Dissertations / Theses: 'Amputation rehabilitation'

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Crowther, H. "An investigation of rehabilitation with special reference to lower limb amputation." Thesis, University of Hull, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.375615.

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Mpezeni, Stella. "Community experiences of persons with lower extremity amputation in Malawi." University of the Western Cape, 2018. http://hdl.handle.net/11394/7034.

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Magister Scientiae (Physiotherapy) - MSc(Physio)
Persons with lower limb amputations (LLA) experience different challenges in the community. These challenges include the physical, psychological and social function of an individual. Little is known in Malawi on what persons with lower limb amputations go through in the communities where they live. Therefore, the study aimed at exploring and determining community experiences of persons with LLA in Malawi. The study sought to address the following objectives: 1) To determine the functional and psychological status of persons with LLA in the community; 2) To explore and describe experiences on social participation of persons with LLA in the community; 3). To explore experiences on community re-integration following LLA.

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Harbridge, Jenny. "Adjustment to amputation : identifying the contribution of family environment, coping style, functional ability and satisfaction with life variables to adjustment following unilateral below-knee amputation in adults." Thesis, Open University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.286952.

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Johansson, Ida, and Jonas Jönsson. "Hälsofrämjande faktorer vid benamputation." Thesis, Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-15341.

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En amputation innebär både en fysisk och en psykisk påverkan vilket är relaterat till en lång rehabilitering och anpassning till den nya livssituationen. För att som sjuk-sköterska kunna optimera vården av den amputerade personen är det viktigt att ha en ökad förståelse för vad ingreppet medför. Syftet var därför att beskriva faktorer som påverkar patientens upplevelse av hälsa i samband med en planerad benamputation. I denna litteraturstudie låg 15 vetenskapliga artiklar som grund för resultatet där två huvudkategorier med betydelse för upplevelsen av hälsa framkom; stödets betydelse och kroppsbildens betydelse. Stödet innebar de yttre resurserna i form av professionellt och socialt stöd. Kroppsbilden innebar de inre resurserna vilka handlade om den egna kroppsbildens betydelse för att återfå kroppsfunktionen och självständigheten. För den amputerade var det därför viktigt att nyttja hälsofrämjande faktorer som resurser för att anpassas till sina nya förutsättningar. Mer forskning kring personens erfarenheter av en amputation eftersträvas i syfte att öka sjuksköterskans förståelse för upplevelsen av ingreppet. Även forskning kring preoperativ information eftersöks då detta påvisades ha en positiv effekt för den postoperativa bearbetningen.
An amputation implies both a physical and a psychological impact which is related to a long rehabilitation and adjustment to the new life situation. To optimize the care of the amputee it is important as a nurse to increase the understanding of what the procedure entails. Therefore the aim of this study was to describe the factors that affect the lived experience of health related to a leg amputation. In this literature review 15 articles were used and two major subjects were generated which were of importance regarding the lived experience of health; the importance of support and the importance of the body image. The support implied the external resources in the terms of professional and social support. The body image implied the internal resources in the terms of regaining the body function and the independence. For the amputee it was therefore of importance to utilize health-promoting factors as resources to adjust to the new condition. More research regarding the personal experiences of an amputation is required to increase the nurses’ understanding of the procedure. Research regarding the preoperative information is also required due to the positive effect that it has been proven to inflict on the postoperative processing.

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Uytman, Clare Louise. "Living with limb loss : individuals' and prosthetists' perceptions of amputation, prosthesis use and rehabilitation." Thesis, Queen Margaret University, 2014. https://eresearch.qmu.ac.uk/handle/20.500.12289/7354.

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Loss of limb through amputation presents a significant, life changing, circumstance for individuals. The prosthetist as the gate keeper to the health-care system and the facilitator of rehabilitation is essential to positive adjustment post-amputation. As yet, however, commonalities and differences in the understandings of each of these parties of the experience of limb loss, prosthesis use and rehabilitation remain unexamined. This comparison provides the focus for this study. Fifteen individuals post amputation and 13 prosthetists were interviewed on their perceptions of limb loss and prosthesis use. Semi structured interviews were conducted, face to face, via telephone or via email. Data were audio-recorded and transcribed as necessary and thereafter analysed using Interpretative Phenomenological Analysis (IPA) in order to gain an understanding of the subjective experiences of individuals with limb loss and of prosthetists of the post-amputation process. Analysis of the data led to identification of four key themes, namely Personal Identity, Social Identity, The Prosthesis and Communication. These themes were relevant for both groups. The meanings that they held for the two groups, however, differed in relation to key elements of the post-amputation experience. Both groups have a shared interest in the process of prosthetic limb fitting and rehabilitation and yet come from very differing perspectives. The fitting and use of a prosthetic device is not a simple, technical process but rather involves a combination of psychological, social and practical components all of which must be recognized in the rehabilitation process. The differing expectations and understandings held by both groups become especially evident in interactions between individuals with limb loss and prosthetists. Communications between members of these groups can provide a central point for addressing differences in their understandings of living with limb loss and might provide a focus for further developments in research and practice.

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Sifunda, Sibusiso. "The determinants of adhering to rehabilitation in diabetics who have undergone lower limb amputation." Master's thesis, University of Cape Town, 2001. http://hdl.handle.net/11427/9366.

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Bibliography: leaves 54-56.
Chronic diseases of lifestyle (CDLs) have been rapidly increasing in population groups which had previously been least affected by this kind of illness. Diabetes Mellitus in particular has been shown to be rapidly increasing in South Africa among the non-white population which traditionally, had low reported prevalence rates of the condition. The rapid increase in urbanisation and adoption of a western diet by the urbanised black population has been one of the main contributing factors. In contrast to this picture the socio-economic status of this population has remained relatively low and the high costs of long term management of CDLs poses a potential time bomb to the public health system. This study sought to explore the psychosocial determinants of adhering to rehabilitation for diabetic amputees.

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Fredericks, Jerome P. "Description and evaluation of the rehabilitation programme for persons with lower limb amputations at Elangeni, Paarl, South Africa." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/20029.

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Thesis (MScMedSc)--Stellenbosch University, 2012.
ENGLISH ABSTRACT: Lower limb amputations cause multiple physical, psychological, environmental and socioeconomic barriers. Individuals who have suffered a lower limb amputation require comprehensive rehabilitation to ensure social integration and economic self-sufficiency. In addition, constant monitoring and evaluation is an essential part of human service delivery programmes. However, the amputation rehabilitation programme offered at Elangeni an outpatient rehabilitation centre for clients with physical disabilities in Paarl, Western Cape, South Africa is not monitored, and has not been evaluated since its inception in 2000. Thus, the current study evolved to describe and evaluate the rehabilitation programme for persons with lower limb amputations at Elangeni. A mixed method descriptive design was implemented. All persons who received rehabilitation, after a major lower limb amputation at Elangeni, between 2000 to 2011, were included in the study population. In addition, the physiotherapist and occupational therapist that provided amputation rehabilitation at Elangeni, at the time of the study, were interviewed. Thirty participants who met the study inclusion criteria were identified. Quantitative data was collected using a researcher designed, structured demographic questionnaire, an International Classification of Function checklist based questionnaire and a participant rehabilitation folder audit form. Two interview schedules one for clients and one for therapists were used for guidance during semi structured interviews. Quantitative data was entered onto a spread sheet and analysed by a statistician using Statistica, version 8. Qualitative data was thematically analysed according to predetermined themes. No programme vision, mission or objectives could be identified for the amputation rehabilitation programme. Poor record keeping practices and a lack of statistics were found. Rehabilitation was impairment focused with no attention given to social integration. Clients who received prosthetic rehabilitation showed improved functional ability with regard to picking up objects from the floor (p = 0.031) getting up from the floor (p = 0.00069), getting out of the house (p = 0.023), going up and down stairs with a handrail (p = 0.037) and moving around in the yard (p = 0.0069), climbing stairs without a handrail (p = 0.037), going up and down a kerb (p = 0.0082) walking or propelling a wheelchair more than 1km (0.0089) and walking in inclement weather (0.017). A lack of indoor mobility training had a statistically significant negative impact on the participants’ ability to lift and carry objects (p 0.011), standing up from sitting (p = 0.042), getting around inside the house (p = 0.00023), picking up objects from the floor (p = 0.00068), getting up from the floor (p = 0.0072), getting out of the house (p = 0.0016), going up and down stairs with a handrail (p = 0.019), moving around in the yard (0.0013), going up and down stairs with-out a hand-rail (p = 0.019), getting up and down a kerb (p = 0.0022), walking or wheeling 1km or more (p = 0.0032) and using transport (p = 0.0034). Failure to address community mobility during rehabilitation had a statistically significant negative impact on all aspects of community mobility scores except doing transfers and driving. In conclusion, for the study participants, Elangeni failed to provide rehabilitation according to the social model of disability and Community Based Rehabilitation principles. It is recommended that managers, service providers, and clients re-consider the purpose of Elangeni and develop a vision and objectives for that service. In addition, management should take an active role in service monitoring and evaluation and provide guidance and mentorship to therapists.
AFRIKAANSE OPSOMMING: Onderste ledemate amputasies impak negatief op `n persoon se fisiese, sielkundige en sosiale funksionering. Individue wat ’n amputasie ondergaan het benodig omvattende rehabilitasie om sosiale integrasie en ekonomiese onafhanklikheid te verseker. Konstante monitering en evaluasie is ’n essensiële deel van rehabilitasie programme. Nietemin die amputasie rehabilitasie program wat by Elangeni aangebied word, word nie gemoniteer nie en was nog nooit geëvalueer nie. Dus het hierdie studie dit ten doel om die rehabilitasie programme vir persone met onderste ledemate amputasies by Elangeni te beskryf en te evalueer. Kwantitatiewe en kwalitatiewe navorsingsmetodes is in kombinasie gebruik in die studie. Alle persone wat rehabilitasie by Elangeni ontvang het na ’n onderste ledemaat amputasie, sowel as die terapeute wat by Elangeni werk, het die studie populasie gevorm. In totaal het 32 persone aan die studie deelgeneem. Kwantitatiewe data is met behulp van `ŉ demografiese vraelys, `ŉ ICF gebaseerde vraelys, en `ŉ leer oudit vorm ingesamel. Twee onderhoud skedules, een vir die kliënte en een vir die terapeute, is gebruik as riglyn tydens insameling van kwalitatiewe data. Kwantitatiewe data is statisties ontleed deur ŉ statistikus wat gebruik gemaak het van Statistica 8. Voorafbepaalde temas is gebruik tydens tematies ontleding van kwalitatiewe data. Geen program visie, missie of doelwitte kon geïdentifiseer word nie. Swak rekord houdings praktyke was gevind. Rehabilitasie het gefokus op die fisiese en nie op sosiale integrasie nie. Die kliënte wat prostetiese rehabilitasie ontvang het, het statisties beduidend beter gevaar ten opsigte van optel van voorwerpe van die vloer af (p = 0.031), om van die vloer af op te staan (p = 0.00069), om uit die huis uit te kom (p = 0.023), om trappe met `ŉ handreling te klim (p = 0.037), om op die erf rond te beweeg (p = 0.0069), om trappe sonder `ŉ reling te klim (p = 0.037), om by sypaadjies op en af te gaan (p = 0.0082), om meer as `ŉ kilometer te loop of met die rolstoele te ry (0.0089) en om in ongure weer te loop (0.017). `ŉ Tekort aan heropleiding van mobiliteit binne die huis het `ŉ statisties beduidende impak gehad op die vermoë om goed te dra (p 0.011), op te staan van sit af (p = 0.042), in die huis rond te beweeg (p = 0.00023), voorwerpe van die vloer af op te tel (p = 0.00068), van die vloer af op te staan (p = 0.0072), uit die huis uit te kom (p = 0.0016), trappe met `ŉ handreling te klim (p = 0.019), in die erf rond te beweeg (0.0013), trappe sonder `ŉ handreling te klim (p = 0.019), by `n sypaadjie op en af te gaan (p = 0.0022), meer as 1km te loop of met die rystoel te ry (p = 0.0032) en om vervoer te gebruik (p = 0.0034). `ŉ Gebrek aan heropleiding van gemeenskapsmobiliteit het `ŉ statisties negatiewe impak gehad op alle aspekte van gemeenskapsintegrasie behalwe die doen van oorplasings en bestuur. Rehabilitasie praktyke was nie gebaseer op die sosiale model van gestremdheid en Gemeenskap Gebaseerde Rehabilitasie beginsels nie. Dit word aanbeveel dat diens verskaffers, kliënte en bestuurders oor die fokus van rehabilitasie by Elangeni moet besin. Daar moet ŉ visie en doelwitte vir die diens ontwikkel word. Voorts moet bestuurders van distrik vlak ŉ aktiewe rol speel in die monitering en evaluasie van dienste en mentorskap aan terapeute verseker.

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Gabrielsson, Jenny, and Martin Liepe. "Patienters erfarenheter av rehabilitering efter amputation av nedre extremitet." Thesis, Malmö universitet, Fakulteten för hälsa och samhälle (HS), 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25387.

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Bakgrund: Att genomgå en amputation är en livsomvälvande händelse som bjuder på utmaningar både fysiskt och psykiskt för den drabbade personen inte minst efter utskrivning från sjukhus. Syfte: Syftet med den här litteraturstudien var att sammanställa tidigare kvalitativ forskning om patienters erfarenheter av rehabilitering efter amputation av nedre extremitet efter utskrivning från sjukhus. Metod: Scoping review. Resultat: Resultatet av den här studien byggde på tolv artiklar och fem huvudteman identifierades samt femton subteman. Studien visade bland annat på hur informationsbrist råder från sjukvårdspersonalen till patienten på olika nivåer och att tilliten till personalen är viktig. Bristande ekonomi minskade följsamheten till rehabiliteringen av olika anledningar, men har även en direkt korrelation till patientens överlevnad. Kostnaden för sjukvården beskrevs även som en fråga om liv och död där fri sjukvård var avgörande för socioekonomiskt utsatta grupper. Konklusion: Konklusionen belyste att partner och familj är viktiga för hur patienten tacklar själva rehabiliteringsprocessen. Därför är det viktigt att sjuksköterskan är lyhörd vid vårdövergång från sjukhus till hemmiljö eftersom vårdbördan för familjen ökar och patienten är som mest sårbar.
Background: Going through an amputation is a life-changing event followed by challenges physically and mentally for the affected person not least after discharge from hospital. Aim: The aim of this literature review was to compile previous qualitative research of patients’ experience of rehabilitation after amputation of lower extremity after discharge from hospital. Method: Scoping review. Result: Based on twelve scientific articles five main themes and fifteen subthemes were identified. This study illustrated how lack of information exists from healthcare professionals to the patient on different levels and trust towards the staff is important. Lack of financial resources reduced the adherence to rehabilitation and had a direct correlation to patient survival. The cost of medical care was described as a matter of life and death where free health care was crucial for socio-economically vulnerable groups. Conclusion: The conclusion illuminated the importance of the partner and family for how the patient deal with the rehabilitation process. It is important that the nurse is responsive when care transition occurs from hospital to home environment as the burden of care for the family increases and the patient is the most vulnerable.

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Fan, Richard E., Christopher R. Wottawa, Marilynn P. Wyatt, Todd C. Sander, Martin O. Culjat, and Martin O. Culjat. "A Wireless Telemetry System to Monitor Gait in Patients with Lower-Limb Amputation." International Foundation for Telemetering, 2009. http://hdl.handle.net/10150/606038.

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ITC/USA 2009 Conference Proceedings / The Forty-Fifth Annual International Telemetering Conference and Technical Exhibition / October 26-29, 2009 / Riviera Hotel & Convention Center, Las Vegas, Nevada
Even after rehabilitation, patients with lower-limb amputation may continue to exhibit suboptimal gait. A wireless telemetry system, featuring force sensors, accelerometers, control electronics and a Bluetooth transmission module was developed to measure plantar pressure information and remotely monitor patient mobility. Plantar pressure characterization studies were performed to determine the optimal sensor placement. Finally, the wireless telemetry system was integrated with a previously developed haptic feedback system in order to allow remote monitoring of patient mobility during haptic system validation trials.

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Imam, Bita. "Incidence and rehabilitation of lower limb amputation in Canada, and feasibility of a novel training program." Thesis, University of British Columbia, 2017. http://hdl.handle.net/2429/61350.

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Background: There is a dearth of evidence about lower limb amputation (LLA) incidence, rehabilitation, and practice in Canada. Such data are crucial for assessing the burden of the disability and making informed healthcare decisions. We know from the literature that the current resource-intensive rehabilitation model is costly and perhaps not sustainable. This highlights the need for exploring interventions that are less resource-intensive and, therefore, more cost-effective. Purpose: To gain an understanding about the incidence of LLA, current practices, and rehabilitation services provided in Canada and to design and evaluate a novel approach that may ultimately provide cost-effective LLA rehabilitation. Methods: Five studies were conducted. Studies 1-2) analyses of Canadian data to determine the incidence of LLA and the provision of inpatient rehabilitation services from 2006 to 2011; studies 3-4) a Canadian survey to describe prosthetic rehabilitation practices and to explore therapists’ perspectives about the use of commercial games, particularly the Nintendo Wii Fit, in rehabilitation; and study 5) a feasibility randomized controlled trial (RCT) to evaluate the use of Wii Fit intervention (named Wii.n.Walk) in LLA rehabilitation. Results: The age-adjusted incidence of LLA was 22.9 per 100,000 individuals. Although there was a decline in the incidence rates, the number of LLAs increased for older age categories. In total, 18.0% (n=2,902/16,114) of the individuals received inpatient rehabilitation in Canada over the study years. When asked about the use of commercial games, 43.9% (n=36/82) of the therapists indicated that they use the Wii Fit in rehabilitation. Our feasibility RCT showed the intervention adherence was 83.4%. No adverse events occurred. Conclusions: Although the age-adjusted incidence rates have declined, the number of LLAs has increased in individuals older than 50. Given the increase in number of LLAs and the fact that only 18% of individuals receive inpatient rehabilitation, there is a need for other service deliveries. The Wii Fit is prevalently used in prosthetic rehabilitation in Canada and was found to be feasible for LLA rehabilitation. A future powered RCT is required to provide more evidence about the efficacy and cost-effectiveness of the Wii Fit in prosthetic rehabilitation.
Medicine, Faculty of
Graduate

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Manig, Sarah Mary. "Understanding the rehabilitation needs of persons living with a lower limb amputation in rural areas of the OR Tambo district of the Eastern Cape, South Africa." University of the Western Cape, 2018. http://hdl.handle.net/11394/6882.

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Magister Scientiae (Physiotherapy) - MSc(Physio)
Background: Globally, the leading cause of lower limb amputation is diabetes mellitus. In South Africa, there is a rise in diabetes-related lower limb amputation with a marked increase in the number of persons with diabetes mellitus in rural areas. However, there is no information on the number of people who are living with a lower limb amputation. An amputation does not only have an impact on a person’s physical functioning but can result in poor quality of life, dependence and exclusion from societal participation. Rehabilitation and prosthetic interventions are known to facilitate those with a lower limb amputation to return to independence in activities of daily living, improved quality of life and inclusion in society. Access to health care is very challenging for persons living in rural areas. Challenges to accessing health care include limited rehabilitation staff, harsh terrain and far distances from services, a lack of access to transport, or the lack of confidence in the service provided by the healthcare institutions. For optimal and patient-centred outcomes, rehabilitation services are of paramount importance. Due to the challenges with providing services in rural areas, community-based rehabilitation is the ideal model for providing rehabilitation to persons with lower limb amputation in rural settings. In order to plan an appropriate community-based approach to rehabilitation, establishing the prevalence of disability and patient-specific needs are imperative. Aims of the study: The aims of this study were firstly, to determine the period prevalence of people living with a lower limb amputation within the rural OR Tambo District of the Eastern Cape in order to determine the need for services and secondly, to gain a deeper understanding of the rehabilitation needs of persons living with a lower limb amputation within the rural OR Tambo District of the Eastern Cape.

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Wing, Yu Tak. "Participation restrictions and vocational needs amongst persons with a lower limb amputation in Cape Town, South Africa." University of the Western Cape, 2017. http://hdl.handle.net/11394/6299.

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Masters of Science - Msc (Physiotherapy)
Vocational rehabilitation relates to rehabilitating a person with an amputation back into actively participating in society. Although vocational rehabilitation is important, before it can be implemented, the participation restrictions should be identified. Even though lower limb amputation surgery is commonly performed in South Africa, and given the high unemployment rate in the country, no research has been done into the participation restrictions and vocational needs of a person with a unilateral lower limb amputation in the Western Cape. The aim of this study was to determine and explore the participation restrictions and vocational rehabilitation needs in terms of hobbies, sport activities, employment and employment needs of persons with a unilateral lower limb amputation (LLA) in the Western Cape. The objectives were to: 1) Determine the participation restrictions of persons with a unilateral LLA in the Western Cape. 2) To explore the vocational rehabilitation needs of persons with a lower limb amputation. A mixed methods approach, and an explanatory sequential design was used in this study. The study was conducted in two phases. The first phase utilised a quantitative approach and the WHODAS 2.0 was used as the instrument to collect data. The second phase aimed to explain the data collected in the first phase in more depth, and semi-structured telephonic interviews were utilized to collect the qualitative data. The study was set in the Cape Metropole region of the Western Cape. Participants were recruited from Tygerberg Tertiary Hospital and a private sub-acute rehabilitation centre. In the quantitative (first) phase of the study, 50 participants were conveniently recruited to participate. In the second phase eight participants were purposefully selected from the pool of 50 participants from the first phase of the study who consented to participate in the second phase. Quantitative data was analysed using SPSS vs. 22 and analysed for descriptive and inferential statistics. Qualitative data has been analysed using Creswell's seven step process of thematic analysis. Ethical clearance has been obtained from the University of the Western Cape, permission to access patients' details has been obtained from Tygerberg Tertiary Hospital and private sub-acute rehabilitation centre. Written informed consent as well as permission for audio recording during the telephonic interview was obtained.

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Mpezeni, Stella. "Community experiences of persons with lower limb amputations in Malawi." University of the Western Cape, 2018. http://hdl.handle.net/11394/7062.

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>Magister Scientiae - MSc
Persons with lower limb amputations (LLA) experience different challenges in the community. These challenges include the physical, psychological and social function of an individual. Little is known in Malawi on what persons with lower limb amputations go through in the communities where they live. Therefore, the study aimed at exploring and determining community experiences of persons with LLA in Malawi. The study sought to address the following objectives: 1) To determine the functional and psychological status of persons with LLA in the community; 2) To explore and describe experiences on social participation of persons with LLA in the community; 3). To explore experiences on community re-integration following LLA. A mixed method approach was applied where quantitative and qualitative data were collected simultaneously to provide a more holistic overview of the experiences of persons with LLA at one point in time. The study setting was Queen Elizabeth Central Hospital (QECH) and Kamuzu Central Hospitals (KCH) (500 miles), located in Malawi. A sample of 180 participants was recruited to participate in the study. Three self-administered questionnaires (socio-demographic questionnaire, OPUS module of lower extremity functional status, and a Beck’s depression inventory scale) and a semi-structured interview guide were used for data collection. Thematic data analysis was used to analyze qualitative data, while quantitative data was analyzed using descriptive and inferential statistics. Ethical clearance was obtained from the University of the Western Cape Biomedical Research Ethics Committee (BMREC) and College of Medicine Research Ethics Committee (COMREC). Permission to conduct the study was obtained from KCH (500 miles) and QECH. Privacy andconfidentiality was strictly observed such that data obtained was anonymous. It was kept in a secure place, and electronic data was secured using a password.

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Yancosek, Kathleen E. "INJURY-INDUCED HAND DOMINANCE TRANSFER." UKnowledge, 2010. http://uknowledge.uky.edu/gradschool_diss/18.

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Hand dominance is the preferential use of one hand over the other for motor tasks. 90% of people are right-hand dominant, and the majority of injuries (acute and cumulative trauma) occur to the dominant limb, creating a double-impact injury whereby a person is left in a functional state of single-handedness and must rely on the less-dexterous, non-dominant hand. When loss of dominant hand function is permanent, a forced shift of dominance is termed injury-induced hand dominance transfer (I-IHDT). Military service members injured in combat operation may face I-IHDT following mutilating injuries (crush, avulsion, burn and blast wounds) that result in dominant limb amputation or limb salvage. Military occupational therapy practitioners utilize an intervention called Handwriting For Heroes to facilitate hand dominance transfer. This intervention trains the injured military member how to write again using the previously non-dominant hand. Efficacy and clinical effectiveness studies were needed to validate the use of this intervention. This dissertation contains three studies related to I-IHDT. One study measured handwriting performance in adults who previously (greater than 2 years ago) lost function of their dominant hands. Results verified that handwriting performance, when measured on two separate occasions (six-weeks apart) was similar (stable). A second study examined the efficacy of Handwriting For Heroes in non-impaired participants. Results demonstrated a positive effect on the variables that measured the written product: legibility, writing speed (letters-per-minute); as well as a positive effect on the variables that measured the writing process: kinematic and kinetic parameters. The final study examined the clinical effectiveness of Handwriting For Heroes in an injured military population. Results did not show as positive results as the efficacy study, despite similar compliance with the intervention. Specifically, non-impaired participants started with faster writing speeds in their non-dominant hands (higher letters-per-minute) and made more gains (wider ranges). The non-impaired participants also started with faster dexterity (betters scores on the Grooved Pegboard) but they made fewer gains than the injured service members (smaller ranges). Nevertheless, injured participants clearly made gains in all dependent variables thereby demonstrating clinical effectiveness of the intervention

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Carvalho, José André 1970. "Vantagens na protetização de amputados transtibiais submetidos a técnias cirúrgicas não convencionais = Advantages of below knee amputees prosthetization subjected to non-conventional surgical techniques." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308490.

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Orientador: Bruno Livani
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A escolha do nível de amputação e da técnica cirúrgica a ser adotada nas amputações dos membros inferiores deve ser avaliada com muita atenção, pois influenciará diretamente na reabilitação física e na protetização do amputado. A preservação da articulação do joelho permitirá ao amputado uma marcha mais fisiológica e o processo de reabilitação mais funcional. Em situações específicas como nos traumas ortopédicos com lesão grave do membro inferior, a opção por uma amputação transtibial realizada imediatamente abaixo da tuberosidade tibial com manutenção da inserção do tendão patelar, pode resultar em cotos extremamente curtos, porem cotos funcionais. Amputados com cotos transtibiais extremamente curtos, com comprimento ósseo médio de 4,4cm, ao final do tratamento encontravam-se plenamente adaptados as próteses e satisfeitos com a qualidade de marcha após a reabilitação. Em situações eletivas, a indicação de amputações transtibiais clássicas podem ser substituídas por amputações com periosteoplastia tibio-fibular ou amputações com o uso do retalho plantar neuro-vascular pediculado e com fusão do calcâneo à tíbia. Os pacientes submetidos à técnica de periosteoplastia apresentaram grande capacidade na realização de descarga distal sem dor, durante a utilização de suas próteses. Pacientes submetidos às amputações transtibiais com uso do retalho plantar neuro-vascular pediculado e com fusão do calcâneo à tíbia, apresentaram como resultado um coto ósseo distal bastante estável, com maior área terminal para descarga de peso e fixação do próprio soquete protético, contribuindo muito no processo de reabilitação. Nestas três situações distintas, realizadas com técnicas cirúrgicas não convencionais, como nos cotos transtibiais extremamente curtos, na perioplastia tibio-fibular e com uso retalho plantar neuro-vascular pediculado e fusão do calcâneo à tíbia; excelentes resultados puderam ser observados no processo de reabilitação e na confecção customizada das próteses, quando comparada com as amputações transtibiais clássicas
Abstract: The choice of the level of amputation and surgical technique to be adopted in lower limb amputations should be assessed carefully, because it will influence directly on the fitting and physical rehabilitation of the amputee. The preservation of the knee joint renders the amputee a more physiological gait and a more functional process of rehabilitation. In specific situations, such as orthopedic trauma with severe lower limb injury, the option for a transtibial amputation performed just below the tibial tuberosity, with maintenance of the insertion of the patellar tendon, can result in extremely short, stumps, but functional stumps. Transtibial amputees with stumps extremely short, with an average bone length of 4.4cm, were fully adapted to the prostheses and satisfied with the quality of gait after rehabilitation. In elective situations, the classical transtibial amputations can be substituted by amputations with tibio-fibular periosteoplasty or the use of a neuro-vascular pediculated plantar flap graft, with fusion of the calcaneous to the tibia. Patients undergoing periosteoplasty technique presented a painless and high capacity terminal discharge during use of the prostheses. Patients submitted to a neuro-vascular pediculated plantar flap graft with fusion of the calcaneous to the tibia, presented a stable distal bone stump with a larger distal bearing area and better fixation of the prostheses, contributing positively to the rehabilitation process. In these three different situations, that made use of no convencional surgical techniques, as in the extremely short leg stumps, tibio-fibular periosteoplasty and the use of a neuro-vascular pediculated plantar flap graft, with fusion of the calcaneous to the tibia; excellent results may be achieved in the rehabilitation process and in the fitting of custom prostheses, when compared with traditional transtibial amputations
Doutorado
Fisiopatologia Cirúrgica
Doutor em Ciências

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De, Santis Letizia. "Studio di prevalenza a medio e lungo termine della Sindrome dell'arto fantasma in pazienti amputati trans femorali e trans tibiali." Bachelor's thesis, Alma Mater Studiorum - Università di Bologna, 2019. http://amslaurea.unibo.it/19334/.

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Background: A seguito di amputazione possono sopraggiungere tre sindromi differenti: la sindrome dell’arto fantasma o PLS (63-90% dei casi), la sindrome dell’arto fantasma doloroso o PLP (47-76%) e la sindrome del moncone doloroso o RLP (32-93%). Tra le tecniche di trattamento sono presenti sia la terapia farmacologica che la riabilitazione. Per quest’ultima ci sono evidenze su: Mirror Therapy, GMI, TENS e tDCS. Disegno di Studio: Osservazionale retrospettivo. Obiettivo: Valutazione della prevalenza a medio e lungo termine del dolore e delle sensazioni relative a PLS, PLP e RLP in pazienti amputati a livello trans-femorale, trans-tibiale ed emi-pelvectomia, trattati presso l’Istituto Ortopedico Rizzoli tra il 2008 e il 2018, ed indagine delle correlazioni con: età del paziente alla data dell'intervento, follow up dall'intervento, diagnosi, livello di amputazione, BMI, uso di farmaci e riabilitazione. Materiali e Metodi: I pazienti sono stati reclutati attraverso il Centro Elaborazione Dati dell’Istituto ed i dati anagrafici provengono dal Sistema Informatizzato Rizzoli. I pazienti scelti secondo i criteri di inclusione sono stati contattati al telefono per aderire allo studio e autorizzare l’invio di un questionario da compilare a domicilio. I dati sono stati esaminati con analisi statistica. Risultati: Il 68,5% riferisce di avere la PLS, il 65,9% la PLP ed il 53,3% la RLP. Chi è più anziano prova la PLP con maggior frequenza (p=0,040), mentre i pazienti che fanno più uso di farmaci sono quelli che presentano frequenza, durata, intensità e fastidio maggiori dovuti alla PLP (p=0, p=0,014, p=0.013 e p=0,004). Non sono state identificate altre correlazioni tra la prevalenza delle sindromi e i fattori considerati. Conclusioni: I dati sulla prevalenza a medio e lungo termine della PLS, PLP e RLP sono coerenti con la letteratura. Essendo sindromi clinicamente incisive, un intervento riabilitativo specifico può favorirne il contenimento e limitarne la disabilità.

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Sullins, Tyler Kayne. "The Development of a Prosthetic Training Software for Upper Limb Amputees." Scholar Commons, 2016. http://scholarcommons.usf.edu/etd/6406.

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The purpose of this study was to develop an intuitive software that aids in the field of prosthetic training and rehabilitation by creating an individualized visualization of joint angles. This software is titled “the prosthetic training software (PTS) for individualized joint angle representation”, and it enables the individualized portrayal of predicted or pre-recorded joint angles. The PTS is an intuitive program for clinicians and prosthesis users that produces an animation of a virtual avatar reflecting the user’s segment lengths and amputation for rehabilitation and training purposes. The PTS consists of a graphical user interface (GUI) and a 3D visualization of the information input into the GUI. This software was developed in Microsoft Visual Studio (Microsoft, Redmond, Washington) as well as the Unity game engine (Unity Technologies, San Francisco, California) in the programming language C#. Four GUI tabs were created consisting of a patient input tab, a patient measurements tab, a prosthesis view and search tab, and a tab dedicated to editing a list of prostheses. Code was developed to take information input into these tabs to create an individualized 3D human model for the visualization. Twenty-four models were created in order to allow for unique portrayal of that input data. The models consisted of small, medium and large sizes, both male and female genders, and able-bodied, transradial left side, and transradial right side amputation variations. A generic transradial prosthesis was created for the use in the variations of these models. An additional six stick figure models were generated in order to give additional perspective of the portrayed joint angles. Code was also developed in order to animate these models accurately to the joint angles that are sent to them. Playback speed, viewing orientation, and perspective control functionalities were developed in order to assist in the comprehensiveness of the displayed joint angles. The PTS is not meant to be standalone software, however, the functionalities that it needed to encapsulate in order to work in conjunction with research currently being conducted at USF were tested. The intuitiveness of the GUI and visualization was evaluated by ease of use surveys, as well as volunteer commentary, in order to find how easily the interface that can be operated in a home setting without the oversight of an experienced operator. On average, subjects agreed that the PTS was intuitive to use, both for inputting information and utilizing the visualization. Feedback from these surveys will be used to further improve the PTS in the future. The feasibility of learning from the visualization output from the PTS was tested by comparing motions from five able-bodied subjects before and after having been taught three motions comprising pre-recorded joint angles animated by the PTS. Joint angles were calculated from recorded marker positions. It was found that after viewing the animation, the joint angles were markedly closer to the joint angles portrayed to them. This shows that the PTS is fully capable of showing joint angles in a comprehensive way. Future work will include additional testing of these functionalities, including the testing of prosthesis users, as well as the introduction and testing of new features of prosthesis recommendation and predictive joint angle production when later combined with future research.

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Skau, Jeronimo Rafael. "Avaliação do comportamento mecânico dos músculos do quadril em amputados transfemorais." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-23112006-104002/.

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Introdução: O amputado transfemoral apresenta alterações anatômicas e funcionais importantes que se manifestam na marcha e nas atividades diárias. Apesar do lado envolvido na amputação apresentar menor força, não se sabe ao certo se há alguma posição angular ou velocidade angular específica em que isso ocorre, o tipo de contração muscular mais acometido e, além disso, se o lado não envolvido na amputação, também, possui variações da força muscular. Objetivos: Avaliar o torque e trabalho nos músculos do quadril através da dinamometria isocinética nos amputados transfemorais, em contrações isométricas, concêntricas e excêntricas dos músculos do quadril dos amputados transfemorais e comparar estes valores com o lado não envolvido pela amputação e grupo controle. Casuística e Método: A característica do estudo é do tipo transversal, no qual 23 sujeitos do sexo masculino, sedentários, foram divididos em dois grupos. O grupo controle foi constituído de 13 sujeitos com média de idade de 27,2 ± 7,6 anos, massa corporal de 69,7 ± 9,9 kg, e estatura de 1,74 ± 0,05 m. O grupo de amputados foi constituído de 10 (dez) sujeitos amputados transfemorais, com 37,7 ± 12,5 anos de idade, massa corporal de 63,9 ± 7,5 kg e estatura média de 1,70 ± 0,09 m. O dinamômetro isocinético Biodex modelo System 3 Pro foi utilizado para as coletas dos dados isométricos e dos movimentos isocinéticos, tanto para contração muscular concêntrica quanto para contração excêntrica. As posições angulares foram de 0º,10º, 20º e 30 º de abdução do quadril, para os grupos adutores e abdutores, e 0º, 30º, 60º e 90º para os grupos flexores e extensores. As contrações concêntricas e excêntricas foram avaliadas nas velocidades angulares de 30º/s, 90º/s e 150º/s. Resultados: O grupo amputado apresentou reduções significativas do torque e trabalho no lado envolvido nas contrações isométricas, principalmente nas posições de maior grau de alongamento muscular. Os achados das contrações concêntricas e excêntricas mostraram que o lado envolvido e não envolvido têm menores torque que o grupo controle, principalmente em maior velocidade. O grupo adutor do quadril tem importante diminuição de força em ambos os lados no amputado. Interessantemente, o torque e trabalho dos músculos extensores do quadril, nos amputados, em ambos os lados, foram maiores que o grupo controle, o que indicar uma adaptação dos músculos ao uso da prótese. A variável trabalho pode ser importante para revelar as condições musculares desta população. Conclusão: Os achados do presente estudo mostraram que os amputados transfemorais têm alterações no torque e trabalho mecânico gerados pelos músculos do quadril, no lado envolvido e não envolvido, dependendo da velocidade angular e da posição da articulação.
Introduction Amputation at the transfemoral level leads to anatomical and functional adaptations that change the gate pattern and influences daily-life activities. It is well known that the side of the amputation presents lower force. However, it is not known if there is a specific angular position or angular velocity in that the force is even lower. Moreover, how amputation affects the type of muscular contraction and the force generated in the contralateral side needs further investigation. Objectives: to investigate torque and mechanical work generated by hip muscles in transfemoral amputees subjects during concentric and eccentric isometric contractions. Furthermore, to compare these parameters with the non-involved side and a control non-amputee group. Methods: Thirteen subjects (mean age ±SD, 27,2 ± 7,6 years, mean height ± SD, 1,74 ± 0,05 cm, mean weight 69,7 ± 9,9 kg) in the control group and ten (mean age ±SD, 37,7 ± 12,5 years, mean height ± SD, 1,70 ± 0,09 cm, mean weight 63,9 ± 7,5 kg) in the amputee group participated in the study. A dynamometer Biodex System 3 Pro was used to measure torque and mechanical work in four (0º, 10º, 20º e 30) hip abduction positions during hip abduction and adduction efforts, and four (0º, 30º, 60º e 90) hip abduction positions during hip flexion and extension. Concentric and eccentric contractions were evaluated during 30º/s, 90º/s and 150º/s. Results: The amputee group presented significant reduction in the isometric torque generated in the ipsilateral side, mainly when the muscle was further stretched. For concentric and eccentric contractions, in high angular velocity, the control group presented significantly higher torque values when compared with the both sides of the amputee group. Interestingly, the torque and mechanical work generated by the amputee group, in both sides, were significantly higher compared with the control group. Mechanical work might be an important parameter to understand muscular conditions in the amputee population. Conclusion: The present study showed that transfemoral amputees have alterations in hip muscles torque and mechanical work generation, in the involved and uninvolved side, according to the joint position and angular velocity.

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Semple, Karen. "Exploring decision making and patient involvement in prosthetic prescription." Thesis, University of Stirling, 2015. http://hdl.handle.net/1893/22705.

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Background Recent conflicts have seen an increase in trauma related military amputees who incur complex injuries which result in varied residual limbs. In many cases these amputees have been provided with state of the art (SOTA) components with the expectation that they will transfer into NHS care after military discharge. However, there is a lack of knowledge around how prosthetic prescriptions are made in both the MOD and NHS, including patient involvement. It is important to explore prosthetic prescription decisions to enhance the quality, consistency and equity of care delivery for trauma amputees. This thesis explores decision making in prosthetic care for trauma amputees in the UK during this period of change. Aims To explore aspects of prosthetic care provision in the UK including clinical decision making, patient experience and the transition of prosthetic care from the MOD to the NHS. Design An exploratory qualitative project informed by decision making and patient involvement theory. Semi-structured interviews were carried out with nineteen clinical staff involved in prosthetic provision, six civilian and five veteran trauma amputees. Thematic analysis was used to analyse the data. Findings Prosthetists used a wide range of factors in making prescription decisions, including physical characteristics, patients’ goals, and predicted activity levels. Prescription decision making varied depending on the prosthetists’ level of experience and the different ‘cues’ identified. In some cases there was a lack of transparency about drivers for the prescription choice. Prescription decisions are influenced by long term relationships between prosthetist and patient, allowing a trial and error approach with increasing patient involvement over time. Patient experiences of their trauma amputation influenced their approach to rehabilitation. Patients reported wanting different levels of involvement in their prosthetic care, however, communication was essential for all. Veteran amputees benefited from peer support opportunities which NHS services were less conducive to. However, NHS amputees were more likely to have been ‘involved’ in care decisions. The expectations that MOD patients had of inferior care in the NHS were not realised in the majority of veteran cases. Recommendations Research is needed to support prosthetists’ decisions to become more consistent and transparent. The NHS should consider introducing a peer support model for trauma patients, and particularly in the early stages of rehabilitation.

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Silva, Ana Patrícia Matos da Costa. "Amputação e reabilitação: Estudo dos aspectos psico-legais do sujeito com amputação." Master's thesis, Instituto Superior de Psicologia Aplicada, 2006. http://hdl.handle.net/10400.12/925.

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Dissertação de Mestrado em Psicologia Legal
Independentemente da sua gravidade, as deficiências adquiridas alteram o balanço psicodinâmico do sujeito, pois afectam o seu ambiente intrapsíquico, interpessoal, bem como todo o percurso de vida da pessoa. Em contraste com outras doenças físicas, a amputação tem sido menos estudada. O sujeito amputado está muitas vezes ligado a imagens de guerra, devido a aspectos históricos, influentes e decisivos, nomeadamente as graves consequências resultantes da II Guerra Mundial, onde o número de sujeitos com incapacidade adquirida aumentou extraordinariamente. O objectivo do nosso estudo foi avaliar a satisfação e sua relação com a adaptação funcional à prótese em sujeitos com amputações dos membros inferiores, ex-combatentes da Guerra Colonial, e a averiguar a existência de desvantagem social na nossa amostra. Participaram no estudo vinte sujeitos (n=20) com amputação do(s) membro(s) inferior(es). A adaptação à prótese foi avaliada pelo TAPES, instrumento que mede o ajustamento psicossocial, restrição de actividades, e satisfação com a prótese (Parte I), e outros aspectos relacionados com a saúde e capacidades físicas, bem como a experiência de dor no coto e dor fantasma (Farte U). A medida de desvantagem foi-nos fornecida pela utilização do CHART-SF, nos seus diferentes factores: incapacidade física, mobilidade, ocupação, integração social e auto-suficiência económica. Os resultados sugerem correlações com significado estatístico entre: Ajustamento Psicossocial (T) e Ocupação; Satisfação com a Prótese (T) e Mobilidade; Satisfação com a Prótese (T) e Ocupação; Restrição de Actividades (T) e Mobilidade; Ajustamento à Limitação e Independência Funcional; Ajustamento Geral e Mobilidade; Ajustamento Geral e Ocupação; Ajustamento Social e Integração Social; Satisfação Estética e Independência Funcional; Satisfação Estética e Mobilidade; Satisfação com o Peso da Prótese e Independência Funcional; Satisfação Funcional com a Prótese e Mobilidade; Satisfação Funcional com a Prótese e Ocupação; Ajustamento Psicossocial (T) e Satisfação com a Prótese (T); Sugerem ainda correlações negativas com significado estatístico entre Restrições de Actividades (T) e Satisfação com a Prótese (T); entre Restrição de Actividades Funcionais e Integração Social; entre Restrição de Actividades Sociais e Mobilidade; entre Ajustamento Psicossocial (T) e Restrição de Actividades (T). Concluímos com a necessidade de promover uma reabilitação que assente em critérios de natureza fisiológica (indiscutivelmente necessários), mas que valorize também critérios de natureza subjectiva, de forma que se possa considerar a reabilitação como um processo global, em que se possa olhar para o sujeito amputado e valorizar não aquilo que ele perdeu (o membro), mas o que ele ainda pode fazer (as suas capacidades).

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Cuberovic, Ivana. "Understanding factors affecting perception and utilization of artificial sensory location." Case Western Reserve University School of Graduate Studies / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=case1574075500769757.

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Galvan, Gabriela Bruno. "Corpo ferido: os caminhos do self a partir de uma ruptura na integridade corporal." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/47/47131/tde-20052009-155102/.

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Este trabalho surgiu a partir da experiência como psicóloga do Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da faculdade de Medicina da Universidade de São Paulo. Mais especificamente ao longo dos anos trabalhando no Grupo de Prótese e Órteses, com pessoas que sofreram amputação de um ou mais membros. A perda de uma parte do corpo implica alterações significativas na vida de um indivíduo, sendo que as amputações decorrentes de acidentes em geral têm a característica de serem súbitas e imprevisíveis, ocasionando mudanças bruscas para as quais não existe preparo possível. A principal questão que norteou este trabalho diz respeito às conseqüências psíquicas que uma perda física pode ocasionar. Procurou-se compreender de que forma, diante de uma ruptura no corpo, há uma interferência na organização psíquica e na maneira pela qual o indivíduo percebe o mundo e se percebe nele; isso, durante o período de reabilitação. Buscou-se refletir sobre um momento de perda da integridade corporal e seus reflexos na unidade psicossomática, a partir de casos clínicos, tendo como referência a psicanálise winnicottiana. Dessa forma, levou-se em conta o percurso do desenvolvimento emocional segundo a teoria do amadurecimento pessoal de D.W.Winnicott para se refletir acerca da possível relação existente entre o estágio alcançado nas tarefas próprias do desenvolvimento normal pelo indivíduo e as conseqüências em termos da continuidade ou não do processo de amadurecimento após a amputação. Para esta investigação utilizou-se o método clínico e o referencial psicanalítico, sendo que para a análise da questão proposta neste trabalho foram apresentados quatro casos clínicos. A perda de uma parte do corpo ocasionou mudanças em todos os indivíduos que fizeram parte deste estudo. Mudou o corpo, a forma de se locomover, o trabalho, o sustento pessoal e familiar, o contato social. Porém a maneira por meio da qual cada um percebeu, significou e vivenciou essa perda e essas mudanças não foi equivalente nem determinada pela qualidade da perda. Assim, concluímos que as conseqüências psíquicas de uma perda física serão aquelas relativas às condições que cada indivíduo tem de elaborar imaginativamente essa perda e transformá-la em vivência, experiência, história pessoal e interpessoal. A articulação da teoria com a análise e discussão do material clínico permitiu perceber que não é possível caracterizar uma clínica dos amputados. Isso porque o que temos são tantas clínicas quanto nos for possível conhecer os indivíduos amputados em seu processo de amadurecimento pessoal anteriormente à amputação. Ou seja, uma amputação não direciona incondicionalmente o modo de um indivíduo estar no mundo, mas implica alterações significativas em sua existência, o que remete à necessidade de reformulações em sua identidade para incluir essa nova dimensão de experiência. A dificuldade em realizar a elaboração imaginativa dessa perda, pode tornar a amputação um acontecimento não integrado na vida de uma pessoa, com conseqüências prejudiciais à sua saúde e ao seu desenvolvimento.
This work arose from the experience as a psychologist in the Institute of Orthopedist and Traumatology of the Hospital das Clinicas of the faculty of Medicine of the University of São Paulo. More specifically along the years working on the Group of Prothesis and Orthesis, with people that suffered amputation of one or more members. The loss of a part of the body involves significant changes in the life of a person. The amputations originated from accidents in general have a characteristic of being sudden and unpredictable causing abrupt alterations in which no preparation is made possible. The main subject which directed this work concerns the psychic consequences that a physical loss causes. We intend to understand in what way, from a rupture of the body, there is the interference of the psychic organization and in what way the person notices the world and perceives himself in it; this, during the period of rehabilitation. We wanted to reflect about the moment of the loss of the integrity of the body and its reflexes on the psychosomatic unit, from clinical cases, with the theoretical reference of maturing of D. W. Winnicott. In this way, we took into account the course of the emotional development according to the theory of personal maturing to reflect about the possible relation existing between the stages reached on the proper tasks of the normal development of the person and the consequences in terms of continuity or not of the process of maturing after the amputation. For this investigation we used the clinical method and the psychoanalysis reference. For the analysis of the subject proposed in this work we presented four clinical cases. The loss of a part of the body caused changes in all of the persons which were part of this study. Changed the body, the way to move, the job, the personal and family maintenance, the social contact. In the other hand the way through which each one perceives, signifies and lives this loss and these changes was not equivalent nor determined by the quality of the loss. This way, we conclude that the psychic consequences of a physical loss are those related to the conditions that each person has to elaborate imaginatively the loss and transform it in a way of life, experience, personal and interpersonal story. The articulation of the theory with the analysis and discussion of the clinical material permitted to notice that it is not possible to characterize a clinic of the amputated. This because what we have are as many clinics as we are able to know the amputated persons in their process of personal maturing previous to the amputation. Or else, an amputation does not direct unconditionally the way that a person exists in the world, but implies in significant alteration of his existence, what refers to a need of reformulations in his identity to include this new dimension of experience. The difficulty in accomplishing the imaginative elaboration of this loss, can transform the amputation in a non integrated occurence in the life of a person, with bad consequences to his health and to his development.

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Gonçalves, Júnior Erádio. "Reabilitação da pessoa amputada de membros inferiores: barreiras e facilitadores." Universidade do Estado de Santa Catarina, 2015. http://tede.udesc.br/handle/handle/1834.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
The lower limb amputation involves important motor, psychological and social sequelae, being a serious public health problem in Brazil and worldwide. Identify the major barriers and facilitators involved in the person s rehabilitation process with amputated lower limb in Florianópolis were the main objective of this study. Look at the amputee person in the context of functionality enlarges the horizon and contextualizes the individual, the family, the community in the biopsychosocial perspective. Therefore it attempted to describe the functionality and disability process through ICF and know the issues related to assistance and therapeutic itineraries experience. This is an exploratory and descriptive research with qualitative approach, with production data purchased through semi-structured interviews, in depth, complemented by a field diary with six individuals who experienced amputation of lower limbs. The data were organized and processed by means of coding, classification and categorization, following the Analysis of Content technique suggested by Bardin. Observing the therapeutic itinerary of the interviewees are perceived access barriers, structural and organizational imposed by the health services and social security. It also was evidenced, the unpreparedness scientific-technical of health professionals, the barriers related to physical accessibility and the lack of medical transports for treatment. During the interviews, the social support, especially the provided by family members and friends were highlighted as an important facilitator. The trajectories also served to highlight the importance of prosthetic for rehabilitation of person amputee as well as the barriers faced to your assurance through Brazilian health system or Social Security.
A amputação de membros inferiores envolve sequelas motoras, psicológicas e sociais importantes, sendo um grave problema de saúde pública no Brasil e no mundo. Identificar as principais barreiras e os facilitadores envolvidos no processo de reabilitação da pessoa amputada de membro inferior no município de Florianópolis foi o principal objetivo deste estudo. Olhar a pessoa amputada no contexto da funcionalidade amplia os horizontes e contextualiza o indivíduo, a família, a comunidade em uma perspectiva biopsicossocial. Para tanto se buscou descrever o processo de funcionalidade e de incapacidade por meio da CIF e conhecer as questões relacionadas à assistência e aos itinerários terapêuticos vivenciados. Trata-se de uma pesquisa exploratória e descritiva com abordagem qualitativa, com produção de dados adquiridos por meio de entrevistas semiestruturadas, em profundidade, complementadas por um diário de campo, com seis indivíduos que sofreram amputação de membros inferiores. Os dados foram organizados e tratados por meio de codificação, classificação e categorização, seguindo a técnica de Análise de Conteúdo sugerida por Bardin. Observando o itinerário terapêutico dos entrevistados perceberam-se barreiras de acesso, estruturais e organizacionais impostas pelos serviços de saúde e previdência social. Ficou evidenciado, também, o despreparo técnico-científico dos profissionais de saúde, as barreiras ligadas à acessibilidade física e a falta de transporte sanitário para tratamento. Durante as entrevistas, o suporte social, sobretudo aquele oferecido pelos familiares e amigos foram ressaltados como importante facilitador. As trajetórias também serviram para destacar a importância da prótese para reabilitação da pessoa amputada, bem como as barreiras enfrentadas para sua garantia por meio do SUS ou Previdência Social.

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Santos, Kadine Priscila Bender dos. "Carga da doença para as amputações de membros inferiores atribuíveis ao diabetes Mellitus no estado de Sana Catarina 2008-2013." Universidade do Estado de Santa Catarina, 2015. http://tede.udesc.br/handle/handle/1852.

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Made available in DSpace on 2016-12-12T17:32:59Z (GMT). No. of bitstreams: 1 RESUMO KADINE.pdf: 15853 bytes, checksum: bfa11d3fee681ef7c30a44a0738800d9 (MD5) Previous issue date: 2015-12-10
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Os estudos de Carga Global da Doença (GBD) alertam que idosos com doenças crônicas irão viver mais, porém com incapacidades como é o caso das amputações de membros inferiores atribuíveis ao diabetes mellitus (DM). O objetivo deste estudo foi estimar a GBD para as amputações de membros inferiores atribuíveis ao DM no Estado de Santa Catarina, no período de 2008 a 2013. Realizou-se um estudo epidemiológico descritivo de base hospitalar, utilizando o cálculo de DALY (disability adjusted life years). A partir das Autorizações de Internação Hospitalar no período de 2008 a 2013, foram incluídas pessoas submetidas à cirurgia de amputação nos hospitais públicos do Estado de Santa Catarina e a prevalência do óbito por DM registrados no sistema de informação de mortalidade nesse período. Ocorreram 1.183 amputações de membros inferiores em pessoas com DM nos últimos 6 anos considerando-se todas as microrregiões do Estado de Santa Catarina. A carga revelou-se elevada e a morbidade foi a principal responsável por mais de 8 mil anos de vida sadia perdidos (93% do DALY), em homens e mulheres acima de 60 anos de idade com maior impacto na expectativa de vida de homens. Estimamos a GBD de uma população majoritariamente idosa que envelhecerá com a amputação de membro Inferior. Assim, há necessidade de assistência planejada a partir de intervenções reabilitadoras em tempo real, levando em consideração que as distribuições das taxas de DALY nas 20 microrregiões do estado não mostraram distribuição homogênea. Alerta-se para a criação de equipes multidisciplinares para a identificação precoce do pé diabético, além da necessidade de capacitação das equipes na atenção especializada e ampliação da atuação do fisioterapeuta na reabilitação pré e pós-protetização.

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Naidoo, Ugendrie. "Barriers and facilitators to utilisation of rehabilitation services amongst persons with lower-limb amputations in a rural community in Kwa-Zulu Natal." University of the Western Cape, 2017. http://hdl.handle.net/11394/6151.

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Masters of Science - Msc (Physiotherapy)
An estimated 387 million people worldwide already have diabetes mellitus (DM), with those numbers rising to an estimated 592 million people by the year 2035. The prevalence of diabetes mellitus continues to increase with the largest increase seen in low- and middleincome countries, such as South Africa (Shaw, Sicree,& Zimmet, 2010; Peer et al., 2012; International Diabetes Federation, 2014; Bertram et al., 2013; Mayosi et al., 2009). Lowerlimb amputation is a common complication of uncontrolled diabetes mellitus (Moxey et al., 2011) and there is a marked increase in the incidence of diabetes mellitus in rural areas in South Africa. The impact that the amputation has on the individual's life can be devastating since the amputation of the limb is likely to be accompanied by a profound sense of loss. Rehabilitation can assist to retrain physical and functional abilities, psychological and emotional adjustment issues, as well as social and community reintegration (Manderson & Warren, 2010). Therefore, comprehensive rehabilitation is vital to mitigate the negative impact that a lower-limb amputation has on a person. Persons with disabilities who live in rural areas experience challenges accessing health services and rehabilitation (Harris et al., 2011). Even though challenges with accessing healthcare in rural settings are well documented, there is no literature specifically pertaining to persons with lower-limb amputations in a rural South African context.

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"Hand function assessment: a study of finger amputation." Chinese University of Hong Kong, 1991. http://library.cuhk.edu.hk/record=b5887085.

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by Ho Kim Kong Enoch.
Thesis (M.Phil.)--Chinese University of Hong Kong, 1991.
Includes bibliographical references (leaves 98-102).
ABSTRACT --- p.I
ACKNOWLEDGMENT --- p.IV
TABLE OF CONTENTS --- p.V
LIST OF TABLES --- p.VIII
LIST OF ILLUSTRATIONS --- p.X
Chapter CHAPTER 1 - --- INTRODUCTION --- p.1-5
Chapter 1.1 --- Introduction
Chapter 1.2 --- Questions address
Chapter 1.3 --- Definition
Chapter CHAPTER 2 - --- LITERATURAL REVIEW - DEVELOPMENT OF HAND FUNCTION TESTS --- p.6-14
Chapter 2.1 --- Introduction
Chapter 2.2 --- Trends of studies of hand injury in Hong Kong
Chapter 2.3 --- Previous studies to compare and relate physical and functional impairment
Chapter 2.4 --- Conclusion
Chapter CHAPTER 3 - --- FUNCTION ASSESSMENT - CRITERIA FOR THE EVALUATION --- p.15-28
Chapter 3.1 --- Introduction
Chapter 3.2 --- Functional Anatomy
Chapter 3.3 --- Grip force study
Chapter 3.4 --- Sensation
Chapter 3.5 --- Functional assessment
Chapter 3.6 --- Conclusion
Chapter CHAPTER 4 - --- METHODOLOGY --- p.29-43
Chapter 4.1 --- Subject selection
Chapter 4.2 --- Organization
Chapter 4.3 --- Physical assessment
Chapter 4.4 --- Functional assessment
Chapter 4.5 --- Evaluation of loss of earning capacity
Chapter 4.6 --- Control group
Chapter 4.7 --- Statistical analysis
Chapter CHAPTER 5 - --- RESULT --- p.44-57
Chapter 5.1 --- Introduction
Chapter 5.2 --- Subject characteristics
Chapter 5.3 --- Result of individual tests
Chapter 5.4 --- Assessment of loss of earning capacity
Chapter 5.5 --- Hand function assessment after return to work
Chapter 5.6 --- Effect of severity of injury
Chapter CHAPTER 6 - --- DISCUSSION --- p.58-67
Chapter 6.1 --- Introduction
Chapter 6.2 --- Impairment of hand function in finger amputation
Chapter 6.3 --- The effect of return to work
Chapter 6.4 --- Official schema for assessment of percentage of loss of earning capacity
Chapter 6.5 --- Severity of injury and the outcome
Chapter 6.6 --- The hand assessment protocol
Chapter CHAPTER 7 - --- CONCLUSION --- p.68-70
APPENDIX --- p.71-90
ILLUSTRATIONS --- p.91-97
REFERENCES --- p.98-102

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Sapsford, Karen Nowak. "Evaluation of an amputee peer visitor program a report submitted in partial fulfillment ... Master of Science (Community Health Nursing) ... /." 1992. http://catalog.hathitrust.org/api/volumes/oclc/68796562.html.

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Timms, J., and Catherine Carus. "Mirror Therapy for the Alleviation of Phantom Limb Pain Following Amputation: A literature review." 2015. http://hdl.handle.net/10454/7125.

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Introduction: Phantom Limb pain (PLP) affects up to 85% of all patients following an amputation, causing debilitating effects on their quality of life. Mirror Therapy (MT) has been reported to have potential success for the alleviation of PLP. Current understanding of PLP and the efficacy of MT for its alleviation are still unclear, therefore guidelines for treatment protocols are lacking. This literature review assesses the current best evidence for using MT to alleviate PLP of patients with amputation. Method: The authors systematically searched the academic databases Medline, Amed, CINAHL and Google Scholar, using key search terms with inclusion and exclusion criteria to identify relevant articles on the use of MT in populations of patients suffering PLP after unilateral limb amputation. Findings: Seven primary papers were identified and appraised. All the articles reported significant PLP alleviation after using MT with a trend for achieving phantom limb movement (PLM) prior to pain relief. Conclusions: Mirror Therapy is a promising intervention for PLP. Regular MT sessions are required to maintain treatment effect. Causes of PLP and pathways to its alleviation may be multifactorial; therefore further well-conducted RCTs are required to identify best practice.

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Liu, Fen, and 劉棻. "The Effectiveness of a Support Group Program for Patients with Lower Extremity Amputation in the Prosthetic Rehabilitation Center." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/39894455383693388864.

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博士
長庚大學
臨床醫學研究所
98
More than 6,800 lower-extremity amputations (LEA) are performed annually in Taiwan. Living with limb loss may cause a number of challenges in physical, psychological and social dimensions, as well as quality of life. Although it has been demonstrated that support groups can decrease individual’s stress and promote their adjustment, no study has examined the effectiveness of a support group program for people with LEA in Taiwan. The major purposes of this study were to (1) develop the amputee support group (ASG) program for patients with LEA specifically, and (2) evaluate the effectiveness of the ASG program. This study included 2 phases. In phase I, according to the findings of phenomenological approach and many other methods, the needs of amputees were assessed and an ASG program was developed with cultural consideration. The 6-session support group program ran for 2-hour twice a week for a period of 3 weeks. In phase II, a quasi-experimental trial with a time-series design was selected to identify the outcomes of the ASG program. The study subjects were recruited from three large prosthetic rehabilitation centers in northern part of Taiwan. Out of 85 eligible patients were assigned into the experimental group (attending 3-week ASG program) or the control group (CG, received routine care) according to their personal choice, 78 completed the study (ASG group = 34, CG = 44). Instruments included the Chinese version of Medical Outcomes Study Short-Form Health Survey (SF-36), Center for Epidemiological Studies Depression Scale (CES-D) and Multidimensional Scale of Perceived Social Support (MSPSS). Data were collected at pre-test, post-test, 3 months and 6 months following the intervention. The generalized estimating equation (GEE) was used to analyze the effectiveness of the ASG program on outcome measures over time. The 3-week ASG program effectively improved the perceived social support and 5 domains of HRQOL (physical function, social function, mental health, vitality and general health) of participants in the experimental group at 3-month follow-up, with maintaining at 6 months. For the depressive symptoms and domains of physical role limitations and bodily pain of HRQOL, significant effects were observed at 6-month follow-up. In addition, the scores of emotional role limitations had gradually improved in the experimental group but did not yield statistical significance during the research period. These results suggested that participation in the ASG program may generally improve health-related quality of life and perceived social support and decrease depressive symptoms for lower-extremity amputees. It is anticipated that the findings may provide information for health professionals to develop the discharge planning and provide continuity of care for persons with LEA in the future.

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McGiffin, Jed N. "Psychological Adjustment to Disability: Heterogeneous Trajectories of Resilience and Depression Following Physical Impairment or Amputation." Thesis, 2020. https://doi.org/10.7916/d8-24by-d053.

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Adjustment to disability is a foundational concept within rehabilitation psychology and constitutes an important public health problem given the adverse outcomes associated with maladjustment. While the disability literature has highlighted depressive elevations in response to functional impairment, resilience and alternative patterns of psychological adjustment have received substantially less empirical inquiry. This dissertation is comprised of three papers, the first two of which are longitudinal studies utilizing distinct samples of individuals with acquired disabilities: a population-sample of physically impaired older adults, and a convenience sample of individuals with newly acquired amputations. The third paper summarizes current data science and statistical findings regarding disability adjustment for patients and their providers. The two longitudinal studies share a common statistical methodology, latent growth mixture modeling (LGMM), allowing for the identification of distinct subgroups (classes) of individuals who share similar symptom profiles over time. LGMM is well-poised to resolve fundamental questions about whether psychological functioning after disability is best described by a population-level archetypal response (i.e., distress and depression that remits over time), or alternatively, whether the data suggest a variety of definable subgroups with distinct psychological trajectories. Results of empirical papers 1 and 2 provide strong empirical evidence that the process of disability adjustment is heterogeneous, with multiple pathways of symptom development and remission. The third paper demonstrates how findings from current rehabilitation science can be utilized to inform psychoeducational materials for practitioners and their patients with recent limb loss. This chapter addresses gaps in dissemination of knowledge by describing various patterns of psychological outcomes encountered by individuals following amputation surgery, as supported by Study 2 and the broader resilience literature.

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"An Evaluation of the Suitability of Commercially Available Sensors for Use in a Virtual Reality Prosthetic Arm Motion Tracking Device." Thesis, 2012. http://hdl.handle.net/10388/ETD-2012-12-890.

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The loss of a hand or arm is a devastating life event that results in many months of healing and challenging rehabilitation. Technology has allowed the development of an electronic replacement for a lost limb but similar advancements in therapy have not occurred. The situation is made more challenging because people with amputations often do not live near specialized rehabilitation centres. As a result, delays in therapy can worsen common complications like nerve pain and joint stiffness. For children born without a limb, poor compliance with the use of their prosthesis leads to delays in therapy and may affect their development. In many parts of the world, amputation rehabilitation does not exist. Fortunately, we live in an age where advances in technology and engineering can help solve these problems. Virtual reality creates a simulated world or environment through computer animation much like what is seen in modern video games. An experienced team of rehabilitation doctors, therapists, engineers and computer scientists are required to realize a system such as this. A person with an amputation will be taught to control objects in the virtual world by wearing a modified electronic prosthesis. Using computers, it will be possible to analyze his or her movements within the virtual world and improve the wearer's skills. The goals of this system include making the system portable and internet compatible so that people living in remote areas can also receive therapy. The novel approach of using virtual reality to rehabilitate people with upper limb amputations will help them return to normal activities by providing modern and appropriate rehabilitation, reducing medical complications, improving motivation (via gaming modules), advancing health care technology and reducing health care costs. The use of virtual reality technology in the field of amputee rehabilitation is in its earliest stages of development world wide. A virtual environment (VE) will facilitate the early rehabilitation of a patient before they are clinically ready to be fitted with an actual prosthesis. In order to create a successful virtual reality rehabilitation system such as this, an accurate method of tracking the arm in real-time is necessary. A linear displacement sensor and a microelectromechanical system (MEMS) inertial measurement unit (IMU) were used to create a device for capturing the motion of a user's movement with the intent that the data provided by the device be used along with a VE as a virtual rehabilitation tool for new upper extremity amputation patients. This thesis focuses on the design and testing of this motion capture device in order to determine the suitability of current commercially available sensing components as used in this system. Success will be defined by the delivery of accurate position and orientation data from the device so that that data can be used in a virtual environment. Test results show that with current MEMS sensors, the error introduced by double integrating acceleration data is too significant to make an IMU an acceptable choice for position tracking. However, the device designed here has proven to be an excellent cable emulator, and would be well suited if used as an orientation tracker.

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Chen, Wen Jia Caroline. "Evaluation of Dynamic Prosthetic Alignment Techniques for Individuals with Transtibial Amputation." Thesis, 2012. http://hdl.handle.net/1807/33376.

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Although dynamic prosthetic alignment is an important process for the rehabilitation of transtibial amputees, such alignment technique is subjective and inconsistent. Using biomechanical variables and questionnaire assessments, this study compared an instrument-assisted dynamic alignment technique using the Compas™ system and conventional alignment techniques on nine adults with unilateral transtibial amputation. A focus group discussion was conducted with six prosthetists to understand clinical practice of dynamic alignment and their perception of the Compas™ system. Results found that Compas™ produced more anterior weight line displacement and greater varus moment on the prosthesis than conventional alignment techniques. Alignment changes did not affect pelvic acceleration, and the instrument-assisted alignment technique produced certain biomechanical changes but not necessarily better alignments. Although the current version of the Compas™ system is not clinically feasible, it can be used as a teaching/justification tool. Further investigation with larger sample size and ankle alignment or moment measures is needed.

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Engenheiro, Gonçalo Gomes. "Accidental Falls in Unilateral Prosthetized Lower Limb Amputees: functional evaluation and prevention." Master's thesis, 2017. http://hdl.handle.net/10316/81828.

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Trabalho de Projeto do Mestrado Integrado em Medicina apresentado à Faculdade de Medicina
Lower limb amputated patients have a greater risk of falling than general population possibly due to reduced mobility and altered somatosensory input in the prosthetic limb, increased fear of falling and decreased balance confidence. Investigation concerning risk of fall in prosthetized lower limb amputees (LLA) is scarse in Portugal. This study aims at comparing the transfemoral and transtibial levels of amputation and testing different functional measures to develop fall preventive strategies. An exploratory, non-randomized study was conducted in 52 prosthetized unilateral LLA (80,8% male; mean age 5712 years), with Functional Measure of Independence (FIM) 100, attending a Physical and Rehabilitation Medicine (PRM) department in Central Portugal. Patients were applied a questionnaire of individual characterization, the Portuguese version of Falls Efficacy Scale (FES) and the 10 Meter Walk test (10MWT). A control group of 30 healthy adults (73,3% female; mean age 682 years) was assembled. Comparative analyses between groups and correlation analysis between number of falls and FIM, FES and walking speed (WS) were made. The amputee group (44% transfemoral; 56% transtibial) reported 19 fall occurrences in the previous year. Of the control group 17 fell at least once in the same period. There was no difference in the number of falls between the controls and the amputees aged 57 years old (p=0,569). Transfemoral amputees had higher number of falls (p=0,025) and lower WS (p<0,001) than transtibials. No correlation between number of falls and FIM, FES nor WS was found. Amputation level has different impact on daily activities. We should invest more time in transfemoral amputees rehabilitation to improve fall and mobility outcomes. FIM, FES and 10MWT are not good measures to predict risk of falling in LLA.
Em doentes amputados do membro inferior o risco de queda é mais elevado do que a população geral possivelmente devido a diminuição da mobilidade e alteração do input somatossensorial no membro protésico, aumento do receio em cair e baixa confiança no equilíbrio. Em Portugal, a investigação do risco de queda em amputados do membro inferior (LLA) protetizados é escassa. Os objetivos deste estudo são comparar amputados transfemorais com transtibiais e testar diferentes instrumentos de avaliação funcional para estabelecer estratégias de prevenção da queda. Foi realizado um estudo exploratório, não-randomizado, em 52 LLA unilaterais, protetizados (80,8% homens; média de idades 5712 anos), com Medida de Independência Funcional (FIM) 100, seguidos em consulta externa num serviço de Medicina Física e de Reabilitação (PRM) da região centro. Foram submetidos a um questionário de caracterização individual, à versão portuguesa da Falls Efficacy Scale (FES) e ao Teste dos 10 Metros de marcha (10MWT). Recorreu-se também a um grupo de controlo de 30 adultos saudáveis (73,3% mulheres; media de idades 682 anos). Foram feitas comparações entre grupos e o número de quedas foi correlacionado com FIM, FES e velocidade de marcha (WS). Os amputados (44% transfemorais e 56% transtibiais) reportaram 19 ocorrências de queda no ano transato. Do grupo controlo, 17 caíram pelo menos uma vez no mesmo período. Não se verificou diferença significativa no número de quedas entre o grupo controlo e os amputados com 57 anos (p=0,569), apesar da FIM ser significativamente menor nos amputados (p<0,001). Amputados transfemorais caíram maior número de vezes (p=0,025) e apresentaram velocidade de marcha inferior (p<0,001) relativamente aos transtibiais. Não se verificou haver correlação entre o número de quedas e FIM, FES ou WS. O nível de amputação tem impacto diverso nas atividades quotidianas. É necessário investir mais na reabilitação dos amputados transfemorais para evitar quedas e melhorar a sua mobilidade. Os instrumentos métricos FIM e FES e o 10MWT não demonstraram ser bons para prever o risco de queda em amputados.

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Sobotková, Ivona. "Vliv aplikovaných pohybových programů na pohybový systém osob po amputaci dolní končetiny." Doctoral thesis, 2020. http://www.nusl.cz/ntk/nusl-412031.

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The subject of this dissertation was the creation of the adapted exercise program for unilateral transfemoral amputees and its verification in practice. The content of this program was chosen based on the practical experience and theoretical background in the field of anatomy, kinesiology, rehabilitation, lower- limb amputations and Motion Capture technologies. The four-month intervention program was designed as an adapted corrective exercise aimed at the major muscle groups influencing the posture, especially the position of the pelvic segment, which is the dominant element in the kinematic chain. The aim of this project was to ascertain whether this intervention can affect the pelvic tilt (in frontal and sagittal plane) of unilateral transfemoral amputees and so improve their quality of life. This was a project based on combination of quantitative and qualitative research methods. The measurement of the size of angles determining the pelvic tilt by Qualisys optoelectronic system was the essence of the quantitative part of the research. Qualitative data were collected through semi-structured in-depth interviews from persons who completed whole project. This research is by its nature and focus characterized as a set of case reports and as a pilot study, proof of concept respectively. 10 unilateral...

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Bartůňková, Petra. "Význam sociální rehabilitace u klientů po amputaci končetiny v domácí péči." Master's thesis, 2018. http://www.nusl.cz/ntk/nusl-384082.

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This diploma thesis deals with the topic of clients after lower limb/s amputation and their social rehabilitation afterwards in home care. Beginning of thesis describes the current situation and the concept of social rehabilitation as one of the comprehensive rehabilitation process of people in early post-amputation stage. Next section of thesis shows difficulties that occurs after amputation and impact upon personal life that is materially changed. Describing the process of coping with this unpleasant health change is based on traditional model of two important people in this field Mr. Kübler-Ross and Mr. Křivohlavý. At the same time, analysis of the formal support system in Ústí nad Labem is being evaluated. This system provides support not only to disabled people but also to people who take infromal care of the one injured. Informal care plays significant role in the process of social rehabilitation of people starting new life stage due to physical change. In thesis are mentioned possibilities of developing skills of informal caregivers, usage of financial benefits for disabled people and possible providers support of medical and social services in a given location. However, it also focuses on possible troubles associated with care provided by family members or other persons. At the same time,...

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Perry, Karen-Marie Elah. "Virtual reality and the clinic: an ethnographic study of the Computer Assisted Rehabilitation Environment (The CAREN Research Study)." Thesis, 2018. https://dspace.library.uvic.ca//handle/1828/9261.

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At the Ottawa Hospital in Ontario, Canada, clinicians use full body immersion virtual reality to treat a variety of health conditions, including: traumatic brain injuries, post- traumatic stress disorder, acquired brain injuries, complex regional pain syndrome, spinal cord injuries, Guillain-Barré syndrome, and lower limb amputations. The system is shared between military and civilian patient populations. Viewed by clinicians and the system’s designers as a value neutral medical technology, clinical virtual reality’s sights, sounds, movements, and smells reveal cultural assumptions about universal patient experiences. In this dissertation I draw from reflexive feminist research methodologies, visual anthropology and sensory ethnography in a hospital to centre the body in current debates about digital accessibility in the 21st Century. 40 in-depth interviews with practitioners and patients, 210 clinical observations, and film and photography ground research participant experiences in day-to-day understandings of virtual reality at the hospital. In this dissertation I address an ongoing absence of the body as a site of analytical attention in anthropological studies of virtual reality. While much literature in the social sciences situates virtual reality as a ‘post-human’ technology, I argue that virtual reality treatments are always experienced, resisted and interpreted through diverse body schemata. Furthermore, virtual reality cannot be decoupled from the sensitivities, socialities and politics of particular bodies in particular places and times. The Ottawa Hospital’s Computer Assisted Rehabilitation Environment (CAREN) system features a digitally enhanced walk-in chamber, treadmills on hydraulic pistons, surround sound audio, advanced graphics and user feedback utilizing force plates and a dynamic infrared motion capture system. The CAREN system utilizes hardware and software reliant on specific assumptions about human bodies. For example, these assumptions are echoed in depictions of race, gender, class, and indigeneity. Patients using virtual reality technologies can experience more than one disability or health condition at a time, further disrupting the idea of universal user experiences. As clinicians and patients confront the limitations of body normativity in the CAREN system’s interface design, they improvise, resist, and experience virtual reality in ways that defy design agendas, ultimately shaping patient treatments and unique paths to healing and health.
Graduate

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HANZLÍKOVÁ, Soňa. "Sociální aspekty po amputacích končetin u dětí a dospělých." Master's thesis, 2007. http://www.nusl.cz/ntk/nusl-46304.

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The aim of my extended essay is to evaluate some social aspects after amputations of extremities with children and adults. The work is divided into several parts. In the first theoretical part, the attention is paid to a history of amputations and some indications for an extremity amputation. At the same time, the summary of amputation lines of upper and lower extremities is set up here as well. In this part, there is a list of some indications leading to an amputation of an extremity, too. Besides, here is some theoretical imformation on the comprehensive rehabilitation, especially on therapeutic, social and working one. Some data obtained by evaluating my own research are presented in the practical part of this extended essay. The research was carried out with a quantitative questionnaire method. After the evaluation, all three determined hypotheses were confirmed. Hypothesis No. 1: I suppose the children and adolescents do not feel being seen at a disadvantage after the amputation of an extremity, which is brought by this treatment. Hypothesis No. 2: Women come to terms with the amputation of an extremity psychically worse than men do. Hypothesis No. 3: I suppose the amputation of an upper extremity is a greater handicap than a loss of a lower one, in consideration of one's asserting at the labour market. The practical evaluation contains all the comparisons of the research results with some specialized literature, too. The main contribution of my extended essay is the summarization of the certain points at issue and the facilitation of an easier orientation in a social situation after the amputation of an extremity.

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Zidarov, Diana. "Évolution de la qualité de vie des personnes amputées d'un membre inférieur suite à une réadaptation fonctionnelle." Thèse, 2008. http://hdl.handle.net/1866/7600.

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Boer, Wiebke Ada de [Verfasser]. "Klinisches Bild erworbener Amputationen im Kindesalter : retrospektive Analyse von 124 Patienten aus der Klinik und Poliklinik für technische Orthopädie und Rehabilitation in Münster von 1986 - 2003 / vorgelegt von Wiebke Ada de Boer." 2008. http://d-nb.info/98922564X/34.

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Dissertations / Theses on the topic 'Amputation rehabilitation'

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