, were used to investigate the associations between independence and limitations in rising and sitting down, and personal and clinical characteristics. Results: Of the participants, 91% and 47% perceived independence in rising from a chair and rising from the floor, respectively. Older participants and women perceived less independence in rising. Participants perceived marked limitations in rising and sitting down, with those rehabilitated in a nursing home perceiving more limitations. Conclusion: After a lower-limb amputation, most persons wearing a prosthesis are able to rise independently from a chair, but many perceive decreased independence in other forms of rising, especially older participants and women. Participants, especially those rehabilitated in a nursing home, perceive considerable limitations in rising and sitting down. However, in those patients rehabilitated in a nursing home these limitations may be due to indication bias

Prevalence of comorbidity and its association with demographic and clinical characteristics in persons wearing a prosthesis after a lower-limb amputation

Objective: To describe the prevalence of comorbidity and its relationship with demographic and clinical characteristics in persons wearing a prosthesis after lower-limb amputation. Design: Cross-sectional study. Subjects/patients: Persons wearing a prosthesis after lower-limb amputation (n = 171; mean age 65 years (standard deviation 12); 72% men) at the end of outpatient rehabilitation treatment. Methods: Comorbidity was assessed with the Functional Comorbidity Index: a list of 18 items addressing the presence of specific comorbid conditions impacting on functional status. Comorbidities in medical records were assessed independently by 2 assessors. Associations with demographic and clinical characteristics were analysed using linear or logistic regression. Results: The median (interquartile range) number of comorbidities was 3 (2; 4). Three or more comorbidities were present in 103 of 171 (60%) participants. Diabetes was present in 71 (41%), cardiac disease in 60 (35%), and lumbago/degenerative disc disease in 39 (23%) participants. The prevalence of comorbidities was higher in women and those with vascular cause of amputation. Conclusion: There is a high prevalence of comorbidity at the end of outpatient rehabilitation treatment in persons wearing a prosthesis after a lower-limb amputation, especially in women and those with vascular cause of amputation

The eldery amputee: rehabilitation and functional outcome

Several studies are performed in a population of elderly people with lower limb amputations in the north of the Netherlands. Changes in patterns of reasons for amputations are shown over time. The majority of amputations are caused by vascular occlusive diseases with or without diabetes mellitus. ... Zie: Summary

Bewegingsapparaat: onderste extremiteiten

Objetivo general: Describir los factores asociados a la enfermedad pulmonar obstructiva crónica en el paciente VIH del Hospital Nacional Alberto Sabogal Sologuren 2014-2017. La incidencia del compromiso pulmonar no infeccioso en pacientes VIH está aumentando a nivel mundial. Este incremento representa cifras importantes de comorbilidad actual, a pesar de, la recuperación inmunológica asociada al TARGA. Un aumento de la prevalencia de la enfermedad pulmonar obstructiva crónica (EPOC) entre las personas que tienen VIH ha planteado la posibilidad de que este pueda predisponer al desarrollo o progresión de la EPOC. Así la infección por este virus ha sido asociada al desarrollo de patología pulmonar obstructiva. Diversos estudios en los últimos años, plantean la posibilidad de un mayor riesgo de EPOC entre las personas con infección por VIH. El desarrollo de enfermedades pulmonares crónicas asociada al VIH ha sido poco estudiado en nuestro país por lo que demanda desarrollar nuevas investigaciones para la identificación oportuna de la EPOC logrando establecer medidas de detección oportuna y el tratamiento adecuado. En nuestra investigación se parte de la premisa en que debemos ser conscientes de la mayor probabilidad de EPOC entre pacientes con infección por VIH, este concepto facilitaría su diagnóstico precoz y manejo oportuno. Además, la posibilidad de que la infección por VIH aumenta la susceptibilidad a EPOC merece investigación adicional y simultáneamente es imperioso describir y estudiar aquellos factores que puedan aumentar la probabilidad de acelerar la aparición del EPOC en esta población de pacientes. Además, sin contar con que existen pocos trabajos sobre este tema, cada vez con mayor incidencia en nuestro medio, se justificó la presente investigación que busca identificar aquellos factores de riesgo asociados a EPOC en pacientes con infección por VIH., desde lo cual parte el problema de investigación de este trabajo

Prosthetic fitting in a patient with a transtibial amputation due to a congenital vascular malformation of the right leg

Background: The problems of prescribing a prosthesis for a young girl with severe congenital vascular malformation deformity leading to a transtibial amputation. Case description and methods: Due to the high risk of recurrent bleeding and limitations regarding full weight bearing of the stump, a normal socket fitting process was not possible. Using a multidisciplinary approach, a prosthesis was designed to enable full weight bearing in a flexed knee position with ischial tuberosity support to prevent full weight bearing on the tibial part of the stump. Findings and outcomes: After training and adjustments to the design, a definitive prosthesis with a free motion mechanical knee joint could be used. During the training with this prosthesis, no skin problems were observed, and at the end of the rehabilitation, the patient had a high level of activities of daily living and sports. Conclusion: The above prosthetic solution with an adjusted socket design proved to be successful in this case. Clinical relevance In a patient with severe congenital vascular malformation deformity leading to a transtibial amputation, fitting of a good prosthesis without full weight bearing of the stump proved to be successful