Physiotherapy

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Browsing Physiotherapy by Subject "Amputees -- Rehabilitation"

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    The impact of prosthetic limbs on children with bilateral lower limb amputations using the lived experiences of two adult prosthetic users and healthcare practitioners
    (Stellenbosch : Stellenbosch University, 2023-03) Zantsi, Siphosethu; Joseph, Conran; Ennion, Liezel; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Physiotherapy.
    ENGLISH SUMMARY: Background: Major lower limb amputations can have a life-changing impact on an individual’s functional mobility. The literature supports the view that children with lower limb amputations, even bilateral amputations, have the potential to be highly functional with a prosthesis. However, there is insufficient research to demonstrate the impact of prostheses on children with bilateral lower limb amputations. This challenges the screening and prescription requirements currently in use which tends to hinder the equitable distribution of prosthetics among people with bilateral lower limb amputations. Aim: The aim of this study was to explore and describe the constructs that determine the impact of prosthetic interventions on children with bilateral lower limb amputations. Method: A multiple-methods approach was adopted for this study which consisted of a secondary scoping review and a primary qualitative study. The scoping review used Arksey & O’Malley’s (2005) five steps to explore and described the constructs used to evaluate the prosthetic impact in children with lower limb amputations in current literature. The information obtained from this review was then used to design the qualitative study. A qualitative approach and descriptive design were also taken for this study. Semi-structured interviews were conducted with two groups of key informants. Group A (five participants) consists of physiotherapists and prosthetists who have experience rehabilitating children with bilateral lower limb amputations. Group B (two participants) include adult prosthetic users who have undergone bilateral lower limb amputations in childhood. In total, seven individuals participated in the study. The interviews were conducted virtually and were recorded, transcribed and analysed using deductive analysis. Results: The findings from the scoping review showed that the constructs and outcome measures used to evaluate the prosthetic impact in children with lower limb amputations had a high focus on physical function as an outcome and were limited in evaluating other constructs of impact in prosthetic intervention, with little focus on the qualitative experiences of prosthetic users, specifically relating to satisfaction, quality of life, and other socio-relational constructs. There was also a low number of children with bilateral amputations included in the studies. The qualitative study exploring the experiences of children who are prosthetic users identified the constructs that impact children with bilateral prosthetic limbs; these include mobility, activities of daily living, physical participation, education, body image, quality of life and socio-economic participation. Challenges that impact prosthetic use are also explored and include personal and environmental challenges such as finances, prosthetic equipment, availability of resources and supportive relationships, as well as pain. Conclusion: While physical function has been a consistently evaluated theme in prosthetic rehabilitation, this study provides other areas of impact that healthcare providers might not assess or consider in their decision-making on prosthetic prescription. The emerging themes are holistic and encourage the use of the International Classification of Functioning, Disability and Health (ICF) model which could be helpful in developing a holistic outcome measure that is appropriate for children with bilateral lower limb amputations. It is hoped that this can provide evidence to improve the distribution of necessary resources to optimise equality among the vulnerable children with bilateral amputations.