Impact of Physical Therapy for a Patient with Multiple Limb Amputations Secondary to Legionnaires' Disease: A Case Report

Abstract

ABSTRACT Background and Purpose Collaboration between the physical therapist and prosthetist is essential for patients with any type of amputation. This case report describes a patient with multiple limb amputations due to medical complications resulting from community acquired Legionnaires' disease (LD). The physical therapy evaluation, examination, diagnosis, interventions, and outcomes along with collaboration with the prosthetist are discussed. Case Description A 55-year-old previously healthy male contracted LD and subsequently developed multiple medical complications in acute care. This resulted in left transradial and bilateral transtibial amputations due to hypotension-induced ischemia from sepsis. A 2-month course of inpatient rehabilitation is described, including changes in functional status and progression to safe discharge home. Outcomes Physical therapy interventions resulted in an improvement from total assist for all functional mobility to ambulating at a standby assist level with bilateral lower limb and left upper limb prosthesis. He improved his 10-m walk test score from 0.07 to 0.60 m/s, 6-minute walk test to 133 m, and timed up and go test to 47 seconds. Discussion A comprehensive list of physical therapy interventions needs to be included for successful rehabilitation of a medically complex patient with multiple limb amputations. Collaboration with the prosthetist is inherent and critical. Future research may include a series of case reports or a study using practice-based evidence. This would allow for more associations to be made regarding interventions for patients with multiple limb amputations.