Title PROCJENA USPJEŠNOSTI PROTETIČKE REHABILITACIJE OSOBA SA AMPUTACIJOM DONJEG UDA Title (english) EVALUATION OF THE SUCCESS THE PROSTHETIC REHABILITATION PERSONS WITH LOWER LIMB AMPUTATION Author Dunja Mršić Mentor Tanja Grubić Kezele (mentor)Committee member Juraj Arbanas (predsjednik povjerenstva)Committee member Marina Nikolić (član povjerenstva)Committee member Tanja Grubić Kezele (član povjerenstva)Granter University of Rijeka Defense date and country 2018-09-18, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Uvod i cilj: Protetička rehabilitacija nakon amputacije donjeg uda uključuje sve kompleksne postupke i interakcije rehabilitacijskog tima i pacijenta koje su usmjerene cilju uspostavljanja sigurnog i stabilnog hoda s protezom. Nakon otpuštanja iz rehabilitacijskog centra bolesnik koristi protezu, sukladno dobi, stilu života i okolini u kojoj živi.
Cilj rada je procijeniti uspješnost protetičke rehabilitacije osoba s amputacijom donjeg uda (DU) koristeći indekse predviđene mobilnosti bolesnika (engl. Amputee Mobility Predictor; AMP), indeks funkcionalne onesposobljenosti bolesnika (engl. Functional Independence Measure; FIM) i brzinu hoda.
Ispitanici i metode: U radu su korišteni podaci pacijenata iz baze podataka Zavoda za fizikalnu i rehabilitacijsku medicinu Kliničkog bolničkog centra u Rijeci, a pri tome su u skladu s Helsinskom deklaracijom ostali anonimni: dob, spol, vrsta i strana amputacije, AMP i FIM mjerenja, brzina hoda i vrijeme provedeno u protezi. Od sto bolesnika s amputacijom 62 je transtibijalnih (TT), a 38 je trasfemoralnih (TF). U ispitivanju je sudjelovalo 27 žena i 73 muškarca. Kod svih bolesnika se radilo o unilateralnoj amputaciji i prilikom opskrbe korištena je stopalna jedinica SACH+ i jednoosovinsko koljeno s kočnicom.
Svim pacijentima je utvrđen FIM indeks pri dolasku (FIM1) i odlasku (FIM2), za procjenu motoričke i kognitivne neovisnosti prilikom izvođenja svakodnevnih aktivnosti, te AMP indeks bez korištene proteze (AMPnoPRO) i s korištenom protezom (AMPPRO), za procjenu pokretljivosti nakon amputacije. Sva spomenuta mjerenja su uspoređivana unutar (prije-poslije) te između grupa (TT i TF).
Rezultati: Nakon povedene protetičke rehabilitacije utvrđena je statistički značajna razlika u konačnoj mobilnosti (AMP: p=0,00008), neovisnosti (FIM: p=0,02) i brzini hoda (p=0,002) između TT i TF grupa, odnosno bolji rezultat su postigli pacijenti s nižom razinom amputacije (TT). Također je utvrđena statistički značajna povezanost između vremena provedenog u protezi i brzini hoda (p<0,001) te AMP indeksa (p<0,001).
Zaključak: Razina amputacije ja važna stavka koja pridonosi konačnom ishodu rehabilitacijskog postupka, odnosno viša razina amputacije kod pacijenata (TF) predstavlja jedan oblik ograničenja za bolji uspjeh u odnosu na pacijente s nižom razinom amputacije (TT).
Abstract (english) Introduction and Aim: Prosthetic rehabilitation after lower limb amputation includes all complex procedures and interactions between the rehabilitation team and the patient aimed to establishing a safe and stable walk with the prosthesis. After being released from the rehabilitation center, the patient uses the prosthesis, according to age, lifestyle and the environment in which he lives. The aim of the study was to evaluate the success of the prosthetic rehabilitation in lower limb amputation using Amputee Mobility Predictor (AMP), the Functional Independence Measure (FIM), and the walking speed. Participants and Methods: The patients data were taken from the database of the Physical and Rehabilitation Medicine Institute of the Clinical Hospital Center in Rijeka and used in this paper, and according to the Helsinki Declaration they were made anonymous: age, sex, type and side amputation, AMP and FIM measurements, walking speed and time spent in the prosthesis. Out of 100 patients with amputation, 62 are transtibial (TT), and 38 are transfemoral (TF). The study included 27 women and 73 men. In all patients, this is due to unilateral amputation and during the supply the SACH + foot unit and the one-axle knee with brakes were used. For all patients, the FIM index was established on the arrival and the outbound, for estimation of motor and cognitive independence when performing daily activities. The AMP index tested the mobility after amputation in patients with and without the prosthesis. All of these measurements were compared within (before-after) and between groups (TT and TF). Results: After the prosthetic rehabilitation, a statistically significant difference in ultimate mobility (AMP: p = 0.00008), independence (FIM: p = 0.02) and walking speed (p = 0.002) were determined between TT and TF groups. The results were better in patients with a lower amputation level (TT). A statistically significant correlation between time spent in the prosthesis and walking speed (p<0.001) and AMP index (p<0.001) was also established.
Conclusion: The level of amputation is an important factor contributing to the ultimate outcome of the rehabilitation process, respectively a higher level of amputation in patients (TF) is one form of restriction for better success compared to patients with lower amputation levels (TT).
Keywords
Amputacija
Amputee Mobility Predictor (AMP)
brzina hoda
Functional Independence Measure (FIM)
protetička rehabilitacija.
Keywords (english)
Amputation
Amputee Mobility Predictor (AMP)
Walk Speed
Functional Independence Measure (FIM)
Prosthetic Rehabilitation.
Language croatian URN:NBN urn:nbn:hr:184:427979 Study programme Title: Graduate university study of Physiotherapy (Biomedicine and Healthcare; clinical medical sciences) Type of resource Text File origin Born digital Access conditions Access restricted to students and staff of home institution Terms of use Created on 2018-10-29 10:08:55
